In the light of waste prevention in the conventional acrylic acid (AA) removal process uses a water washing tower, we report on an experimental evidence of a proof-of-concept alternative process using TiO2 ceramic membrane contactors. Experimental results allow us to estimate the mass transfer coefficient of the proposed membrane system, being 0.003 m3/m2h. Based on this value, we perform a techno-economic assessment (TEA) for the acrylate production process using membrane contactors for AA removal. The acrylate production cost is estimated with a focus on downstream processing. The results are benchmarked with the process using a water washing tower for AA removal. 2-ethylhexyl acrylate (2-EHA) is taken as the model product with a yield of 20,000 ton/year. We find that for the membrane contactors to be cost competitive with the water washing tower, the AA mass transfer coefficient needs to increase to 0.005 m3/m2h, keeping the other parameters constant.

In biological systems, molecular assembly primarily relies on the assistance of molecular chaperones. Inspired by nature, strategies like ‘chaperone-assisted assembly’ and ‘catalyzed assembly’ have been proposed towards the sophisticated control of molecular assembly. Nonetheless, significant challenges remain in the rational design of such systems, calling for a deep understanding of underlying principles. Herein, we demonstrate an artificial chaperone serves a dual role, i.e. catalyst in low dosages and inhibitor in high dosages, in regulating the supramolecular polymerization of peptides. Low dosages of carboxymethyl cellulose, as the chaperones, catalyse the assembly of Aβ16-22 peptides into fibrils through multi-step phase separation, while high dosages trap the peptides into coacervate intermediates and therefore inhibit the fibrillation. Consequently, the quantity of chaperone does not follow the intuition that ‘more is better’ for catalyzing assembly, but instead has an optimal molar ratio. Investigation reveals that the interplay and evolution of electrostatic and hydrophobic interactions between chaperones and peptides are the keys to achieving these processes. This study provides insights into the multifaceted roles artificial chaperones may play in a dosage-dependent manner, and enriches the toolkit for efficient and controllable construction of complex assembly systems.

Objective: The objective of this paper is to evaluate and analyze the contribution of the region of residence to the inequality of opportunity (IOp) in the utilization of reproductive healthcare services (RHCS) in Cameroon. Data source: The data used come from the last two Demographic and Health Surveys carried out in Cameroon in 2011 and 2018. Study design: The Human Opportunity Index (HOI) and the Dissimilarity Index (D-Index) are used to assess the level of IOp in the utilization of antenatal, delivery and postnatal healthcare. The Shapley decomposition method is used to estimate the contributions of circumstances to IOp. Principal findings: Findings show that between 2011 and 2018, HOI increased slightly for antenatal care and the place of delivery, and increased considerably for postnatal care. D-index is higher for the place of delivery and it fell slightly for all the reproductive healthcare outcomes between 2011 and 2018. Results of the Shapley decomposition show that (i) the region of residence is the circumstance factor with the highest contribution to the IOp no matter the reproductive healthcare outcome, and (ii) this contribution decreased between 2011 and 2018. Conclusion: This paper therefore recommends to the Government the gradual extension of the health voucher programme, implemented only in the three northern regions, to the other regions to make it possible to balance the access to adequate reproductive health care between the regions.

The 35 member states (MS) of the Pan American Health Organization (PAHO) have been committed to training physicians in leadership competencies since 2008. However, four reviews on teaching leadership using competency-based education (CBE) in undergraduate medical education (UME) identified only two MS: Canada and the USA that worked on identifying gaps in teaching leadership in UME. Previous reviews did not focus on factors influencing leadership education and did not use qualitative methodology to support their findings. Therefore, this review aims to identify facilitating and inhibiting factors in teaching leadership in UME using a scoping review and thematic analysis. Six databases containing grey and indexed literature in English, Spanish, and Portuguese were searched including hand search and authors’ consultations. Forty-eight documents out of 7849 were selected based on eligibility criteria. Braun and Clarke’s thematic analysis guide was used, resulting in seven themes: curriculum, intended learning outcomes, teaching methods, assessment, addressing barriers, supporting organizational change, and building networks. Considering these themes, the authors propose a critical route for teaching leadership in UME in the Americas. First, institutional design should consider governance gaps, such as having national and international policies for leadership in UME with an inter-professional, trans-professional, and citizen-focused approach. This means that there is a pressing need to equip physicians and other professionals from the government, academia, non-governmental organizations, hospitals, and national and international organizations whose missions are related to health or education with leadership competencies. Networking among actors for leadership education and teacher training is also essential. Second, instructional design reveals knowledge-do gaps in MS when incorporating leadership into the medical curriculum. This includes using leadership frameworks, defining learning outcomes, and employing assessment and monitoring tools for leadership education. Mechanisms to reduce these gaps in MS include the Equator Network and Evidence-Informed Policy Networks which foster knowledge translation and governance.

