A treadmill exercise reduced cardiac fibrosis, inflammation and vulnerability to ischemia-reperfusion in rat pristane-induced arthritis

AIMS

To explore cardiac structural and functional parameters and myocardial sensitivity to ischemia in a rat model of chronic arthritis, pristane-induced arthritis (PIA), and to investigate the effects of a running exercise protocol on cardiac disorders related to rheumatoid arthritis (RA).

MAIN METHODS

3 groups of male Dark Agouti rats were formed: Controls, PIA and PIA-Exercise. The PIA-Exercise group was subjected to an individualized treadmill running protocol during the remission phase. At acute and chronic phases of PIA, cardiac structure was analyzed by histology. Cardiac function was explored in isolated hearts to measure left ventricular developed pressure (LVDP), cardiac compliance and infarct size before and after ischemia/reperfusion. Cardiac inflammation was evaluated through VCAM-1 mRNA expression by RT-qPCR. Plasma irisin levels were measured by ELISA.

KEY FINDINGS

PIA rats exhibited myocardial hypertrophy fibrosis and inflammation at the 2 inflammatory phases of the model. At chronic phase only, LVDP and cardiac compliance were lower in PIA compared to controls. As compared to sedentary PIA, exercise did not change cardiac function but reduced fibrosis, inflammation, infarct size, and arthritis severity and increased irisin levels. Cardiac inflammation positively correlated with fibrosis, while irisin levels negatively correlated with cardiac inflammation and fibrosis.

SIGNIFICANCE

In the PIA model that recapitulated most cardiac disorders of RA, a daily program of treadmill running alleviated cardiac fibrosis and inflammation and improved resistance to ischemia. These data provide arguments to promote the practice of exercise in RA patients for cardiac diseases prevention.

[O-DEM: a new cognitive screening in patients with hearing loss]

BACKGROUND

Hearing loss is a significant risk factor for dementia. To date, cognitive impairment and dementia in patients with hearing impairment (HI) cannot be adequately diagnosed by commonly administered cognitive screening tests due to sensory impairments. Therefore, an adapted screening is needed. The aim of the present study was to develop and evaluate a cognitive screening for people with HI.

MATERIALS AND METHODS

The new cognitive screening, called O‑DEM, entails a word fluency test, the Trail Making Test A (TMT-A), and a subtraction task. First, the O‑DEM was tested in a large clinical sample (N = 2837) of people without subjective HI. In a second step, the O‑DEM was evaluated in 213 patients with objectively assessed HI and compared with the Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA).

RESULTS

The results indicate that the O‑DEM subtests significantly discriminate between participants with no, mild, and moderate to severe cognitive impairment. Based on the mean and standard deviation of the participants without cognitive impairment, a transformation of the raw scores was performed and a total score with a maximum value of 10 was determined. In the second part of the study, the O‑DEM was shown to be as sensitive as the HI-MoCA in differentiating between people with and without cognitive impairment.

CONCLUSION

Compared to other screenings, the O‑DEM is a quickly administrable screening for the detection of mild and moderate cognitive impairment in people with HI.

Association of placental and umbilical cord characteristics with cerebral palsy: national cohort study

OBJECTIVES

Cerebral palsy (CP) is a group of movement disorders usually diagnosed in childhood. A substantial proportion are thought to be caused by antenatal events. Abnormalities of the umbilical cord and placenta are associated with an increased risk of adverse neonatal outcomes, but it is unclear whether these conditions also carry an increased risk of CP. We aimed to determine whether abnormalities of the umbilical cord or placenta are associated with CP and assess if these associations differ by sex of the child or gestational age at birth.

METHODS

We performed a national cohort study by linking data from The Medical Birth Registry of Norway with other national registries. All liveborn singletons born between 1999 and 2017 (n = 1 087 486) were included and followed up until the end of 2019. Diagnoses of CP were provided by the Norwegian National Insurance Scheme and the Norwegian Patient Register. We used generalized estimating equations and multilevel log binomial regression to calculate relative risks (RR), adjusted for year of birth, and stratified analyses were carried out based on sex and gestational age at birth. Exposures were abnormal umbilical cord (velamentous or marginal insertion, single umbilical artery (SUA), knots and entanglement), and placental abnormalities (retained placenta, placental abruption and previa).

