Tunable anisotropic van der Waals films of 2M-WS2 for plasmon canalization

In-plane anisotropic van der Waals materials have emerged as a natural platform for anisotropic polaritons. Extreme anisotropic polaritons with in-situ broadband tunability are of great significance for on-chip photonics, yet their application remains challenging. In this work, we experimentally characterize through Fourier transform infrared spectroscopy measurements a van der Waals plasmonic material, 2M-WS2, capable of supporting intrinsic room-temperature in-plane anisotropic plasmons in the far and mid-infrared regimes. In contrast to the recently revealed natural hyperbolic plasmons in other anisotropic materials, 2M-WS2 supports canalized plasmons with flat isofrequency contours in the frequency range of ~ 3000-5000 cm-1. Furthermore, the anisotropic plasmons and the corresponding isofrequency contours can be reversibly tuned via in-situ ion-intercalation. The tunable anisotropic and canalization plasmons may open up further application perspectives in the field of uniaxial plasmonics, such as serving as active components in directional sensing, radiation manipulation, and polarization-dependent optical modulators.

[Analysis of the incidence and symptomatology of low anterior resection syndrome after laparoscopic anterior resection for rectal cancer]

Objective: This study aims to explore the temporal trend of Low Anterior Resection Syndrome (LARS) and its symptoms after laparoscopic anterior resection for rectal cancer. Methods: A retrospective cohort study design was employed. The study included primary rectal (adenocarcinoma) cancer patients who underwent laparoscopic anterior resection at Tongji Hospital, Huazhong University of Science and Technology, between January 1, 2010, and December 31, 2020. Complete medical records and follow-up data at 3, 6, 9, 12, and 18 months postoperatively were available for all patients. A total of 1454 patients were included, of whom 1094 (75.2%) were aged ≤65 years, and 597 (41.1%) were females. Among them, 1040 cases (71.5%) had an anastomosis-to-anus distance of 0-5cm, and 86 cases (5.9%) received neoadjuvant treatment. All patients completed the Chinese version of the LARS questionnaire and their LARS occurrence and specific symptom information were recorded at 3, 6, 9, 12, and 18 months postoperatively. Considering past literature and clinical experience, further subgroup analyses were performed to explore the potential impact factors on severe LARS, including anastomosis level, preoperative neoadjuvant therapy, postoperative adjuvant therapy, and the presence of preventive stoma. Results: The occurrence rates of LARS at 3, 6, 9, 12, and 18 months postoperatively were 78.5% (1142/1454), 71.4% (1038/1454), 55.0% (799/1454), 45.7% (664/1454), and 45.7% (664/1454), respectively (χ2=546.180, P<0.001). No statistically significant difference was observed between the 12-month and 18-month time points (P>0.05). When compared with the symptoms at 3 months, the occurrence rates of gas incontinence [1.7% (24/1454) vs. 33.9% (493/1454)], liquid stool incontinence [3.9% (56/1454) vs. 41.9% (609/1454)], increased stool frequency [79.6% (1158/1454) vs. 95.9% (1395/1454)], stool clustering [74.3% (1081/1454) vs. 92.9% (1351/1454)], and stool urgency [46.5% (676/1454) vs. 78.7% (1144/1454)] in the LARS symptom spectrum were significantly alleviated at 12 months (all P<0.05) and remained stable beyond 12 months (all P>0.05). With the extension of postoperative time, the incidence rates of severe LARS exhibited a decreasing trend in different subgroups, of anastomosis level, preoperative neoadjuvant therapy, postoperative adjuvant therapy, and the presence of preventive stoma, and reached stability at 12 months postoperatively (all P>0.05). Conclusion: LARS and its specific symptom profile showed a trend of gradual improvement over time up to 1 year postoperatively, and stabilized after more than 1 year. Increased stool frequency and stool clustering are the most common features of abnormal bowel dys function, which improve slowly after surgery.

Identification and validation of molecular subtypes and prognostic signature for stage I and stage II gastric cancer based on neutrophil extracellular traps

Purpose

This study identified subtypes and prognostic signature of stage I and stage II gastric cancer based on neutrophil extracellular trap (NET)-related genes.

Methods

The gene expression data associated with stage I and stage II gastric cancer were downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. NET-related genes were obtained from previous reference. Differentially expressed NET-related genes were selected by consensus cluster analysis. The differences in immune infiltration between two subtypes were analyzed. Prognosis-related genes were further screened by univariate Cox regression analysis. Gene Set Enrichment Analysis (GSEA) of prognostic signatures was conducted with clusterprofiler. Finally, a miRNA-mRNA-transcription factor (TF) network was constructed.