The brain‘s default mode network (DMN) and the executive control network (ECN) switch engagement influenced by the ventral attention network (VAN). Alterations in resting-state functional connectivity (RSFC) within this so-called triple network have been demonstrated in patients with major depressive disorder (MDD) or anxiety disorders (AD). This study investigated alterations in the RSFC in patients with comorbid MDD and ADs to better understand the pathophysiology of this prevalent group of patients. Sixty-eight participants (52.9 % male, mean age 35.25 years), consisting of 25 patients with comorbid MDD and ADs (MDD+AD), 20 patients with MDD only (MDD-AD) and 23 healthy controls (HC) were investigated clinically and with 3T resting-state fMRI. RSFC utilizing a seed-based approach within the three networks belonging to the triple network was compared between the groups. Compared to HC, MDD+AD showed significantly reduced RSFC between the ECN and the VAN, the DMN and the VAN and within the ECN. No differences could be found for the MDD group compared to both other groups. Furthermore, symptom severity and medication status did not affect RSFC values. The results of this study show a distinct set of alterations of RSFC for patients with comorbid MDD and AD compared to healthy controls. This set of dysfunctions might be related to less adequate switching between the DMN and the ECN as well as poorer functioning of the ECN. This might contribute to additional difficulties engaging and utilizing consciously controlled emotional regulation strategies.

Systems-of-Systems (SoS) are composed of multiple independent systems called constituents that, together, achieve a set of goals by means of emergent behaviors. Those behaviors can be deliberately planned as a combination of the individual functionalities (herein named as features) provided by the constituents. Currently, SoS engineers heavily rely on their own creativity and prior experience to combine the features and design the behaviors. However, the limitation of human perception in complex scenarios can lead to engineering sub-optimized SoS arrangements, potentially causing waste of the resources, sub-optimal services and reduction in quality. To handle the aforementioned issues, this article presents a machine learning-based mechanism for inferring/suggesting emergent behaviors that could be designed over a given set of constituents. An initial dataset was elaborated from a systematic mapping to feed the mechanism and a web-application was developed as a means for experts to evaluate this mechanism. Results revealed that the algorithm developed is capable of predicting feasible emergent behaviors for different sets of constituents and the system can be useful in the sense of aiding SoS engineers and experts in the bottom-up design of these behaviors.

Introduction: We present the application of pulsed-field ablation (PFA) for the treatment of para-Hisian accessory pathways (APs). Medthods: We consecutively enrolled patients diagnosed with paroxysmal supraventricular tachycardia (PSVT) to undergo PFA isolation. Two patients of this series exhibited para-Hisian AP and experienced frequent palpitations. The JJEC PFA catheter were used to deliver PFA applications. Results: No complications occurred, even when pulsed ablation was performed in proximity to the His bundle. During the 6-month follow-up visits, the patients remained free of palpitations and arrhythmias. Conclusions: This report suggests that PFA serve as a novel and effective modality for para-Hisian AP ablation.

Aims: To evaluate the effect of the combination of carotegrast methyl with rifampicin, a potent inhibitor of organic anion transporter polypeptide, on the pharmacokinetics (PK), safety and tolerability. Methods: In this 2 x 2 crossover study in 20 healthy Japanese adults, 10 subjects received carotegrast methyl 960 mg and rifampicin 600 mg on day 1, and received carotegrast methyl 960 mg on day 8. The subjects in the other sequence received the same treatments but in the opposite order. When the 90% confidence interval (CI) of the geometric mean ratio of the AUC0-t and Cmax for carotegrast, the main active metabolite of carotegrast methyl, with/without rifampicin fell within the range of 0.80 – 1.25, it was deemed that no PK interaction occurred. Adverse events (AEs) were monitored. Results: The Cmax and AUC0-t for carotegrast with/without rifampicin was 11724.5 ± 6097.6 vs 2620.1 ± 1843.0 ng mL-1, and 55046.0 ± 23427.8 vs 9849.9 ± 4580.6 ng h mL-1, respectively. The ratios (90% CI) of the Cmax and AUC0-t with/without rifampicin were 4.78 (3.64 – 6.29) and 5.59 (4.60 – 6.79), respectively, indicating carotegrast has a PK interaction with rifampicin. The combination with rifampicin also increased the exposure of carotegrast and its metabolites. The incidence of any AEs with/without rifampicin was five (25.0%) and one (5.0%), respectively. Conclusion: Coadministration of carotegrast methyl with rifampicin significantly increased exposure of carotegrast compared with carotegrast methyl administration alone. However, no increase in the incidence of adverse drug reactions due to coadministration with rifampicin was observed.

