Glutamate Chemical Exchange Saturation Transfer (GluCEST) MRI to Evaluate the Rapid Antidepressant Effects of Ketamine in the Hippocampus of Rat Depression Model

BACKGROUND

Ketamine is a quick acting antidepressant drug, and an accurate detection method is lacking. Ketamine's effects in a rat depression model have not previously been well explored using glutamate chemical exchange saturation transfer (GluCEST).

PURPOSE

To investigate the GluCEST changes of chronic unpredictable mild stress (CUMS) rats after receiving either ketamine or saline injection.

STUDY TYPE

Randomized animal model trial.

ANIMAL MODEL

12 CUMS and 6 Sprague-Dawley rats. Divided into three groups: ketamine (N = 6), saline (N = 6), and control (N = 6).

FIELD STRENGTH/SEQUENCE

7.0 T/the sequence is GluCEST and 1 H MR spectroscopy (MRS).

ASSESSMENT

The CUMS rats were exposed to different stress factors for 8 weeks. The glutamate concentration in the hippocampus was assessed by the GluCEST,1 H MRS, and the high-performance liquid chromatography (HPLC).

STATISTICAL TESTS

The t-test, Mann-Whitney U test, and Pearson's correlation.

RESULTS

In depression conditions, GluCEST signals were lower in the bilateral hippocampus than in control group. Thirty minutes after ketamine injection, the GluCEST signals in the bilateral hippocampus were higher compared with the saline group (left: 2.99 ± 0.34 [Control] vs. 2.44 ± 0.20 [Saline] vs. 2.85 ± 0.11 [Ketamine]; right: 2.97 ± 0.28 [Control] vs. 2.49 ± 0.25 [Saline] vs. 2.86 ± 0.19 [Ketamine]). In 1 H MRS, significant changes were only observed in the left hippocampus (2.00 ± 0.16 [Control] vs. 1.81 ± 0.09 [Saline] vs. 2.04 ± 0.14 [Ketamine]). Furthermore, HPLC results showed similar trends to those observed in the GluCEST results (left: 2.32 ± 0.22 [Control] vs. 1.96 ± 0.11 [Saline] vs. 2.18 ± 0.11 [Ketamine]; right: 2.35 ± 0.18 [Control] vs. 1.87 ± 0.16 [Saline] vs. 2.09 ± 0.08 [Ketamine]).

DATA CONCLUSION

GluCEST can sensitively evaluate the ketamine's antidepressant effects by detecting the fast increase in glutamate concentration.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY STAGE: 1.

Relationship between serum uric acid in early pregnancy and gestational diabetes mellitus: a prospective cohort study

PURPOSE

The association between serum uric acid (UA) and gestational diabetes mellitus (GDM) was still unclear. Serum UA levels in pregnancy differed from that in non-pregnancy. This study aimed to investigate the changes of serum UA in early pregnancy, and to explore the association of serum UA with the risk of GDM.

METHODS

A prospective double-center study including 873 singleton pregnant women was conducted in Beijing, China since 2019 (clinical trial number: NCT03246295). Seventy-eight healthy non-pregnant women were selected to compare the changes of biomarkers in pregnancy. Spearman correlation and logistic regression analysis were performed to measure the relationship between serum UA in early pregnancy and GDM.

RESULTS

The incidence of GDM in our cohort was 20.27%(177/873). Compared with non-pregnant women, serum UA and creatinine decreased significantly during early pregnancy. Serum UA concentration in early pregnancy was significantly higher in GDM women than that in normal glucose tolerance (NGT) women [217.0(192.9, 272.0) μmol/l vs. 201.9(176.0, 232.0) μmol/l, p < 0.001]. After adjusted for confounding factors, elevated serum UA remained as an independent risk factor for GDM. The risk of GDM increased when serum UA was above 240 μmol/l (adjusted OR 1.964, 95% CI 1.296-2.977, p < 0.001), and stronger relationships between serum UA and GDM were observed in pregnant women aged over 35 years old and preBMI ≥ 24 kg/m2.

CONCLUSION

The normal range of serum UA and creatinine in pregnant women were lower than those in non-pregnant women. It is essential to monitor serum UA concentrations since early pregnancy to alert and prevent GDM, especially in older and heavier pregnant women.

CLINICAL TRIAL NUMBER

NCT03246295.

The innovative checkpoint inhibitors of lung adenocarcinoma, cg09897064 methylation and ZBP1 expression reduction, have implications for macrophage polarization and tumor growth in lung cancer

Lung cancer, a prevalent and aggressive disease, is characterized by recurrence and drug resistance. It is essential to comprehend the fundamental processes and discover novel therapeutic objectives for augmenting treatment results. Based on our research findings, we have identified a correlation between methylation of cg09897064 and decreased expression of ZBP1, indicating a link to unfavorable prognosis in patients with lung cancer. Furthermore, these factors play a role in macrophage polarization, with ZBP1 upregulated in M1 macrophages compared to both M0 and M2 polarized macrophages. We observed cg09897064 methylation in M2 polarization, but not in M0 and M1 polarized macrophages. ATACseq analysis revealed closed chromatin accessibility of ZBP1 in M0 polarized macrophages, while open accessibility was observed in both M1 and M2 polarized macrophages. Our findings suggest that ZBP1 is downregulated in M0 polarized macrophages due to closed chromatin accessibility and downregulated in M2 polarized macrophages due to cg09897064 methylation. Further investigations manipulating cg09897064 methylation and ZBP1 expression through overexpression plasmids and shRNAs provided evidence for their role in modulating macrophage polarization and tumor growth. ZBP1 inhibits M2 polarization and suppresses tumor growth, while cg09897064 methylation promotes M2 polarization and macrophage-induced tumor growth. In mechanism investigations, we found that cg09897064 methylation impairs CEBPA binding to the ZBP1 promoter, leading to decreased ZBP1 expression. Clinical experiments were conducted to validate the correlation between methylation at cg09897064, ZBP1 expression, and macrophage M2 polarization. Targeting these factors may hold promise as a strategy for developing innovative checkpoint inhibitors in lung cancer treatment.

Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

Clinical features of adult patients with allergic parotitis

Background

Allergic parotitis (AP), due to its non-specific symptoms, frequently poses a diagnostic challenge, leading to cases being overlooked or misdiagnosed by clinicians.

Objective

This study aimed to elucidate detailed clinical characteristics and common diagnostic indicators of AP.

Methods

A comprehensive review and analysis of medical records was conducted from patients diagnosed with AP, encompassing demographic, clinical, and laboratory data, at the Affiliated Stomatological Hospital of Nanjing Medical University between January 2019 and March 2022.

Results

The study enrolled 17 patients, evidenced by an average age of 36.00 ± 12.95 years. Common presentations of AP among the patients included notable symptoms such as parotid gland swelling, associated pain, and xerostomia. Ten patients had other atopic diseases. Palpation revealed the affected parotid glands to be soft and nodular, with an elevated local skin temperature. The unstimulated whole saliva flow rate was decreased. Ultrasonography demonstrated increased volume, reduced echo heterogeneity, and lymph node enlargement in the affected parotid glands. All cases observed increased serum salivary amylase and total IgE levels. Investigation of food allergens and inhaled allergen-specific IgE showed that all patients had suspected food allergies. Food provocation tests (FPT) induced AP in 13 cases, confirming the role of food allergens.