Results

Total 43 differential NET-related genes were obtained and two subtypes were obtained based on these genes. Patients of cluster 2 had a better prognosis compared to cluster 1. Eight types of immune cells were differential in infiltration level between two subtypes. Following univariate Cox regression analysis, two genes of CXC chemokine receptor 4 (CXCR4) and nuclear factor, erythroid 2-like 2 (NFE2L2) significantly related to patient survival were selected. GSEA of single gene revealed that CXCR4 was associated with allograft rejection and NFE2L2 was associated with drug metabolism-cytochrome P450. A network with 421 miRNA-mRNA-TF regulatory pairs was constructed.

Conclusion

The present study identified two subtypes and a prognostic signature for stage I and stage II gastric cancer based on NET-related genes.

Effects of direct-fed microbial supplementation on performance and immune parameters of lactating dairy cows

We evaluated the effects of supplementing bacterial direct-fed microbial (DFM) on performance, apparent total-tract digestibility, rumen fermentation, and immune parameters of lactating dairy cows. One hundred fourteen multiparous Holstein cows (41 ± 7 DIM) were used in a randomized complete block design with an experiment comprising 14 d of a covariate (pre-experimental sample and data collection) and 91 d of an experimental period. Cows were blocked based on energy-corrected milk (ECM) yield during the covariate period and the following treatments were randomly assigned within each block: (1) control (CON), corn silage-based total mixed ration without DFM; (2) PRO-A, basal diet top-dressed with a mixture of Lactobacillus animalis and Propionibacterium freudenreichii at 3 × 109 cfu/d; and 3) PRO-B, basal diet top-dressed with a mixture of L. animalis, P. freudenreichii, Bacillus subtilis, and Bacillus licheniformis at 11.8 × 109 cfu/d. Milk yield, dry matter intake (DMI), and body weight were measured daily, while milk samples for component analysis were taken on 2 consecutive days of each week of data collection. Feces, urine, rumen, and blood samples were taken during the covariate period, wk 4, 7, 10, and 13 for estimation of digestibility, N-partitioning, rumen fermentation, plasma nutrient status and immune parameters. Treatments had no effect on DMI and milk yield. Fat-corrected milk (3.5% FCM) and milk fat yield were improved with PRO-B, while milk fat percent and feed efficiency (ECM/DMI) tended to increase with PRO-B compared with PRO-A and CON. Crude fat digestibility was greater with PRO-B compared with CON. Feeding CON and PRO-A resulted in higher total volatile fatty acid concentration relative to PRO-B. Percentage of neutrophils tended to be reduced with PRO-A compared with CON and PRO-B. The mean fluorescence intensity (MFI) of anti-CD44 antibody on granulocytes tended to be higher in PRO-B compared with CON. The MFI of anti-CD62L antibody on CD8+ T cells was lower in PRO-A than PRO-B, with PRO-A also showing a tendency to be lower than CON. This study indicates the potential of DFM to improve fat digestibility with consequential improvement in fat corrected milk yield, feed efficiency and milk fat yield by lactating dairy cows. The study findings also indicate that dietary supplementation with DFM may augment immune parameters or activation of immune cells, including granulocytes and T cells; however, the overall effects on immune parameters are inconclusive.

Injectable Antiswelling and High-Strength Bioactive Hydrogels with a Wet Adhesion and Rapid Gelling Process to Promote Sutureless Wound Closure and Scar-free Repair of Infectious Wounds

Developing injectable antiswelling and high-strength bioactive hydrogels with wet tissue adhesiveness and a rapid gelling process to meet the requirements for rapid hemostasis, sutureless wound closure, and scar-free repair of infected skin wounds continues to have ongoing challenges. Herein, injectable, antibacterial, and antioxidant hydrogel adhesives based on poly(citric acid-co-polyethylene glycol)-g-dopamine and amino-terminated Pluronic F127 (APF) micelles loaded with astragaloside IV (AS) are prepared. The H2O2/horseradish peroxidase (HRP) system is used to cause cross-linking of the hydrogel network through oxidative coupling between catechol groups and chemical cross-linking between the catechol group and the amino group. The hydrogels exhibit a rapid gelling process, high mechanical strength, an antiswelling effect, good antioxidant property, H2O2 release behavior, and degradability. In addition, the hydrogels present good wet tissue adhesiveness, high bursting pressure, excellent antibacterial activity, long-term sustained release of AS, and good biocompatibility. The hydrogels perform good hemostasis on mouse liver, rat liver, and rabbit femoral vein bleeding models and achieve much better closure and healing of skin incisions than biomedical glue and surgical sutures. Furthermore, the hydrogel dressing significantly improved the scar-free repair of MRSA-infected full thickness skin defect wounds by modulating inflammation, regulating the ratio of collagen I/III, and improving the vascularization and granulation tissue formation. Thus, AS-loaded hydrogels show huge potential as multifunctional dressings for in vivo hemostasis, sutureless wound closure, and scar-free repair of infected skin wounds.

