Automatic Machine Learning to Differentiate Pediatric Posterior Fossa Tumors on Routine MR Imaging

BACKGROUND AND PURPOSE

Differentiating the types of pediatric posterior fossa tumors on routine imaging may help in preoperative evaluation and guide surgical resection planning. However, qualitative radiologic MR imaging review has limited performance. This study aimed to compare different machine learning approaches to classify pediatric posterior fossa tumors on routine MR imaging.

MATERIALS AND METHODS

This retrospective study included preoperative MR imaging of 288 patients with pediatric posterior fossa tumors, including medulloblastoma (n = 111), ependymoma (n = 70), and pilocytic astrocytoma (n = 107). Radiomics features were extracted from T2-weighted images, contrast-enhanced T1-weighted images, and ADC maps. Models generated by standard manual optimization by a machine learning expert were compared with automatic machine learning via the Tree-Based Pipeline Optimization Tool for performance evaluation.

RESULTS

For 3-way classification, the radiomics model by automatic machine learning with the Tree-Based Pipeline Optimization Tool achieved a test micro-averaged area under the curve of 0.91 with an accuracy of 0.83, while the most optimized model based on the feature-selection method χ2 score and the Generalized Linear Model classifier achieved a test micro-averaged area under the curve of 0.92 with an accuracy of 0.74. Tree-Based Pipeline Optimization Tool models achieved significantly higher accuracy than average qualitative expert MR imaging review (0.83 versus 0.54, P < .001). For binary classification, Tree-Based Pipeline Optimization Tool models achieved an area under the curve of 0.94 with an accuracy of 0.85 for medulloblastoma versus nonmedulloblastoma, an area under the curve of 0.84 with an accuracy of 0.80 for ependymoma versus nonependymoma, and an area under the curve of 0.94 with an accuracy of 0.88 for pilocytic astrocytoma versus non-pilocytic astrocytoma.

CONCLUSIONS

Automatic machine learning based on routine MR imaging classified pediatric posterior fossa tumors with high accuracy compared with manual expert pipeline optimization and qualitative expert MR imaging review.

Association of Mycobacterium tuberculosis L-formmpb64 gene and lung cancer

OBJECTIVE

Tuberculosis is one of the most infectious diseases worldwide and lung cancer is one of the leading causes of death. The major contagious agent for tuberculosis, Mycobacterium tuberculosis (M. tuberculosis), has been well studied for its pathogenicity. Even though there are studies showing that patients with a history of tuberculosis are more likely to develop lung cancer, the association between M. tuberculosis and lung cancer largely remains unknown. In this study, we used in situ hybridization to analyze lung tissues from patients who underwent surgical resection or bronchoscopy for the expression of M. tuberculosis-specific gene, mpb64, to provide evidence for the association of M. tuberculosis L-form to the occurrence of lung cancer.

PATIENTS AND METHODS

Experiments were conducted in the lung cancer group (80 cases), pulmonary tuberculosis group (80 cases) and pulmonary tuberculosis plus lung cancer group (77 cases). For each group of tissue samples, in situ hybridization was used to detect the expression of mpb64 gene fragment in cell nuclei.

RESULTS

Mpb64 gene was positively expressed in 45% (CI: 38.63-51.37) of the cancerous cell nuclei. When compared to the expression level of 66.25% (CI: 59.88-72.62) in the pulmonary tuberculosis cells, the difference was statistically significant (p=0.007). However, when compared to the expression of 49.35% (CI: 42.98-55.72) in pulmonary tuberculosis plus lung cancer cells, the difference was not statistically significant (p=0.585). Mpb64 gene expression level was independent from the different tissue types, pathological stages, or metastasis situations in the lung cancer group (p>0.05).

CONCLUSIONS

The mpb64 gene fragment is highly expressed in the nucleus of pulmonary tuberculosis tissues. Its expression in the nucleus of pulmonary tuberculosis plus lung cancer tissue is significant and the expression in the nucleus of lung cancer tissue is also high. The expression of mpb64 is independent from the various pathological features of the cancerous tissues. Taken all together, we provided evidence for the correlation of M. tuberculosis L form and the occurrence of lung cancer. Thus, patients with a history of tuberculosis may be more likely to develop lung cancer than those without a history of tuberculosis.