Conclusion

Food allergens are involved in the etiology of AP, underscoring the importance of comprehensive clinical evaluation, including symptoms, signs, and confirmatory auxiliary tests, such as FPT, for accurate diagnosis and differentiation from other salivary gland pathologies.

Mitochondrial DNA mutations in HIV-exposed uninfected infants following the cessation of triple antiretroviral drugs

OBJECTIVES

Mitochondrial mutations in HIV-exposed uninfected (HEU) infants after cessation of ART are rarely studied. We analysed a group of HEU newborns born to mothers with late HIV diagnosis who received three doses of ART immediately after birth. We observed mitochondrial DNA (mtDNA) mutations at different times of withdrawal.

METHODS

The study was based on a clinical trial conducted from 2015 to 2020. Newborns of the intervention group who met the criteria for this study received triple antiretroviral drugs, zidovudine + lamivudine + nevirapine, within 2 h after the birth, as post-partum prophylaxis, and at 14 days were switched to zidovudine + lamivudine + lopinavir/ritonavir, which was continued until 6 weeks of age. From August to November 2019, blood samples from HEU infants were also collected after ceasing 12 months of ART, and analysed for mtDNA.

RESULTS

Our study found that mtDNA mutations remained prevalent in HEU infants a few years after three ARTs were stopped immediately after birth. Among them, D-loop, ND1 and CYTB are the first three mutated regions during different withdrawal periods. This pattern of mutations is similar to, but not exactly consistent with, HIV-infected children receiving standard ART.

CONCLUSIONS

Further studies are needed to determine the effects of these mutations on the development of HEU infants and whether stopping ART leads to the restoration of mitochondrial function.

Association of cord plasma metabolites with birth weight: results from metabolomic and lipidomic studies of discovery and validation cohorts

BACKGROUND

Birth weight is a good predictor of fetal intrauterine growth and long-term health. Although several studies have evaluated the relationship between metabolites and birth weight, no prior study has comprehensively investigated the metabolomic and lipidomic and further validated and quantified meaningful metabolites.

METHODS

Firstly, a pseudotargeted metabolomics approach was applied to detect 2418 metabolites in 504 cord blood samples in the discovery set enrolled from the Wuhan Healthy Baby Cohort (HBC), China. Metabolome-wide association scan (MWAS) analysis and pathway enrichment were applied to discover metabolites and metabolic pathways that were significantly associated with birth weight for gestational age (BWGA) z-score. Logistic regression models were used to analyze the association of metabolites in the most significantly associated pathways with small for gestational age (SGA) and low birth weight (LBW). Subsequently, 350 cord blood samples in a validation cohort were subjected to targeted analysis to validate the metabolites screened from the discovery cohort.

RESULTS

In the discovery set, 513 metabolites were significantly associated with BWGA z-score (PFDR <0.05), of which 298 KEGG-annotated metabolites were included in the pathway analysis. The primary bile acid biosynthesis pathway was the most relevant metabolic pathway associated with BWGA z-score in our study. Elevated cord plasma primary bile acids were associated with lower BWGA z-score and higher odds of SGA or LBW in the discovery and validation cohorts. In the validation set, a 2-fold increase in taurochenodeoxycholic acid (TCDCA) and taurocholic acid (TCA) was associated with 0.10 (95% CI: 0.00, 0.20) and 0.18 (95 %CI: 0.04, 0.31) decrease in BWGA z-score, respectively, after adjusting for covariates. In addition, a 2-fold increase in cord plasma TCDCA and TCA was associated with an adjusted odds ratio of 1.52 (1.00, 2.30) and 1.77 (1.05, 2.98) for SGA, respectively. The adjusted ORs for a 2-fold increase in TCDCA and TCA concentrations were 2.39 (95% CI 1.00, 5.71) and 3.21 (0.96, 10.74) for LBW, respectively.

CONCLUSIONS

The results indicate a significant association between primary bile acids and lower BWGA z-score, as well as higher risk of SGA and LBW. Abnormalities of primary bile acid metabolism may play an important role in restricted fetal development. This article is protected by copyright. All rights reserved.

[Genetic analysis of the false positive trisomy 7 and false negative trisomy 18 by NIPT-PLUS]

OBJECTIVE

To explore the cause of inconsistency between the results of trisomy 7 by expanded non-invasive prenatal testing (NIPT-PLUS) and trisomy 18 by prenatal diagnosis.

METHODS

A pregnant woman who received genetic counseling at Jiaozuo Maternal and Child Health Care Hospital on July 5, 2020 was selected as the study subject. NIPT-PLUS, systematic ultrasound and interventional prenatal testing were carried out. The middle segment and root of umbilical cord, center and edge of the maternal and fatal surface of the placenta were sampled for the validation by copy number variation sequencing (CNV-seq).

RESULTS

The result of NIPT-PLUS indicated that the fetus has trisomy 7. Systematic ultrasound has shown multiple malformations including atrioventricular septal defect, horseshoe kidney, and rocker-bottom feet. However, QF-PCR, chromosomal karyotyping analysis, and CNV-seq of amniotic fluid samples all showed that the fetus was trisomy 18. Validation using multiple placental samples confirmed that the middle segment of the umbilical cord contains trisomy 18, the center of the placenta contained trisomy 7, and other placental sites were mosaicism for trisomy 7 and trisomy 18. Notably, the ratio of trisomy 18 became lower further away from the umbilical cord.

CONCLUSION

The false positive results of trisomy 7 and false negative trisomy 18 by NIPT-PLUS was probably due to the existence of placental mosaicism. Strict prenatal diagnosis is required needed aneuploidy is detected by NIPT-PLUS to exclude the influence of placental mosaicisms.

Toxicity of fungal-derived volatile organic compounds against root-knot nematodes

BACKGROUND

Root-knot nematodes (RKNs), including Meloidogyne species, are among the most destructive plant-parasites worldwide. Recent evidence suggests that entomopathogenic fungi (EPF) can antagonize RKNs. Such antagonistic effects are likely mediated by toxic metabolites, including volatile organic compounds (VOCs), produced by the fungi. However, how widespread these effects are across EPF species, and which VOCs mediate negative interactions between EPF and RKNs needs to be further elucidated.

RESULTS

First, we evaluated the nematicidal effect of VOCs emitted by 46 EPF isolates against Meloidogyne incognita and found variable toxicity depending on the isolate. Second, we measured the nematicidal effect of highly toxic isolates, including species in the genus Talaromyces, Aspergillus, Clonostachys, and Purpureocillium and, third, we analyzed the nematicidal effect of major VOCs, including 2-methyl-1-propanol, 3-methyl-1-butanol, isopropyl alcohol and 2-methyl-3-pentanone. The mortality of M. incognita juveniles (J2s) was generally high (50%) either via airborne or in-solution contact with VOCs. Moreover, the tested VOCs significantly inhibited egg hatching, and repelled J2s away from the VOCs.