Comparing Long-Term survival benefits of hepatocellular carcinoma between thermal ablation monotherapy and combined therapy with transarterial Chemoembolization: A propensity score matched study

PURPOSE

To compare the long-term survival benefits of hepatocellular carcinoma (HCC) in thermal ablation (TA) monotherapy and TA combined with transarterial chemoembolization (TACE) using propensity score matching (PSM).

MATERIALS AND METHODS

Between 1 January 2015 and 28 February 2021, 432 consecutive patients (357 men, 75 women; age range, 20-87 years) with HCC (Barcelona Clinic Liver Cancer stage 0-B) underwent ultrasonography-guided percutaneous TA, which included radiofrequency ablation (n = 340) and microwave ablation (n = 92). The association between combined treatment of TACE prior to TA versus TA monotherapy and survival prognosis was evaluated, including (a) local tumor progression (LTP) by using a logistic regression model, and (b) disease-free survival (DFS) and (c) overall survival (OS) by using a Cox proportional hazards model according to propensity score matched data.

RESULTS

After PSM, the final matched cohort consisted of 146 patients, with 73 receiving TA monotherapy and 73 receiving TA combined with TACE. The cumulative LTP rates did not show a significant difference between the two groups (P = 0.960). Neither the DFS nor OS rate was significantly different between the two groups (P = 0.070 and P = 0.680, respectively). The multivariate analysis identified two significant findings. Firstly, ultrasound echo, minimal ablative margin, and high risk of tumor burden score were found to be associated with LTP. Secondly, the type of TA, Child-Turcotte-Pugh grade, ablation time, and lymphocyte-monocyte ratio were identified as independent prognostic factors for OS.

CONCLUSION

The differences in LTP, DFS, and OS rates of HCC patients were found to be statistically non-significant between TA monotherapy and TACE + TA groups. For HCC patients with BCLC stage 0-B, the combination treatment of TACE prior to TA may be not associated with long-term survival benefits relative to TA monotherapy.

Layer-dependent exciton polarizability and the brightening of dark excitons in few-layer black phosphorus

The evolution of excitons from 2D to 3D is of great importance in photo-physics, yet the layer-dependent exciton polarizability hasn't been investigated in 2D semiconductors. Here, we determine the exciton polarizabilities for 3- to 11-layer black phosphorus-a direct bandgap semiconductor regardless of the thickness-through frequency-resolved photocurrent measurements on dual-gate devices and unveil the carrier screening effect in relatively thicker samples. By taking advantage of the broadband photocurrent spectra, we are also able to reveal the exciton response for higher-index subbands under the gate electrical field. Surprisingly, dark excitons are brightened with intensity even stronger than the allowed transitions above certain electrical field. Our study not only sheds light on the exciton evolution with sample thickness, but also paves a way for optoelectronic applications of few-layer BP in modulators, tunable photodetectors, emitters and lasers.

Twist-Angle and Thickness-Ratio Tuning of Plasmon Polaritons in Twisted Bilayer van der Waals Films

Stacking bilayer structures is an efficient way to tune the topology of polaritons in in-plane anisotropic films, e.g., by leveraging the twist angle (TA). However, the effect of another geometric parameter, the film thickness ratio (TR), on manipulating the plasmon topology in bilayers is elusive. Here, we fabricate bilayer structures of WTe2 films, which naturally host in-plane hyperbolic plasmons in the terahertz range. Plasmon topology is successfully modified by changing the TR and TA synergistically, manifested by the extinction spectra of unpatterned films and the polarization dependence of the plasmon intensity measured in skew ribbon arrays. Such TR- and TA-tunable topological transitions can be well explained based on the effective sheet optical conductivity by adding up those of the two films. Our study demonstrates TR as another degree of freedom for the manipulation of plasmonic topology in nanophotonics, exhibiting promising applications in biosensing, heat transfer, and the enhancement of spontaneous emission.

Tunable optical topological transitions of plasmon polaritons in WTe2 van der Waals films

Naturally existing in-plane hyperbolic polaritons and the associated optical topological transitions, which avoid the nano-structuring to achieve hyperbolicity, can outperform their counterparts in artificial metasurfaces. Such plasmon polaritons are rare, but experimentally revealed recently in WTe2 van der Waals thin films. Different from phonon polaritons, hyperbolic plasmon polaritons originate from the interplay of free carrier Drude response and interband transitions, which promise good intrinsic tunability. However, tunable in-plane hyperbolic plasmon polariton and its optical topological transition of the isofrequency contours to the elliptic topology in a natural material have not been realized. Here we demonstrate the tuning of the optical topological transition through Mo doping and temperature. The optical topological transition energy is tuned over a wide range, with frequencies ranging from 429 cm-1 (23.3 microns) for pure WTe2 to 270 cm-1 (37.0 microns) at the 50% Mo-doping level at 10 K. Moreover, the temperature-induced blueshift of the optical topological transition energy is also revealed, enabling active and reversible tuning. Surprisingly, the localized surface plasmon resonance in skew ribbons shows unusual polarization dependence, accurately manifesting its topology, which renders a reliable means to track the topology with far-field techniques. Our results open an avenue for reconfigurable photonic devices capable of plasmon polariton steering, such as canaling, focusing, and routing, and pave the way for low-symmetry plasmonic nanophotonics based on anisotropic natural materials.