RESULTS

A total of 2443 cases with CP (59.8% males) were identified. Velamentous cord insertion (adjusted RR (aRR), 2.11 (95% CI, 1.65-2.60)), cord knots (aRR, 1.53 (95% CI, 1.15-2.04)) and placental abnormalities (placenta previa (aRR, 3.03 (95% CI, 2.00-4.61)), placental abruption (aRR, 10.63 (95% CI, 8.57-13.18)) and retained placenta (aRR, 1.71 (95% CI, 1.32-2.22))) carried an increased risk of CP. Velamentous cord insertion was associated with CP regardless of gestational age or sex. A retained placenta was associated with a 2-fold increased risk for CP in males, while the associations of SUA and cord knot with CP were significant only among females.

CONCLUSIONS

The detection of placental and umbilical cord abnormalities may help identify children at increased risk of CP. The associations between placental or umbilical cord abnormalities and the risk of CP do not vary substantially with gestational age at birth or sex of the child. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

POS1039 PSORIATIC ARTHRITIS AND PHYSICAL ACTIVITY, A SYSTEMATIC REVIEW

Background:

The beneficial effects of physical activity (PA) have been demonstrated in rheumatoid arthritis and ankylosing spondylitis on disease and co-morbidities while they are not clearly established in psoriatic arthritis.

Objectives:

Thus, the aim of this study was, on the basis of a systematic review of the literature, (i) to assess the level of physical activity in these patients and (ii) to determine the effects of physical activity on joint and extra articular symptoms and on well-being.

Methods:

The research strategy was performed on Pubmed, Cochrane,and PEDro databases using the following keywords: “psoriatic arthritis AND physical activity” without restriction. Articles published in English before October 2019 were identified and selected according to the PRISMA methodology by two independent investigators. In case of disagreement, a third investigator was interviewed. To be included in the qualitative synthesis, the studies had to meet the PICOS criteria.

Results:

Among the 259 studies identified, 13 were finally included. 241 were excluded because they did not address the topic or were not in English and 5 were duplicated. Two epidemiological studies revealed that 17 and 68 % of patients comply with WHO recommendations for the general population in terms of physical activity. The main explanations expressed by patients are; a lack of promotion of physical activity by the rheumatologist and the fear of pain during the movement also called “kinesiophobia”. Among the three prospective randomized clinical trials, one of them showed a significant 20% reduction in the BASDAI (Bath Ankylosing Spondylitis Disease) and a 25% reduction in pain. Fatigue was significantly reduced by 15% following a physical activity protocol on a cyclergometer for 11 weeks. Muscle strength and maximum VO2 were significantly improved after participation in the physical activity protocol in two of the clinical trials. Four retrospective studies evaluated the effect of physical activity on the risk of enthesitis or dactylitis. None were associated with an increased risk of enthesitis. However, physical activity was found to be a risk factor for structural remodelling of the Achilles tendon. And, avoiding physical activity seems to be a protective factor against the risk of enthesitis. On the other hand, the three clinical trials did not mention any increase in the disease’s activity score. Finally, the effects of four rehabilitation programs have been evaluated in psoriatic arthritis and other inflammatory rheumatism. The beneficial effects were modest and concerned the reduction of pain for all the programs and of fatigue for two of the programs.

Conclusion:

The studies showed a beneficial effect of physical activity on disease activity, on well-being and on comorbidities. The data on the risk of enthesitis are reassuring. Further investigations are necessary to confirm these results and to precise the modalities of exercise.

Table 1.

PICOS criteria according to PRISMA methodology.

ParticipantsAdults > 18 years old,Psoriatic Arthritis defined to CASPAR classification criteria (2006) or Moll Wright criteria (1973)InterventionAny type of physical activity regardless of intensity and durationComparisonControl group (not mandatory)OutcomesLevel of physical activityDisease activity scoreComorbiditiesStudy designNo restriction

Disclosure of Interests:

None declared.

Transcriptome and regulatory maps of decidua-derived stromal cells inform gene discovery in preterm birth

While a genetic component of preterm birth (PTB) has long been recognized and recently mapped by genome-wide association studies (GWASs), the molecular determinants underlying PTB remain elusive. This stems in part from an incomplete availability of functional genomic annotations in human cell types relevant to pregnancy and PTB. We generated transcriptome (RNA-seq), epigenome (ChIP-seq of H3K27ac, H3K4me1, and H3K4me3 histone modifications), open chromatin (ATAC-seq), and chromatin interaction (promoter capture Hi-C) annotations of cultured primary decidua-derived mesenchymal stromal/stem cells and in vitro differentiated decidual stromal cells and developed a computational framework to integrate these functional annotations with results from a GWAS of gestational duration in 56,384 women. Using these resources, we uncovered additional loci associated with gestational duration and target genes of associated loci. Our strategy illustrates how functional annotations in pregnancy-relevant cell types aid in the experimental follow-up of GWAS for PTB and, likely, other pregnancy-related conditions.

