[Clinical characteristics and prognosis of five children with maturity onset of diabetes of the young 12 subtype]

Objective: To analyze the genetic and clinical characteristics, treatment and prognosis of patients diagnosed with maturity onset of diabetes of the young (MODY) 12 subtype. Methods: This retrospective study collected and analyzed data from 5 children with MODY12 subtype caused by ABCC8 gene variants who underwent inpatient and outpatient genetic testing at Beijing Children's Hospital from January 2016 to December 2023. Their clinical and genetic features, treatment, and follow-up results were analyzed. Results: Among the 5 patients with MODY12 subtype, 4 were male and 1 was female, with an age of 13.4 (5.5, 14.6) years. Four of the patients were born large for gestational age, while one was born small for gestational age. Two patients were overweight or obese. Three patients exhibited typical symptoms of diabetes, while 2 were incidentally found to have elevated blood glucose level. One patient was found to have diabetic ketoacidosis at onset, who was diagnosed with congenital hyperinsulinism during the neonatal period and received diazoxide treatment, and experienced intellectual developmental delay. All 5 patients had autosomal dominant inherited diabetes within 3 generations. The fasting blood glucose at onset was 7.5 (6.5, 10.0) mmol/L, the haemoglobin, A1c (HbA1c) was 11.8% (7.5%, 13.5%), and the fasting C-peptide was 1.2 (1.1, 2.2)μg/L. The duration of follow-up was 15 (9, 32) months. One patient underwent lifestyle intervention, two received metformin orally, one received insulin therapy, and the other received subcutaneous injection of insulin combined with sulfonylurea orally. At the last follow-up, the median fasting blood glucose was 6.1 (5.1, 7.0) mmol/L, the HbA1c was 5.9% (5.7%, 7.1%), and the fasting C-peptide was 1.7 (0.9, 2.9)μg/L. One patient developed diabetic retinopathy. There were 4 missense variations in ABCC8 gene and one in-frame deletion, all of which were maternally inherited heterozygotes. Conclusions: MODY12 subtype is a heterogeneous disorder with the age of onset from infancy to adolescence. It can present as mild hyperglycemia or diabetic ketoacidosis, and has a high incidence of obesity. Definitive diagnosis can be achieved through genetic test, and individualized treatment is recommended based on glucose levels.

Systematic identification and expression analysis of bHLH gene family reveal their relevance to abiotic stress response and anthocyanin biosynthesis in sweetpotato

BACKGROUND

bHLH transcription factors play significant roles in regulating plant growth and development, stress response, and anthocyanin biosynthesis. Sweetpotato is a pivotal food and industry crop, but little information is available on sweetpotato bHLH genes.

RESULTS

Herein, 227 putative IbbHLH genes were defined on sweetpotato chromosomes, and fragment duplications were identified as the dominant driving force for IbbHLH expansion. These IbbHLHs were divided into 26 subfamilies through phylogenetic analysis, as supported by further analysis of exon-intron structure and conserved motif composition. The syntenic analysis between IbbHLHs and their orthologs from other plants depicted evolutionary relationships of IbbHLHs. Based on the transcriptome data under salt stress, the expression of 12 IbbHLHs was screened for validation by qRT-PCR, and differential and significant transcriptions under abiotic stress were detected. Moreover, IbbHLH123 and IbbHLH215, which were remarkably upregulated by stress treatments, had obvious transactivation activity in yeasts. Protein interaction detections and yeast two-hybrid assays suggested an intricate interaction correlation between IbbHLHs. Besides, transcriptome screening revealed that multiple IbbHLHs may be closely related to anthocyanin biosynthesis based on the phenotype (purple vs. white tissues), which was confirmed by subsequent qRT-PCR analysis.

CONCLUSIONS

These results shed light on the promising functions of sweetpotato IbbHLHs in abiotic stress response and anthocyanin biosynthesis.

