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Abstract Background Esophageal cancer brings emotional changes, especially anxiety to patients. Co-existing anxiety makes the surgery difficult and may cause complications. This study aims to evaluate effects of anxiety in postoperative complications of esophageal cancer patients with chronic obstructive pulmonary disease (COPD). Methods Patients with esophageal cancer and co-existing COPD underwent tumor excision. Anxiety was measured using Hospital Anxiety and Depression Scale (HAD) before surgery. Clavien-Dindo criteria were used to grade surgical complications. A multiple regression model was used to analyze the relationship between anxiety and postoperative complications. The chi-square test was used to compare the differences in various types of complications between the anxiety group and the non-anxiety group. A multinomial logistic regression model was used to analyze the influencing factors of mild and severe complications. Results This study included a total of 270 eligible patients, of which 20.7% had anxiety symptoms and 56.6% experienced postoperative complications. After evaluation by univariate analysis and multivariate logistic regression models, the risk of developing complications in anxious patients was 4.1 times than non-anxious patients. Anxious patients were more likely to develop pneumonia, pyloric obstruction, and arrhythmia. The presence of anxiety, surgical method, higher body mass index (BMI), and lower preoperative oxygen pressure may increase the incidence of minor complications. The use of surgical methods, higher COPD assessment test (CAT) scores, and higher BMI may increase the incidence of major complications, while anxiety does not affect the occurrence of major complications (P = 0.054). Conclusion Preoperative anxiety is associated with postoperative complications in esophageal cancer patients with co-existing COPD. Anxiety may increase the incidence of postoperative complications, especially minor complications in patient with COPD and esophageal cancer.

This study investigates the correlation between the soil-water characteristic curve (SWCC) of undisturbed loess and its collapsibility. Undisturbed loess soil samples, obtained from depths up to 30 meters below the surface in Chang’an District, Xi’an City, Shaanxi Province, were taken for basic physical index tests and collapsibility assessments. SWCC analyses of loess-paleosol samples from different typical strata were conducted and analyzed using scanning electron microscope. The findings reveal a positive correlation between the number of macropores and saturated volumetric water content. Additionaly, the number of pores is positively correlated with the slope of the transition zone, indicating that a higher pore count accelerates the soil's water loss rate. The number of tiny voids and the plasticity index of soil affect the residual moisture content. For different soil layers, saturated volumetric water content and slope of transition zone exhibit a positive correlation with collapsible coefficient. The influence of collapsible coefficient of plastic index close to soil layer on residual volumetric water content is not obvious. The study also indicates a positive correlation between SWCC and the collapsibility coefficient of the loess layer. By approaching loess collapsibility from the direction of unsaturated soil mechanics, this paper introduces a novel research angle for the study of collapsibility.

Objective: To investigate the effects and mechanisms of pomegranate flower water extract on hepatic insulin signaling in type 2 diabetic mice. Methods: C57BL/6J was randomly divided into normal group, model group, metformin group (Met), pomegranate flower water extract low-dose group (PFWL) and pomegranate flower water extract high-dose group (PFWH). The drug was administered continuously for 11 weeks. Mice were tested for body mass, fasting blood glucose (FBG), insulin (INS), triglycerides (TG), total cholesterol (TC) and insulin resistance index (HOMA-IR) was calculated. Hematoxylin-eosin (HE) staining was used to observe the pathologic changes in hepatic tissue. The expression levels of insulin receptor substrate 1 (IRS1), p-IRS1 (Ser307), protein kinase B (AKT), p-AKT (Ser473), glycogen synthase kinase-3β (Gsk3β), p-Gsk3β (S9), aromatidic hydrocarbon receptor (AhR), phosphatidylethanolamine N-methyltransferase (PEMT), and Bcl-2/adenovirus E1B19-kDa interacting protein 3 (BNIP3) in mouse liver tissues were determined by Western blot. Results: Compared with the model group, the FBG, INS, HOMA-IR, TG and TC levels were significantly decreased in the PFWH group (P

Excessive nitrogen and phosphorus (N/P) input is the important reason for lake eutrophication, a widespread environmental problem that harms freshwater ecosystems worldwide. Land use land cover changes (LULCCs) strongly affect the migration and transformation process on land of N/P. Aiming to improve the accuracy of N/P estimation and deeply understand the spatiotemporal impact of LULCCs on N/P distribution, this study proposed an optimized framework, InVEST-UM, by integrating an unmixing algorithm with the conventional InVEST model. A comprehensive and intuitive index LPI (LULCCs purification capacity index) is developed for the impact assessment and spatialization. Validation shows a strong correlation (0.94) between the LPI and eutrophication degree of Dianshan Lake. This suggests the LPI effectively captures the spatiotemporal influence of LULCCs on lake eutrophication. Based on the sub-pixel results of N/P estimation, dramatic changes of LPI with an average rate of 46.182% were explored. There is a strong positive correlation (0.91) between vegetation area and LULCCs purification capacity for N/P. Conversely, negative relationships are found between LULCCs purification capacity with bare lands (−0.86), and artificial surfaces (−0.75). Changes in the water bodies have weak influence (−0.33) on LULCCs purification capacity. The increase in vegetation area can not only enhance the lake purification capacity, but also help maintain low ecological sensitivity. By employing this comprehensive framework, this study provides valuable insights into the long-term dynamics of LULCCs changes and their implications for lake ecosystems, and could support the protection and land use planning for the sustainability and ecological balance of the lake.

Background: Carrier screening is the most effective method to block the occurrence of thalassemia. However, due to differences in race and genotype, MCV, MCH, HbA2 and other indicators are far from each other. The purpose of this study is to evaluate the common screening indicators of a, b and ab-compound thalassemia carriers in Hunan Province, and try to use the relevant formulas in the existing literature to predict and distinguish different types of thalassemia carriers. Methods: Receiver operating characteristic curve (ROC curve) combined with Youden index was utilized to analyze results of blood routine examination, hemoglobin electrophoresis, and literature-related formulas for 1111 a-thalassemia carriers, 464 b-thalassemia carriers and 24 ab-thalassemia carriers. Results: For a-thalassemia carriers, no matter which screening index or formula, the screening efficiency was not ideal. For b-thalassemia minor carriers, RBC, RDW-CV, HBA2, HbF and formula 5-7 could be used, and for compound thalassemia, RBC, RDW-CV, HbA2 and formula 5-6 are suitable. HbA2 has high efficiency in the screening of b-thalassemia minor and ab-thalassemia. For the screening of b-thalassemia minor, if the cutoff value of HbA2 is set to 3%, the detection rate of 93.32% can be obtained at the positive rate of 9.6%, and if it is set to 3.15%, the detection rate can also reach 81.68% at the positive rate of 2.89%. For ab-thalassemia, if the cutoff value of HbA2 is set to 3%, the detection rate of 95.83% can be obtained under the positive rate of 8.08%. Conclusion: Different screening indicators and formulas have different efficiencies for different thalassemia carriers. a-thalassemia carriers are easily missed by screening indicators or corresponding formulas. HbA2 is a better screening indicator for both b-thalassemia minor carriers and abthalassemia carriers, and formulas 5, 6, and 7 are suitable for b-thalassemia minor carriers, and formulas 5 and 6 are better for ab-thalassemia carriers. To fully and objectively understand each screening index, data support has been provided for clinical and laboratory tests.