EXTH-48. BMP4 BINDING PEPTIDE AMPHIPHILE NANOFIBERS FOR THE TREATMENT OF PEDIATRIC HIGH-GRADE GLIOMAS

Pediatric high-grade glioma (pHGG) is among the most formidable cancers occurring in childhood. Bone morphogenetic protein 4 (BMP4) reduces the number of glioma stem-like cells and induces apoptosis. Treating tumors with exogenous BMP4 could prove effective in treating gliomas. However, a short half-life limits its clinical application. Glycosylated peptide amphiphile (GlycoPA), with a design inspired by heparin’s natural ability to bind growth factors including BMP4 through non-covalent interactions, was previously characterized and found to form high-aspect ratio supramolecular nanofibers that present growth-factor binding sulfated monosaccharides on their surface. These supramolecular nanofibers could carry excessive amounts of growth factor and markedly enhance their biological function. In this study, we verified that GlycoPA is able to bind BMP4 and dramatically increase its half-life with an ELISA assay. We also show that GlycoPA-BMP4, in comparison to free BMP4, significantly decreases pHGG cells’ proliferation in vitro. Initial in vivo intracranial distribution experimental results showed that GlycoPA has a superior normal brain distribution in comparison to a control PA (E2 PA) that has the same base structure as GlycoPA except with no glycosylated group. Preliminary results show that GlycoPA-BMP4 markedly decreases pediatric glioma tumor growth in comparison to free BMP4. Our combined in vitro and in vivo results demonstrate PA supramolecular nanofibers as an innovative and promising BMP4 delivery platform for clinical application in the treatment of brain tumors. Our future directions will investigate the therapeutic efficacy of GlycoPA-BMP4 in pediatric HGG through testing large numbers of animals and introducing first-line clinical chemotherapy drugs in combination and in various consequence.

[Prevalence and characteristics of apraxic deficits after left and right hemisphere stroke]

Die überwiegende Anzahl bisheriger Studien zu Apraxien fokussiert die Rolle der linken Hemisphäre (LH), obwohl im klinischen Alltag apraktische Defizite auch bei Patienten mit rechtshemisphärischen Schlaganfällen (RH) beobachtet werden. Daher wurden in der aktuellen Untersuchung die Prävalenz und Ausprägung apraktischer Defizite bei Patienten mit linkshemisphärischen (n = 66) und rechtshemisphärischen (n = 73) Schlaganfällen verglichen, nachdem für Alter und sprachliche Leistung kontrolliert worden war.

Unter Anwendung dieser Kontrollvariablen ergab sich kein signifikanter Unterschied zwischen den linkshemisphärisch und rechtshemisphärisch betroffenen Patienten bei der Imitation von Handpositionen. Übereinstimmend mit früheren Berichten schnitten die Patienten mit rechtshemisphärischen Schlaganfällen aber bei der Imitation der Fingerkonstellationen schlechter ab. Interessanterweise zeigten die rechtshemisphärisch betroffenen Patienten auch geringere Leistungen bei den bukkofazialen Items des Kölner Apraxie Screenings (KAS), vornehmlich bei Gesten der oberen Gesichtshälfte. Für beide Patientengruppen wirkten sich sprachliche Auffälligkeiten mehr auf die Pantomime- als auf die Imitationsleistungen beeinträchtigend aus.

Die Ergebnisse legen nahe, dass nach der Kontrolle für Alter und sprachliche Leistungen die Prävalenz und Ausprägung apraktischer Defizite bei Patienten mit rechts- und linkshemisphärischen Schlaganfällen nicht signifikant unterschiedlich sind und in den jeweiligen Rehabilitationsprogrammen entsprechend berücksichtigt werden sollten.

Single umbilical artery and risk of congenital malformation: population-based study in Norway

OBJECTIVES

Single umbilical artery (SUA) is associated with congenital malformations in most organ systems, but reported findings have not been consistent. While it has been suggested that genetic and persisting environmental factors influence the development of SUA, it is not known whether there is an increased risk of recurrence in a subsequent pregnancy of the same woman. The aims of this study were to investigate the occurrence of, and risk factors for, SUA in Norway, to assess its association with congenital malformations and trisomies 13, 18 and 21 and to study the risk of recurrence of SUA in subsequent pregnancies.