Aims: To evaluate drug-drug interactions between carotegrast methyl, a CYP3A4 inhibitor, and other CYP3A4 substrates, midazolam, atorvastatin, and prednisolone. Methods: A total of 88 healthy volunteers orally received carotegrast methyl 960 mg three times daily for 14 days. A single oral (5 mg) or intravenous (0.017 mg kg-1) midazolam, oral (5 mg) prednisolone, or oral (10 mg) atorvastatin was administered before, with, and after carotegrast methyl treatment. When the 90% confidence interval (CI) for the geometric mean ratios of the pharmacokinetic (PK) parameters with coadministration with carotegrast methyl (day 14) to those before carotegrast methyl administration was between 0.80 and 1.25, no PK interaction were deemed. Results: The Cmax and AUC0-t of oral midazolam before administration of carotegrast methyl was 30.9 ± 9.8 ng mL-1 and 74.5 ± 21.9 ng h mL-1, respectively. The geometric mean ratio of the Cmax and AUC0-t of midazolam on day 14 to those on day -1 was 1.86 (90% CI, 1.64 – 2.11) and 3.07 (90% CI, 2.81 – 3.35), which did not fall within the range of 0.80 – 1.25, suggesting that carotegrast methyl had a PK interaction with midazolam. Similar PK interactions were found for intravenous midazolam and atorvastatin, but not for prednisolone. The inhibitory effect of carotegrast methyl on CYP3A4-mediated metabolism of midazolam and atorvastatin had almost disappeared by 14 days after the end of administration. Conclusion: Carotegrast methyl was classified as a moderate CYP3A4 inhibitor in humans. Carotegrast methyl might enhance the action of drugs that are metabolized by CYP3A4.

Snowmelt drives a large portion of streamflow in many mountain areas of the world. However, the water pathways since snow melts until water reaches the streams, and its associated transit time is still largely unknown. Such processes are important for drawing conclusions about the hydrological role of the upstream snowpack after melting. This work analyzes for first time the influence of snowmelt on spring streamflow in years of different snow accumulation and duration, in an alpine catchment of the central Spanish Pyrenees. A multi-approach research was performed, by combining the analysis of climatic, snow, streamflow, piezometric levels, water temperature, electrical conductivity and isotopic (δ 18O) data. Results show that snow played a preeminent role on the hydrological response of the catchment during spring. Liquid precipitation during the melting period also determined the shape of the spring hydrographs. When snow cover disappeared from the catchment, soil water storage and streamflow showed a sharp decline. Consequently, streamflow electrical conductivity, temperature and δ 18O showed a marked tipping point towards higher values. The fast hydrological response of the catchment to snow and meteorological fluctuations, as well as the marked diel fluctuations of streamflow δ 18O during the melting period, strongly suggests soil storage was small, leading to short meltwater transit times. As a consequence of this hydrological behavior, independently of the amount of snow accumulated and of melting date, summer streamflow remained always low, with small runoff peaks driven by rainfall events. The expected reduction of snow accumulation and duration in the area in a next future will bring an earlier snowmelt and rise of stream water temperature. However, given the low storage capacity of the catchment and the contribution of rainfall events to spring runoff, the annual water balance and the runoff seasonality of the catchment would not change drastically.