Machine learning model for prediction of low anterior resection syndrome following laparoscopic anterior resection of rectal cancer: A multicenter study

BACKGROUND

Low anterior resection syndrome (LARS) severely impairs patient postoperative quality of life, especially major LARS. However, there are few tools that can accurately predict major LARS in clinical practice.

AIM

To develop a machine learning model using preoperative and intraoperative factors for predicting major LARS following laparoscopic surgery of rectal cancer in Chinese populations.

METHODS

Clinical data and follow-up information of patients who received laparoscopic anterior resection for rectal cancer from two medical centers (one discovery cohort and one external validation cohort) were included in this retrospective study. For the discovery cohort, the machine learning prediction algorithms were developed and internally validated. In the external validation cohort, we evaluated the trained model using various performance metrics. Further, the clinical utility of the model was tested by decision curve analysis.

RESULTS

Overall, 1651 patients were included in the present study. Anastomotic height, neoadjuvant therapy, diverting stoma, body mass index, clinical stage, specimen length, tumor size, and age were the risk factors associated with major LARS. They were used to construct the machine learning model to predict major LARS. The trained random forest (RF) model performed with an area under the curve of 0.852 and a sensitivity of 0.795 (95%CI: 0.681-0.877), a specificity of 0.758 (95%CI: 0.671-0.828), and Brier score of 0.166 in the external validation set. Compared to the previous preoperative LARS score model, the current model exhibited superior predictive performance in predicting major LARS in our cohort (accuracy of 0.772 for the RF model vs 0.355 for the preoperative LARS score model).

CONCLUSION

We developed and validated a robust tool for predicting major LARS. This model could potentially be used in the clinic to identify patients with a high risk of developing major LARS and then improve the quality of life.

Structure and bonding properties of the platinum-mediated tetrametallic endohedral fullerene La3Pt@C98

Nowadays, focus is on encapsulating a greater variety and amount of metal species into fullerene cages due to their diverse structures and fascinating properties. Nevertheless, the encapsulation of more positively charged metal atoms inside one cage means more Coulomb repulsion, which makes the formation of such endohedral metallofullerenes (EMFs) difficult. In general, non-metallic atoms such as N and O should be introduced as mediators for the formation of trimetallic or tetrametallic endohedral fullerenes. However, it is still unknown whether metal atoms can serve as mediators themselves to form such EMFs. In this paper, the endohedral tetrametallic fullerene La₃Pt@C₉₈ with the platinum atom as a metallic mediator is reported. The EMFs of La₃Pt@C_2n (2n = 98-300) were generated by the method of laser ablation in the gas phase and verified by mass spectrometry. Among them, the EMF of La₃Pt@C₉₈ was selected and studied by theoretical calculations. Results show that the two most stable isomers are La₃Pt@C₂(231010)-C₉₈ and La₃Pt@C₁(231005)-C₉₈. For both of them, the inner La₃Pt metallic cluster appears in a pyramidal shape, different from the planar triangular pattern of La₃N clusters previously reported. Further calculations prove the existence of encaged La-Pt bonds in the La₃Pt cluster. It was also revealed that the negatively charged Pt atom is situated near the center of the four-center two-electron (4c-2e) metal bond with the highest occupancy number. The platinum-mediated cluster stabilizes the EMFs greatly, promising the possibility of synthesizing new species of Pt-containing EMFs.

[Clinical analysis of liver dysfunction induced by SHR-1210 alone or combined with apatinib and chemotherapy in patients with advanced esophageal squamous cell carcinoma]