METHODS

This was a population-based study of all (n = 918 933) singleton pregnancies of > 16 weeks' gestation recorded in the Medical Birth Registry of Norway from 1999 to 2014. To identify risk factors and congenital malformations associated with SUA, generalized estimating equations and logistic regression were used to calculate odds ratios (OR) with 95% CIs. ORs were also calculated for the recurrence of SUA in subsequent pregnancy.

RESULTS

The occurrence of SUA in our population was 0.46% (4241/918 933). Parity ≥ 4, smoking, maternal pregestational diabetes, epilepsy, chronic hypertension, previous Cesarean delivery and conception by assisted reproductive technology increased the odds of having SUA. There was a particularly strong association between SUA and gastrointestinal atresia or stenosis in the neonate, with ORs of 25.8 (95% CI, 17.0-39.1) and 20.3 (95% CI, 13.4-30.9) for esophageal and anorectal atresia or stenosis, respectively, followed by an OR of 5.9 (95% CI, 1.9-18.5) for renal agenesis. SUA was associated with an up to 7-8 times increased risk of congenital heart defects. There was an association with microcephaly, congenital hydrocephalus and other congenital malformations of the brain and spinal cord. Diaphragmatic hernia, limb reductions and cleft lip or palate had a weaker association with SUA, with ORs ranging from 4.8 to 2.8. The associations with trisomy 18 and 13 were equally strong (OR 14.4 (95% CI, 9.3-22.4) and OR 13.6 (95% CI, 6.7-27.8), respectively), and the risk of trisomy 21 was doubled (OR 2.1 (95% CI, 1.2-3.6)). Pregnancies with SUA, with or without an associated malformation, had a 2-fold increased risk for SUA in a subsequent pregnancy.

CONCLUSIONS

SUA is associated strongly with gastrointestinal atresia or stenosis, suggesting common developmental mechanisms. The increased risk of recurrence of SUA suggests that genetic and/or persisting environmental factors influence the risk. We found that SUA had equally strong associations with trisomies 13 and 18. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

EXTH-18. PEPTIDE NANO-STRUCTURES ENHANCE PEDIATRIC BRAIN TUMOR CHEMOTHERAPEUTIC EFFICACY

Pediatric gliomas, particularly high-grade gliomas, which include diffuse intrinsic pontine gliomas (DIPGs), are among the most formidable and devastating cancers in children. These tumors remain incurable, despite many treatment approaches. We recently identified a small population of glioma cells with stem-like features in pediatric gliomas (glioma stem cells: GSCs), that may be responsible, for therapeutic resistance. Bone morphogenetic protein 4 (BMP4), essential for CNS development, increases GSC therapeutic sensitivity and is a promising adjuvant for glioma treatment. Mechanisms through which BMP4 increases therapeutic sensitivity need to be elucidated, as this can lead to identification of additional treatment targets and delivery systems for BMP4 administration in a clinical setting. Additionally, extension of BMP4 short half-life would enhance its’ clinical application. Here we show that BMP4 increases chemosensitivity by decreasing H3K4me3 at the promoter of multidrug resistant gene 1 (MDR1), resulting in decreased MDR1 expression. BMP4 appears to bring about this effect by decreasing hSETD1A, an H3K4me3 methyltransferase. Our work also demonstrates the first use of a novel sulfated glycopeptide (glyco-PA) nanostructure as a vector for BMP4 delivery. Glyco-PA markedly extended and enhanced BMP4 function, and increased chemotherapeutic anti-tumor activity against pediatric malignant glioma cells in culture. Overall, this work illuminates BMP4 effects on pediatric glioma therapeutic sensitivity through epigenetic mechanisms, and demonstrates the potential of bioactive glyco-PA nanostructures as a delivery mechanism for treating pediatric malignant gliomas and other tumors.

The Multiple Sclerosis Inventory of Cognition for Adolescents (MUSICADO): A brief screening instrument to assess cognitive dysfunction, fatigue and loss of health-related quality of life in pediatric-onset multiple sclerosis

OBJECTIVE

Screening for cognitive impairment (CI), fatigue and also Health-related quality of life (HRQoL) in patients with pediatric-onset multiple sclerosis (POMS) is of utmost importance in clinical practice. The aim of this study was to establish a new and validated pediatric screening tool "MUSICADO" that is easy to use and time economical.

METHODS

106 patients with POMS aged 12-18 years and 210 healthy controls (HCs) stratified for age and education underwent neuropsychological testing including a screening test "Multiple Sclerosis Inventory of Cognition" for adults and 8 standardized cognitive tests and established scales to assess fatigue and HRQoL.