Transcription Factors BLH2 and BLH4 Regulate Demethylesterification of Homogalacturonan in Seed Mucilage

The polysaccharide pectin is a major component of the plant cell wall. The pectic glycan homogalacturonan (HG) is a proportionally small but important component of a specialized seed cell wall called mucilage. HG is synthesized in a highly methylesterified form, and, following secretion, is de-methylesterified by pectin methylesterases (PMEs). The degree of methylesterification of HG determines the structural and functional properties of pectin, but how methylesterification is regulated remains largely unknown. Here, we identified two BEL1-Like homeodomain (BLH) transcription factors, BLH2 and BLH4, as positive regulators of HG de-methylesterification in Arabidopsis (Arabidopsis thaliana) seed coat mucilage. BLH2 and BLH4 were significantly expressed in mucilage secretory cells during seed mucilage production. BLH2 and BLH4 single mutants exhibited no obvious mucilage phenotype, but the blh2 blh4 double mutant displayed significantly reduced mucilage adherence to the seed. Reduced mucilage adherence in blh2 blh4 was caused by decreased PME activity in the seed coat, which increased the degree of methylesterification of HG in mucilage. The expression of several PME metabolism-related genes, including PME58, PECTIN METHYLESTERASE INHIBITOR6, SEEDSTICK, and MYB52 was significantly altered in blh2 blh4 seeds. BLH2 and BLH4 directly activated PME58 expression by binding to its TGACAGGT cis-element. Moreover, pme58 mutants exhibited reduced mucilage adherence similar to that of blh2 blh4, and the blh2 blh4 pme58 triple mutant exhibited no additional mucilage adherence defects. Furthermore, overexpression of PME58 in blh2 blh4 rescued the mucilage adherence defect. Together, these results demonstrate that BLH2 and BLH4 redundantly regulate de-methylesterification of HG in seed mucilage by directly activating PME58.

An empirical study on waste generation rates at different stages of construction projects in China

Estimation of construction waste generation is critical to construction waste management decisions. However, current construction waste estimation methods have various limitations (e.g. small samples). To address those limitations, this research conducts an empirical study to evaluate the waste generation rate of different types of waste at different construction stages. In this study, construction waste from 148 new-built residential construction sites in China were sorted and weighted on site and their waste generation rates were estimated separately. The results indicated that the amount of inorganic nonmetallic waste with a generation rate of 16.59 kg m^-2 was the highest among the five types of waste (i.e. inorganic nonmetallic waste, organic waste, metallic waste, composite waste, hazardous waste), while the waste generation rate for the underground construction stage, which was 27.57 kg m^-2, was the highest among the three stages (i.e. underground stage, superstructure stage, finishing stage). Compared with previous data, the new waste generation rate proposed in this research can better estimate the actual waste generation situation in construction sites, which provides reliable information for proper decision-making. Furthermore, based on the result of the empirical study, some recommendations for construction waste reduction are proposed.

Genome-wide identification and expression profiling of HD-ZIP gene family in Medicago truncatula

The homeodomain-leucine zipper (HD-ZIP) transcription factors are important regulators in various developmental processes and responses to environmental stimuli. Currently, little information is available for HD-ZIP gene family in Medicago truncatula. Here we perform a genome-wide analysis of HD-ZIP gene family in M. truncatula. Totally 52 M. truncatula HD-ZIPs (MtHDZs) were identified and classified into four distinctive subfamilies (I to IV). Members clustered in the same subfamily shared similar gene structure and protein motifs. Fifty-one MtHDZs were non-evenly distributed on eight chromosomes. Segmental duplication and purifying selection mainly contributed to the expansion and retention of M. truncatula HD-ZIP gene family. Expression profiling using the publicly available microarray data revealed that MtHDZ genes exhibited distinctive tissue-specific patterns and divergent responses to drought and salt stresses. In addition, the expression profile between each paralogous pair diverged differentially. Our results identified potential targets for the genetic improvement of abiotic stress tolerance in Medicago.