Parental preferences for rotavirus vaccination for their children under 5 years old in China: A discrete choice experiment

Rotavirus vaccination is the most effective means to prevent rotavirus gastroenteritis, but its coverage in China is not ideal. We aimed to explore parental preferences for rotavirus vaccination for their children under 5years old to improve vaccination coverage. A Discrete Choice Experiment was conducted online on 415 parents with at least one child under 5years old in 3 cities. Five attributes including vaccine effectiveness, protection duration, risk of mild side-effects, out-of-pocket costs, and time required for vaccination were identified. Each attribute was set at three levels. Mixed-logit models were used to measure parental preferences and the relative importance of vaccine attributes. The optimal vaccination strategy was also explored. 359 samples were included in the analysis. The impacts of the vaccine attribute levels on vaccine choice were all statistically significant (p < .01), except for 1-hour vaccination time. The risk of mild side-effects was the most important factor influencing vaccination. The time required for vaccination was the least important attribute. The largest increase in vaccination uptake (74.45%) occurred with decreased the vaccine risk of mild side-effects from 1/10 to 1/50. The predicted vaccination uptake of the optimal vaccination scenario was 91.79%. When deciding about vaccination, parents preferred the rotavirus vaccination with lower risk of mild side-effects, higher effectiveness, longer protection duration, 2-hour vaccination time and lower cost. The authorities should support enterprises to develop vaccines with lower side-effects, higher effectiveness and longer protection duration in the future. We call for appropriate government subsidies for the rotavirus vaccine.

TFAM Modulates Cardiomyocytes Pyroptosis Induced by Ionizing Radiation through mtDNA/TLR9/NF-kB Pathway

PURPOSE/OBJECTIVE(S)

Mitochondrial transcription factor A (TFAM) is a pivotal factor for regulating mitochondrial DNA (mtDNA) replication, transcription and biogenesis. Previous studies have reported that cytosolic mtDNA stress can lead to cardiomyocytes pyroptosis, which is characterized by inflammasome formation. In this study, we attempted to investigate the mechanism of TFAM regulate cardiomyocytes pyroptosis induced by ionizing radiation.

MATERIALS/METHODS

The peripheral blood serum of patients with esophageal cancer before and after definitive chemoradiotherapy was collected for Luminex multiplex cytokine assays. C57BL/6 mice were irradiated with the whole heart using small animal radiation research platform (SARRP) to construct a radiation-induced myocardial damage (RIMD) mouse model, and the ventricular function was evaluated using 9.4T Bruker magnetic resonance (MR) scanner. The function changes of cardiomyocytes exposed to radiation were observed in vitro and in vivo after knocking out GSDMD. Furthermore, the changes of mitochondrial function, the levels of cytosolic mtDNA, and the protein levels of NF-kB and pyroptosis pathway in irradiated cardiomyocytes were analyzed by knockdown and overexpression of TFAM in vitro and in vivo.

RESULTS

By multifactor cytokine assays we found that pyroptosis related IL-1β and IL-18 were significantly increased in patients with high mean heart dose (MHD) after radiotherapy, while those with low MHD were not significantly increased after radiotherapy. Next, we successfully constructed the RIMD mouse model using a single heart irradiation of 20 Gy. We found that the gene expression of pyroptosis pathway was significantly up-regulated after cardiac irradiation by myocardial tissue transcriptomic sequencing. Compared with wild-type (WT) mice, cardiac systolic function of Gsdmd-/- mice was significantly improved at 1, 2, 6, 12, and 24 weeks after heart irradiation. In vitro, we also demonstrated increased viability of irradiated cardiomyocytes by knocking out GSDMD. In vitro and in vivo experiments confirmed the expression of TFAM decreased after radiation. By overexpression of TFAM, we found that irradiated cardiomyocytes showed improved mitochondrial function, decreased release of mtDNA into cytoplasm through mitochondrial permeability transition pores (mPTPs), decreased binding of cytosolic mtDNA to TLR9, and decreased expression of NF-kB and pyroptosis pathway proteins. Dual luciferase gene reporter assays and Chromatin immunoprecipitation (CHIP) assay confirmed that p65 could bind the NLRP3 promoter region. In addition, we found that ventricular function deteriorated and improved in mice with knockdown and overexpression of TFAM through adeno-associated virus serotype 9 (AAV9), respectively.

CONCLUSION

Our study indicated that TFAM regulate irradiated cardiomyocytes pyroptosis through mtDNA/TLR9/NF-kB pathway. We provide a novel mechanism of RIMD, revealing an underappreciated intervention target for RIMD.