RESULTS

The phonemic verbal fluency task (RWT "s-words"), the Trail Making Test A (TMT-A), and the Digit Span Forward discriminated significantly between patients and HCs (p = 0.000, respectively) and showed the highest proportion of test failure in patients (24.5%, 17.9%; 15.1%, respectively). Therefore, they were put together to form the cognitive part of the "MUSICADO". After applying a scoring algorithm with balanced weighting of the subtests and age and education correction and a cut-off score for impairment, 35.8% of patients were categorized to be cognitively impaired (specificity: 88.6%). Fatigue was detected in 37.1% of the patients (specificity: 94.0%) and loss of HRQoL in 41.8% (specificity 95.7%) with the screening version, respectively.

CONCLUSION

The MUSICADO is a newly designed brief and easy to use screening test to help to early identify CI, fatigue, and loss of HRQoL in patients with POMS as cut scores are provided for all three items. Further studies will have to show its usability in independent samples of patients with POMS.

Abstract 3432: Novel roles of LY6K in glioblastoma tumorigenesis

Glioblastoma (GBM) is the most malignant brain cancer, with extremely poor prognosis in patients. GBM tumors are characterized by distinct molecular subtypes, known as proneural (PN), classical, and mesenchymal (MES). Inherited heterogeneity and aberrant aggressiveness contribute to therapy resistance and frequent recurrence of malignant GBM tumors. In addition, GBM tumors also contain a small subpopulation of tumor-initiating or stem-like cancer cells (GSCs). Gene expression profiling studies from our laboratory showed that patient-derived GSCs can also be classified into two subtypes, PN and MES, that are phenotypically similar to clinical GBM. Among three thousand genes that are differentially expressed between PN and MES-like GSCs, Lymphocyte Antigen 6 Complex, Locus K (LY6K) was identified as one of the top differentially expressed genes. LY6K is a GPI-anchored protein from the LY6 family. Several members of the LY6 family have been implicated in human cancers, including breast, esophageal, and lung cancers. Moreover, the function of LY6K in GBM has not been reported. Here, we examined the roles of LY6K upregulation in GBM tumorigenesis and investigated the underlying mechanism of LY6K action. We hypothesized that high levels of LY6K in GSCs promotes GBM tumorigenesis. Based on our other preliminary data, we further hypothesized that LY6K functions by enhancing ERK activation, thus promoting radioresistance. To test our hypotheses, we first examined the role of LY6K in advancing GBM tumorigenic behaviors of GSCs. We performed in vitro and in vivo tumorigenicity assays and showed that the presence of LY6K significantly increases GSC cell growth and glioma sphere forming ability in vitro and promotes tumor formation in orthotopic brain xenograft mouse models. The underlying mechanism governing LY6K expression was found to be DNA promoter methylation. Moreover, irradiation strongly induces LY6K expression via demethylation of LY6K promoter in GSCs with otherwise undetectable levels of LY6K. Furthermore, we investigated the mechanism by which LY6K contributes to GSC tumorigenicity. We observed that there is a strong relationship between LY6K and ERK signaling in GSCs and U87 glioma cells. The presence of LY6K stimulates ERK activation and subsequently augments cell proliferation of GSCs. Lastly, we identified the GPI-anchor domain of LY6K as a key region in enhancing ERK activation and are currently examining the mechanistic properties of this domain. The mechanistic insights gained from our studies will advance current knowledge of aberrantly upregulated LY6K and ERK signaling enhancement in promoting GBM tumorigenicity.

Citation Format: Namratha G. Sastry, Tianzhi Huang, Angel Alvarez, Rajendra Pangeni, Xiao Song, Xuechao Wan, John Kessler, Ichiro Nakano, Bo Hu, Shi-Yuan Cheng. Novel roles of LY6K in glioblastoma tumorigenesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3432.

Maternal exercise, season and sex modify the daily fetal heart rate rhythm

AIM

The knowledge on biological rhythms is rapidly expanding. We aimed to define the longitudinal development of the daily (24-hour) fetal heart rate rhythm in an unrestricted, out-of-hospital setting and to examine the effects of maternal physical activity, season and fetal sex.

METHODS

We recruited 48 women with low-risk singleton pregnancies. Using a portable monitor for continuous fetal electrocardiography, fetal heart rate recordings were obtained around gestational weeks 24, 28, 32 and 36. Daily rhythms in fetal heart rate and fetal heart rate variation were detected by cosinor analysis; developmental trends were calculated by population-mean cosinor and multilevel analysis.