ABSTRACT: Hurood is a traditional fermented milk product prepared by traditional Mongolian techniques of fermenting raw milk, partial degreasing, heating, whey drainage, emulsification of curd, and molding. Currently, Hurood available in the market is generally prepared by small-scale enterprises at home or in open air. Therefore, lack of standardization of bacterial starter culture leads to variation in the flavor and sensory properties of Hurood from batch to batch. In this study, we aimed to assess the best starter culture combination obtained from 37 lactic acid bacterial strains isolated from traditional Hurood. The solidification state and sensory quality were used as indexes for determining the fermentation efficiency of the bacterial starter culture combinations. The yield and texture characteristics were used to determine the optimal ratio of bacterial strains in a combination and the processing conditions for traditional Hurood production. The most optimal bacterial culture combination was observed to be NF 9–3:NF 10–4:CH 3–1 in 5:4:1 ratio and in 3% amount. The most optimal whey temperature and heating–stirring temperature were observed to be 55°C to 60°C and 85°C to 90°C, respectively. Hurood prepared with the optimal combination of bacterial strains exhibited significantly enhanced sensory quality, flavor, and contents of AA and fatty acids. Therefore, the use of optimal starter culture of lactic acid bacteria could produce Hurood with significantly superior sensory qualities, making the product more acceptable to consumers.

Abstract Unsorted retired batteries with varied cathode materials hinder the adoption of direct recycling due to their cathode-specific nature. The surge in retired batteries necessitates precise sorting for effective direct recycling, but challenges arise from varying operational histories, diverse manufacturers, and data privacy concerns of recycling collaborators (data owners). Here we show, from a unique dataset of 130 lithium-ion batteries spanning 5 cathode materials and 7 manufacturers, a federated machine learning approach can classify these retired batteries without relying on past operational data, safeguarding the data privacy of recycling collaborators. By utilizing the features extracted from the end-of-life charge-discharge cycle, our model exhibits 1% and 3% cathode sorting errors under homogeneous and heterogeneous battery recycling settings respectively, attributed to our innovative Wasserstein-distance voting strategy. Economically, the proposed method underscores the value of precise battery sorting for a prosperous and sustainable recycling industry. This study heralds a new paradigm of using privacy-sensitive data from diverse sources, facilitating collaborative and privacy-respecting decision-making for distributed systems.

PurposeTo investigate the contrast sensitivity function (CSF) changes in simple high myopia (SHM) and evaluate the correlations between these changes with the early changes in the retinal microstructure.MethodsThis prospective study comprised 81 subjects, 20 with emmetropia (EM), 26 with low myopia and moderate myopia (LM/MM), and 35 with SHM. The area under the log CSF curve (AULCSF) and the cut-off spatial frequency (Cut-off SF) were employed as measures of CSF. Adaptive optics (AO) was employed to quantify the cone density, spacing, and regularity. The thickness and blood flow of the retinal sublayers were determined from vertical and horizontal optical coherence tomography angiography (OCTA) A-scans. Swept-source optical coherence tomography (SS-OCT) was employed to analyze the choroidal thickness (CT) and choroidal vascularity using a custom algorithm. Differences in the retinal and choroidal parameters, cone distribution, AULCSF, and Cut-off SF were compared among the three groups. Multivariate linear mixed models were used to elucidate the associations between photoreceptor morphological alterations, retinal and choroidal parameters, and AULCSF.ResultsThe AULCSF and Cut-off SF were significantly lower in the SHM group compared to the EM and LM groups (p

Abstract Background Lymph node dissection is essential for staging of pure solid lung adenocarcinoma and selection of treatment after surgical resection, particularly for stage I disease since the rate of lymph node metastasis can vary from 0 to 23.7%. Methods We retrospectively screened all adult patients (18 years of age or older) who underwent lobectomy for pure solid cT1N0M0 lung adenocarcinoma between January 2015 and December 2017 at our center. Cox proportional hazard regression was used to assess the association between the number of dissected lymph nodes and recurrence-free survival (RFS) and to determine the optimal number of dissected lymph nodes. Results The final analysis included 458 patients (age: 60.26 ± 8.07 years; 241 women). RFS increased linearly with an increasing number of dissected lymph nodes at a range between 0 and 9. Kaplan-Meier analysis revealed significantly longer RFS in patients with ≥ 9 vs.

Abstract Deep Learning (DL) has been widely used in many applications, and its success is achieved with large training data. A key issue is how to provide a DL solution when there is no large training data to learn initially. In this paper, we explore a meta-learning approach for a specific problem, subgraph isomorphism counting, which is a fundamental problem in graph analysis to count the number of a given pattern graph, p, in a data graph, g, that matches p. There are various data graphs and pattern graphs. A subgraph isomorphism counting query is specified by a pair, (g, p). This problem is NP-hard and needs large training data to learn by DL in nature. We design a Gaussian Process (GP) model which combines Graph Neural Network with Bayesian nonparametric, and we train the GP by a meta-learning algorithm on a small set of training data. By meta-learning, we can obtain a generalized meta-model to better encode the information of data and pattern graphs and capture the prior of small tasks. With the meta-model learned, we handle a collection of pairs (g, p), as a task, where some pairs may be associated with the ground-truth, and some pairs are the queries to answer. There are two cases. One is there are some with ground-truth (few-shot), and one is there is none with ground-truth (zero-shot). We provide our solutions for both. In particular, for zero-shot, we propose a new data-driven approach to predict the count values. Note that zero-shot learning for our regression tasks is difficult, and there is no hands-on solution in the literature. We conducted extensive experimental studies to confirm that our approach is robust to model degeneration on small training data, and our meta-model can fast adapt to new queries by few-shot and zero-shot learning.