Safety and Efficacy Analysis of Patients with Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Treated with SHR-1316 Plus Chemotherapy and Sequential Chest Radiotherapy as First-Line Therapy from a Phase II Trial

PURPOSE/OBJECTIVE(S)

CAPSTONE-1, a phase 3 trial, showed that SHR-1316 (PD-L1 antibody) combined with standard first-line chemotherapy could prolong overall survival (OS) in patients (pts) with ES-SCLC. The CREST trial reported consolidative thoracic radiotherapy (TRT) of 30 Gy in 10 fractions provided a 10% 2-year OS benefit and more intensive TRT should be investigated in ES-SCLC. In the era of immunotherapy, the role of TRT also needs further exploration. Therefore, we designed this clinical trial to investigate the efficacy and safety of SHR-1316 plus first-line chemotherapy followed by TRT combined with SHR-1316.

MATERIALS/METHODS

Key inclusion criteria were pts aged 18-75 years, with previously untreated histologically or cytologically confirmed ES-SCLC, and an ECOG performance status of 0-1. Eligible pts would receive 4∼6 cycles of SHR-1316 (20mg/kg, D1, q3w) combined with EP/EC (etoposide, 100mg/m2, D1-5, q3w and cisplatin, 75mg/m², D1-3, q3w or carboplatin, AUC = 5, D1, q3w), followed by SHR-1316 combined with TRT (≥3 Gy*10 f or ≥2 Gy*25 f, involved-field irradiation), and then the maintenance therapy with SHR-1316 until disease progression or intolerable adverse events (AEs). The main endpoints included ORR, PFS and safety.

RESULTS

From October 2020 to January 2023, 33 pts received SHR-1316 and sequential consolidative TRT. Among them, 19 pts received high-dose TRT (>3 Gy*10 f or ≥2 Gy*25 f) and 14 pts received low-dose TRT (≤3 Gy*10 f or<2 Gy*25 f). The median age was 62 (range: 38-73). Most pts were male (28, 84.8%), former smokers (22, 66.7%) with an ECOG performance status 1 (32, 97%). Ten (30.3%) pts were diagnosed with brain metastasis and 10 (30.3%) pts had liver metastasis at baseline. At the data cutoff date, 9 pts remained on treatment, the average number of treatment cycles was 9.2. 33 pts had at least one 1 post-treatment tumor assessment. The confirmed ORR and DCR were 90.9% (30/33) and 100% (33/33) in all pts, were 89.5% (17/19) and 100% (19/19) in high-dose TRT group, and were 92.9% (13/14) and 100% (14/14) in low-dose TRT group. The median PFS was 10.2(CI: 5.8∼14.7) months in all pts, was 7 (CI: 3.8∼10.2) months in high-dose TRT group and 10.4 (CI: 8.4∼12.3) months in low-dose TRT group. AEs occurred in 27 (81.8%) pts and grade 3 or 4 AEs occurred in 20 (60.6%) pts. The most common grade 3 or 4 AEs included neutropenia (15, 45.5%), leukopenia (8, 24.2%), lymphocytopenia (5, 15.2%), pneumonia (3, 9.1%), anemia (3, 9.1%) and thrombocytopenia (2, 6.1%).

CONCLUSION

SHR-1316 plus chemotherapy and sequential TRT as first-line therapy for ES-SCLC showed promising efficacy and acceptable safety. There is no significant difference between high-dose and low-dose TRT groups in terms of safety and efficacy according to current data.

Performance Evaluation in Automatic Plan Generation for Ethos Intelligent Optimization Engine

PURPOSE/OBJECTIVE(S)

To evaluate the automatic optimization performance and clinical feasibility of the Intelligent Optimization Engine (IOE) of Ethos online adaptive radiotherapy platform.