CONCLUSION

This study not only provides insights into the ecological function of VOCs in the rhizosphere, but also provides new approaches for developing environmentally friendly control methods of RKNs in agroecosystems. © 2023 Society of Chemical Industry.

A Simplified Screening Model to Predict the Risk of Gestational Diabetes Mellitus in Pregnant Chinese Women

INTRODUCTION

This study aimed to develop a simplified screening model to identify pregnant Chinese women at risk of gestational diabetes mellitus (GDM) in the first trimester.

METHODS

This prospective study included 1289 pregnant women in their first trimester (6-12 weeks of gestation) with clinical parameters and laboratory data. Logistic regression was performed to extract coefficients and select predictors. The performance of the prediction model was assessed in terms of discrimination and calibration. Internal validation was performed through bootstrapping (1000 random samples).

RESULTS

The prevalence of GDM in our study cohort was 21.1%. Maternal age, prepregnancy body mass index (BMI), a family history of diabetes, fasting blood glucose levels, the alanine transaminase to aspartate aminotransferase ratio (ALT/AST), and the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) were selected for inclusion in the prediction model. The Hosmer-Lemeshow goodness-of-fit test showed good consistency between prediction and actual observation, and bootstrapping indicated good internal performance. The area under the receiver operating characteristic curve (ROC-AUC) of the multivariate logistic regression model and the simplified clinical screening model was 0.825 (95% confidence interval [CI] 0.797-0.853, P < 0.001) and 0.784 (95% CI 0.750-0.818, P < 0.001), respectively. The performance of our prediction model was superior to that of three other published models.

CONCLUSION

We developed a simplified clinical screening model for predicting the risk of GDM in pregnant Chinese women. The model provides a feasible and convenient protocol to identify women at high risk of GDM in early pregnancy. Further validations are needed to evaluate the performance of the model in other populations.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT03246295.

[Clinical and pathological features of 20 cases of congenital hepatic fibrosis]

Objective: To investigate the clinical and pathological features of congenital hepatic fibrosis (CHF). Methods: The clinical and pathological findings of 20 patients diagnosed with CHF from 2017 to 2023 were retrospectively analyzed. Results: Among the 20 patients, 8 were males and 12 were females with a median age of 21.5 years. Mostly patients were admitted to the hospital with cirrhosis, portal hypertension and upper gastrointestinal bleeding. Pathological features were diffuse fibrosis in the portal area, formation of fibrous septa of varying width, segmentation of the liver parenchyma, with hyperplasia of small bile ducts. Among them, 1 case (5%) was complicated with Caroli's disease, and 1 case (5%) was HNF1α hepatocellular adenoma. IHC GS showed that was positively expressed in acinar region 3 in 75% cases. Conclusion: CHF is mainly manifested by portal hypertension and its complications. Histopathology is the gold standard for diagnosis. The possibility of CHF should be considered first in children and adolescents with portal hypertension but no history of hepatitis, and complicated kidney disease. The positive pattern of acinus-3 region of GS in IHC is helpful for the diagnosis of CHF.

Design and Finite Element Simulation of a Novel 3D-CMUT Device for Simultaneous Sensing of In-Plane and Out-of-Plane Displacements of Ultrasonic Guided Waves

In this study, we introduce a physical model of a three-dimensional (3D) guided wave sensor called 3D-CMUT, which is based on capacitive micro-machined ultrasonic transducers (CMUTs). This 3D-CMUT sensor is designed to effectively and simultaneously obtain 3D vibration information about ultrasonic guided waves in the out-of-plane (z-direction) and in-plane (x and y-directions). The basic unit of the 3D-CMUT is much smaller than the wavelength of the guided waves and consists of two orthogonal comb-like CMUT cells and one piston-type CMUT cell. These cells are used to sense displacement signals in the x, y, and z-directions. To ensure proper functioning of the 3D-CMUT unit, the resonant frequencies of the three composed cells are set to be identical by adjusting the microstructural parameters appropriately. Moreover, the same sensitivity in the x, y, and z-directions is theoretically achieved by tuning the amplification parameters in the external circuit. We establish a transient analysis model of the 3D-CMUT using COMSOL finite element simulation software to confirm its ability to sense multimode ultrasonic guided waves, including A0, S0, and SH0 modes. Additionally, we simulate the ball drop impact acoustic emission signal on a plate to demonstrate that the 3D-CMUT can not only utilize in-plane information for positioning but also out-of-plane information. The proposed 3D-CMUT holds significant potential for applications in the field of structural health monitoring (SHM).

High Resolution Imaging with Focused kV X-Rays for Small Animal Radio-Neuromodulation

PURPOSE/OBJECTIVE(S)

High precision radiotherapy for small animal radio-neuromodulation requires conformal treatment to very small targets down to 2.5 mm. A focused kV technique based on novel usage of polycapillary x-ray lenses can focus x-ray beams to <0.2 mm in diameter, which is ideal for such uses. Such application also requires high resolution CT images for treatment planning and setup, which was hard to achieve using conventional x-ray tube. In this work, we demonstrate the feasibility of using a virtual focal spot generated with an x-ray lens to perform high-resolution CBCT acquisition.

MATERIALS/METHODS

The experiment with x-ray lens was set up on an x-ray tabletop system to generate a virtual focal spot. A pinhole image was acquired for the virtual focal spot and compared with the one acquired with the conventional focal spot without the lens. The planar imaging resolution with and without the lens were evaluated using a line pair resolution phantom. The spatial resolution of the two settings were estimated by reconstructing a 0.15-mm wire phantom and comparing its full width half maximum (FWHM). A CBCT scan of a rodent head was also acquired to further demonstrate the improved resolution using the x-ray lens.

RESULTS

Compared to conventional imaging acquisition with a measured x-ray focal spot of 0.395 mm FWHM, the virtual focal spot size was measured at 0.175 mm. The reduction in focal spot size with lens leads to an almost doubled planar imaging resolution and a 26% enhancement in 3D spatial resolution. A realistic CBCT acquisition of a rodent head mimicked the imaging acquisition step for radio-neuromodulation and further showed the improved visualization for fine structures.

CONCLUSION

This work demonstrated that the focused kV x-ray technique was capable of generating small focal spot size of <0.2 mm. The proposed method provides an adaptive imaging platform to acquire x-ray and CBCT images for treatment planning and setup with improved spatial resolution compared to conventional CBCT image acquisition.

First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment

The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9  GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36  GeV/c^{2}, rejecting cross sections above 9.2×10^{-48}  cm at the 90% confidence level.