Objective: To investigate the clinical characteristics of abnormal liver function in patients with advanced esophageal squamous carcinoma treated with programmed death-1 (PD-1) antibody SHR-1210 alone or in combination with apatinib and chemotherapy. Methods: Clinical data of 73 patients with esophageal squamous carcinoma from 2 prospective clinical studies conducted at the Cancer Hospital Chinese Academy of Medical Sciences from May 11, 2016, to November 19, 2019, were analyzed, and logistic regression analysis was used for the analysis of influencing factors. Results: Of the 73 patients, 35 had abnormal liver function. 13 of the 43 patients treated with PD-1 antibody monotherapy (PD-1 monotherapy group) had abnormal liver function, and the median time to first abnormal liver function was 55 days. Of the 30 patients treated with PD-1 antibody in combination with apatinib and chemotherapy (PD-1 combination group), 22 had abnormal liver function, and the median time to first abnormal liver function was 41 days. Of the 35 patients with abnormal liver function, 2 had clinical symptoms, including malaise and loss of appetite, and 1 had jaundice. 28 of the 35 patients with abnormal liver function returned to normal and 7 improved to grade 1, and none of the patients had serious life-threatening or fatal liver function abnormalities. Combination therapy was a risk factor for patients to develop abnormal liver function (P=0.007). Conclusions: Most of the liver function abnormalities that occur during treatment with PD-1 antibody SHR-1210 alone or in combination with apatinib and chemotherapy are mild, and liver function can return to normal or improve with symptomatic treatment. For patients who receive PD-1 antibody in combination with targeted therapy and chemotherapy and have a history of long-term previous smoking, alcohol consumption and hepatitis B virus infection, liver function should be monitored and actively managed in a timely manner.

Capillary-driven horseshoe vortex forming around a micro-pillar

HYPOTHESIS

Horseshoe vortices are known to emerge around large-scale obstacles, such as bridge pillars, due to an inertia-driven adverse pressure gradient forming on the upstream-side of the obstacle. We contend that a similar flow structure can arise in thin-film Stokes flow around micro-obstacles, such as used in textured surfaces to improve wettability. This could be exploited to enhance mixing in microfluidic devices, typically limited to creeping-flow regimes.

EXPERIMENTS

Numerical simulations based on the Navier-Stokes equations are carried out to elucidate the flow structure associated with the wetting dynamics of a liquid film spreading around a 50 μm diameter micro-pillar. The employed multiphase solver, which is based on the volume of fluid method, accurately reproduces the wetting dynamics observed in current and previous (Mu et al., Langmuir, 2019) experiments.

FINDINGS

The flow structure within the liquid meniscus forming at the foot of the micro-pillar evinces a horseshoe vortex wrapping around the obstacle, notwithstanding that the Reynolds number in our system is extremely low. Here, the adverse pressure gradient driving flow reversal near the bounding wall is caused by capillarity instead of inertia. The horseshoe vortex is entangled with other vortical structures, leading to an intricate flow system with high-potential mixing capabilities.

Artificial intelligence assists surgeons' decision-making of temporary ileostomy in patients with rectal cancer who have received anterior resection

BACKGROUND

Due to the difficult evaluation of the risk of anastomotic leakage (AL) after rectal cancer resection, the decision to perform a temporary ileostomy is not easily distinguishable. The aim of the present study was to develop an artificial intelligence (AI) model for identifying the risk of AL to assist surgeons in the selective implementation of a temporary ileostomy.

MATERIALS AND METHODS

The data from 2240 patients with rectal cancer who received anterior resection were collected, and these patients were divided into one training and two test cohorts. Five AI algorithms, such as support vector machine (SVM), logistic regression (LR), Naive Bayes (NB), stochastic gradient descent (SGD) and random forest (RF) were employed to develop predictive models using clinical variables and were assessed using the two test cohorts.

RESULTS

The SVM model indicated good discernment of AL, and might have increased the implementation of temporary ileostomy in patients with AL in the training cohort (p < 0.001). Following the assessment of the two test cohorts, the SVM model could identify AL in a favorable manner, which performed with positive predictive values of 0.150 (0.091-0.234) and 0.151 (0.091-0.237), and negative predictive values of 0.977 (0.958-0.988) and 0.986 (0.969-0.994), respectively. It is important to note that the implementation of temporary ileostomy in patients without AL would have been significantly reduced (p < 0.001) and which would have been significantly increased in patients with AL (p < 0.05).

CONCLUSION

The model (https://alrisk.21cloudbox.com/) indicated good discernment of AL, which may be used to assist the surgeon's decision-making of performing temporary ileostomy.

Changes in the gut microbiota structure and function in rats with doxorubicin-induced heart failure

Objectives

The rat model of heart failure (HF) induced by doxorubicin (DOX), a broad spectrum and highly effective chemotherapeutic anthracycline with high-affinity to myocardial tissue that causes severe dose-dependent irreversible cardiotoxicity has been widely recognized and applied in HF pathogenesis and drug therapy studies. The gut microbiota (GM) has attracted significant attention due to its potential role in HF, and research in this area may provide beneficial therapeutic strategies for HF. Considering the differences in the route, mode, and total cumulative dose of DOX administration used to establish HF models, the optimal scheme for studying the correlation between GM and HF pathogenesis remains to be determined. Therefore, focusing on establishing the optimal scheme, we evaluated the correlation between GM composition/function and DOX-induced cardiotoxicity (DIC).