MATERIALS/METHODS

Eleven patients with cervical cancer treated with Halcyon accelerator were retrospectively selected. All the patients manually planned with four full arc volume rotating intensity modulated radiotherapy (VMAT) (Manual-4Arc), and the prescription dose was 45 Gy/25F. All patient images and structures were imported into Ethos simulator, and clinical goals were added appropriately based on clinical requirements. The target coverage was normalized to 95%. 7F, 9F, 12F IMRT plans and 2Arc, 3Arc VMAT plans were automatically generated by IOE. Dosimetric index comparisons were made among the Manual-4Arc plans and five group IOE generated plan to evaluate the automatic optimization performance of IOE.

RESULTS

In terms of hot dose area, for PTV, D1% of IMRT-12F plans was the lowest, and there were significant differences between IMRT-12F plans and Manual-4Arc plans (46.936 ± 0.241 vs 48.639 ± 2.395, p = 0.004); In terms of target coverage, the CTVs of all groups meet clinical requirements. Although the Ethos online adaptive plans have been normalized during planning, the PTV coverage is slightly insufficient (12F: 94.913 ± 0.154; 9F: 94.585 ± 1.148). For OARs close to target, such as bladder, V30Gy, V40Gy and Dmean have significant differences among the six group plans. The order of bladder dose is basically followed by IMRT-12F

CONCLUSION

The plans automatically generated by Ethos IOE can achieve similar performance as the manual plan, and the automatically generated IMRT-12F and 9F plans are preferred for clinical use.

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Dose DIBH Really Reduce the Subclinical Cardiac Acute Injury? Analysis of Clinical Real World from Our Institute

PURPOSE/OBJECTIVE(S)

The study is aim to investigate whether Deep-inspirational breath-hold (DIBH), compared with free breathing (FB), could provide a short-term cardiac benefit in patients with early left breast cancer after breast-conserving surgery combined whole breast radiotherapy.

MATERIALS/METHODS

A total of 78 patients with early stage left breast cancer treated with radiotherapy between 2021-2022 after breast-conserving surgery were enrolled. Among them, 32 cases were treated with DIBH technique and 46 cases were treated with free breathing. Patients with previous cardiac disease such as coronary artery disease were excluded. We performed myocardial enzymes, ECG, and ECHO in all patients within 2 weeks before, during, and 6 months after radiotherapy. The results of the two groups were compared using nonparametric tests and chi-square tests, and P < 0.05 indicated statistical significance. Where subclinical acute cardiac injury was defined as new above-normal myocardial enzymes and/or electrocardiographic ST-T or T-wave changes and/or ECHO abnormalities after the start of radiotherapy.

RESULTS

The median follow-up of patients was 6 months and the mean age of patients was 52.3 years for FB and 44.9 years for DIBH. There were no significant differences in staging, molecular subtype, chemotherapy and endocrine therapy history. The proportion of subclinical acute cardiac injury was smaller in the DIBH group compared to the FB group (DIBH = 31/46 and FB = 28/32, p = 0.042). The most sensitive of the subclinical acute cardiac injury events were detected by myocardial enzymes rising, with cTnI (p = 0.034) and NT-proBNP (p = 0.023) appearing significantly lower in the DIBH patients during radiotherapy. The difference of cTnI between 2 groups at 6 months after radiotherapy became non-significant. In contrast, CK-MB was higher in DIBH compared with FB only 6 months after radiotherapy (p = 0.006). The differences in ECG and ECHO were not significant between the two groups.

CONCLUSION

After breast-conserving surgery combined with radiotherapy for left early breast cancer, DIBH compared to FB reduces the proportion of acute subclinical cardiac injury that occurs with the most sensitive changes in myocardial enzymes. Subsequent studies will explore the relationship between the short-term subclinical injury and irradiated dose, as well as long term cardiac injury.

The Predictive Value of Changes in Basal Myocardial F-18 Fluorodeoxyglucose Uptake for Cardiotoxicity in Locally Advanced Esophageal Cancer Patients Receiving Definitive Radiotherapy

PURPOSE/OBJECTIVE(S)

To investigate the predictive value of changes in myocardial 18F-FDG uptake for major adverse cardiac events (MACEs) in locally advanced esophageal cancer patients receiving definitive radiotherapy.

