Refusal of treatment among HER2-positive breast cancer patients in China: a retrospective analysis

BackgroundThere is a need to update the understanding of treatment refusal among cancer patients in China, taking into account recent developments. This study investigated how public insurance coverage of the first breast cancer targeted therapy contributed to the changes in treatment refusal among HER2-positive breast cancer patients in China. And it intensively examined and discussed additional barriers affecting patient utilization of innovative anticancer medicines based on the types and reasons for treatment refusal.MethodsThis retrospective study included female breast cancer patients diagnosed as HER2-positive who received treatment at a provincial oncology center in southern China between 2014 and 2020. Multivariable analysis was conducted using a binary logistic regression model. Subgroup analysis was performed with the same regression model.ResultsAmong the 1,322 HER2-positive breast cancer patients who received treatment at the study hospital between 2014 and 2020, 327 (24.55%) had ever refused treatment. Economic reasons were reported as the primary cause by 142 patients (43.43%). Patients diagnosed after September 2017, when the first breast cancer targeted therapy was included in the public health insurance, were less likely to refuse treatment (OR = 0.64, 95% CI:0.45 ~ 0.91, p = 0.01) compared to those diagnosed before September 2017. Patients enrolled in the resident health insurance were more likely to refuse treatment (OR = 2.43, 95% CI:1.77 ~ 3.35, p < 0.001) than those enrolled in the employee health insurance.ConclusionThis study reveals a high rate of treatment refusal among HER2-positive breast cancer patients, primarily attributed to financial factors. The disparity in public health insurance benefits resulted in a heavier economic burden for patients with less comprehensive benefits. Furthermore, the study identified challenges faced by patients seeking quality-assured cancer care in underdeveloped regions in China. By addressing economic barriers, promoting accurate health information, and improving cancer care capacity across the country can reduce the rate of treatment refusal

Evaluation of Alpha-Ketoglutarate Supplementation on the Improvement of Intestinal Antioxidant Capacity and Immune Response in Songpu Mirror Carp (Cyprinus carpio) After Infection With Aeromonas hydrophila

As an intermediate substance of the tricarboxylic acid cycle and a precursor substance of glutamic acid synthesis, the effect of alpha-ketoglutarate on growth and protein synthesis has been extensively studied. However, its prevention and treatment of pathogenic bacteria and its mechanism have not yet been noticed. To evaluate the effects of alpha-ketoglutarate on intestinal antioxidant capacity and immune response of Songpu mirror carp, a total of 360 fish with an average initial weight of 6.54 ± 0.08 g were fed diets containing alpha-ketoglutarate with 1% for 8 weeks. At the end of the feeding trial, the fish were challenged with Aeromonas hydrophila for 2 weeks. The results indicated that alpha-ketoglutarate supplementation significantly increased the survival rate of carp after infection with Aeromonas hydrophila (P < 0.05), and the contents of immune digestion enzymes including lysozyme, alkaline phosphatase and the concentration of complement C4 were markedly enhanced after alpha-ketoglutarate supplementation (P < 0.05). Also, appropriate alpha-ketoglutarate increased the activities of total antioxidant capacity and catalase and prevented the up-regulation in the mRNA expression levels of pro-inflammatory cytokines including tumor necrosis factor-α, interleukin-1β, interleukin-6, and interleukin-8 (P < 0.05). Furthermore, the mRNA expression levels of toll-like receptor 4 (TLR4), and nuclear factor kappa-B (NF-κB) were strikingly increased after infection with Aeromonas hydrophila (P < 0.05), while the TLR4 was strikingly decreased with alpha-ketoglutarate supplementation (P < 0.05). Moreover, the mRNA expression levels of tight junctions including claudin-1, claudin-3, claudin-7, claudin-11 and myosin light chain kinases (MLCK) were upregulated after alpha-ketoglutarate supplementation (P < 0.05). In summary, the appropriate alpha-ketoglutarate supplementation could increase survival rate, strengthen the intestinal enzyme immunosuppressive activities, antioxidant capacities and alleviate the intestinal inflammation, thereby promoting the intestinal immune responses and barrier functions of Songpu mirror carp via activating TLR4/MyD88/NF-κB and MLCK signaling pathways after infection with Aeromonas hydrophila

Making courses flexible: From grading schemes to assignments - their impact on student learning outcomes

Recently there has been a renewed interest in understanding how different student learning styles impacts the design and implementation of courses, particularly with respect to assessments (Leite et al., 2010). Moreover, due to the nature of the courses in the basic and life sciences, there is often very little variation in the assessments of learning that are used, which often causes both the learner and educators a great deal of stress and angst. It is also becoming increasingly clear that different styles of learning and learners would benefit from having a greater variety of assessments used within these courses (Leite et al. 2010), likely by reducing student stress levels. We introduce a discussion of the rationale surrounding flexible student assessments, the various types of flexible options for students (from re-weighting options to reduced impact assessments), how these flexible assessments reduce student stress, and how these types of flexible assessments can be implemented across different courses will be presented. At the end of this session, participants will have an understanding of how flexible learning assessments positively impact student learning and engagement from both instructor and student perspectives, and will be able to identify several examples of flexible assessments that could be adapted for use in their own courses to reduce stress and enhance learning. Leite et al. (2010). Educational and Psychological Measurement., 70(2), 323–339

Highly Efficient Photocatalytic Hydrogen on CoS/TiO2 Photocatalysts from Aqueous Methanol Solution