RESULTS

For the fetal heart rate and fetal heart rate variation, a significant daily rhythm was present in 122/123 (99.2%) and 116/121 (95.9%) of the individual recordings respectively. The rhythms were best described by combining cosine waves with periods of 24 and 8 hours. With increasing gestational age, the magnitude of the fetal heart rate rhythm increased, and the peak of the fetal heart rate variation rhythm shifted from a mean of 14:25 (24 weeks) to 20:52 (36 weeks). With advancing gestation, the rhythm-adjusted mean value of the fetal heart rate decreased linearly in females (P < .001) and nonlinearly in males (quadratic function, P = .001). At 32 and 36 weeks, interindividual rhythm diversity was found in male fetuses during higher maternal physical activity and during the summer season.

CONCLUSION

The dynamic development of the daily fetal heart rate rhythm during the second half of pregnancy is modified by fetal sex, maternal physical activity and season.

Abstract 3175: Sulfated glycopeptide nanostructures activate and extend bone morphogenetic protein 4 ability to increase pediatric malignant glioma chemotherapeutic efficacy

Pediatric gliomas, particularly high-grade gliomas, are among the most formidable and devastating cancers in children. These tumors have remained incurable, regardless of the many treatment approaches attempted. We recently identified a small population of glioma cells with stem-like features in pediatric gliomas (glioma stem cells: GSCs), that may be responsible, for therapeutic resistance in pediatric gliomas. Signaling by bone morphogenetic protein 4 (BMP4), an essential molecule for central nervous system (CNS) development, increases GSC therapeutic sensitivity, and whose activation is a promising adjuvant for glioma treatment. Mechanisms through which BMP4 increases therapeutic sensitivity need to be elucidated as this can lead to the identification of additional targets for treating malignant gliomas in children. Delivery systems for administering BMP4 in a clinical setting also need to be developed. Here, we show that BMP4 increases chemosensitivity by decreasing H3 lysine 4 trimethylation (H3K4me3) at the promoter of multidrug resistant gene 1 (MDR1) that, in turn, results in increased BMP4 expression. This appears to be the result of BMP4 decreasing levels of hSETD1A, a critical methyltransferase for H3K4me3. Our work also demonstrates the first use of a novel sulfated glycopeptide (glycol-PA) nanostructure as a vector for delivery of BMP4. Glycol-PA markedly extended and enhanced BMP4 function, and increased chemotherapeutic anti-tumor activity against pediatric malignant glioma cells in culture. Overall, our results expand understanding of how BMP4 brings about glioma therapeutic sensitization through epigenetic mechanisms, and show that highly bioactive glyco-PA nanostructures have potential as a novel delivery mechanism for treating pediatric malignant glioma, as well as other tumors.

Citation Format: Guifa Xi, Benjamin Best, Sonali Nayak, Mark McClendon, Barbara Mania-Farnell, John Kessler, Charles David James, Samuel Stupp, Tadanori Tomita. Sulfated glycopeptide nanostructures activate and extend bone morphogenetic protein 4 ability to increase pediatric malignant glioma chemotherapeutic efficacy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3175.

Abstract 1122: MST4 phosphorylation of ATG4B regulates autophagic activity, tumorigenicity, and radio resistance in glioblastoma

Autophagy-mediated intracellular catabolism sustains the rapid growth of established tumors and tumors in response to multiple stresses including genotoxic/cytotoxic therapies. Here we identify and validate ATG4B, a key regulator that stimulates autophagic process by promoting autophagosome through reversible modification of ATG8 as a novel substrate of mammalian sterile20-like kinase (STK) 26/MST4 that is less known for its function in cellular process (none in autophagy) and unknown authentic substrates in cancer. We show that MST4 phosphorylates ATG4B at serine residue 383, which stimulates ATG4B activity and increases autophagic flux. Inhibition of MST4 or ATG4B activities suppresses autophagic process and the tumorigenicity of glioblastoma (GBM) cells. Furthermore, radiation induces MST4 expression, ATG4B phosphorylation and autophagy. Inhibiting ATG4B in combination with radiotherapy in treating mice with intracranial GBM tumor xenografts markedly slows tumor growth and provides significant survival benefit to animal subjects. This study not only describes a novel regulatory mechanism by which the MST4-ATG4B axis accelerates autophagic process, regulates GBM tumorigenicity, and responses to radiotherapy (RT), but also explores imminent clinical utility of combination of ATG4B inhibition with RT to suppress orthotopic GBM tumor xenografts. This study should prove generalizable to other types of cancer and have positive impacts in advancing our knowledge of cancer biology and designing new cancer treatments.