MATERIALS/METHODS

Between August 2012 and January 2018, 400 patients with stage II-III esophageal cancer receiving definitive radiotherapy at two institutions were divided into the training (n = 240) and external validation cohorts (n = 160). All patients underwent FDG-PET imaging within 1 week before treatment and 3 months after treatment. Myocardium delineation was performed by Carimas software (version 2.10) based on the AHA 17-segment model. When contouring the left ventricle, the myocardium was automatically divided into basal (segments 1-6), middle (segments 7-12), and apical (segments 13-16) regions, and the mean dose and FDG uptake parameters of each region were obtained by Carimas. Our primary endpoint was MACEs. Patient clinicopathologic factors, dosimetric parameters for the whole heart and cardiac substructures, and myocardial changes within the three regions on 18F-FDG PET were utilized to seek the best predictive models for cardiotoxicity. To avoid multicollinearity between dose-volume histogram (DVH) parameters, we selected the variables with the lowest Akaike Information Criterion (AIC) value from the DVH parameters of the same cardiac structure for the actual modeling procedure. Competing risk analysis and Cox regressions analysis were performed. The predictive performance of the models was evaluated using the area under the receiver operating characteristic curve (AUC) and Brier score.

RESULTS

At a median follow-up interval of 78 months, 28 patients (11.7%) developed MACEs. The basal region of the myocardium received the highest radiation dose, followed by the middle and the apex region. The basal myocardial SUVmax and SUVmean significantly increased after radiotherapy while the apical and middle myocardial SUVmax and SUVmean not significantly increased. In univariate analysis, age, pre-existing cardiac disease, changes in pre- and post-treatment basal myocardial SUVmax and SUVmean (∆SUVmax and ∆SUVmean), and dosimetric parameters for MHD, mean LCX, mean LAD, and mean LV dose were associated with an increased hazard of MACEs. Multivariate analysis showed that basal ∆SUVmean retained significance after adjusting for age, pre-existing cardiac disease, and dosimetric parameters for whole heart and cardiac substructures. The AUCs and Brier scores demonstrated favorable predictive accuracies of the model's integrating variables with significant difference in multivariate analysis when predicting MACEs in the training and validation cohorts.

CONCLUSION

∆SUVmean was an independent indicator of MACE in locally advanced esophageal cancer patients receiving definitive radiotherapy. Changes in basal myocardial FDG uptake is a promising biomaker for predicting radiation-induced cardiotoxicity.

PD-L1 Inhibitors Combined with Thoracic Radiotherapy in First-Line Treatment of Extensive Stage Small Cell Lung Cancer: A Propensity Score-Matched, Real-World Study

PURPOSE/OBJECTIVE(S)

The CREST study showed that the addition of thoracic radiotherapy (TRT) could improve the survival of extensive stage small cell lung cancer (ES-SCLC), but whether TRT can bring survival benefit in the era of immunotherapy is controversial. This study aims to explore the efficacy and safety of adding TRT to the combination of PD-L1 inhibitors and chemotherapy.

MATERIALS/METHODS

Thepatients who received PD-L1 inhibitors combined with platinum-based chemotherapy as the first-line treatment of ES-SCLC from January 2019 to December 2021 were retrospectively collected. According to whether they received TRT, they were divided into two groups, and the follow-up analysis was performed. Propensity score matching (PSM) in with a 1:1 ratio was performed to balance the baseline characteristics of the two cohorts. The endpoints were progression-free survival (PFS) and OS.

RESULTS

A total of 211 patients with ES-SCLC were enrolled, of whom 70 (33.2%) patients received standard therapy plus TRT as first-line treatment, and 141 (66.8%) patients in the control group received PD-L1 inhibitors plus chemotherapy. After PSM, a total of 65 pairs of patients were enrolled in the analysis. There were no significant differences in baseline characteristics between the two groups of patients who received TRT and those who did not. In all patients, the median PFS (mPFS) in the TRT group and the non-TRT groupwere 9.5 months and 7.2 months, respectively, with HR = 0.60 (95% CI 0.41-0.87, p = 0.007). The median OS (mOS) in the TRT group was also significantly longer than that in the non-TRT group (24.1 months vs. 18.5 months, HR = 0.53, 95% CI 0.32-0.85, p = 0.009). Multivariable analysis showed that baseline liver metastasis and bone metastasis were independent prognostic factors for OS. In terms of safety, immunotherapy combined with thoracic radiotherapy increased the incidence of treatment-related pneumonia (p<0.001), most of which were grade 1-2.