Biodiesels constitute a growing class of fuel in the world which is increasingly inclined towards more ecological and sustainable energy. Despite their advantages, biodiesels are of limited cold flow properties and of larger NOx emissions, which are mostly attributed to the chemical composition of their oil feedstocks. This study presents a novel approach to produce Genetically Engineered Biodiesel from genetically manipulated oleaginous yeast oils for improving biodiesel properties and performances. Using full-factorial central composite design, the best chemical composition of an optimal biodiesel was predicted. Then, simple and combined MFE1, PEX10 and POX2 mutants of the oleaginous yeast Yarrowia lipolytica were constructed and showed interesting lipid profiles whose biodiesel is predicted to have better cold flow properties. These mutants showed also higher lipid titers by 2-3 folds compared to the parent strain. This study provides a genetic engineering strategy for tailor design of biodiesel properties and performance.

Extracellular vesicles (EVs) are categorized according to their formation mechanisms and come in three basic types: exosomes, microvesicles, and apoptotic bodies. Exosomes are a subtype of EVs, which are small, round sacs with a diameter of between 30 and 120 nm that are released by most cell types. Exosomes have the potential to be used as novel therapeutic agents as well as tools for the diagnosis and prognosis of various diseases. The main requirement for exosomal large-scale implementation in medical practice is rapid, easy, high purity, high yield isolation, and characterization processes. In this review, various isolation and characterization methods of exosomes are discussed together with their advantages and disadvantages.

This study conducted a thorough investigation into the impact of two emulsification techniques, namely high-pressure homogenization (HPH) and microfluidization (MF), on the emulsification of krill oil. The comprehensive analysis encompassed various aspects, including particle size characterization, structural assessment, oxidative stability evaluation during storage, measurement of bioaccessibility, and in vitro simulated digestion analysis. Emulsions produced through MF exhibited several noteworthy advantages over those generated by HPH. Most prominently, MF-prepared emulsions featured smaller and more uniformly distributed particles, in stark contrast to the less uniform particles generated by HPH. Moreover, MF-based emulsions demonstrated significantly enhanced oxidative stability during storage, with astaxanthin degradation occurring at a substantially lower rate (38.11% for HPH compared to 89.44% for MF). When assessing emulsion behavior during in vitro simulated digestion, microfluidization formulations exhibited superior stability and markedly higher bioaccessibility in comparison to their HPH counterparts. Of particular significance was the remarkable increase in the release of free fatty acids observed during the intestinal phase of digestion in MF emulsions, indicating an improved lipid digestion process. This study firmly establishes microfluidization as the superior method for crafting emulsions of krill oil, especially within the context of the food industry. Microfluidization not only ensures the preservation of oil quality during storage but also significantly enhances emulsion stability and promotes improved digestibility. These findings hold substantial promise for the development of delivery systems for n-3 fatty acids, making them suitable for incorporation into a wide range of commercial food, beverage, and pharmaceutical products.

Biodiesel (fatty acid methyl esters [FAME]) is a renewable biomass-based diesel (BBD) fuel made from plant oils, animal fats and waste greases. Its production continues to increase globally, especially with more countries moving to increase the use of renewable fuels. One of the main disadvantages of biodiesel is its relatively poor oxidative stability. During longer periods of storage at fuel terminals or in vehicle tanks and fuel systems, biodiesel can react with oxygen in ambient air, leading to degradation that can adversely affect its viscosity and ignition quality. The shelf-life of biodiesel is an important property that can determine the conditions such as how long it can be stored at low temperatures. The objective of this work is to develop mathematical equations to estimating the shelf-life of biodiesel at T = 25 °C. This was done by measuring the induction period by Rancimat instrument (IP R) at different temperatures and extrapolating the results using two types of linear models. Model equations were developed from regression analysis performed on results for canola, palm and soybean oil-FAME (CaME, PME and SME), methyl oleate (MeC18:1) and methyl linoleate (MeC18:2). The best results from confirmation analysis were obtained for Model B type equations. This model type correlated ln(IP R) with inverse T (T −1) data and provided the most realistic estimates of the shelf-life (SL B) of the five FAME studied in this work.

Surgical retrieval of embolized atrial septum defect closure device from right pulmonary veinYu Xiong1, Yongjun Qian2#1 Operating Room, Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.2 Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxuexiang 37th, 610041 Chengdu, Sichuan, P.R. China.# Correspondence: Yongjun Qian, No. 37 GuoXue Xiang, Chengdu, Sichuan, 610041, People’s Republic of China; fax: + 86 28 85422897; e-mail: qianyongjun@scu.edu.cn .