Citation Format: Tianzhi Huang, Chung Kwon Kim, Angel A. Alvarez, Rajendra P Pangeni, Xuechao Wan, xiao song, Taiping shi, Yongyong Yongyong, Namratha Sastry, Craig Horbinski, Songjian Lu, Roger Stupp, John Kessler, Ryo Nishikawa, Ichiro Nakano, Erik Sulman, Xinghua Lu, Charles David James, Xiao-Ming Yin, Bo Hu, Shi-Yuan Cheng. MST4 phosphorylation of ATG4B regulates autophagic activity, tumorigenicity, and radio resistance in glioblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1122.

[Potential of specialized outpatient palliative care]

Palliative care patients with incurable advanced disease suffering from complex symptoms can receive specialized outpatient palliative care in addition to the existing ambulatory care system. Qualified physicians and nurses care for patients and their dependents in cooperation with other professionals. In addition to a 24/7 on-call service for emergencies or acute crises, patients and their dependents are offered regular visits.

Impact of Annealing-Induced Intermixing on the Electronic Level Alignment at the In2S3/Cu(In,Ga)Se2 Thin-Film Solar Cell Interface

The interface between a nominal In2S3 buffer and a Cu(In,Ga)Se2 (CIGSe) thin-film solar cell absorber was investigated by direct and inverse photoemission to determine the interfacial electronic structure. On the basis of a previously reported heavy intermixing at the interface (S diffuses into the absorber; Cu diffuses into the buffer; and Na diffuses through it), we determine here the band alignment at the interface. The results suggest that the pronounced intermixing at the In2S3/CIGSe interface leads to a favorable electronic band alignment, necessary for high-efficiency solar cell devices.

Foetal Doppler abnormality is associated with increased risk of sepsis and necrotising enterocolitis in preterm infants

AIM

Fetoplacental Doppler abnormalities have been associated with increased neonatal mortality and morbidity. This study evaluated the associations between prenatal Doppler assessments and neonatal mortality and morbidity in premature infants born small for gestational age or after pre-eclampsia.

METHODS

This was a population-based study of infants born alive at 22(0) -33(6) weeks of gestation, a birthweight <10th percentile for gestational age and/or maternal pre-eclampsia. Doppler assessments of the umbilical artery, middle cerebral artery and ductus venosus were evaluated in 127, 125 and 95 cases, respectively. Circulatory compromise was defined as absent or reversed end-diastolic velocity in the umbilical artery (AREDF), middle cerebral artery pulsatility index <2.5 percentile for gestational age and ductus venosus pulsatility index for veins >97.5 percentile.

RESULTS

AREDF was present in 28% of the infants. This was associated with increased frequencies of neonatal sepsis and necrotising enterocolitis after adjusting for gestational age. Abnormal ductus venosus pulsatility index for veins was associated with increased risk of neonatal sepsis, but only in combination with AREDF. These associations were only present when gestational age was <28 weeks.

CONCLUSION

AREDF was associated with increased neonatal morbidity in premature infants born small for gestational age or after pre-eclampsia.

[DemTect 40- and DemTect 80+: New scoring routines for these age groups]

The DemTect, a frequently used cognitive screening tool for the German-speaking population, has been proven to be age-, but not education-dependent. To date, scoring routines for persons under and over 60 years of age have been available. In order to describe the age-effect more specifically, the DemTect was administered to persons under 40 (n = 105; median 33 years [18 - 39]) and over 80 years of age [n = 68; median 83 years [80 - 93}). After transformation of the raw scores, which are based on the mean and standard deviation of the respective reference group, an adequate attribution of scores could be achieved and no differences between the groups can be observed in the total score or the subtest scores. The median of the transformed total score was 16 [5 – 18] for the younger and 15 [5 – 18] for the older age group. The new scoring routines supplement the scoring procedures of the DemTect for these age groups.

An assessment of electric vehicles: technology, infrastructure requirements, greenhouse-gas emissions, petroleum use, material use, lifetime cost, consumer acceptance and policy initiatives

Concerns about climate change, urban air pollution and dependence on unstable and expensive supplies of foreign oil have led policy-makers and researchers to investigate alternatives to conventional petroleum-fuelled internal-combustion-engine vehicles in transportation. Because vehicles that get some or all of their power from an electric drivetrain can have low or even zero emissions of greenhouse gases (GHGs) and urban air pollutants, and can consume little or no petroleum, there is considerable interest in developing and evaluating advanced electric vehicles (EVs), including pure battery-electric vehicles, plug-in hybrid electric vehicles and hydrogen fuel-cell electric vehicles. To help researchers and policy-makers assess the potential of EVs to mitigate climate change and reduce petroleum use, this paper discusses the technology of EVs, the infrastructure needed for their development, impacts on emissions of GHGs, petroleum use, materials use, lifetime costs, consumer acceptance and policy considerations.