Can we evidence-base injury prevention and management in women's football? A scoping review

This review aimed, as part of a larger FIFA project aiming to steer women's football research, to scope literature on any level of competitive football for women, to understand the current quantity of research on women's football injuries. The study reviewed all injury-related papers scoped by a recent scoping review mapping all published women's football research with an updated search performed on 23 February 2021. Eligibility criteria assessment followed the recent scoping review with injury-specific research focus. A total of 497 studies were scoped. Most studies contained an epidemiological (N = 226; 45%) or risk factors assessment (N = 105; 21%). Less assessed areas included financial burden (N = 1; <1%) and injury awareness (N = 5; 1%). 159 studies (32%) assessed injuries of the whole body. The most common single location assessed in the literature was the knee (N = 134, 27%), followed by head/face (N =108, 22%). These numbers were, however, substantially lowered, when subdivided by playing level and age-group. The volume of research focuses especially on descriptive research and specific body locations (head/face and knee). Although information can be taken from studies in other sports, more football-specific studies to support management and prevention of injuries are warranted.

Asymmetric warming reduces the strength of selection pressure of moderate grazing on reproductive phenology in alpine plants

Both warming and grazing already affect the reproductive phenology of alpine plants. However, their effects have mostly been studied in isolation, and their interaction is still unclear. In this study, an asymmetric warming (average + 1.2 °C during daytime and + 1.7 °C during nighttime and + 1.5 °C during summer and + 2.0 °C during winter) with moderate grazing experiment was conducted for four years to determine their individual and interactive effects on the onsets and durations of reproductive phenophases for fifteen alpine plant species on the Qinghai-Tibetan Plateau. Individual warming and grazing simultaneously advanced the average start dates and ending dates of budding, flowering and fruiting by 5.3-6.2 days, and further resulted in smaller effects on their durations for most plant species. The interactions between warming and grazing on them varied with plant species and year, which advanced by average 12.1 days for all plant species. The effects of grazing on the temperature sensitivity of the start dates of reproductive phenophases (average by -8.5 days °C^-1) were greater than that of warming alone (average by -3.4 days °C^-1) and warming with grazing (average by -5.5 days °C^-1) for most of the alpine plant species. There were significant effects of the previous phenological events on subsequent reproductive phenophases. Therefore, our results suggested that both warming and grazing advanced reproductive phenophases through altered soil temperature and soil moisture and carry-over effects of previous phenological events on subsequent phenological events. Warming reduced the temperature sensitivity of the start dates of reproductive phenophases to grazing, suggesting that it depressed strength of selection pressure of grazing on the onsets of reproductive phenology in alpine plants.

Radiomic analysis of MRI for prediction of response to induction chemotherapy in nasopharyngeal carcinoma patients

AIM

To establish and validate radiomic models for response prediction to induction chemotherapy (IC) in nasopharyngeal carcinoma (NPC) using the radiomic features from pretreatment MRI.

MATERIALS AND METHODS

This retrospective analysis included 184 consecutive NPC patients, 132 in the primary cohort and 52 in the validation cohort. Radiomic features were derived from contrast-enhanced T1-weighted imaging (CE-T1) and T2-weighted imaging (T2-WI) for each subject. The radiomic features were then selected and combined with clinical characteristics to build radiomic models. The potential of the radiomic models was evaluated based on its discrimination and calibration. To measure the performance of these radiomic models in predicting the treatment response to IC in NPC, the area under the receiver operating characteristic curve (AUC), and sensitivity, specificity, and accuracy were used.

RESULTS

Four radiomic models were constructed in the present study including the radiomic signature of CE-T1, T2-WI, CE-T1 + T2-WI, and the radiomic nomogram of CE-T1. The radiomic signature of CE-T1 + T2-WI performed well in distinguishing response and non-response to IC in patients with NPC, which yielded an AUC of 0.940 (95% CI, 0.885-0.974), sensitivity of 83.1%, specificity of 91.8%, and accuracy of 87.1% in the primary cohort, and AUC of 0.952 (95% CI, 0.855-0.992), sensitivity of 74.2%, specificity of 95.2%, and accuracy of 82.7% in the validation cohort.

CONCLUSION

MRI-based radiomic models could be helpful for personalised risk stratification and treatment in NPC patients receiving IC.

Chinese Mothers' Intent to Disclose Their HIV Status to Their Children: The Role of Positive Outcome Expectations and Reward Responsiveness

Objective: The current study investigated the role of positive outcome expectations and reward responsiveness in intention to disclose HIV status to children among women living with HIV in China. The moderating role of reward responsiveness was also explored. Method: A 1-year longitudinal survey was conducted. 269 women living with HIV who had at least one child aged >5 years and had not yet disclosed their HIV status to their oldest child were selected from a larger sample of women living with HIV at baseline, with a total of 261 respondents completing the follow-up survey. Results: After adjusting for significant socio-demographic and medical variables, positive outcome expectations positively predicted mothers' intention to disclose HIV, while reward responsiveness had a negative effect. A moderation effect of reward responsiveness was found, with further analysis showing that reward responsiveness has strengthened the relationship between positive outcome expectations and intention to disclose HIV. Conclusion: Findings support the relevance of positive outcome expectations and reward responsiveness to intention of disclosure among women living with HIV in China.

Two Chiral YbIII Enantiomeric Pairs with Distinct Enantiomerically Pure N-Donor Ligands Presenting Significant Differences in Photoluminescence, Circularly Polarized Luminescence, and Second-Harmonic Generation

Using enantiomerically pure bidentate and tridentate N-donor ligands (¹L_R/¹L_S and ²L_R/²L_S) to replace two coordinated H₂O molecules of Yb(tta)₃(H₂O)₂, respectively, two eight- and nine-coordinated Yb^III enantiomeric pairs, namely, Yb(tta)₃¹L_R/Yb(tta)₃¹L_S (Yb-R-1/Yb-S-1) and [Yb(tta)₃²L_R]·CH₃CN/[Yb(tta)₃²L_S]·CH₃CN (Yb-R-2/Yb-S-2), were isolated, in which Htta = 2-thenoyltrifluoroacetone, ¹L_R/¹L_S = (-)/(+)-4,5-pinene-2,2'-bipyridine, and ²L_R/²L_S = (-)/(+)-2,6-bis(4',5'-pinene-2'-pyridyl)pyridine. Interestingly, they not only present distinct degrees of chirality but also show large differences in near-infrared (NIR) photoluminescence (PL), circularly polarized luminescence (CPL), and second-harmonic generation (SHG). Eight-coordinated Yb-R-1 with an asymmetric bidentate ¹L_R ligand has a high NIR-PL quantum yield (1.26%) and a long decay lifetime (20 μs) at room temperature, being more than two times those (0.48%, 8 μs) of nine-coordinated Yb-R-2 with a C₂-symmetric tridentate ²L_R ligand. In addition, Yb-R-1 displays an efficient CPL with a luminescence dissymmetry factor g_lum = 0.077, being 4 × Yb-R-2 (0.018). In particular, Yb-R-1 presents a strong SHG response (0.8 × KDP), which is 8 × Yb-R-2 (0.1 × KDP). More remarkably, the precursor Yb(tta)₃(H₂O)₂ exhibits a strong third-harmonic generation (THG) response (41 × α-SiO₂), while the introduction of chiral N-donors results in the switching of THG to SHG. Our interesting findings provide new insights into both the functional regulation and switching in multifunctional lanthanide molecular materials.