Variation trends and principal component analysis of nitrogen oxide emissions from motor vehicles in Wuhan City from 2012 to 2017

In addition to fine particulate matter and oxysulfides, nitrogen oxides (NO_x) emitted by motor vehicles are among the most important pollutants affecting air quality and public health in those urban areas where centralized heating and chemical industry absent. We utilized correlation analysis (pearson correlation coefficient and spearman correlation coefficient) and principal component analysis (PCA) to identify the variation trends and main causes of NO_x emissions from motor vehicles in Wuhan City. We considered the total number of motor vehicles (TN), ratios of motor vehicles of different emission standards (RE), rations of labeled motor vehicles (RL), and rations of motor vehicles' fuel types (RF). The results show that: 1) with an increase in the total amount of motor vehicles, the NO_x emissions of motor vehicles have been decreasing since 2015; 2) three sub-categories (the ratio of the State III emission standard, the ration of yellow label diesel vehicles, and the ration of diesel vehicles) were recognized as key indexes of PE, PL and PF, respectively, in the PCA; 3) a new parameter, the ES_index is proposed as an index to represent the variation trend of the NO_x emissions of motor vehicles in Wuhan City.

Surprisingly good thermoelectric performance of a black phosphorus/blue phosphorus van der Waals heterostructure

Thermoelectric properties of a black phosphorus/blue phosphorus van der Waals heterostructure are investigated by using first-principles calculations and Boltzmann transport theory for both electrons and phonons.

[Clinical characteristics of left atrial appendage thrombus in patients with hypertrophic cardiomyopathy and non-valvular atrial fibrillation]

Objective: To investigate the incidence and clinical characteristics of left atrial appendage (LAA) thrombus in patients with hypertrophic cardiomyopathy (HCM) and non-valvular atrial fibrillation (AF) . Methods: Data from 10 440 patients with AF who had undergone transesophageal echocardiography (TEE) before cardioversion or catheter ablation at Beijing Anzhen Hospital from April 2006 to December 2018 were retrospectively screened. Two hundred and five HCM patients were included, 820 AF patients with the same CHA(2)DS(2)-VASc score over the same period were selected as the control group. HCM patients were divided into two subgroups based on presence or absence of LAA thrombus/sludge. The baseline of clinical information, transthoracic echocardiographic and TEE measures were compared among all the groups. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of left atrial diameter (LAD) for LAA thrombus/sludge. Multivariate logistic regression analysis was applied to analyze the correlative factors of LAA thrombus/sludge in HCM patients. Results: The incidences of LAA thrombus or sludge were higher in HCM group than in control group (10.7% (22/205) vs. 0.7% (6/820); 8.8% (18/205) vs.7.0% (57/820), P<0.001) . In HCM patients, LAD was significantly larger in LAA thrombus/sludge subjects than in those without thrombus/sludge ((48.9±5.1)mm vs. (45.2±6.1) mm, P<0.001). CHA(2)DS(2)-VASc score was similar between the two subgroups ((2.0±1.4) vs. (1.8±1.4), P>0.05). There was no difference in the rate of patients with a CHA(2)DS(2)-VASc scores ≥2 between the subgroups(62.5% (25/40) vs. 57.0% (94/165), P=0.525). The incidences of LAA thrombus in HCM and AF patients with CHA(2)DS(2)-VASc scores of 0, 1 and 2 were 8.8% (3/34) , 9.6% (5/52) , 11.8% (11/119) , respectively; and the rate of LAA sludge were 8.8% (3/52) , 7.7% (4/52) , 9.2% (11/119) , respectively. The cut off value of LAD for the diagnosis of LAA thrombus/sludge was 44.5 mm. Multivariate logistic regression analysis showed that LAD≥44.5 mm (OR=5.134, 95%CI 1.862-14.156, P=0.002) , non-paroxysmal AF (OR=2.782, 95%CI 1.238-6.252, P=0.013) , previous thromboembolism or stroke (OR=1.820, 95%CI 0.774-4.227, P=0.017) were independent determinants of LAA thrombus/sludge. Conclusions: The incidence of LAA thrombus/sludge is higher in patients with HCM and AF than in AF patients without HCM. The CHA(2)DS(2)-VASc score is similar between HCM and AF patients with LAA thrombus/sludge and those without thrombus/sludge. Patients with CHA(2)DS(2)-VASc score 0-1 are also likely to suffer LAA thrombus/sludge. Left atrial enlargement is associated with LAA thrombus/sludge.