Measurement of the 13C/12C of atmospheric CH4 using near-infrared (NIR) cavity ring-down spectroscopy

A near-infrared (NIR) continuous-wave-cavity ring-down spectrometry (CW-CRDS) device was developed with the goal of measuring seasonal changes in the isotopic composition of atmospheric CH4 on Earth and eventually on Mars. The system consisted of three distributed feedback laser diodes (DFB-LDs), two of which were tuned to the absorption line peaks of (12)CH4 and (13)CH4 at 6046.954 cm(-1) and 6049.121 cm(-1), respectively, and a third that measured the baseline at 6050.766 cm(-1). The multiple laser design improved the long-term stability of the system and increased the data acquisition rate. The acquisition frequency was further increased by utilizing a semiconductor optical amplifier (SOA) to initiate cavity ring-down events. The high repetition rate combined with the superhigh reflectivity mirrors yielded precise isotopic measurements in this NIR region, even though the line strengths of CH4 in this region are 200 times weaker than those of the strongest mid-IR absorption bands. The current system has a detection limit of 1.9 × 10(-12) cm(-1), corresponding to 10 pptv of CH4 at 100 Torr. For ambient air samples that contained 1.9 ppmv CH4, the δ(13)C of the CH4 was determined to be -48.7 ± 1.7‰ (1σ).

Keratinocyte expression of calcitonin gene-related peptide β: implications for neuropathic and inflammatory pain mechanisms

Calcitonin gene-related peptide (CGRP) is a vasodilatory peptide that has been detected at high levels in the skin, blood, and cerebrospinal fluid (CSF) under a variety of inflammatory and chronic pain conditions, presumably derived from peptidergic C and Aδ innervation. Herein, CGRP immunolabeling (IL) was detected in epidermal keratinocytes at levels that were especially high and widespread in the skin of humans from locations afflicted with postherpetic neuralgia (PHN) and complex region pain syndrome type 1 (CRPS), of monkeys infected with simian immunodeficiency virus, and of rats subjected to L5/L6 spinal nerve ligation, sciatic nerve chronic constriction, and subcutaneous injection of complete Freund's adjuvant. Increased CGRP-IL was also detected in epidermal keratinocytes of transgenic mice with keratin-14 promoter driven overexpression of noggin, an antagonist to BMP-4 signaling. Transcriptome microarray, quantitative Polymerase Chain Reaction (qPCR), and Western blot analyses using laser-captured mouse epidermis from transgenics, monolayer cultures of human and mouse keratinocytes, and multilayer human keratinocyte organotypic cultures, revealed that keratinocytes express predominantly the beta isoform of CGRP. Cutaneous peptidergic innervation has been shown to express predominantly the alpha isoform of CGRP. Keratinocytes also express the cognate CGRP receptor components, Calcitonin receptor-like receptor (CRLR), Receptor activity-modifying protein 1 (RAMP1), CGRP-receptor component protein (RCP) consistent with known observations that CGRP promotes several functional changes in keratinocytes, including proliferation and cytokine production. Our results indicate that keratinocyte-derived CGRPβ may modulate epidermal homeostasis through autocrine/paracrine signaling and may contribute to chronic pain under pathological conditions.

Growth of Co-evaporated Cu(In,Ga)Se2 – The Influence of Rate Profiles on Film Morphology

The influence of the evaporation rate profiles on the microstructure of co-evaporated Cu(In,Ga)Se2, (CIGS), is discussed. The influence of Cu excess in the beginning of the CIGS growth has been investigated. In addition, the Ga rate has been varied in order to create bandgap grading in the CIGS film. By studying CIS and CGS films separately and as CGS/CIS stacks results on interdiffusion of In and Ga interdiffusion have been obtained. The resulting thin films are investigated mainly using Scanning Electron Microscopy (SEM) and X-ray Diffraction (XRD). Solar cell devices were prepared and IV measurements performed on samples with varying CIGS deposition parameters.

Technological Development for Commercialization of Amorphous Silicon Based Multijunction Modules

Some of the significant steps in technological development for large-scale commercialization of amorphous silicon (a-Si:H) based multijunction photovoltaic modules are presented. These developments are establishing a high quality baseline process for manufacturing large-area ( ˜ 8 ft2) a-Si:H/a-SiGe:H tandem junction modules with improved stabilized conversion efficiency, throughput, yield, and reduced materials usage.