The photocatalyzed water splitting reaction in aqueous methanol solution is an efficient preparation method for hydrogen and methanal under mild conditions. In this work, metal sulfide-loaded TiO2 photocatalysts for hydrogen and methanol production were synthesized by hydrothermal method (180°C/12 h) and characterized by X-ray diffraction (XRD), UV-visible diffuse reflectance spectroscopy (DRS), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). The crystal structures of the samples are the typical anatase phase of TiO2 and exhibit a spherical morphology. When TiO2 was loaded with CoS, ZnS, and Bi2S3, respectively, the resulting catalysts showed photocatalytic activities for water decomposition to hydrogen in aqueous methanol solution under 300 W Xe lamp irradiation. Among the photocatalysts with various compositions, the 20 wt% CoS/TiO2 sample with a 2.1 eV band gap showed the maximum photocatalytic activity for the photocatalytic reaction, which indicated that CoS improved the separation ratio of photoexcited electrons and holes. The enhanced activity can be attributed to the intimate junctions that are formed between CoS and TiO2, which can reduce the electron-hole recombination. The production rate of hydrogen with 20 wt% CoS/TiO2 photocatalyst was about 5.6 mmol/g/h, which was 67 times higher than that of pure TiO2. The formation rate of HCHO was 1.9 mmol/g/h with 98.7% selectivity. Moreover, the CoS/TiO2 photocatalyst demonstrated good reusability and stability. In the present study, it is demonstrated that CoS can act as an effective cocatalyst to enhance the photocatalytic hydrogen and methanal production activity of TiO2. The highly improved performance of the CoS/TiO2 composite was mainly ascribed to the efficient charge separation

Nitrogen Status Assessment for Multiple Cultivars of Strawberries Using Portable FT-NIR Spectrometers Combined With Cultivar Recognition and Multivariate Analysis

The nondestructive assessment of nitrogen status in strawberry was performed to analyze its growth and provide guidance for precise management of N fertilizer using Fourier transform near-infrared reflectance (FT-NIR) spectroscopy with leaf spectral reflectance. The leaf soil plant analysis development (SPAD) value is considered as an indicator that indirectly reflects the nitrogen status in strawberry. However, the variation of cultivars leads to differences in the cell structure and light scattering and/or reflection effects of strawberry leaves during strawberry N status assessment, which means, leaf SPAD threshold value and the specific N demand will vary with different cultivars. As a result, accurate measurement of SPAD values and N status in strawberries with multiple cultivars is still challenging. In this study, the individual-cultivar, hybrid-cultivar, and multi-cultivar models were developed for the determination of SPAD values, and the performance of the models in lessening the impact of cultivar variation was studied and compared. The individual-cultivar model was constructed on the basis of a single cultivar of strawberry leaf. The hybrid-cultivar model was developed by merging the spectrum reflectance data and SPAD values of all studied leaf samples, and a multi-cultivar model was built in combination with cultivar identification, individual-cultivar models, and model search strategy. The results indicated that the multi-cultivar model was superior to the other two models for SPAD value estimation of strawberry leaves from different cultivars, with the overall Rp and RMSEP values of 0.966 and 0.468, respectively. We demonstrate that the leaf N content of strawberry is profoundly affected by cultivar variation, and establishing a multi-cultivar model is useful in monitoring the nitrogen status and guiding N fertilization recommendations for different strawberry cultivars

Down-Regulation of MiR-30c Promotes the Invasion of Non-Small Cell Lung Cancer by Targeting MTA1

Background: The connection between microRNA expression and lung cancer development has been identified in recent literature. However, the mechanism of microRNA has been poorly elucidated in non-small-cell lung cancer (NSCLC). Methods and Results: Comparing with adjacent tissues (n=75), miR-30c has a lower expression in lung cancer specimens (n=75). The knockdown of miR-30c enhanced the invasion of A549 cells; meanwhile, the overexpression of miR-30c could reverse the effect of the knockdown of miR-30c in vitro. A luciferase assay revealed that miR-30c was directly bound to the 3‘-untranslated regions (3‘-UTR) of MTA1. QRT-PCR and western blot shows MTA1 was up-regulated in mRNA and protein levels. The effect taken on the invasion of NSCLC by overexpression of MTA1 works the same as down-regulated miR-30c. Conclusion: miR-30c may play a pivotal role in controlling lung cancer invasion through regulating MTA1in NSCLC

Effects of the Surface Charge of Graphene Oxide Derivatives on Ocular Compatibility

The incorporation of functional groups endows graphene oxide (GO) with different surface charges, which plays important roles in biological interactions with cells. However, the effect of surface charge of GO derivatives on ocular biocompatibility has not been fully elucidated. Previously, we found that positively, negatively and neutrally charged PEGylated GO (PEG-GO) nanosheets exerted similar effect on the viability of ocular cells. In this work, we performed in vitro and in vivo studies to comprehensively study the effect of surface charge of PEG-GO on ocular compatibility. The in vitro results showed that the cellular uptake efficacy of negatively charged PEG-GO nanosheets was significantly decreased compared with positively charged and neutrally charged analogs. However, three kinds of PEG-GO nanosheets produced similar amounts of intracellular reactive oxygen species and showed similar influence on mitochondrial membrane potential. By analysis of global gene expression profiles, we found that the correlation coefficients between three kinds of PEG-GO-treated cells were more than 0.98. Furthermore, in vivo results showed that all these PEG-GO nanosheets had no significant toxicity to ocular structure and function. Taken together, our work suggested that surface charge of PEG-GO exerted negligible effect on its ocular compatibility, except for the cellular uptake. Our work is conducive to understanding the relationship between surface charge and biocompatibility of GO derivatives