Heart diseases and oncologic diseases are more often found simultaneously worldwide. There is an increasing tendency of both diseases’ incidence due to better diagnostic approaches and increasing aging population. Patients often come to hospital to treat one disease, but during preparation to surgery are found to have another additional. The present study represents the clinical case of patients with concomitant heart and colon disease. The patient underwent simultaneous surgery: CABG and laparoscopic anterior resection. The post-operative period went well with no complications. Patient was discharged with recommendations and referred to further rehabilitation. The chosen treatment method is consistent by many studies and was the best option for our patient.

For 40 years MAGIC has been used to simulate the acidification of soils and waters due to acid deposition. The original model has now been updated and re-implemented in the C++ Mobius platform and is available as open source. New features include multipoint calibration, forest growth, and a soil carbon module. The Mobius platform facilitates automatic optimisation of calibrated parameters and multiple-calibrations using Monte-Carlo routines. The usefulness of MAGIC is demonstrated by application to the 50-year data series for deposition and runoff at Birkenes, a small, calibrated catchment in southern Norway. Acid deposition has declined dramatically at Birkenes since the peak in the 1970s. Sulphate is 90% lower. Stream water has recovered strongly. Decreased concentrations of sulphate have led to increased acid neutralising capacity, pH and reduced concentrations of toxic aluminium. These changes are well-simulated by MAGIC. The new features added as part of Mobius improve the simulations. The MAGIC-Mobius modelling tool is now available for applications to scenarios of land-use and climate change.

In cell encapsulation, a suitable environment is provided for cell growth, proliferation and differentiation. Alginate hydrogel is an ideal medium for encapsulating cells and facilitating the production of cartilage tissue due to its desirable properties. Also using Layer by layer assembly of polyelectrolytes on microcapsules could be an ordinary imitation of zonal organization of cartilage and force hypoxia to cells encapsulated. In this project, alginate and chitosan, which are structurally similar to glycosaminoglycans, were assembled layer by layer on alginate microcapsules containing mesenchymal stem cells. The formation of these nanolayers was checked using uv-vis absorption technique and the amount of water absorption of different samples was determined within a week. FESEM images showed that the microcapsules have a completely porous and interconnected structure and the cells were well entrapped inside them. The results of AO/PI staining revealed that the cells showed viability for 7 days. The results of alcian blue staining, antibody staining and the expression of genes demonstrated that cartilaginous differentiation has occurred completely in the S10 sample, which has maximum number of nanolayers. These results showed that the hypoxia applied due to the assembly of nanolayers has an effective role in the differentiation of mesenchymal stem cells into chondrocyte cells.

For decades community ecology has examined empirical relationships between ecosystem productivity and diversity. Despite this long history, tests of hypothesized mechanisms, namely the interplay between environmental filtering, biotic interactions, and dispersal, are lacking, largely due to their intractability using traditional approaches. Across a productivity gradient in a serpentine grassland in California, USA, we coupled occupancy data for four annual plants with persistence measures of paired transplants under natural conditions and reduced biotic interactions with neighbors. We found a positive relationship between productivity and biodiversity (i.e., the proportion of our four focal species found in a location) despite strong competition limiting species persistence in productive environments. Additionally, across species and for the community, we found a strong mismatch between occupancy and persistence, largely due to dispersal excess. Our results suggest that biodiversity-productivity relationships can be largely driven by dispersal and its interactive effects with local biotic and abiotic conditions.

A LITTLE MORE THAN JUST AIR AND FLUID: AN UNCOMMON CASE OF HYDROPNEUMOTHORAXDr. Akash Sengupta1, Dr. Saikat Dutta21 senior resident, department of chest medicine;2 Professor and head of the department, department of medicine, MJN medical college and hospital, Cooch behar, West BengalEmail:akashsengupta09@gmail.com (corresponding author)

Objective: Emotion intolerance and perfectionism are two maintaining mechanisms to eating disorder psychopathology. However, it is unclear how these mechanisms relate to one another. This study explored whether perfectionism is a vulnerability factor for facets of restrictive eating in the context of body-related emotions. Methods: Female undergraduate students ( N=148) completed questionnaires assessing baseline levels of self-critical perfectionism and personal standards perfectionism. Participants then engaged in an ecological momentary assessment protocol where body-related emotion intolerance and restrictive eating facets (cognitive restraint and behavioural restriction) were assessed over 10 consecutive days. Multi-level modeling and simple slopes analysis were used to explore these moderated relationships. Results: Based on the analyses, both self-critical and personal standards perfectionism dimensions interacted with body-related emotion intolerance to predict increases in restrictive eating facets. Conclusion: These findings indicate that personal standards perfectionism, though conceptualized as the less maladaptive dimension of perfectionism, should not be ignored in eating disorder conceptualizations and treatments. Recommendations are provided on how to refine treatment targets to be more attuned with situations that elicit body-related emotion intolerance.