In order to solve the problem of water pollution caused by traditional phosphorus-containing scale inhibitors, a phosphorus-free MA-SAS-HEMA copolymer scale inhibitor was prepared by aqueous solution free radical polymerization using maleic anhydride (MA), sodium allylsulfonate (SAS) and hydroxyethyl methacrylate (HEMA) as synthetic monomers. The microstructure of the copolymer and the thermal stability were characterized by infrared spectroscopy, gel permeation chromatography and thermogravimetric analysis. The scale inhibition performance of the copolymer was explored by static scale inhibition method. X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used to analyze the calcium carbonate and calcium sulfate crystals produced before and after the addition of MA-SAS-HEMA copolymer to explore the scale inhibition mechanism of the copolymer. The results of static scale inhibition show that the copolymer can achieve good scale inhibition effect at low concentration, and are highly temperature resistant. The scale inhibition performance is stable in high alkalinity and high hardness water. The results of XRD and SEM showed that the scale structure was obviously loose and the scale inhibition effect was good after adding the copolymer. The crystal form of calcium carbonate changed, the characteristic peak of calcite decreased significantly, and the characteristic peaks of metastable vaterite and aragonite appeared. The crystal form of calcium sulfate did not change but the crystallinity was greatly reduced. The carboxylic acid group in the MA-SAS-HEMA copolymer.

Longan (Dimcarpus longan Lour.) is a kind of traditional fruit used as a medicine and a food. Fresh longan is primarily consumed as a fruit, whereas dried longan is commonly employed for medicinal purposes. The differences in the immunomodulatory activities and mechanisms of polysaccharides between dried and fresh longan remain unclear. The present study comparatively analyzed the mechanisms of macrophage activation induced by polysaccharides from dried (LPG) and fresh longan (LPX). The results revealed that LPG and LPX differentially promoted macrophage phagocytosis and the secretion of NO, TNF-α, and IL-6. RNA-seq analysis revealed that LPG and LPX differentially affected gene expression in macrophages. The LPG treatment identified Tnf and chemokine-related genes as core genes, while myd88 and interferon-related genes were the core genes affected by LPX. A comprehensive analysis of the differentially expressed genes showed that LPG initiated macrophage activation primarily through the TLR2/4-mediated TRAM/TRAF6 and CLR-mediated Src/Raf1 NF-κB signaling pathways. LPX initiated macrophage activation predominantly via the CLR-mediated Bcl10/MALT1 and NLR-mediated Rip2/TAK1 MAPK and NF-κB signaling pathways. Interestingly, the non-classical NF-κB signaling pathway was activated by polysaccharides in both dried and fresh longan to elicit a slow, mild immune response. LPG tends to promote immune cell migration to engage in the immune response, while LPX facilitates antigen presentation to promote T cell activation. These findings contribute insights into the mechanisms underlying the differences in bioactivity between dried and fresh longan and their potential applications in immune-enhancing strategies and functional-food development.

Background. Joint articular injection of mesenchymal stem cells (MSCs) has emerged as a novel treatment approach for osteoarthritis (OA). However, the effectiveness of MSCs derived from different sources in treating OA patients remains unclear. Therefore, this study aimed to explore the differences between the effectiveness and safety of different sources of MSCs. Materials and Methods. For inclusion consideration, we searched trial registries and published databases, including PubMed, Cochrane Library, Embase, and Web of Science databases. Revman (V5.3), STATA (V16.0), and R (V4.0) were utilized for conducting data analysis, while the Cochrane Risk of Bias Tool was employed for assessing the quality of the studies. We derived outcome measures at 6 and 12 months based on the duration of study follow-up, including visual analog scale (VAS) score, WOMAC score, WOMAC pain, WOMAC Functional Limitation, and WOMAC stiffness. The evaluation time for short-term effectiveness is set at 6 months, while 12 months is utilized as the longest follow-up time for most studies to assess long-term effectiveness. Results. The evaluation of literature quality showed that the included studies had excellent methodological quality. A meta-analysis revealed that different sources of MSCs improved knee function and pain more effectively among patients suffering from knee OA (KOA) than controls. The results of the network meta-analysis showed the following: short-term functional improvement (the indexes were evaluated after 6 months of follow-up) (WOMAC total score: bone marrow-derived MSC (BMMSC) vs. adipose-derived MSC (ADMSC) (mean difference (MD) = −20.12, 95% confidence interval (CI) −125.24 to 42.88), umbilical cord-derived MSC (UCMSC) (MD = −7.81, 95% CI −158.13 to 74.99); WOMAC stiffness: BMMSC vs. ADMSC (MD = −0.51, 95% CI −7.27 to 4.29), UCMSC (MD = −0.75, 95% CI −9.74 to 6.63); WOMAC functional limitation: BMMSC vs. ADMSC (MD = −12.22, 95% CI −35.05 to 18.86), UCMSC (MD = −9.31, 95% CI −44.26 to 35.27)). Long-term functional improvement (the indexes were evaluated after 12 months of follow-up) (WOMAC total: BMMSC vs. ADMSC (MD = −176.77, 95% CI −757.1 to 378.25), UCMSC (MD = −181.55, 95% CI −937.83 to 541.13); WOMAC stiffness: BMMSC vs. ADMSC (MD = −0.5, 95% CI −26.05 to 18.61), UCMSC (MD = −1.03, 95% CI −30.44 to 21.69); WOMAC functional limitation: BMMSC vs. ADMSC (MD = −5.18, 95% CI −316.72 to 177.1), UCMSC (MD = −8.33, 95% CI −358.78 to 218.76)). Short-term pain relief (the indexes were evaluated after 6 months of follow-up) (VAS score: UCMSC vs. BMMSC (MD = −10.92, 95% CI −31.79 to 12.03), ADMSC (MD = −14.02, 95% CI −36.01 to 9.81), PLMSC (MD = −17.09, 95% CI −46.31 to 13.17); WOMAC pain relief: BMMSC vs. ADMSC (MD = −11.42, 95% CI −39.52 to 11.77), UCMSC (MD = −6.73, 95% CI −47.36 to 29.15)). Long-term pain relief (the indexes were evaluated after 12 months of follow-up) (VAS score: BMMSC vs. UCMSC (MD = −4.33, 95% CI −36.81 to 27.08), ADMSC (MD = −11.43, 95% CI −37.5 to 13.42); WOMAC pain relief: UCMSC vs. ADMSC (MD = 0.23, 95% CI −37.87 to 38.11), BMMSC (MD = 5.89, 95% CI −25.39 to 51.41)). According to the GRADE scoring system, WOMAC, VAS, and AE scores were of low quality. Conclusion. Meta-analysis suggests MSCs can effectively treat KOA by improving pain and knee function compared to control groups. In terms of functional improvement in KOA patients, both short-term (6-month follow-up) and long-term (12-month follow-up) results indicated that while the differences between most treatments were not statistically significant, bone marrow-derived MSCs may have some advantages over other sources of MSCs. Additionally, BM-MSCs and UC-MSCs may offer certain benefits over ADMSCs in terms of pain relief for KOA patients, although the variances between most studies were not statistically significant. Therefore, this study suggests that BM-MSCs may present clinical advantages over other sources of MSCs.