CONCLUSION

This real-world study shows that adding TRT to durvalumab or atezolizumab plus chemotherapy significantly improves survival in ES-SCLC. It leads to more treatment-related pneumonia, but most of them can be relieved after symptomatic treatment. This treatment model deserves to be explored in prospective clinical trials.

Enhanced Radiosensitivity of Esophagus Cancer through Loss of ADAR1 and Cell Apoptosis via NF-kB Signaling Pathway

PURPOSE/OBJECTIVE(S)

RNA editing is a common posttranslational mechanism for generating genomic diversity by modifying selected RNA sequences without altering the genome. A new understanding of cancer therapy can be enhanced by the discovery of ADAR1 in the control of signal transduction pathways. However, the study of the biological effects of ADAR1 in radioresistance of esophageal cancer is not very deep.

MATERIALS/METHODS

The TCGA data sets were used to explore the correlations between ADAR1 and prognosis in esophageal cancer. Two pairs of ADAR1 gene siRNA fragments (siADAR1-1 and siADAR1-2) were designed and transiently transfected into KYSE410 cells and KYSE410-RT cells. The expression of ADAR1 was detected by RT-PCR and WB. Colony formation assay was used to evaluate the radiosensitivity. Apoptosis was measured using a flow cytometric apoptosis assay. Furthermore, transcriptome sequencing was performed to elucidate the pathways regulated by ADAR1.

RESULTS

In this study, we found that ADAR1 is overexpressed in esophageal tumors and is associated with poor prognosis in bioinformatics analysis. Colony formation experiment showed that siRNA-mediated depletion of ADAR1 in KYSE410 cells could inhibit cell proliferation and reduce radiosensitivity significantly. Consistently results were showed in KYSE410-RT cells. Mechanism studies revealed loss of ADAR1 induced cell apoptosis and radiotherapy could enhance this process. Transcriptomic data indicated that ADAR1 could regulate apoptosis through the NF-kB pathway.

CONCLUSION

RNA editing was found to be involved in the regulation of radiosensitivity of esophageal cancer and loss of ADAR1 can cause cell apoptosis though NF-kB pathway. A better understanding of A-to-I RNA editing and its oncogenic mechanisms may facilitate the development of radiotherapy in esophageal cancer.

NHC-mediated photocatalytic deoxygenation of alcohols for the synthesis of internal alkynes via a Csp3-Csp coupling reaction

NHC-mediated deoxygenation of alcohols under photocatalytic conditions is described. The process provides various alkyl radicals, which can react with 1-bromoalkyne via Csp3-Csp coupling to afford internal alkynes in moderate to good yields. The method offers a new and convenient approach to synthesize internal alkynes.

Comparative Analysis of the PYL Gene Family in Three Ipomoea Species and the Expression Profiling of IbPYL Genes during Abiotic Stress Response in Sweetpotato

Abscisic acid (ABA), a critical phytohormone that regulates plant development and stress response, is sensed by the ABA receptors PYR/PYL/RCAR (PYLs). The PYL genes have been widely studied in multiple plant species, while a systematic analysis of PYL genes in the genus Ipomoea remains unperformed. Here, a total of 13, 14, and 14 PYLs were identified in Ipomoea batatas, Ipomoea trifida, and Ipomoea triloba, respectively. Fragment duplication was speculated to play prominent roles in Ipomoea PYL gene expansions. These Ipomoea PYLs were classified into three subfamilies via phylogenetic analysis, which was supported by exon-intron structures and conserved motif analyses. Additionally, the interspecies collinearity analysis further depicted a potential evolutionary relationship between them. Moreover, qRT-PCR analysis showed that multiple IbPYLs are highly and differentially responsive to abiotic stress treatments, suggesting their potential roles in sweetpotato stress responses. Taken together, these data provide valuable insights into the PYLs in the genus Ipomoea, which may be useful for their further functional analysis of their defense against environmental changes.

Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or Δ L ∼ 0.56 ) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L ∼ 5 - 7 at dusk, while a smaller subset exists at L ∼ 8 - 12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L -shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼ 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.

