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IntroductionElectronic patient-reported outcome (ePROs)-based symptom monitoring benefits health-related quality of life (HRQoL) in various cancers. However, despite the high disease and economic burden of hepatocellular carcinoma (HCC) and the complex symptom profile during immunotherapy, the effectiveness and implementation of ePROs-based interventions in this population remain unclear. This study aims to evaluate the clinical and implementation outcomes of ePROs-based symptom monitoring among patients with HCC receiving immunotherapy in China.Methods and analysisThe trial is a two-arm randomised controlled trial (RCT). Approximately 238 patients with HCC undergoing immunotherapy in China will be recruited and randomly assigned (1:1) to an intervention or control group. The intervention group will receive an 18 week, weekly ePROs symptom monitoring survey via a WeChat-based platform, featuring reactive alerts that provide patients with automated, evidence-based self-management advice when predefined thresholds are exceeded. The control group will receive usual care. Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework and normalisation process theory (NPT), the study employs a mixed-methods approach. The primary outcome is the between-group difference in HRQoL at 18 weeks. Secondary effectiveness outcomes include physical function, symptom burden, overall survival, mental health and healthcare utilisation. Key implementation outcomes, assessed quantitatively and qualitatively, include acceptability, feasibility, fidelity, cost-effectiveness and the contextual mechanisms influencing sustainability and scalability.Ethics and disseminationThe study has been approved by the Institutional Review Board of Peking University (IRB No. 00001052-24066). This protocol is based on V2.0, 6 July 2024 of the protocol. Electronic informed consent is obtained from all participants. Findings will be disseminated through peer-reviewed publications and academic conferences, providing evidence to inform scalable integration of digital symptom monitoring into oncology care.Trial registration numberNCT06938945.

Background Visceral hemangiomatosis is a benign tumor (rarer than hemangioma) that has not been reported to occur in the pancreas, duodenum, or choledoch. It can be easily confused with other pancreatic tumors or choledocholithiasis. Herein, we describe a case of a child with pancreaticoduodenal and choledochal hemangiomatosis and the key characteristics for the accurate diagnosis of pancreatic tumors based on previous reports and our findings. Case presentation We report a case of a 2-year and 9-month-old child who presented with repeated and fluctuating jaundice for 3 months with a history of endoscopic stone removal in a local hospital, following the diagnosis of choledocholithiasis. An abdominal computed tomography revealed a previously undiagnosed pancreatic head tumor and celio-mesenteric trunk (a rare vascular variation). This was misdiagnosed as a pancreatic neuroendocrine tumor. Since the patient’s parents refused FNA biopsy and insisted on surgery, pancreaticoduodenectomy was performed; however, postoperatively, the child was correctly diagnosed with pancreaticoduodenal and choledochal hemangiomatosis. Although the patient was in good condition and had gained 4 kg in weight 3 months postoperatively, pancreaticoduodenectomy could have been avoided if an accurate diagnosis had been established before or during the operation. Conclusion Our report highlights the difficulty in diagnosing visceral hemangiomatosis. Radiologists, endoscopists, and surgeons should consider this possibility in cases of repeated and fluctuating jaundice that cannot be explained by choledocholithiasis alone.

The greater wax moth (GWM), Galleria mellonella (Lepidoptera: Pyralidae), is a major bee pest that causes significant damage to beehives and results in economic losses. Bacillus thuringiensis (Bt) appears as a potential sustainable solution to control this pest. Here, we develop a novel Bt strain (designated BiotGm) that exhibits insecticidal activity against GWM larvae with a LC 50 value lower than 2 μg/g, and low toxicity levels to honey bee with a LC 50  = 20598.78 μg/mL for larvae and no observed adverse effect concentration = 100 μg/mL for adults. We design an entrapment method consisting of a lure for GWM larvae, BiotGm, and a trapping device that prevents bees from contacting the lure. We find that this method reduces the population of GWM larvae in both laboratory and field trials. Overall, these results provide a promising direction for the application of Bt-based biological control of GWM in beehives, although further optimization remain necessary. The greater wax moth (GWM) is a major bee pest. Here, the authors show how a pest control method that combines a strain of Bacillus thuringiensis and a lure-based entrapment can help to control GWM using lab experiments and field beehives.