Comparison of Unenhanced and Gadolinium-Enhanced Imaging in Multiple Sclerosis: Is Contrast Needed for Routine Follow-Up MRI?

BACKGROUND AND PURPOSE

Gadolinium enhanced MRI is routinely used for follow-up of patients with multiple sclerosis. Our aim was to evaluate whether enhancing multiple sclerosis lesions on follow-up MR imaging can be detected by visual assessment of unenhanced double inversion recovery and FLAIR sequences.

MATERIALS AND METHODS

A total of 252 consecutive MRIs in 172 adult patients with a known diagnosis of multiple sclerosis were reviewed. The co-presence or absence of associated double inversion recovery and FLAIR signal abnormality within contrast-enhancing lesions was recorded by 3 neuroradiologists. In a subset of patients with prior comparisons, the number of progressive lesions on each of the 3 sequences was assessed.

RESULTS

A total of 34 of 252 MRIs (13%) demonstrated 55 enhancing lesions, of which 52 (95%) had corresponding hyperintensity on double inversion recovery and FLAIR. All lesions were concordant between double inversion recovery and FLAIR, and the 3 enhancing lesions not visible on either sequence were small (<2 mm) and cortical/subcortical (n = 2) or periventricular (n = 1). A total of 17 (22%) of the 76 MRIs with a prior comparison had imaging evidence of disease progression: Ten (59%) of these showed new lesions on double inversion recovery or FLAIR only, 6 (35%) showed progression on all sequences, and 1 (6%) was detectable only on postcontrast T1, being located in a region of confluent double inversion recovery and FLAIR abnormality.

CONCLUSIONS

There was a high concordance between enhancing lesions and hyperintensity on either double inversion recovery or FLAIR. Serial follow-up using double inversion recovery or FLAIR alone may capture most imaging progression, but isolated enhancing lesions in confluent areas of white matter abnormality could present a pitfall for this approach.

Intraoperative TOE guided management of newly diagnosed severe tricuspid regurgitation and pulmonary hypertension during orthotopic liver transplantation: a case report demonstrating the importance of reversibility as a favorable prognostic factor

Background

Tricuspid regurgitation (TR) and pulmonary hypertension (PHT) are highly dynamic cardiovascular lesions that may progress rapidly, particularly in the orthotopic liver transplantation (OLT) waitlist population. Severe TR and PHT are associated with poor outcomes in these patients, however it is rare for the two to be newly diagnosed intraoperatively at the time of OLT. Without preoperative information on pulmonary vascular and right heart function, the potential for reversibility of severe TR and PHT is unclear, making the decision to proceed to transplant fraught with difficulty.

Case presentation

We present a case of successful orthotopic liver transplantation (OLT) in a 48 year old female with severe (PHT) (mean pulmonary arterial pressure > 55 mmHg) and severe TR diagnosed post induction of anaesthesia. The degree of TR was associated with systemic venous pressures of > 100 mmHg resulting in massive haemorrhage during surgery and difficulty in distinguishing venous from arterial placement of vascular access devices. Intraoperative transoesophageal echocardiography (TOE) proved crucial in diagnosing functional TR due to tricuspid annular and right ventricular (RV) dilatation, and dynamically monitoring response to treatment. In response to positioning, judicious volatile anaesthesia administration, pulmonary vasodilator therapy and permissive hypovolemia during surgery we noted substantial improvement of the TR and pulmonary arterial pressures, confirming the reversibility of the TR and associated PHT.

Conclusion

TR and PHT are co-dependent, dynamic, load sensitive right heart conditions that are interdependent with chronic liver disease, and may progress rapidly in patients waitlisted for OLT. Use of intraoperative TOE and pulmonary artery catheterisation on the day of surgery will detect previously undiagnosed severe TR and PHT, enable rapid assessment of the cause and the potential for reversibility. These dynamic monitors permit real-time assessment of the response to interventions or events affecting right ventricular (RV) preload and afterload, providing critical information for prognosis and management. Furthermore, we suggest that TR and PHT should be specifically sought when waitlisted OLT patients present with hepatic decompensation.

Electronic supplementary material

The online version of this article (10.1186/s12871-019-0795-6) contains supplementary material, which is available to authorized users.