Virtual simulation technology is used to construct a teaching model for kindergarten ring creation based on this paper. Virtual simulation technology uses the classical K-Means clustering algorithm to confirm information on kindergarten teaching resources. Using a particle swarm optimization algorithm, weights are calculated for kindergarten and preschool education resource categories to determine the similarity of usage frequency. To improve the efficiency of preschool education resources scheduling, to verify the feasibility of the teaching model, the results show that the mean value of student-teacher interaction with virtual simulation technology is 2.180, and the highest mean value of student-teacher interaction is 2.220. It proves that the teaching model constructed using virtual reality technology can effectively improve the quality of teaching conducted in early childhood circumvention practices.

This study explores the skill demand and supply of the current Moroccan urban labor workforce. It seeks to understand the experience of skill mismatch, and how it affects employability. Using semi-structured interviews and a phenomenological approach, the study explores the nature of job queues as informed by recruiters and educators. A total of 27 interviews were conducted with recruits, recruiters, and university professors, all of whom were selected using a criterion-based approach coupled with snowball sampling. Over-education was affirmed among employees, and the findings yielded a crossover of skill sets. The job queue for a balanced labor market is oriented towards personal attitudes and capabilities related to the field of study. Finally, responses from both recruiters’ and professors’ interviews yielded a framework of education-job matches for the demand-supply sides, and oriented workplace-based employability.

Appropriate material model will provide more accurate predictions for the mechanical response and damage mode of concrete structures, and thus developing a material model that is more consistent with the dynamic behavior of concrete has an important significance to obtain better numerical results. In this paper, an improved damage-plasticity material model for concrete is presented to predict its mechanical response subjected to dynamic loading. Based on the current extent of damage, the failure strength surface is modified through linearly interpolating between the maximum and yield strength surfaces or the maximum and residual strength surfaces. The shear, compacted and tensile damage are separately defined, and a unified hardening/softening function associated with the shear and compacted damage is introduced as the prediction of strain hardening and softening behaviors under compression. The Lode angle effect is considered for describing the reduction of shear strength on the compressive meridian, and the strain rate effect is considered by the radial enhancement method. The calibration method of material parameters is suggested according to the existing experimental data and empirical equations. The feasibility and accuracy of this improved concrete model are verified by the single element validation, and its performance improvement is discussed by comparing with the popular material models for concrete. The experiments and numerical simulations of split Hopkinson pressure bar (SHPB) are conducted for concrete and cement to further verify the validity and accuracy of this improved concrete model.

Colorectal cancer (CRC) is one of the most common tumors in the world. Colorectal polyps are local protuberant lesions that elevate the intestinal mucosa, and about 90% of CRC is evolved from polyp. According to the traditional concept, the occurrence and development of CRC is mostly through the "adenoma-cancer" sequence. However, studies have found that serrated polyps also form subclasses with different morphology and genes, and are closely related to microsatellite unstable CRC. About 15%-30% of CRC develops through the "serrated polyp-cancer" pathway. This article mainly reviewed the clinical characteristics of colorectal adenoma, serrated polyp and post-inflammatory polyps, through retrospective analysis of large samples, to summarize the incidence of different pathological types of colorectal polyps in the progression of carcinogenesis and the follow-up monitoring after polypectomy, so as to provide a better reference for follow-up monitoring of polyp patients and early screening and treatment of precancerous lesions.

In order to improve the anti-corrosion performance of epoxy coatings, modified nano-ZrO2/Zn-Al-C epoxy resin composite coatings were prepared by using γ-aminopropyltriethoxysilane (KH-550) to improve the agglomeration phenomenon of nano-ZrO2 particles in combination with Zn-Al-C alloy powder. X-ray diffraction (XRD), Fourier infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) were used to characterize the structural changes of nano-ZrO2 before and after the modification. With electrochemical AC impedance spectroscopy (EIS) and polarization curves (Tafel), the corrosion behavior of the composite coatings in simulated geothermal water environment was analyzed. The results show that the nano-ZrO2 surface is successfully grafted with KH-550; the number of corrosion scaling products on the surface of the composite coating is significantly reduced compared with the original sheet after full immersion in simulated geothermal water for 720 h; the self-corrosion current density is 6.113×10-10 (A·cm-2), and the electrochemical performance is good. The modified epoxy composite coating effectively utilizes the superior properties of nanomaterials and metallic materials, and its hardness and corrosion resistance are improved significantly, which provides a reference for the long-term use of epoxy coating in geothermal water environment.

Spatiotemporal changes in lake water resources critically affect the livelihoods and the sustainable development of the local social economy. Understanding the evolution of lake water resource and its influence on economic development is important for achieving sustainable development goals. Taking Africa’s largest lake, Lake Victoria, as the study area, a framework was developed to investigate long-term (2000–2019) water volume variations and their influence on local economic sustainable development. First, an estimation model of water volume variations was constructed based on an optimized joint process of multi-mission altimetry data and water surface area calculations of multispectral images. Furthermore, based on nighttime light remote sensing data, three factors (namely economic level, growth, and inequality) were calculated and applied to quantify the sustainability of local economic development. Finally, the influence mechanism was explored using the Pearson correlation coefficient and grey-value relationship analysis. The results reveal significant interannual and seasonal variations in water volume of the Lake Victoria. Spatially, the western part of Lake Victoria experienced more frequent changes than the east. From the three economic perspectives, the spatiotemporal evolution of water volume variations strongly affected the economic level, whereas economic growth is influenced the least. Additionally, different effects were observed in the surrounding countries. The water volume variations had the greatest impact on Uganda’s sustainable economic development from all three perspectives, with a significant lagged impact of three years on agricultural production. This study provides valuable insights into the dynamic influence of water resources on sustainable economic development, offering a viable alternative to mass field surveys, especially relevant for developing and underdeveloped regions.