A196 CROHN’S DISEASE PATIENT DERIVED MACROPHAGES ARE MORE SUSCEPTIBLE TO HYDROGEN PEROXIDE INDUCED CELL DEATH

Background

Crohn’s disease (CD) is characterized by intestinal inflammation due to the interplay between immunity, genetics, and environmental factors such as diet. Selenium (Se) deficiency is common in patients with CD due to malabsorption or high enteric losses. Selenium is used in the synthesis of selenoproteins that have antioxidant properties (e.g. glutathione peroxidases (GPx)) and are highly expressed in macrophages. However, how Se deficiency affects immune system function in patients with CD is unknown. We hypothesize that characterizing Se status, selenoprotein expression and subsequently macrophage function will advance knowledge of mucosal immunity and provide novel insight into CD.

Purpose

To determine if patients with active CD and healthy controls differ in Se dietary intake and status, oxidative stress, and macrophage cytotoxicity in response to oxidative stress.

Method

Blood was collected from healthy volunteers and patients diagnosed with ileal, ileocolonic or colonic CD (age ≥18 years, with mild or moderate endoscopic disease activity or fecal calprotectin ≥250 µg/g, and Harvey Bradshaw index <16, stable medications including biologics for at least 8-weeks prior to recruitment). Serum was analyzed for GPx activity, malondialdehyde (MDA) and C-reactive protein (CRP) concentrations. Monocytes were isolated by plastic adherence and treated with M-CSF (10 ng/ml, 7d) to derive macrophages. mRNA expression of GPx1, GPx4 and SelenoP was determined by qPCR. Lactate dehydrogenase release was measured in macrophages treated with 500 µM H₂O₂ for 2h.

Result(s)

Samples and/or dietary intake data were collected from 9 patients with CD (3 female, 6 male, mean age=36.8 years) and 13 controls (7 female, 6 male, mean age=27.7 years). Dietary Se intake did not differ between patients with CD and controls (126.1 ± 23.2 vs. 123.3 ± 19.8 µg/day). GPx activity was greater in the serum of patients with CD compared to controls (369 ± 49 vs. 169 ± 27 mU/mL, n=6-8, p<0.005). Patients with CD and controls did not differ in serum MDA concentration (7.80 ± 0.57 vs. 6.53 ± 1.1 µM). CRP levels correlated with serum MDA concentration in patients with CD (r=0.95, n=5, p<0.05) but not GPx activity. Macrophages from patients with CD (n=6) and controls (n=7) did not differ in expression of GPx1 and GPx4 mRNA, whereas SelenoP mRNA was ~200-fold lower in macrophages from patients with CD. Macrophages derived from patients with CD were more susceptible to H₂O₂-evoked cell death (10.3 ± 1.1 vs. 4.7 ± 0.7 % n=2-3 p<0.05).

Conclusion(s)

Despite adequate dietary Se intake our findings suggest altered Se metabolism in patients with active CD, with increases in serum GPx potentially indicative of the need for antioxidant activity to counter oxidative stress. The increased sensitivity of macrophages from patients with CD to H₂O₂ emphasizes the role of oxidative stress and redox balance in IBD. Defining how micronutrients, in this instance Se, impacts innate immunity may provide new approaches to the management of CD.

Disclosure of Interest

None Declared

A4 PREDNISOLONE, A GLUCOCORTICOID WIDELY USED FOR TREATMENT OF IBD, ENHANCES A HUMAN INTERLEUKIN-4-ACTIVATED MACROPHAGE PHENOTYPE

Background

With cellular immunotherapy, the individuals’ medication could ablate (or enhance) any therapeutic benefit of the transferred cells. Murine and human macrophages activated with IL-4 (i.e., M(IL4)) improve wound healing and reduce the severity of disease in murine models of colitis. Advancing the position that autologous M(IL4) could be a novel approach to IBD, a critical question arises: will concurrent medication impact the M(IL4)s anti-colitic effect? To address this, we tested if prednisolone, a synthetic, anti-inflammatory glucocorticoid used to induce remission in IBD flares,impacts human M(IL4) phenotype and function.

Purpose

To determine if prednisolone suppresses or enhances a human M(IL4) phenotype as defined by canonical marker molecules and wound healing and anti-colitic activities.

Method

Macrophages were differentiated from the blood monocytes of healthy volunteers using M-CSF (7 days) and treated with GMP-grade IL-4 (10 ng/mL, 48h) ± a 24h treatment with prednisolone (1μg/mL). Subsequently, conditioned medium was collected for TGFb measurement by ELISA and for use in a T84 epithelial cell in vitro wound healing assay. Retrieved M(IL4) and M(IL4,pred.) were characterized by mRNA expression of CD206 (mannose receptor), RAMP1 (CGRP receptor), and CD14 (LPS co-receptor). One million murine bone marrow-derived M(IL4) or M(IL4,pred.) were injected into BALB/c mice 48h prior to intra-rectal DNBS (3mg), and colitis was assessed 72h-post DNBS.

Result(s)

Human M(IL4)s displayed increased mRNA expression of CD206 and RAMP1, and reduced CD14 compared to M(0), with the CD206 and RAMP1 being further increased by prednisolone treatment. M(IL4,pred.) produced more TGF-β than M(IL4) upon LPS stimulation [363 ± 30 vs. 241 ± 24 pg/ml, n= 4, p<0.05], which would predict an enhanced wound healing capacity. Stimulated M(IL4,pred.) produced more IL-10 than M(IL4). Furthermore, murine M(IL4,pred.) retained an anti-colitic capacity comparable to M(IL4) as determined by disease activity score in the DNBS model.

Conclusion(s)

Human M(IL4)s subsequently exposed to the potent immunomodulatory glucocorticoid, prednisolone show increased expression of phenotypic markers and increased output of TGFb and IL-10. Crucially M(IL4,pred.) retained an anti-colic effect in the murine DNBS model of colitis. Interpreting these data, we suggest that the anti-colitic effect of M(IL4) immunotherapy would not be adversely offset by the individuals concomitant use of steroids. Our preliminary findings support pursuing M(IL4) transfers as a novel approach to the management of IBD.

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Other

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Helmsley Charitable Trust

Disclosure of Interest

None Declared

A29 HIGH DIMENSIONAL SINGLE CELL ANALYSIS OF IL-4 TREATED MACROPHAGES REVEALS A HETEROGENIC PHENOTYPE AND THE ABSENCE OF CD206+ SUBSETS IN CROHN'S DISEASE PATIENTS

Background

Individuals with IBD have a reduced quality of life and while treatment has improved, a cure remains elusive. Interleukin-4 differentiated macrophages (M(IL4)s) from healthy donors and IBD patients in remission promote epithelial wound repair and reduce the severity of colitis in a mouse model: findings that support the autologous transfer of M(IL4)s to treat IBD. However, issues remain if this novel therapy is to advance to clinical evaluation: a much greater understanding of the possible heterogeneity within the human M(IL4) population, the biology of any sub-groups therein and the biology of any M(IL4) subtypes is needed.