Methods

Three schemes were investigated: DOX (at total cumulative doses of 12, 15 or 18 mg/kg using a fixed or alternating dose via a tail vein or intraperitoneal injection) was administered to Sprague Dawley (SD) for six consecutive weeks. The M-mode echocardiograms performed cardiac function evaluation. Pathological changes in the intestine were observed by H&E staining and in the heart by Masson staining. The serum levels of N-terminal pre-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) were measured by ELISA. The GM was analysed by 16S rRNA gene sequencing.

Key findings

Strikingly, based on the severity of cardiac dysfunction, there were marked differences in the abundance and grouping of GM under different schemes. The HF model established by tail vein injection of DOX (18 mg/kg, alternating doses) was more stable; moreover, the degree of myocardial injury and microbial composition were more consistent with the clinical manifestations of HF.

Conclusions

The model of HF established by tail vein injection of doxorubicin, administered at 4mg/kg body weight (2mL/kg) at weeks 1, 3 and 5, and at 2mg/kg body weight (1mL/kg) at weeks 2, 4 and 6, with a cumulative total dose of 18mg/kg, is a better protocol to study the correlation between HF and GM.

Biomaterials-Based Cell Therapy for Myocardial Tissue Regeneration

Cardiovascular diseases (CVDs) have been the leading cause of death worldwide during the past several decades. Cell loss is the main problem that results in cardiac dysfunction and further mortality. Cell therapy aiming to replenish the lost cells is proposed to treat CVDs especially ischemic heart diseases which lead to a big portion of cell loss. Due to the direct injection's low cell retention and survival ratio, cell therapy using biomaterials as cell carriers has attracted more and more attention because of their promotion of cell delivery and maintenance at the aiming sites. In this review, the three main factors involved in cell therapy for myocardial tissue regeneration: cell sources (somatic cells, stem cells, and engineered cells), chemical components of cell carriers (natural materials, synthetic materials, and electroactive materials), and categories of cell delivery materials (patches, microspheres, injectable hydrogels, nanofiber and microneedles, etc.) are systematically summarized. An introduction of the methods including magnetic resonance/radionuclide/photoacoustic and fluorescence imaging for tracking the behavior of transplanted cells in vivo is also included. Current challenges of biomaterials-based cell therapy and their future directions are provided to give both beginners and professionals a clear view of the development and future trends in this area.

Bacterial Growth-Induced Tobramycin Smart Release Self-Healing Hydrogel for Pseudomonas aeruginosa-Infected Burn Wound Healing

Burns are a common health problem worldwide and are highly susceptible to bacterial infections that are difficult to handle with ordinary wound dressings. Therefore, burn wound repair is extremely challenging in clinical practice. Herein, a series of self-healing hydrogels (QCS/OD/TOB/PPY@PDA) with good electrical conductivity and antioxidant activity were prepared on the basis of quaternized chitosan (QCS), oxidized dextran (OD), tobramycin (TOB), and polydopamine-coated polypyrrole nanowires (PPY@PDA NWs). These Schiff base cross-links between the aminoglycoside antibiotic TOB and OD enable TOB to be slowly released and responsive to pH. Interestingly, the acidic substances during the bacteria growth process can induce the on-demand release of TOB, avoiding the abuse of antibiotics. The antibacterial results showed that the QCS/OD/TOB/PPY@PDA9 hydrogel could kill high concentrations of Pseudomonas aeruginosa (PA), Staphylococcus aureus, and Escherichia coli in a short time and showed a bactericidal effect for up to 11 days in an agar plate diffusion experiment, while showing good in vivo antibacterial activity. Excellent and long-lasting antibacterial properties make it suitable for severely infected wounds. Furthermore, the incorporation of PPY@PDA endowed the hydrogel with near-infrared (NIR) irradiation assisted bactericidal activity of drug-resistant bacteria, conductivity, and antioxidant activity. Most importantly, in the PA-infected burn wound model, the QCS/OD/TOB/PPY@PDA9 hydrogel more effectively controlled wound inflammation levels and promoted collagen deposition, vascular generation, and earlier wound closure compared to Tegaderm dressings. Therefore, the TOB smart release hydrogels with on-demand delivery are extremely advantageous for bacterial-infected burn wound healing.

Facile preparation of melamine foam with superhydrophobic performance and its system integration with prototype equipment for the clean-up of oil spills on water surface

A simple and efficient method was developed to rectify the surface properties of commercial melamine foam. The process was based on the siloxane coating originated from the silanization of methyltrimethoxysilane and tetraethoxysilane. The foam can be easily scaled up by employing low-cost chemicals and devices. The studies on the properties of the material showed that the wettability of melamine foam was changed to superhydrophobic with a water contact angle of 156° due to the presence of alkylsilane. The modified foam exhibited excellent oil/water selectivity and high oil absorption capacities of 77-163 times its own weight. The retention of absorption capacity was greater than 97% after 5000 cycles compression. These fascinating characteristics made the modified foam exceptional recyclability for commonly organic solvents and oils without obvious dissolution/swelling. Based on these inspiring results, the material can be employed for the continuous separation of various oil compounds floating on water surface with the assistance of a vacuum pump. Moreover, the prepared material was integrated with an apparatus to develop a prototype oil collector for the remediation of oil spills in a larger open-air environment. The devices could be readily used in a range of real-world applications, including industrial oil spill clean-up.