Introduction Hormone replacement treatment (HRT) is the most commonly used endometrial preparation protocol for frozen embryo transfer (FET) in patients with polycystic ovary syndrome (PCOS). However, studies have found that HRT may increase the risk of hypertensive disorders of pregnancy and some obstetric complications. Letrozole is a new first-line ovulation induction drug for PCOS and can effectively induce spontaneous ovulation by reducing oestrogen levels. However, letrozole is still rarely used in FET and has only been reported in a few studies in Asian populations. High-quality, well-powered randomised controlled trials (RCTs) comparing HRT and letrozole-stimulated protocols are lacking. The aim of this study is to compare the efficacy and safety of two protocols in patients with PCOS.Methods and analysis This is a multicentre, open-label RCT in four reproductive medical centres in China. In total, 1078 women with PCOS will be randomised (1:1) to the letrozole-stimulated or HRT group in their first FET cycle and their pregnancy and perinatal outcomes during this cycle will be followed up and analysed. The primary outcome is live birth. Secondary outcomes are cycle cancellation rate, biochemical pregnancy, clinical pregnancy, miscarriage, ectopic pregnancy, obstetric and perinatal complications, neonatal complications and birth weight.Ethics and dissemination Ethical approval was obtained from the Institutional Review Board of Reproductive and Genetic Hospital of CITIC-XIANGYA (LL-SC-2022-001). Written informed consent will be obtained from each participant. The findings will be disseminated through conference presentations and publication in peer-reviewed journals.Trial registration number NCT05227391.

This study aimed to comprehend the patterns and scope of the education mismatch in the Moroccan labor market by collecting and analyzing an extensive database of the types of skills that fuel economic expansion and growth. A self-assessment approach was used to determine the extent of mismatch in Morocco by adopting the World Bank’s Skills Toward Employment and Productivity (STEP) survey, which applies mainly to low- and middle-income countries. The study sample consisted of 416 respondents who matched the stipulated criteria. Various statistical tests like the descriptive test, chi-square, and Spearman’s r coefficient were employed to determine the correlation between the three modules of the STEP program and demographic aspects of the respondents. Under the self-assessment approach, the results showed a preponderance of mismatched employees at 55.1%, while 44.9% were matched. The mismatch was found to be vertical. The findings imply that cognitive skills are statistically significant with the required job-specific skills. This is one of the few studies that address the skill mismatch in the North African region and the first to examine the Moroccan case.

Abstract Human mesenchymal stem cells (hMSCs) can be differentiated into osteoblasts and adipocytes. During these processes, super enhancers (SEs) play important roles. Here, we performed comprehensive characterization of the SEs changes associated with adipogenic and osteogenic differentiation of hMSCs, and revealed that SEs changed more dramatically compared with typical enhancers. We identified a set of lineage-selective SEs, whose target genes were enriched with cell type-specific functions. Functional experiments in lineage-selective SEs demonstrated their specific roles in directed differentiation of hMSCs. We also found that some key transcription factors regulated by lineage-selective SEs could form core regulatory circuitry (CRC) to regulate each other’s expression and control the hMSCs fate determination. In addition, we found that GWAS SNPs of osteoporosis and obesity were significantly enriched in osteoblasts-selective SEs or adipocytes-selective SEs, respectively. Taken together, our studies unveiled important roles of lineage-selective SEs in hMSCs differentiation into osteoblasts and adipocytes.

Abstract Blood–brain barrier is a pivotal factor to be considered in the process of central nervous system (CNS) drug development, and it is of great significance to rapidly explore the blood–brain barrier permeability (BBBp) of compounds in silico in early drug discovery process. Here, we focus on whether and how uncertainty estimation methods improve in silico BBBp models. We briefly surveyed the current state of in silico BBBp prediction and uncertainty estimation methods of deep learning models, and curated an independent dataset to determine the reliability of the state-of-the-art algorithms. The results exhibit that, despite the comparable performance on BBBp prediction between graph neural networks-based deep learning models and conventional physicochemical-based machine learning models, the GROVER-BBBp model shows greatly improvement when using uncertainty estimations. In particular, the strategy combined Entropy and MC-dropout can increase the accuracy of distinguishing BBB + from BBB − to above 99% by extracting predictions with high confidence level (uncertainty score

Abstract Background Gait disability affects the daily lives of patients with stroke in both home and community settings. An abnormal foot–ankle position can cause instability on the supporting surface and negatively affect gait. Our research team explored the ability of a portable peroneal nerve-targeting electrical stimulator to improve gait ability by adjusting the foot–ankle position during walking in patients with chronic stroke undergoing home-based rehabilitation. Methods This was a double-blinded, parallel-group randomized controlled trial. Thirty-one patients with chronic stroke and ankle–foot motor impairment were randomized to receive 3 weeks of gait training, which involved using the transcutaneous peroneal nerve stimulator while walking (tPNS group; n = 16, mean age: 52.25 years), or conventional home and/or community gait training therapy (CT group; n = 15, mean age: 54.8 years). Functional assessments were performed before and after the 3-week intervention. The outcome measures included spatiotemporal gait parameters, three-dimensional kinematic and kinetic data on the ankle–foot joint, and a clinical motor and balance function assessment based on the Fugl–Meyer Assessment of Lower Extremity (FMA-LE) and Berg Balance scales (BBS). Additionally, 16 age-matched healthy adults served as a baseline control of three-dimensional gait data for both trial groups. Results The FMA-LE and BBS scores improved in both the tPNS groups (p = 0.004 and 0.001, respectively) and CT groups (p = 0.034 and 0.028, respectively) from before to after training. Participants in the tPNS group exhibited significant differences in spatiotemporal gait parameters, including double feet support, stride length, and walking speed of affected side, and the unaffected foot off within a gait cycle after training (p = 0.043, 0.017, 0.001 and 0.010, respectively). Additionally, the tPNS group exhibited significant differences in kinematic parameters, such as the ankle angle at the transverse plane (p = 0.021) and foot progression angle at the frontal plane (p = 0.009) upon initial contact, and the peak ankle joint angle at the transverse plane (p = 0.023) and foot progression angle (FPA) at the frontal and transverse planes (p = 0.032 and 0.046, respectively) during gait cycles after 3 weeks of training. Conclusions Use of a portable tPNS device during walking tasks appeared to improve spatiotemporal gait parameters and ankle and foot angles more effectively than conventional home rehabilitation in patients with chronic stroke. Although guidelines for home-based rehabilitation training services and an increasing variety of market devices are available, no evidence for improvement of motor function and balance was superior to conventional rehabilitation. Trial registration Chictr, ChiCTR2000040137. Registered 22 November 2020, https://www.chictr.org.cn/showproj.aspx?proj=64424