COPD and comorbidities: the effects of integrated care Chronic obstructive pulmonary disease (COPD), a serious lung condition affecting millions worldwide, often occurs alongside other health problems (e.g., heart disease, diabetes). These additional conditions can worsen outcomes, increasing hospital stays and even death. While “integrated care” (combining treatments, education, and long-term support) is often recommended for such patients, its benefits need clearer evidence. This study reviewed seven high-quality clinical trials from wealthier countries to evaluate how integrated care affects COPD patients with other health issues. Most programs included education, self-management training, and remote health monitoring. Key findings: Integrated care reduced sudden worsening of COPD symptoms (“exacerbations”). It also lowered the chance of being hospitalized for any health reason. However, it did not significantly reduce emergency room visits or improve patients’ self-reported symptom scores (CAT scores). These results suggest that integrated care can help stabilize COPD patients and reduce hospital stays, making it a valuable approach for healthcare systems. However, more research is needed to adapt these programs for low-income regions and to improve their impact on quality of life.

Bees, while individually poikilothermic, can maintain group warmth, which is vital for biodiversity. Apis cerana outperforms Apis mellifera in cold tolerance, particularly as a pollinator in harsh conditions. Here, we utilized transcriptome data to identify alternative splicing events and alternative polyadenylation genes associated with cold stress in A. cerana . These genetic changes are linked to signal transduction, energy metabolism, and oxidative stress, with key genes like HSP70 and BAG increasing in expression and others showing a pattern of an initial decrease followed by an increase. This post-transcriptional regulation may help bees adapt to cold, providing insights for breeding cold-resistant bee strains and advancing cold resistance research in insects.

This retrospective cohort study aimed to delineate the dynamic change trajectories of perioperative inflammatory markers in pediatric patients with Hirschsprung disease (HSCR) who underwent one-stage laparoscopic-assisted pull-through surgery at a single tertiary pediatric center using Group-Based Trajectory Modeling (GBTM), and to explore the association between different trajectory patterns and the risk of postoperative Hirschsprung-associated enterocolitis (HAEC). This study enrolled HSCR patients who underwent surgical treatment. Blood samples were collected at four perioperative time points (preoperative, postoperative days 1, 4, and 7) to calculate composite inflammatory markers such as the systemic inflammation response index (SIRI) and pan-immune inflammation value (PIV), as well as individual markers like white blood cell (WBC) and neutrophil counts. GBTM was employed to identify subgroups with similar inflammatory marker change trajectories. Multivariable logistic regression analysis was used to assess the association between different inflammatory trajectories and postoperative HAEC occurring within several years after surgery. A total of 400 patients were included, of which 133 (33.3%) developed postoperative HAEC. Each inflammatory marker was categorized into 2-3 significantly distinct trajectory groups via GBTM. Multivariable logistic regression analysis revealed that for SIRI and PIV, compared to trajectory group 1 (low baseline with mild rise), patients in trajectory group 2 (moderate baseline with sharp rise and slow decline; SIRI: OR = 5.20, P = 0.011; PIV: OR = 4.75, P = 0.007) and trajectory group 3 (high baseline with sharp rise and slow decline; SIRI: OR = 4.73, P = 0.025; PIV: OR = 5.63, P = 0.008) had a significantly increased risk of postoperative HAEC. For WBC and neutrophils, trajectory group 2 (WBC: persistently high; neutrophils: low baseline with sharp rise and rapid decline) was an independent risk factor for postoperative HAEC (WBC: OR = 2.49, P = 0.004; neutrophils: OR = 2.53, P = 0.001). Specific rising trajectories of SIRI, PIV, WBC, and neutrophils may serve as novel biomarkers for early identification of children at high risk for HAEC.

Genomic assay of sperm cell RNA provides insight into functional control, modes of regulation, and contributions of male gametes to double fertilization. Sperm cells of rice (Oryza sativa) were isolated from field-grown, disease-free plants and RNA was processed for use with the full-genome Affymetrix microarray. Comparison with Gene Expression Omnibus (GEO) reference arrays confirmed expressionally distinct gene profiles. A total of 10 732 distinct gene sequences were detected in sperm cells, of which 1668 were not expressed in pollen or seedlings. Pathways enriched in male germ cells included ubiquitin-mediated pathways, pathways involved in chromatin modeling including histones, histone modification and nonhistone epigenetic modification, and pathways related to RNAi and gene silencing. Genome-wide expression patterns in angiosperm sperm cells indicate common and divergent themes in the male germline that appear to be largely self-regulating through highly up-regulated chromatin modification pathways. A core of highly conserved genes appear common to all sperm cells, but evidence is still emerging that another class of genes have diverged in expression between monocots and dicots since their divergence. Sperm cell transcripts present at fusion may be transmitted through plasmogamy during double fertilization to effect immediate post-fertilization expression of early embryo and (or) endosperm development.