Strain-induced rich magnetic phase transitions and enhancement of magnetic stability for O-terminated h-BN nanoribbons

Mono-layered h-BN and its derivatives are very important low-dimensional materials, which have been widely investigated so far. Here, we theoretically study the structural stability and magneto-electronic properties of oxygen (O) terminated zigzag-edged h-BN nanoribbons, especially focusing on strain tuning effects. The O dimerization at the B edge of the ribbon enhances the system stability greatly. A Poisson ratio of 0.2 and bearing a strain more than 20% can be reached. In the absence of strain, the O-terminated ribbon is a magnetic metal. However, the rich magnetic phase transitions among the non-magnetic metal, a spin gapless semiconductor, and a wide-gap half-metal can be realized continuously by applying strain in the ferromagnetic state. Thus, based on such a material feature, we can design a magnetic switch device which can work between the magnetic and non-magnetic states by strain modification. Also shown is that the magnetism stability can be enhanced to the level at room temperature upon strain, and the massless Dirac-fermion behavior for the β-spin state can be clearly detected in the spin gapless semiconductor phase under appropriate strains.

Spin-dependent carrier mobility and its gate-voltage modifying effects for functionalized single walled black phosphorus tubes

Phosphorene and its derivatives so far have attracted substantial research interest due to its promising properties for developing nanoscale electronic devices. Here, we present a theoretical investigation on the functionalized features, such as the improved electronic structure and carrier mobility, for armchair-edged single walled black phosphorus nanotubes (PNTs) with the substitutional doping of low-concentration transition-metal atoms (Ti, Mn, Fe, and Ni). They are predicted to be exceptional magnetic semiconductors (MSCs), such as half-semiconductor or bipolar MSC. Their spin-resolved carrier mobility at room temperature holds doping element- dependence as well as carrier and spin polarity. Particularly, the difference by two orders of magnitude for carrier mobility emerges due to different TM doping. More interestingly, the carrier mobility in armchair PNTs serving as the channel material of a spin field effect transistor is predicted to be modified strongly by a gate voltage. The enhanced carrier mobility and its gate voltage direction-dependent behavior, as well as the more obvious carrier and spin polarity of mobility, can be observed clearly under gate voltage, which further facilitates the separation of different carriers and spin states and also suggests that realistic carrier mobility is gate voltage-dependent in a field effect transistor.

Tubby-like Protein 2 regulates homogalacturonan biosynthesis in Arabidopsis seed coat mucilage

A possible transcription factor TLP2 was identified to be involved in the regulation of HG biosynthesis in Arabidopsis seed mucilage. TLP2 can translocate into nucleus from plasma membrane by interacting with NF-YC3. The discovery of TLP2 gene function can further fulfill the regulatory network of pectin biosynthesis in Arabidopsis thaliana. Arabidopsis seed coat mucilage is an excellent model system to study the biosynthesis, function and regulation of pectin. Rhamnogalacturonan I (RG-I) and homogalacturonan (HG) are the major polysaccharides constituent of the Arabidopsis seed coat mucilage. Here, we identified a Tubby-like gene, Tubby-like protein 2 (TLP2), which was up-regulated in developing siliques when mucilage began to be produced. Ruthenium red (RR) staining of the seeds showed defective mucilage of tlp2-1 mutant after vigorous shaking compared to wild type (WT). Monosaccharide composition analysis revealed that the amount of total sugars and galacturonic acid (GalA) decreased significantly in the adherent mucilage (AM) of tlp2-1 mutant. Immunolabelling and dot immunoblotting analysis showed that unesterified HG decreased in the tlp2-1 mutant. Furthermore, TLP2 can translocate into nucleus by interacting with Nuclear Factor Y subunit C3 (NF-YC3) to function as a transcription factor. RNA-sequence and transactivation assays revealed that TLP2 could activate UDP-glucose 4-epimerase 1 (UGE1). In all, it is concluded that TLP2 could regulate the biosynthesis of HG possibly through the positive activation of UGE1.