Microorganisms are implicated in the irreversible degradation that usually occurs during the distribution and storage of food items. This action proceeds as biological and/or chemical reactions in foods, handling wares, and food processing facilities, and are also dependent on other several environmental factors. This review discusses the main mechanisms involved in the loss of food quality for most important food items, including the growth and associated metabolism of microorganisms resulting in the possible changes, formation of toxic compounds with adverse biological effects, and the subsequent counteractive effects of antibacterial elements used in food handling (with emphasis on copper). Meanwhile, as food spoilage poses a huge economic burden worldwide, evidence shows that the knowledge of spoilage mechanisms and food interactions with microorganisms is still limited, and in effect, perspectives and outlooks are presented as guides for the future design of wares for food handling applications.

1. While territoriality is one of the key mechanisms influencing carnivore space use, most studies quantify resource selection and movement in the absence of conspecific influence or territorial structure without inference on resource selection processes. 2. Our analysis incorporated intra-specific competition in a resource selection framework, via territorial data of conspecifics, to investigate mechanisms of territoriality and to better understand the role of neighboring packs on African wild dog habitat selection. We fit integrated step selection functions to 3-hour GPS data from 12 collared wild dog packs in the Okavango Delta, and estimated selection coefficients using a conditional Poisson likelihood with random effects. 3. Packs selected for the outline of their neighbors’ 30-day boundary (defined as their 90% kernel density estimate), and for the outline of their own 90-day core (defined as their 50% kernel density estimate). Neighbors’ 30-day boundary had a greater influence on resource selection than any habitat feature. Habitat selection differed when they were within versus beyond their neighbors’ 30-day boundary. 4. Pack size, pack age, pup presence, and seasonality all mediated how packs responded to neighbors, and seasonal dynamics altered the strength of residency. While newly-formed packs and packs with pups avoided their neighbors’ boundary, older packs and those without pups selected for it. Packs also selected for the boundary of larger neighboring packs more strongly than that of smaller ones. 5. Social structure within packs has implications for how they interact with conspecifics, and therefore how they are distributed across the landscape. Future research should continue to investigate how territorial processes are mediated by social dynamics and, in turn, how territorial structure mediates resource selection and movement. These results could inform the development of a human-wildlife conflict (HWC) mitigation tool by co-opting the mechanisms of conspecific interactions to manage space use of endangered carnivores.

Goals This multicenter, retrospective research aims to compare effectiveness and tolerability of paclitaxel-based chemotherapy combined with immune checkpoint inhibitors (ICIs) versus chemotherapy alone as a first-line treatment of HER2-negative AGC in a real-world setting. Background Platinum-based chemotherapy combined with ICIs is now becoming the standard first-line therapy of HER2-negative AGC. In China, paclitaxel has shown good efficacy and tolerability in AGC as an alternative for first-line therapy. Combining ICIs with paclitaxel-based chemotherapy may lead to improved tumor immune microenvironment, but evidence in paclitaxel combing with ICIs as first-line regimen is lacking. Methods 86 patients with HER2-negative AGC were enrolled from 2017 to 2022. Among them, 57 patients received paclitaxel-based chemotherapy plus ICIs, and 29 patients received paclitaxel-based chemotherapy alone. We compared the efficacy and incidence of adverse events between the two therapy options. Results Significant improvements in median PFS (8.77 versus 7.47 months; P=0.048) and median OS (15.70 versus 14.33 months; P=0.048) were observed in the ICIs combined with paclitaxel-based chemotherapy group. Meanwhile, the ICIs plus chemotherapy group demonstrated significantly improved ORR (50.9% vs. 27.6%; P=0.039) and DCR (98.3% vs. 82.8%; P=0.015), and the side effects were tolerable. Conclusion In summary, for HER2-negative AGC, ICIs plus paclitaxel-based chemotherapy is effective with mild toxicities, which should be considered as an alternative first-line therapy regimen.