Abstract This study presents findings in the terahertz (THz) frequency spectrum for non-contact cardiac sensing applications. Cardiac pulse information is simultaneously extracted using THz waves based on the established principles in electronics and optics. The first fundamental principle is micro-Doppler motion effect. This motion based method, primarily using coherent phase information from the radar receiver, has been widely exploited in microwave frequency bands and has recently found popularity in millimeter waves (mmWave) for breathe rate and heart rate detection. The second fundamental principle is reflectance based optical measurement using infrared or visible light. The variation in the light reflection is proportional to the volumetric change of the heart, often referred as photoplethysmography (PPG). Herein, we introduce the concept of terahertz-wave-plethysmography (TPG), which detects blood volume changes in the upper dermis tissue layer by measuring the reflectance of THz waves, similar to the existing remote PPG (rPPG) principle. The TPG principle is justified by scientific deduction, electromagnetic wave simulations and carefully designed experimental demonstrations. Additionally, pulse measurements from various peripheral body parts of interest (BOI), palm, inner elbow, temple, fingertip and forehead, are demonstrated using a wideband THz sensing system developed by the Terahertz Electronics Lab at Arizona State University, Tempe. Among the BOIs under test, it is found that the measurements from forehead BOI gives the best accuracy with mean heart rate (HR) estimation error 1.51 beats per minute (BPM) and standard deviation 1.08 BPM. The results validate the feasibility of TPG for direct pulse monitoring. A comparative study on pulse sensitivity is conducted between TPG and rPPG. The results indicate that the TPG contains more pulsatile information from the forehead BOI than that in the rPPG signals in regular office lighting condition and thus generate better heart rate estimation statistic in the form of empirical cumulative distribution function of HR estimation error. Last but not least, TPG penetrability test for covered skin is demonstrated using two types of garment materials commonly used in daily life.

Simultaneously imposed challenges of high-voltage insulation, high dv/dt, high-switching frequency, fast protection, and thermal management associated with the adoption of 10 kV SiC MOSFET, often pose nearly insurmountable barriers to potential users, undoubtedly hindering their penetration in medium-voltage (MV) power conversion. Key novel technologies such as enhanced gate-driver, auxiliary power supply network, PCB planar dc-bus, and high-density inductor are presented, enabling the SiC-based designs in modular MV converters, overcoming aforementioned challenges. However, purely substituting SiC design instead of Si-based ones in modular MV converters, would expectedly yield only limited gains. Therefore, to further elevate SiC-based designs, novel high-bandwidth control strategies such as switching-cycle control (SCC) and integrated capacitor-blocked transistor (ICBT), as well as high-performance/high-bandwidth communication network are developed. All these technologies combined, overcome barriers posed by state-of-the-art Si designs and unlock system level benefits such as very high power density, high-efficiency, fast dynamic response, unrestricted line frequency operation, and improved power quality, all demonstrated throughout this paper.

Mental health literacy (MHL) is an essential component in the process of de-stigmatization, promoting mental health, and supporting people struggling with mental illness. Today, as the number of people suffering from mental illnesses is nearly 450 million people worldwide, the importance of having a teacher-training program that incorporates MHL in its curriculum has become paramount. This study is a quasi-experimental pre–post research that uses the MHL program as an intervention. The sample included 36 (n = 36) high school in-service teachers from 11 schools. The participants took an online training program for 6 weeks. The evaluations were used before and after the training to assess their mental health knowledge, attitude, and self-efficacy. The data were analyzed using the paired sample t-test. The findings revealed a significant level of improvement in relation to the teachers’ MHL knowledge, attitude, and self-efficacy after the training. The study findings reveal the effectiveness of MHL training in improving in-service teachers’ knowledge, attitude, and self-efficacy in relation to mental health. The study’s limitations and future study recommendations are discussed.

BackgroundThe cblC type methylmalonic acidemia is the most common methylmalonic acidemia (MMA) in China. The biochemical characteristics of this disease include elevated methylmalonic acid and homocysteine (HCY), increased propionylcarnitine (C3), decreased free carnitine (C0). In this study, we aimed to clarify the roles of these biomarkers in cblC-MMA induced cognitive impairment and evaluate the capacity of methylmalonic acid in different fluids or exosomes to distinguish cblC-MMA induced cognitive impairment.Methods15 non-inherited hyperhomocysteinemia (HHcy) patients, 42 cblC-MMA patients and 57 age- and sex-matched healthy children were recruited in this study. The levels of HCY were detected by an automatic immune analyzer. The levels of acylcarnitines and methylmalonic acid were detected by tandem mass spectrometer.ResultsThe main findings were all biomarkers as HCY, acylcarnitines and methylmalonic acid had capacities for distinguishing patients with cblC-MMA induced cognitive impairment from healthy children. The methylmalonic acid in different fluids or exosomes had good performances for distinguishing patients with cblC-MMA induced cognitive impairment from HHcy patients. The methylmalonic acid in serum exosomes and neuronal-derived exosomes were able to distinguishing cblC-MMA patients with cognitive impairment from patients without cognitive impairment. The methylmalonic acid in neuronal-derived exosomes might be helpful to evaluate the severity of cblC-MMA induced cognitive impairment.DiscussionMethylmalonic acid levels in serum exosomes, especially in serum neuronal-derived exosomes, serve as potential biomarkers for distinguishing cblC-MMA induced cognitive impairment.