Abstract P5-04-17: Local network topology differences between early and late recurrence in ER+ breast cancers

Background: Late recurrence is characteristic of ER+ breast cancers. Despite an apparently effective adjuvant endocrine therapy, many breast cancers recur years after their initial endocrine treatment. Why some tumors recur early (&lt;3 years) and some recur later (&gt;5 years) is poorly understood. If systemic endocrine therapies killed all cells, recurrence would reflect only the appearance of new disease. Thus, we hypothesized that cells that survive and lie dormant may be driven, in part, by altered wiring of their cell death signaling. We, therefore, studied how cell death signaling is differentially wired in primary tumors that will recur early versus those that will recur later.

Method: Genes involved in apoptosis, autophagy, ferroptosis, necrosis, and pyroptosis were identified from KEGG to initiate network feature analysis of gene expression data from public and our first in-house gene expression dataset. Data were collected from ER+ breast cancer pre-endocrine treatment samples with up to 20 years follow-up. Publicly available datasets used were GSE6532, GSE2034, GSE7390, GSE17705, GSE12093, and TCGA. We applied our Knowledge-fused Differential Dependency Network (KDDN) analysis tool to the public datasets; KDDN has provided powerful new insights into signaling in breast and other cancers. Common gene-gene interactions (edges) predicted in at least two different datasets were extracted from all KDDN analyses results. To strengthen the relevance of these features, predicted network edges that represent known protein-protein interactions (PPI) were identified from the STRING database, and these edges were noted in the signaling graphs. Final network graphs were constructed using the common edges from all overlaid networks. We conducted IPA analysis on all nodes in the final network and selected those incorporating network hubs. We took a similar approach to our second in-house dataset, which we used for independent testing. Here, patients were included if their tumor exhibited an initial reduction in volume of at least 40% by four months in response to neo-adjuvant Letrozole. Patients were then classified into two groups during follow-up of up to 3.7 years: i) initial tumor size reduction followed by continued response (expected to recur late); ii) initial reduction followed by tumor regrowth (expected to recur early). KDDN analysis was performed on pretreatment samples from these two groups and a network created annotated with PPI information.

Results: MAPK8 and CYCS (Molecular Mechanisms of Cancer, p=1.58E-52), TNFRSF1A Neuroinflammation Signaling Pathway, p=1.26E-54), RELA, and NFKB1 (Colorectal Cancer Metastasis Signaling, p=7.94E-35), were identified as hubs. Hubs may be critical signaling components driving the differences between tumors that will become dormant and recur late. Connections between SLC25A6 and SQSTM1 (p = 0.008), BIRC2 and GABARAP (p = 0.021) in the early group, and AKT3 and IRS2 (p = 0.014) in the late group, were shared between the two final networks. With longer follow-up time on the second in-house dataset, we will better define the two groups and identify additional common phenotype specific gene-gene interactions.

Citation Format: Clarke R, Dixon M, Jin L, Pearce D, Turnbull A, Selli C, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Sims A, Liu MC. Local network topology differences between early and late recurrence in ER+ breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-17.

A novel Miscanthus NAC transcription factor MlNAC10 enhances drought and salinity tolerance in transgenic Arabidopsis

NAC (NAM, ATAF1/2 and CUC2) proteins are key regulators of various plant stress tolerances. However, knowledge of NAC genes remains largely unknown in Miscanthus. Here, we characterized a novel NAC gene MlNAC10 from M. lutarioriparius than plays a role in abiotic stress tolerance. MlNAC10 encodes a nuclear-localized protein with a C-terminal transactivation domain, and has a specific binding affinity to the NAC recognition sequence (NACRS). Ectopic expression of MlNAC10 in Arabidopsis led to increased sensitivity to abscisic acid (ABA) at early seedling growth stages. In addition, the proline content was significantly increased and the reactive oxygen species (ROS) scavenging capability was significantly enhanced in MlNAC10 overexpression lines under ABA treatment. Moreover, the drought and salt stress tolerance was significantly improved in MlNAC10 overexpression lines. Consistently, the activities of three antioxidant enzymes, namely catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD), were dramatically stimulated in the overexpression lines compared to the wild type (WT). Correspondingly, the accumulation of ROS was dramatically decreased and malondialdehyde (MDA) was accumulated at a much lower level in the transgenic lines. Meanwhile, the expression of six abiotic stress-related genes was dramatically stimulated in the overexpression lines in comparison to the WT. Together, our results demonstrated that MlNAC10 acts as an important regulator of drought and salinity stress tolerance by stimulating antioxidant enzymes and alleviating ROS damage via the ABA signaling pathway.