Purpose

To determine if cryopreservation, sex, and disease status in Crohn's disease (CD) impact the phenotype and function of M(IL4)

Method

Blood mononuclear cells were collected from healthy donors, and individuals with active CD or in remission (n=6/group), and differentiated to macrophages with GMP-grade recombinant human M-CSF (10 ng/ml, 7 days). Macrophages (2.5 x10⁵) were activated with IL-4 (10ng/ml, 48h). Fresh and cryopreserved M(0) and M(IL4) were stained using a panel of 18 metal-conjugated antibodies. Data were acquired on a Helios CyTOFII mass cytometer. FCS files were imported into Cytobank for manual gating (viable CD45⁺CD3^-CD19^- singlet cell events) and exported for meta-clustering in R with the CATALYST package using the FlowSOM function with 10 metaclusters.

Result(s)

FlowSOM analysis on M(IL4) from healthy donors indicated clear differences between M(0) and M(IL4), with 8 metaclusters >1.5% of M(IL4)s: the most abundant metaclusters express high and intermediate CD206, PDL1, CD11b, CD33, CD64, HLA-DR and low CD14 levels. There were no significant differences in these M(IL4)s metaclusters between males and females, or fresh vs. cryopreserved cells using this characterization strategy. M(IL4) from patients with active CD, were markedly different with the absence of three high-intermediate CD206⁺PDL1⁺ metaclusters and a general lack of CD206⁺ metaclusters compared to healthy controls. Surprisingly, and despite M(IL4)s from CD patients in remission showing increased CD206 mRNA, CYTOF analysis revealed that the macrophages were more similar to those from individuals with active disease than those from healthy controls

Conclusion(s)

Here human macrophages activated with IL4 in vitro are revealed as a heterogeneous population, and subsets characterized by increased high CD206 expression are generally absent in active Crohn’s disease. Intriguing while prior experiments with M(IL4) from CD patients in remission reduced the severity of colitis in rag1^-/- mice, the characterization of these cells via 18 protein markers indicates they are more like M(IL4)s from patients with active disease compared to healthy controls. While presenting autologous M(IL4) transfer as a novel approach for IBD, a much fuller understanding of the phenotype and function of M(IL4)s (and sub-populations therein) is required before this would become a therapeutic option

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CAG

Disclosure of Interest

None Declared

A58 ENTERIC TUFT CELLS MODULATE LOCAL BUT NOT SYSTEMIC HOST IMMUNE RESPONSES TO CO-ORDINATE TIMELY EXPULSION OF HYMENOLEPIS DIMINUTA

Background

The intestinal tuft cell is a versatile epithelial cell implicated in host detection and defence against enteric nematode and trematode parasites by producing interleukin(IL)-25 and cysteinyl leukotrienes. We have shown that immunocompetent mice develop small intestinal tuft cell hyperplasia during infection with the cestode, Hymenolepis diminuta. Whether tuft cells coordinate murine expulsion of H. diminuta and if this response is similar to other well-established parasitic models is unknown.

Purpose

To test 1) if tuft cells coordinate host detection and immune responses to H. diminuta; and, 2) if the lack of functional B, T cells and innate lymphoid cells (ILC2s) affect tuft cell hyperplasia and expulsion of the parasite.

Method

Male and female pou2f3^-/-/^-/+ littermates, rag-1^-/- and C57BL6 mice were infected with 5 cysticercoids of H. diminuta. ILC2s were depleted in rag-1^-/- with anti-CD90.2 (250μg/mouse, intraperitoneal). At necropsy, small intestines were flushed with cold PBS to count worms. IgG1, IgG2α and mast cell protease-1 (MCPT-1) was measured in serum and supernatants from splenic cells stimulated with ConA (48h) were assessed by ELISA for IL-4, -5, -10 and -13. Doublecortin-like kinase -1 (DCLK-1)+ tuft cells, goblet cells and eosinophils were identified in sections of paraffin embedded or cryopreserved mid-jejunum sections. mRNA of small intestinal epithelium enriched fractions isolated from mice at control and 11 days post-infection (dpi) was evaluated by qPCR.

Result(s)

Unlike pou2f3^+/- and C57Bl6 mice that expel H. diminuta by 8-11 dpi., pou2f3^-/- mice harbour H. diminuta at 11 dpi. Pou2f3^-/- mice show similar splenic IL-4, -5, -10, -13, and serum IgG1, IgG2a and MCPT-1 levels at 8 dpi. and higher splenic IL-4, -10 at 11 dpi. compared to pou2f3^+/- mice. In contrast, pou2f3^+/- mice show higher jejunal goblet cell hyperplasia at 8 dpi., higher levels of small intestinal epithelium expression of dclk-1, alox5 and il-25 and jejunal eosinophilia at 11 dpi. compared to pou2f3^-/- mice. At 11 dpi, ILC^depletedrag-1^-/- develop tuft cell hyperplasia to the same extent as infected PBS/isotype controls and show no trace of intestinal worms in the lumen.

Conclusion(s)

Enteric tuft cells coordinate rapid expulsion of H. diminuta from mice, but are not essential for the host to detect and develop Th2 systemic responses in response to the worm. However, in the absence of tuft cells, deficiencies are observed in gut-specific effector immune events commonly associated with timely expulsion of enteric helminths; illustrating a disparity between local and systemic immunity following infection with this tapeworm parasite in a non permissive host. The lack of a functional adaptive immune system and surprisingly, depletion of ILC2s, does not completely abrogate worm expulsion or tuft cell hyperplasia in rag-1^-/- at 11 dpi. with H. diminuta. This suggests that an innate immune cell population other than CD90.2⁺ ILC2s amplifies Th2 immunity to H. diminuta-infection.

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Other

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NSERC, , Eyes High doctoral scholarship, Alberta Graduate excellence scholarship

Disclosure of Interest

None Declared

A163 INFECTION WITH HYMENOLEPIS DIMINUTA ELICITS A TH2 IMMUNITY AND ALLEVIATES DNBS-COLITIS IN A MOUSE MODEL WITH MINIMAL INTESTINAL MICROBIOTA

Background

Immunocompetent mice infected with the rat tapeworm Hymenolepis diminuta are protected from dinitrobenzene sulphonic-acid (DNBS)-induced colitis that was accompanied by the increased relative abundance of short-chain fatty acid (SCFA)-producing bacteria and fecal SCFA levels at 8 days post-infection (dpi). These changes were not observed in antibiotic-treated BALB/c mice or germ-free mice. To further characterize the host-parasite-microbiota interaction in the control of colitis, experiments have been conducted in a reductionist system in which the H. diminuta anti-colitic response was tested in mice colonized with 12 commensal bacteria representing the major five phyla of the mouse gut.

Purpose

To identify key bacterial species and microbe-derived mediators involved in the H. diminuta-induced protection from DNBS-induced colitis.

Method

OligoMM¹² (Oligo-Mouse-Microbiota) mice (n=4-8/group) were infected with 10 viable antibiotic-treated H. diminuta cysticercoids eight days prior to challenge with DNBS (3mg, i.r.). Mice were monitored daily and necropsied 72h post-DNBS. Disease was assessed by a macroscopic disease activity score, colon length and histopathology on H&E sections of mid-colon. Production of IL-4, -5, -10 and -13 by concanavalin-A treated spleen cells by ELISA was used as an index of successful helminth infection.