Objective To explore the incidence of pain flare (PF) in spine metastasis stereotactic body radiotherapy (SBRT) or hypofractionated radiotherapy (HF) and the prophylactical effect of dexamethasone. Methods Sixty-five patients were treated with spine metastasis SBRT and randomly divided into control group (SBRT or HF, n=32) and treatment group (SBRT or HF and 4.5 mg dexamethasone, n=33). The brief pain inventory (BPI) was used to score the pain before, during and after treatment. PF was recorded and compared between two groups. Results The incidence of PF was 24.6% in all patients (control group: 37.5%, treatment group: 12.1%, P=0.018). PF in both group occurred in d1-2, accounting for 62.5% in all PF (control group: 66.7%, treatment group: 50%, P=0.551). The incidences of PF in control group were 66.7% and 33.3% for three and ten fractions scheme, respectively (P=0.001). However, the incidences of PF in treatment group were 50% and 50% for three and ten fractions scheme, respectively (P=0.643). Conclusion Oral dexamethasone has an excellent efficacy in prevention and treatment of PF in spine metastasis SBRT or HF, with significantly decreased incidence of PF. A phase Ⅲ clinical trial is required to finalize the optimal dose and schedule.

Usher syndrome (USH) is characterised by degenerative vision loss known as retinitis pigmentosa (RP), sensorineural hearing loss, and vestibular dysfunction. RP can cause degeneration and the loss of rod and cone photoreceptors, leading to structural and functional changes in the retina. Cep250 is a candidate gene for atypical Usher syndrome, and this study describes the development of a Cep250 KO mouse model to investigate its pathogenesis. OCT and ERG were applied in Cep250 and WT mice at P90 and P180 to access the general structure and function of the retina. After recording the ERG responses and OCT images at P90 and P180, the cone and rod photoreceptors were visualised using an immunofluorescent stain. TUNEL assays were applied to observe the apoptosis in Cep250 and WT mice retinas. The total RNA was extracted from the retinas and executed for RNA sequencing at P90. Compared with WT mice, the thickness of the ONL, IS/OS, and whole retina of Cep250 mice was significantly reduced. The a-wave and b-wave amplitude of Cep250 mice in scotopic and photopic ERG were lower, especially the a-wave. According to the immunostaining and TUNEL stain results, the photoreceptors in the Cep250 retinas were also reduced. An RNA-seq analysis showed that 149 genes were upregulated and another 149 genes were downregulated in Cep250 KO retinas compared with WT mice retinas. A KEGG enrichment analysis indicated that cGMP-PKG signalling pathways, MAPK signalling pathways, edn2-fgf2 axis pathways, and thyroid hormone synthesis were upregulated, whereas protein processing in the endoplasmic reticulum was downregulated in Cep250 KO eyes. Cep250 KO mice experience a late-stage retinal degeneration that manifests as the atypical USH phenotype. The dysregulation of the cGMP-PKG-MAPK pathways may contribute to the pathogenesis of cilia-related retinal degeneration.

As an effective strategy for oncotherapy, developing efficacious drug delivery systems for cancer combination therapy remains a major challenge. To improve nanodrug biocompatibility and composite function facilitating their clinical conversion application, a novel nanocarrier was presented by a facile method through conjugating humic acid with gadolinium ions to synthesize HA-Gd with good biocompatibility and dispersity. HA-Gd exhibited high photothermal conversion efficiency up to 38%, excellent photothermal stability, and high doxorubicin (DOX) loading capacity (93%) with pH-responsive release properties. HA-Gd loading DOX showed a combined chemo-photothermal inhibitory effect on tumor cells. Compared with lipid-DOX, HA-Gd-DOX had a more significant inhibitory effect on tumor growth and fewer side effects. T1-weighted MRI contrast toward tumor tissue provided HA-Gd with an MRI-based cancer diagnosis. This study revealed the great potential of humic acids as a novel vector for developing more drug carriers with desirable functions for clinical anticancer therapy.

ObjectiveTo compare the complications and long-term survival of esophageal cancer patients with chronic obstructive pulmonary disease (COPD) after minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) using propensity score matching (PSM).MethodsEsophageal cancer patients who underwent esophagectomy at the Thoracic Surgery Department of the First Affiliated Hospital of Hebei North University from January 2010 to December 2018 were retrospectively enrolled. The incidence of postoperative complications and prognosis of the MIE (n = 132) and OE (n = 138) groups were compared. To reduce bias, 1:1 PSM was adopted for the analysis.ResultsThe median disease-free survival (DFS) of the MIE and OE groups were 24 months and 26 months, respectively, and neither group reached median survival. There was no significant difference between the two groups in terms of 3-year DFS and overall survival (OS). The stratification of the patients on the basis of the percentage of estimated forced expiratory volume in the first second (%FEV1) did not result in significant differences in the survival rates. A total of 42 patients (50%) in the MIE group and 55 patients (65.48%) in the OE group experienced complications, and the difference was statistically significant (OR=0.527, 95% CI: 0.283–0.981, P=0.042). The incidence of acute COPD exacerbation (OR=0.213, 95% OR, CI: 0.068–0.666, P=0.004) and pulmonary atelectasis requiring bronchoscopic aspiration (OR=0.232, 95% OR, CI: 0.082–0.659, P=0.004) were significantly higher in the OE versus the MIE group. In addition, the distribution of the various grades of complications also differed significantly between the two groups (P=0.016). While the incidence of minor complications (≤Grade II) was similar in both groups (P=0.503), that of severe complications (≥Grade III) was markedly higher in the OE group (P=0.002) and the Grade-IIIa complications were predominant (P=0.001). The severity of complications was correlated with the postoperative duration of hospital stay in both groups (r=0.187, P=0.015). No significant difference was observed in the incidence of minor complications (≤Grade II) between the two groups following stratification on the basis of %FEV1, whereas severe complications were more frequent in the OE group among patients with %FEV1 between 60% and 70% (P=0.001

Background: “Subjective cognitive decline plus” (SCD plus) increases the risk of Alzheimer's disease (AD), and this may be an early stage of AD that precedes amnestic mild cognitive impairment (aMCI). We examined alterations of serum metabolites and metabolic pathways in SCD plus subjects using 1H-magnetic resonance spectroscopy (1H NMR) metabolomics. Methods: Serum samples from subjects with SCD plus (n = 32), aMCI (n = 33), and elderly controls (ECs, n = 41) were analyzed using an 800MHz NMR spectrometer. Multivariate analyses were used to identify serum metabolites, and two machine-learning methods were used to evaluate the diagnostic power of these metabolites in distinguishing SCD plus subjects, aMCI subjects, and ECs. Results: Eight metabolites differentiated SCD plus from EC subjects. A random forest (RF) model discriminated SCD plus from EC subjects with an accuracy of 0.883 and an area under the receiver operating characteristic curve (AUROC) of 0.951. A support vector machine (SVM) model had an accuracy of 0.857 and an AUROC of 0.946. Nine other metabolites distinguished SCD plus from aMCI subjects. An RF model discriminated SCD plus from aMCI subjects (accuracy: 0.975, AUROC: 0.998) and an SVM model also discriminated these two groups (accuracy: 0.955, AUROC: 0.991). Disturbances of glucose and branched-chain amino acid (BCAA) metabolism were the most striking features of SCD plus subjects, and valine was positively correlated with Auditory Verbal Learning Test delayed-recall score. Conclusions: Serum metabolomics using 1H NMR provided noninvasive identification of perturbations in glucose and BCAA metabolism in subjects with SCD plus.