P-355 Association between high serum uric acid level and adverse reproductive outcomes in infertile women with polycystic ovary syndrome

Study question

Does high serum uric acid (SUA) level affect the reproductive outcomes in women with polycystic ovary syndrome (PCOS) undergoing in-vitro fertilization (IVF)?

Summary answer

Elevated SUA is associated with decreased live birth rate, biochemical pregnancy rate and clinical pregnancy rate, and increased miscarriage rate in women with PCOS.

What is known already

SUA levelsand the prevalence of hyperuricemia (25.48%) are both significantly higher in women with PCOS than in women without PCOS (8.74%). SUA levels also can be used as a predictor of pregnancy complications (gestational diabetes mellitus and hypertensive disorders of pregnancy) and adverse foetal outcomes (preterm birth and low birth weight).

Study design, size, duration

This retrospective cohort study was conducted ininfertile women with PCOS between September 2012 and December 2019.

Participants/materials, setting, methods

A total of 1,032 infertile PCOS women undergoing their first IVF/ICSI cycle were observed. Data of reproductive outcomes including live birth rate, biochemical pregnancy rate, clinical pregnancy rate, and miscarriage rate were analyzed according to the quartile groups of SUA levels.

Main results and the role of chance

In quartiles of SUA levels, there was a significant decreasing trend in live birth rate from the lowest quartile (Q1: 34.5%) to the highest (Q4: 19.2%) (Pfor trend &lt;0.001). Notably, the miscarriage rate in Q4 was significantly higher than that in the other 3 quartiles (all P values &lt; 0.05). From Q1 to Q4, the incidence of miscarriage dramatically increased from 15.5% to 31.0% (Pfor trend &lt;0.05). In addition, the biochemical pregnancy rate and clinical pregnancy rate decreased significantly from the lowest quartile to the highest (Pfor trend &lt;0.05). With the first quartile of uric acid as the reference group, the logistic regression analysis showed that in both unadjusted and adjusted models, elevated SUA level was associated with significantly lower probabilities of live birth, biochemical pregnancy, and clinical pregnancy, and a higher risk of miscarriage in a linear fashion (all Pfor trend&lt; 0.05).

Limitations, reasons for caution

This study is limited by its retrospective design. It was difficult to ensure consistency in clinical practice among the physicians.

Wider implications of the findings

Our study suggeststhat clinical physicians need to pay close attention to PCOS women with high SUA levelsbefore IVF treatment. Prospective studies to determine an appropriate range of lower-SUA levels prior to treatment is necessary to support our findings.

Trial registration number

not applicable

Anisotropic Infrared Response and Orientation-Dependent Strain-Tuning of the Electronic Structure in Nb2SiTe4

Two-dimensional materials with tunable in-plane anisotropic infrared response promise versatile applications in polarized photodetectors and field-effect transistors. Black phosphorus is a prominent example. However, it suffers from poor ambient stability. Here, we report the strain-tunable anisotropic infrared response of a layered material Nb₂SiTe₄, whose lattice structure is similar to the 2H-phase transition metal dichalcogenides (TMDCs) with three different kinds of building units. Strikingly, some of the strain-tunable optical transitions are crystallographic axis-dependent, even showing an opposite shift when uniaxial strain is applied along two in-plane principal axes. Moreover, G₀W₀-BSE calculations show good agreement with the anisotropic extinction spectra. The optical selection rules are obtained via group theory analysis, and the strain induced unusual shift trends are well explained by the orbital coupling analysis. Our comprehensive study suggests that Nb₂SiTe₄ is a good candidate for tunable polarization-sensitive optoelectronic devices.

The relationship between vitamin D receptor gene and TREM-1 gene polymorphisms and the susceptibility and prognosis of neonatal sepsis

Objective

The objective of this was to study the relationship between vitamin D receptor (VDR) and triggering receptor expressed on myeloid cells 1 (TREM‐1) gene single‐nucleotide polymorphisms (SNP) and neonatal sepsis susceptibility and prognosis.

Methods

The blood of 150 neonatal sepsis patients and 150 normal neonates was collected, and genomic DNA was extracted. Sanger sequencing was used to analyze the genotypes of VDR rs739837 and TREM‐1 rs2234246.