Result(s)

OligoMM¹² mice treated with DNBS developed acute colitis, with 3/8 mice requiring humane euthanization, while all mice infected with H. diminuta survived the DNBS challenge. Successful infection was confirmed by statistically significant increases in splenic output of the Th2-cytokines in response to mitogenic stimulation and efficient expulsion of the worms burden by 11 dpi. The severity of DNBS-induced colitis was reduced in H. diminuta-infected mice (n=4), although additional experiments are required to confirm the statistical significance of these data.

Conclusion(s)

Reproducible DNBS-induced colitis in mice with the simplified OligoMM¹² consortium of bacteria and reduced disease in H. diminuta-infected mice has created a model by which the participation of exact bacterial groups or species in H. diminuta-induced suppression of colitis can be tested. This is of translational value, since the failure of helminth therapy in IBD could be predicated by dysbiosis in the patient, and therefore potentially overcome by combination therapy of ‘probiotic’ and helminth.

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CIHR, Other

Please indicate your source of funding;

NSERC-CGS D, Eyes High doctoral Recruitment Scholarship

Disclosure of Interest

None Declared

Two temperature-induced 1D CuII chain enantiomeric pairs showing different magnetic properties and nonlinear optical responses

At different reaction temperatures, using Cu(NO₃)₂·3H₂O to react with enantiomerically pure N-donor ligands (L_S/L_R), respectively, two pairs of chiral one-dimensional (1D) Cu^II chain enantiomers formulated as [Cu(μ₂-NO₃)(NO₃)(L_S)]_n/[Cu(μ₂-NO₃)(NO₃)(L_R)]_n (S-1-Cu/R-1-Cu, formed at 40 °C with an NO₃^- group as a sole bridging ligand) and [Cu(μ₂-L_S)(NO₃)₂]_n/[Cu(μ₂-L_R)(NO₃)₂]_n (S-2-Cu/R-2-Cu, formed at 25 °C with L_S or L_R as a bridging ligand) were prepared, where L_S/L_R = (+)/(-)-4,5-pinenepyridyl-2-pyrazine. Interestingly, such a disparity in bridging ligands leads not only to their distinct structural features but also to their completely different magnetic couplings together with a large difference in their nonlinear optical responses. S-1-Cu with a 1D helical structure shows weak ferromagnetic coupling between Cu^II ions, while S-2-Cu with a 1D stairway-like structure presents weak antiferromagnetic coupling. In particular, they simultaneously possess both second- and third-harmonic generation (SHG and THG) responses in one molecule with large strength differences. More remarkably, S-1-Cu exhibits a very large THG response (162 × α-SiO₂), which is 22.5 times that of S-2-Cu, and the SHG strength of S-1-Cu is more than 3 times that of S-2-Cu. This work demonstrates that reaction temperature has a great impact on the self-assembled structures of coordination polymers and subsequently results in their large performance differences.

Warming delays but grazing advances leaf senescence of five plant species in an alpine meadow

Leaf senescence is the final stage in the life cycle of leaves and is critical to plants' fitness as well as to ecosystem carbon and nutrient cycling. To date, most understanding about the responses of leaf senescence to environmental changes has derived from research in forests, but the topic has been relatively neglected, especially under grazing conditions, in natural grasslands. We conducted a 3-year manipulative asymmetric warming with moderate grazing experiment to explore the responses of leaf senescence of five main species in an alpine meadow on the Qinghai-Tibetan Plateau. We found that warming prolonged leaf longevity through earlier leaf-out and later leaf senescence, and grazing prolonged it through a greater advance in leaf-out than first leaf coloration for all plants. Warming did not affect leaf nitrogen (N) content or N resorption efficiency (NRE), but grazing increased N content in coloring leaves for P. anserine and P. nivea and decreased NRE for K. humilis, P. anserine under no-warming, and for P. nivea under warming. The interactive effects of warming and grazing on leaf phenology and leaf traits depended on species identity and year. There were positive relationships between leaf-out and leaf senescence mainly derived from grazing, and positive relationships between NRE from old leaves and leaf senescence for three out of five plant species. Therefore, our results indicated that earlier leaf-out could result in earlier leaf senescence only under grazing, but depending on plant species. Delayed leaf coloring increased NRE from old leaves for some plant species measured under warming and grazing. Our results suggested that alpine plants may develop strategies to adapt to warming and grazing to assimilate more carbon through prolonged leaf longevity rather than increased NRE through earlier leaf coloring in the alpine meadow.

IFIH1/IRF1/STAT1 promotes sepsis associated inflammatory lung injury via activating macrophage M1 polarization

BACKGROUND

A growing body of research has shown that the phenotypic change in macrophages from M0 to M1 is essential for the start of the inflammatory process in septic acute respiratory distress syndrome (ARDS). Potential treatment targets might be identified with more knowledge of the molecular regulation of M1 macrophages in septic ARDS.

METHODS

A multi-microarray interrelated analysis of high-throughput experiments from ARDS patients and macrophage polarization was conducted to identify the hub genes associated with macrophage M1 polarization and septic ARDS. Lipopolysaccharide (LPS) and Poly (I:C) were utilized to stimulate bone marrow-derived macrophages (BMDMs) for M1-polarized macrophage model construction. Knock down of the hub genes on BMDMs via shRNAs was used to screen the genes regulating macrophage M1 polarization in vitro. The cecal ligation and puncture (CLP) mouse model was constructed in knockout (KO) mice and wild-type (WT) mice to explore whether the screened genes regulate macrophage M1 polarization in septic ARDS in vivo. ChIP-seq and further experiments on BMDMs were performed to investigate the molecular mechanism.

RESULTS

The bioinformatics analysis of gene expression profiles from a clinical cohort of 26 ARDS patients and macrophage polarization found that the 5 hub genes (IFIH1, IRF1, STAT1, IFIT3, GBP1) may have a synergistic effect on macrophage M1 polarization in septic ARDS. Further in vivo investigations indicated that IFIH1, STAT1 and IRF1 contribute to macrophage M1 polarization. The histological evaluation and immunohistochemistry of the lungs from the IRF1^-/- and WT mice indicated that knockout of IRF1 markedly alleviated CLP-induced lung injury and M1-polarized infiltration. Moreover, the molecular mechanism investigations indicated that knockdown of IFIH1 markedly promoted IRF1 translocation into the nucleus. Knockout of IRF1 significantly decreases the expression of STAT1. ChIP-seq and PCR further confirmed that IRF1, as a transcription factor of STAT1, binds to the promoter region of STAT1.

CONCLUSION

IRF1 was identified as the key molecule that regulates macrophage M1polarization and septic ARDS development in vivo and in vitro. Moreover, as the adaptor in response to infection mimics irritants, IFIH1 promotes IRF1 (transcription factor) translocation into the nucleus to initiate STAT1 transcription.