Abstract Fluopyram is commonly used to control banana leaf spot, anthracnose, and scab in tropical agricultural areas. To explore its behaviour in tropical agricultural environments, dissipation, adsorption, and leaching behaviours of fluopyram in three typical banana planting soils were studied. Also, its dissipation and migration capabilities in different regions and different soil types were evaluated. The results showed that the dissipation of fluopyram was in accordance with the first-order kinetic equation in the three banana soils, but the degradation rates were quite different. The degradation half-lives in the Hainan latosol, Yunnan sandy soil, and Fujian Plain alluvial soil were 46.21 days, 36.48 days and 57.76 days, respectively. Fluopyram also exhibited high adsorption and low leachability in the three soils. The Fujian Plain alluvial soil had the highest adsorption capacity for fluopyram, while fluopyram had the low leachability in the Yunnan sandy soil.

BackgroundStroke is among the leading causes of long-term disability worldwide. Motor impairments after stroke not only impact the individuals quality of life but also lay substantial burdens on the society. Motor planning is a key component of cognitive function that impacts motor control. Hand movements such as grasping or reaching to grasp require the application of correct force and the coordination of multiple limb segments. Successful completion of hand motor task requires a certain degree of cognitive function to anticipate the requirement of the task. Cognitive function may thus be a confounding factor to rehabilitation outcomes. ObjectiveThis study aims to explore the impact of cognitive function on functional outcomes in people with subacute stroke after VR intervention. MethodsPatients with stroke were first stratified into cognitively normal (CN) and cognitively impaired (CI), followed by allocation to the VR or control group (CG). Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Barthel Index (BI), and Instrumental Activities of Daily Living (IADL) were recorded at baseline, 3 weeks after the intervention, and 3 and 6 months after the intervention. The between-group and within-group differences were assessed by repeated-measures analysis of variance (ANOVA). ResultsThe between-group comparison indicated that FMA-UE, BI, and IADL (time effect P

Abstract Background Despite increasing acceptance in colorectal surgery, natural orifice specimen extraction (NOSE) surgery for the treatment of gastric cancer is still in its infancy, especially via the transrectal approach, which was barely reported. So little is known about its complications. Here we report the first case of proctotomy leak after transrectal NOSE gastrectomy, and our experience in preventive interventions. Case presentation A 62-year-old male patient complaining of upper abdominal pain who underwent open distal gastrectomy for gastric cancer one year ago was diagnosed with recurrent gastric cancer by gastroscopic biopsy. We performed laparoscopic total gastrectomy with transrectal specimen extraction on the patient. The operation was completed in a total laparoscopic approach and the specimen was extracted through a 3 cm longitudinal incision in the anterior wall of the upper rectum, then interrupted sutures were used for full-thickness closure of the rectal incision. The operative time was 470 min and intra-operative blood loss was 100 mL. The postoperative pathological examination showed pT1bN0M0 gastric adenocarcinoma. The patient developed proctotomy leak on the 10th postoperative day. We analyzed the causes of this rare complication and put forward a series of technical improvements. After failure of conservative treatment, a diverting ileostomy was created and the patient eventually recovered. We successfully prevented proctotomy leak in the subsequent 20 transrectal NOSE gastrectomies using improved techniques. Conclusions Proctotomy leak after transrectal specimen extraction should be considered among the complications of NOSE surgery and can be prevented by technical precautions.

Abstract Background Childhood obesity is reported to be associated with the risk of many diseases in adulthood. However, observational studies cannot fully account for confounding factors. We aimed to systematically assess the causal associations between childhood body mass index (BMI) and various adult traits/diseases using two-sample Mendelian randomization (MR). Methods After data filtering, 263 adult traits genetically correlated with childhood BMI (P 0.05). For dietary habits, different from conventional understanding, we found that higher childhood BMI was associated with low calorie density food intake. However, this association might be specific to the UK Biobank population. Conclusions In summary, we provided a phenome-wide view of the effects of childhood BMI on adult traits. Multivariable MR analysis suggested that the associations between childhood BMI and increased risks of diseases in adulthood are likely attributed to individuals remaining obese in later life. Therefore, ensuring that childhood obesity does not persist into later life might be useful for reducing the detrimental effects of childhood obesity on adult diseases.

Detecting SNPs associated with drug efficacy or toxicity is helpful to facilitate personalized medicine. Previous studies usually find SNPs associated with clinical outcome only in patients received a specific treatment. However, without information from patients without drug treatment, it is possible that the detected SNPs are associated with patients’ clinical outcome even without drug treatment. Here we aimed to detect drug response SNPs based on data from patients with and without drug treatment through combing the cox proportional-hazards model and pairwise Kaplan-Meier survival analysis. A pipeline named Detection of Drug Response SNPs (DDRS) was built and applied to TCGA breast cancer data including 363 patients with doxorubicin treatment and 321 patients without any drug treatment. We identified 548 doxorubicin associated SNPs. Drug response score derived from these SNPs were associated with drug-resistant level (indicated by IC50) of breast cancer cell lines. Enrichment analyses showed that these SNPs were enriched in active epigenetic regulation markers (e.g., H3K27ac). Compared with random genes, the cis-eQTL genes of these SNPs had a shorter protein–protein interaction distance to doxorubicin associated genes. In addition, linear discriminant analysis showed that the eQTL gene expression levels could be used to predict clinical outcome for patients with doxorubicin treatment (AUC = 0.738). Specifically, we identified rs2817101 as a drug response SNP for doxorubicin treatment. Higher expression level of its cis-eQTL gene GSTA1 is associated with poorer survival. This approach can also be applied to identify new drug associated SNPs in other cancers.