[Advances in clinical characteristics of talaromycosis combined with other opportunistic infections]

Talaromycosis (TSM) is an opportunistic deep mycosis prevalent in southeast Asia and southern China, affecting HIV-positive, anti-interferon-gamma autoantibody-positive and other immunodeficiency hosts. These hosts are often co-infected with mycobacterium tuberculosis, non-tuberculosis mycobacteria, bacteria, fungi, viruses and other opportunistic infections. The clinical characteristics and the pathogenic spectrum of TSM with opportunistic infections vary with different immune states. The rates of misdiagnosis, missed diagnosis and mortality are high. This review summarized the clinical characteristics of TSM with opportunistic infections in order to improve the level of clinical diagnosis and treatment.

[Persistence follow-up of immune memory to hepatitis B vaccine among infants with non- and low-response to primary vaccination after revaccination with three doses]

This study followed up the immune memory after 3-dose revaccination among infants with non-and low-response following primary hepatitis B (HepB) vaccination. About 120 children without self-booster doses were finally included who had anti-HBs<10 mIU/ml (anti-HBs negative) at the time of follow-up, of whom 86 children completed blood sampling and anti-HBs testing. Before the challenge dose, all 86 children were negative for anti-HBs, and the GMC of anti-HBs was<10 mIU/ml. The seropositive conversion rate of anti-HBs was 100% and the GMC of anti-HBs was 886.11 (95%CI: 678.15-1 157.84) mIU/ml after the challenge dose. Compared with those with GMC<7 mIU/ml before the challenge dose, infants with GMC>7 mIU/ml had a higher anti-HBs level after the challenge dose. The β value (95%CI) was 0.82 (0.18-1.46) (P=0.012). Compared with those with GMC<1 000 mIU/ml at primary vaccination, infants with GMC≥1 000 mIU/ml had a higher anti-HBs level after the challenge dose. The β value (95%CI) was 0.78 (0.18-1.38)(P=0.012). The results showed a stronger immune memory was found at 9 years after revaccination among infants with non-and low-response to HepB.

Genome-wide survey and expression analysis of Dof transcription factor family in sweetpotato shed light on their promising functions in stress tolerance

DNA-binding with one finger (Dof) transcription factors play a crucial role in plant abiotic stress regulatory networks, although massive Dofs have been systematically characterized in plants, they have not been identified in the hexaploid crop sweetpotato. Herein, 43 IbDof genes were detected to be disproportionally dispersed across 14 of the 15 chromosomes of sweetpotato, and segmental duplications were discovered to be the major driving force for the expansion of IbDofs. The collinearity analysis of IbDofs with their related orthologs from eight plants revealed the potential evolutionary history of Dof gene family. Phylogenetic analysis displayed that IbDof proteins were assigned into nine subfamilies, and the regularity of gene structures and conserved motifs was consistent with the subgroup classification. Additionally, five chosen IbDof genes were shown to be substantially and variably induced under various abiotic conditions (salt, drought, heat, and cold), as well as hormone treatments (ABA and SA), according to their transcriptome data and qRT-PCR experiments. Consistently, the promoters of IbDofs contained a number of cis-acting elements associated with hormone and stress responses. Besides, it was noted that IbDof2 had transactivation activity in yeasts, while IbDof-11/-16/-36 did not, and protein interaction network analysis and yeast two-hybrid experiments revealed a complicated interaction connection amongst IbDofs. Collectively, these data lay a foundation for further functional explorations of IbDof genes, especially with regards to the possible application of multiple IbDof members in breeding the tolerant plants.