Predictability of HOMA-IR for Gestational Diabetes Mellitus in Early Pregnancy Based on Different First Trimester BMI Values

Objective: To investigate the ability of homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy for predicting gestational diabetes mellitus (GDM) in Chinese women with different first-trimester body mass index (FT-BMI) values. Methods: Baseline characteristics and laboratory tests were collected at the first prenatal visit (6−12 weeks of gestation). GDM was diagnosed by a 75 g oral glucose tolerance test (OGTT) at 24−28 weeks of gestation. Partial correlation analysis and binary logistic regression were applied to identify the association between HOMA-IR and GDM. The cutoff points for predicting GDM were estimated using receiver operating characteristic (ROC) curve analysis. Results: Of the total of 1343 women, 300 (22.34%) were diagnosed with GDM in the 24−28 weeks of gestation. Partial correlation analysis and binary logistic regression verified HOMA-IR as a significant risk factor for GDM in the normal weight subgroup (FT-BMI < 24 kg/m2) (adjusted OR 2.941 [95% CI 2.153, 4.016], P < 0.001), overweight subgroup (24.0 kg/m2 ≤ FT-BMI < 28.0 kg/m2) (adjusted OR 3.188 [95% CI 2.011, 5.055], P < 0.001), and obese subgroup (FT-BMI ≥ 28.0 kg/m2) (adjusted OR 9.415 [95% CI 1.712, 51.770], p = 0.01). The cutoff values of HOMA-IR were 1.52 (area under the curve (AUC) 0.733, 95% CI 0.701−0.765, p < 0.001) for all participants, 1.43 (AUC 0.691, 95% CI 0.651−0.730, p < 0.001) for normal weight women, 2.27 (AUC 0.760, 95% CI 0.703−0.818, p < 0.001) for overweight women, and 2.31 (AUC 0.801, 95% CI 0.696−0.907, p < 0.001) for obese women. Conclusions: Increased HOMA-IR in early pregnancy is a risk factor for GDM, and HOMA-IR can be affected by body weight. The cutoff value of HOMA-IR to predict GDM should be distinguished by different FT-BMI values.

Management Algorithm for Prevention of Mother-to-child Transmission of Hepatitis B Virus (2022)

The World Health Organization (WHO) has set the goal of eliminating hepatitis as a threat to public health by 2030. Blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is not only the key to eliminating viral hepatitis, but also a hot issue in the field of hepatitis B prevention and treatment. To standardize the clinical management of preventing MTCT of HBV and achieve zero HBV infection among infants, the Chinese Foundation for Hepatitis Prevention and Control organized experts to compile a management algorithm for prevention of MTCT of HBV based on the latest research progress and guidelines, including 10 steps of pregnancy management and postpartum follow-up, among which screening, antiviral treatment, and infant immunization are its core components.

Clinical outcomes among distinct groups of patients with severe tricuspid valve regurgitation

Introduction

Severe tricuspid valve regurgitation (TR) is associated with increased 1-year morbidity and mortality. Characterization by valve etiology (primary, secondary, and lead-associated), a classification borrowed from mitral valve disease, has not been universally shown to correlate with outcomes.

Purpose

Among a large, racially diverse cohort with newly identified severe TR, we aimed to 1) characterize outcomes of severe TR by etiology, and 2) assess whether unsupervised phenoclustering or supervised outcome-driven prediction trees were more effective in establishing subgroups of TR with differential clinical risk profiles.

Methods

We retrospectively analyzed outcomes of 5-year all-cause death and a composite of death or heart failure hospitalization (HFH) among adult patients with new severe TR identified by echocardiography between 2007 to 2018 at a large academic tertiary referral center in the United States. Patients were initially categorized by etiology of TR, including primary, secondary, and lead-associated. Second, we separately applied unsupervised hierarchical clustering to identify distinct clusters using demographics, clinical, and echo data at the time of diagnosis. Third, we applied a supervised recursive partitioning algorithm (survival trees) by each outcome to identify distinct TR subgroups. We estimated the cumulative incidence of death and composite death or HFH over 5 years by 1) etiology of TR, 2) distinct clusters, and 3) groups identified by supervised learning (prediction trees).

Results

Among 2,379 consecutive patients with newly identified severe TR, the median age was 70 years, 61% were female, and 40% were Black. Event rates (95% CI) were 30.9 (29.0 to 32.8) events/100 PY for death and 49.0 (45.9 to 52.2) events/100 PY for composite death or HFH over median follow-up of 1.6 years. Event rates were similarly high across TR etiology groups for both death and composite death or HFH (Figure 1). Multiple methods of unsupervised clustering did not yield distinct clusters by patient demographic and imaging characteristics. After applying supervised survival tree modeling, four phenoclusters with distinct clinical prognoses were separately identified for death and composite death or HFH (Figure 2). Variables identified to partition the cohort to discriminate both death and composite death or HFH were age, albumin, blood urea nitrogen, right ventricular contractility, and right ventricular systolic pressure (all p&lt;0.05).

Conclusions

Five-year cumulative incidence of adverse events among patients with newly diagnosed severe TR was 69% for death and 80% for composite death or HFH. TR etiology did not stratify prognosis, while supervised survival tree models identified phenoclusters with distinct clinical risk. The identified subgroups of severe TR with differential outcomes offer insights towards enrichment in clinical trials of TR and risk/benefit analysis in patients undergoing TR therapies.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Abbott

[FNDC1 is highly expressed in lung adenocarcinoma and closely related with poor prognosis]

OBJECTIVE

To explore the expression of fibronectin type Ⅲ domain containing 1(FNDC1) protein in lung adenocarcinoma and its prognostic significance.

METHODS

The expression of FNDC1 in lung adenocarcinoma was predicted by analysis of data from GEO database and GEPIA, and the results were verified by immunohistochemical staining in 92 pairs of clinical specimens of lung adenocarcinoma and adjacent tissues.We further analyzed the correlation of FNDC1 expression with the clinicopathological features of the patients, and evaluated its prognostic value using Cox survival analysis.

RESULTS

Analysis of the data form GEO database and GEPIA showed a significantly higher expression level of FNDC1 in lung adenocarcinoma than in matched normal tissues (P < 0.05).Kaplan-Meier survival analysis suggested that a high expression of FNDC1 protein was associated with a significantly shorter overall survival time of the patients (P < 0.05).Immunohistochemistry of the clinical specimens also showed a significantly higher protein expression of FNDC1 in lung adenocarcinoma tissues than in paired adjacent tissues (P < 0.001).A high expression of FNDC1 protein was significantly correlated with advanced clinical stage, T stage and N stage (P < 0.05).Cox univariate and multivariate regression survival analysis indicated that an increased expression of FNDC1 was an independent risk factor for poor prognosis of the patients with lung adenocarcinoma (P < 0.05).

CONCLUSION

FNDC1 protein is highly expressed in patients with lung adenocarcinoma and in closely related with the occurrence, progression and prognosis of the tumor, suggesting the value of FNDC1 protein as a potential biomarker for assessment of the survival and prognosis of patients with lung adenocarcinoma.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.