The implication of the Estimation of Stromal and Immune cells in Malignant tumor tissues using expression data (ESTIMATE) method to determine the tumor microenvironment (TME) and tumor immune score including tumor purity represents an efficient method to identify and assess biomarkers for immunotherapy response in precision medicine. In this study we utilized a machine learning algorithm to analyze the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus database (GEO) lung adenocarcinoma (LUAD) transcriptome data to evaluate the association between TME and tumor purity. Furthermore, we investigated whether fewer TME components or a few dominant genes can infer tumor purity. The results indicated that the 29 immune infiltrating components determined by the ssGSEA method could screen the 5 TME components [chemokine C-C-Motif receptor (CCR), T-helper-cells, Check-point, Treg, and tumor-infiltrating lymphocytes (TIL)] that significantly contributed the most to tumor purity prediction through regression tree and random forest regression methods. The findings revealed that higher activity of these five immune infiltrating components significantly lowered the tumor purity. Moreover, 5 TME components contributed significantly to the improvement of Mean Square Error (MES); therefore, we selected these five sets' genes and analyzed survival data to establish a prognostic model. We screened out 11 prognostic-related genes and constructed a risk model comprising 11 genes with good predictive value for patients' prognosis. Furthermore, we obtained four genes (GIMAP6, CD80, IL16, and CCR2) that had predictive advantages for tumor purity using random forest classification and random forest regression. The comprehensive score of genes for tumor purity prediction (CSGTPP) was obtained by least absolute shrinkage and selection operator (LASSO) regression indicated that four genes could be successfully used to classify high and low CSGTPP samples and that tumor purity was negatively correlated with CSGTPP. Survival analysis revealed that the higher the CSGTPP, the better the prognosis of patients. The association between a cluster of differentiation 274 (CD274) and CSGTPP revealed a higher expression of CD274 in the high CSGTPP group. Collectively, we speculated that CSGTPP could serve as a predictor of the response to immunotherapy and a promising indicator of immunotherapy effect.

The introduction of plasmids into Agrobacterium cells is one of the key steps in the Agrobacterium-mediated transformation of plants for gene editing applications. Depending on chromosomal background, some Agrobacterium strains exhibit a very low transformation efficiency, which results in a low number of colonies for subsequent screening and thus limits the potential for automated high-throughput transformation processes, especially with low copy or large plasmids. This study demonstrates improvements of transformation frequency by modifying the competent cell preparation process and optimizing electroporation parameters for two Agrobacterium strains. The competent cell preparation process was modified by prolonging bacterial growth in the log phase and optimizing the endpoint cell density for cell harvest which resulted in a significant cell yield increase and transformation frequency improvement. Optimization of electroporation by fine-tuning the parameters not only resulted in a 30-fold transformation frequency increase but also revealed a strain-dependent requirement for field strength and electric pulse length. To further improve transformation of a recalcitrant strain, different concentrations of dimethyl sulfoxide (DMSO) in recovery medium were examined. The study revealed an important role of DMSO in transformed cell recovery, with 5% DMSO resulting in the highest transformation frequency. The significant improvements in Agrobacterium transformation frequency addressed a critical bottleneck towards establishing a high throughput process.

The aim of our study was to examine the association of vitamin A status with obesity and the metabolic syndrome (MS) in school-age children in Chongqing, China. A cross-sectional study was conducted of 1,928 children aged 7~11 years from 5 schools in Chongqing, China. Body height, weight, waist circumference (WC) and blood pressure were measured. Blood glucose, lipids and vitamin A were determined. Overall prevalences for overweight, obesity and MS were 10.1%, 6.7% and 3.5%, respectively. There were 274 (14.2%) marginally vitamin A deficient (MVAD) children and 53 (2.8%) vitamin A deficient (VAD) children, respectively. Serum vitamin A in the obese group was significantly lower than in the overweight and normal weight groups (p<0.001). Body mass index (BMI), WC, high density lipoprotein cholesterol (HDL-C) and glucose were strongly associated with vitamin A status (p<0.05). In a separate model adjusted for age and sex, compared with normal children, participants with obesity had a significantly higher risk of having vitamin A insufficiency (=1.05 µmol/L) (OR: 2.37; 95% CI: 1.59, 3.55) (p<0.001), and participants with MS had a 1.99-fold (95% CI: 1.14, 3.47) greater risk of having vitamin A insufficiency (p=0.016), while participants with VAD had significantly higher risk of having MS (OR: 3.82; 95% CI: 1.44, 10.2) (p=0.007). Vitamin A insufficiency among Chongqing urban school-age children was found to be a severe health problem, significantly associated with obesity, hypertriglyceridemia and MS.