The unique sweet potato NAC transcription factor IbNAC3 modulates combined salt and drought stresses

Plants often simultaneously experience combined stresses rather than a single stress, causing more serious damage, but the underlying mechanisms remain unknown. Here, we identified the stress-induced IbNAC3 from sweet potato (Ipomoea batatas) as a nucleus-localized transcription activator. IbNAC3 contains a unique activation domain whose MKD sequence confers transactivation activities to multiple other TFs and is essential for the activated expression of downstream target genes. Ectopic expression of IbNAC3 conferred tolerance to single and combined salt and drought stresses in Arabidopsis (Arabidopsis thaliana), and a group of NAM, ATAF1/2, and CUC2 (NAC) TFs, including ANAC011, ANAC072, ANAC083, ANAC100, and NAP, interacted with IbNAC3, and the specific domains responsible for each interaction varied. Intriguingly, IbNAC3 repressed the interaction among the five NACs, and knockout or mutation of ANAC011 and ANAC072 dramatically impaired combined stress tolerance. IbNAC3-ANAC072 and IbNAC3-NAP modules synergistically activated the MICROTUBULE-RELATED E3 LIGASE57 (MREL57) gene. Consistently, mutation of MREL57 and overexpression of WAVE-DAM-PENED2-LIKE7, encoding a target protein of MREL57, both remarkably impaired combined stress tolerance. Moreover, transgenic plants displayed abscisic acid (ABA) hyposensitivity by directly promoting the transcription of ENHANCED RESPONSE TO ABA 1, a key negative regulator of ABA signaling. The data unravel the unique IbNAC3 TF functions as a pivotal component in combined stress tolerance by integrating multiple regulatory events and ubiquitin pathways, which is essential for developing high-tolerant plants in natural environments.

A systematical genome-wide analysis and screening of WRKY transcription factor family engaged in abiotic stress response in sweetpotato

BACKGROUND

WRKY transcription factors play pivotal roles in regulating plant multiple abiotic stress tolerance, however, a genome-wide systematical analysis of WRKY genes in sweetpotato is still missing.

RESULTS

Herein, 84 putative IbWRKYs with WRKY element sequence variants were identified in sweetpotato reference genomes. Fragment duplications, rather than tandem duplications, were shown to play prominent roles in IbWRKY gene expansion. The collinearity analysis between IbWRKYs and the related orthologs from other plants further depicted evolutionary insights into IbWRKYs. Phylogenetic relationships displayed that IbWRKYs were divided into three main groups (I, II and III), with the support of the characteristics of exon-intron structures and conserved protein motifs. The IbWRKY genes, mainly from the group Ib, displayed remarkable and diverse expression profiles under multiple abiotic stress (NaCl, PEG6000, cold and heat) and hormone (ABA, ACC, JA and SA) treatments, which were determined by RNA-seq and qRT-PCR assays, suggesting their potential roles in mediating particular stress responses. Moreover, IbWRKY58L could interact with IbWRKY82 as revealed by yeast two-hybrid based on the protein interaction network screening. And abiotic stress-remarkably induced IbWRKY21L and IbWRKY51 were shown to be localized in the nucleus and had no transactivation activities.

CONCLUSION

These results provide valuable insights into sweetpotato IbWRKYs and will lay a foundation for further exploring functions and possible regulatory mechanisms of IbWRKYs in abiotic stress tolerance.

To what extent do social support and mastery mediate the association between childhood maltreatment and depression? A sequential causal mediation analysis

AIMS

This study aimed to examine the independent roles of various childhood maltreatment (CM) subtypes in the development of depression; quantify the joint mediation effect of social support and mastery in the association between subtypes of CM and depression and examine the additional contribution of mastery beyond the effect that is operating through social support to this relationship.

METHODS

Data analysed were from the Zone d'Épidémiologie Psychiatrique du Sud-Ouest de Montréal, an ongoing longitudinal population-based study. In total, 1351 participants with complete information on the studied variables were included. The propensity score matching and inverse-probability weighted regression adjustment estimation methods were used to minimise the potential confounding in the relationship between CM and major depression. We then used inverse odds ratio-weighted estimation to estimate the direct effects of maltreatment and indirect effects of social support and mastery.

RESULTS

We found that exposures to all maltreatment subtypes increased the risk of subsequent depression. The joint mediating effect of social support and mastery explained 37.63-46.97% of the association between different maltreatment subtypes and depression. The contribution of these two mediators differed by maltreatment subtypes, with social support being the major contributor to the mediating effect.

CONCLUSIONS

The findings of the study not only provide scientific evidence on the importance of psychosocial attributes in the development of major depression but also suggest that prevention and invention strategies should focus on these psychosocial attributes to effectively break the vicious cycle of CM on major depression.