Pacemaker-driven Tachycardia Induced by Electrocardiograph Monitoring in the Recovery Room

Monitoring devices are known to induce tachycardia in minute-ventilation rate-responsive pacemakers. This is because some monitoring devices measure the same parameter as do the pacemakers (change in thoracic impedance). Hence, the biological signal to the pacemaker is increased and is misconstrued as increased minute ventilation causing tachycardia which resolves when the monitoring device is removed. Whilst this could occur for all minute-volume rate responsive pacemakers, most reported interactions have been with the Telectronics META series. We present a case of an interaction between a Telectronics Tempo DR pacemaker (St. Jude Medical) and an Agilent Patient Care System (Philips). Failure to recognise the true nature and cause of such tachycardias may lead to mismanagement of the patient, including the inappropriate use of cardio-active medications.

Dual antiplatelet therapy reduced stroke risk in high-risk patients with transient ischaemic attack assessed by ABCD3-I score

BACKGROUND AND PURPOSE

Several clinical trials have demonstrated that dual antiplatelet therapy (DAPT) benefited patients with transient ischaemic attack (TIA) with an ABCD2 score ≥4. The present study aimed to investigate whether the ABCD3-I score could be a more appropriate tool for selection of patients with TIA to receive DAPT in real-world settings.

METHODS

We derived data from the TIA database of The First Affiliated Hospital of Zhengzhou University. The predictive outcome was ischaemic stroke at 90 days. The additive interaction effect was presented by the attributable proportion due to interaction. Kaplan-Meier curves were plotted to present cumulative stroke rates in different risk categories with monotherapy and DAPT. Cox proportional hazards regression was used to determine risk factors associated with stroke.

RESULTS

Among 785 patients, the mean (SD) age was 56.95 (12.73) years and 77 patients (9.8%) had an ischaemic stroke at 90 days. A total of 55.8% of patients (attributable proportion due to interaction; 95% confidence interval, 20.8%-90.9%) were attributed to additive interaction of ABCD3-I score and antiplatelet therapy. Kaplan-Meier curves showed a significant difference between patients receiving monotherapy and DAPT in high-risk patients with TIA (P = 0.021). DAPT reduced 90-day stroke risk in high-risk patients with TIA as assessed independently by ABCD3-I score (adjusted hazard ratio, 0.43; 95% confidence interval, 0.20-0.92, P = 0.031). The benefit did not exist in low- and medium-risk patients by ABCD3-I score (patients with ABCD2 score ≥ 4 or <4).

CONCLUSIONS

High-risk patients with TIA assessed by ABCD3-I score received the most pronounced clinical benefit from early use of DAPT in real-world clinical experience.

Genome-Wide Analysis of Sorghum GT47 Family Reveals Functional Divergences of MUR3-Like Genes

Sorghum (Sorghum bicolor) is an important bioenergy crop. Its biomass mainly consists of the cellulosic and non-cellulosic polysaccharides, both which can be converted to biofuels. The biosynthesis of non-cellulosic polysaccharides involves several glycosyltransferases (GT) families including GT47. However, there was no systemic study on GT47 family in sorghum to date. Here, we identified 39 sorghum GT47 family members and showed the functional divergences of MURUS3 (MUR3) homologs. Sorghum GT47 proteins were phylogenetically clustered into four distinct subfamilies. Within each subfamily, gene structure was relatively conserved between the members. Ten gene pairs were identified from the 39 GT47 genes, of which two pairs might be originated from tandem duplication. 25.6% (10/39) of sorghum GT47 genes were homologous to Arabidopsis MUR3, a xyloglucan biosynthesis gene in primary cell walls. SbGT47_2, SbGT47_7, and SbGT47_8, three most homologous genes of MUR3, exhibited different tissue expression patterns and were selected for complementation into Arabidopsis mur3-3. Physiological and cell wall analyses showed that SbGT47_2 and SbGT47_7 may be two functional xyloglucan galactosyltransferases in sorghum. Further studies found that MUR3-like genes are widely present in the seed plants but not in the chlorophytic alga Chlamydomonas reinhardtii. Our results provide novel information for evolutionary analysis and functional dissection of sorghum GT47 family members.