Results

Vitamin D receptor rs739837 locus GT, TT genotype, dominant model, and recessive model were all protective factors for sepsis (0 < OR < 1, p < 0.05). The risk of sepsis in carriers of the rs739837 G allele was 0.65 times that of the rs739837 T allele (95% CI: 0.50–0.83, p < 0.001), CT, TT, dominant model, and recessive model at rs2234246 were risk factors for sepsis (OR > 1, p < 0.05). The risk of sepsis in carriers of the rs739837 T allele was 1.38 times that of carriers of the C allele (95% CI: 1.16–1.61, p < 0.001). The polymorphisms of VDR gene rs739837 and TREM‐1 gene rs2234246 were not significantly correlated with the survival of patients with neonatal sepsis (p > 0.05).

Conclusion

Vitamin D receptor gene rs739837 locus G>T is associated with a reduction in the risk of neonatal sepsis, TREM‐1 rs2234246 C>T is associated with the increased risk of neonatal sepsis, but none of them was significantly associated with the prognosis of neonatal sepsis.

Serum Inflammatory Factors and Oxidative Stress Factors Are Associated With Increased Risk of Frailty and Cognitive Frailty in Patients With Cerebral Small Vessel Disease

Objective: To study the correlation between serum inflammatory factors, oxidative stress factors and frailty, and cognitive frailty in patients with cerebral small vessel disease (CSVD).

Methods: A total of 281 patients with CSVD were selected from Tianjin Huanhu Hospital and Inner Mongolia People's Hospital from March 2019 to March 2021. CSVD was diagnosed by MRI. The FRAIL scale was used to evaluate the frailty of patients. Patients with CSVD with frailty and MMSE score <27 were considered to have cognitive frailty. Patients with non-cognitive frailty were included in the control group. The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients with CSVD. The serum interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase 3 (MMP-3), superoxide dismutase (SOD), and malondialdehyde (MDA) of patients with CSVD were detected. The correlation between blood inflammatory factors and oxidative stress factors with the frailty and cognitive frailty patients of CSVD were analyzed. Univariate and multivariate logistic regression were used to analyze the correlation between cognitive frailty and CSVD.

Results: Among the patients with CSVD selected in this study, female patients and older patients had a higher proportion of frailty (p < 0.001). In the Frail group, MoCA score and MMSE score were significantly lower than in the Pre-Frail and Robust groups, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores were significantly higher than the Pre-Frail and Robust groups, and the differences were statistically significant (p < 0.05). Serum CRP, IL-6, TNF-α, MMP-3, and MDA levels in the Frail group were higher, but SOD levels were lower. The levels of serum CRP, IL-6, TNF-α, MMP-3, and MDA in patients with CSVD in the Cognitive Frailty group were significantly higher than those of the Control group, while the levels of SOD were significantly lower than those of the Control group, and the differences were significant (p < 0.001). The results of univariate and multivariate logistic regression analysis showed that CRP, TNF-α, MMP-3, and MDA levels were associated with cognitive frailty in patients with CSVD (p < 0.05).

Conclusion: The increase of serum CRP, TNF-α, MMP-3, and MDA levels are significantly related to the increased risk of frailty and cognitive frailty in patients with CSVD.

Layer-Dependent Pressure Effect on the Electronic Structure of 2D Black Phosphorus

Through infrared spectroscopy, we systematically study the pressure effect on electronic structures of few-layer black phosphorus (BP) with layer number ranging from 2 to 13. We reveal that the pressure-induced shift of optical transitions exhibits strong layer dependence. In sharp contrast to the bulk counterpart which undergoes a semiconductor to semimetal transition under ∼1.8  GPa, the band gap of 2 L increases with increasing pressure until beyond 2 GPa. Meanwhile, for a sample with a given layer number, the pressure-induced shift also differs for transitions with different indices. Through the tight-binding model in conjunction with a Morse potential for the interlayer coupling, this layer- and transition-index-dependent pressure effect can be fully accounted. Our study paves a way for versatile van der Waals engineering of two-dimensional BP.

Lactobacillus plantarum and molasses alter dynamic chemical composition, microbial community, and aerobic stability of mixed (amaranth and rice straw) silage

BACKGROUND

The objective was to determine how molasses and Lactobacillus plantarum affect chemical composition, fermentation quality, aerobic stability, and the microbial community of an ensiled mixture of amaranth (Amaranthus hypochondriaus, AF) and rice straw. Treatments were control (C, no addition), L. plantarum (L; 2 × 10⁵  cfu g^-1 fresh weight), molasses (M; 40 g kg^-1 fresh matter), and their combination (LM). All treatments were ensiled for 1, 3, 5, 7, and 30 days.

RESULTS

All additives improved fermentation quality with greater lactic acid (LA), acetic acid, and lower pH than C silage over the ensiling period. The LM silage combination optimized fermentability, manifested as greater LA contents and a more rapid pH reduction during the first 7 days of ensiling than L or M silages. After 30 days of ensiling, inoculant L. plantarum increased Lactobacillus abundance and reduced bacterial diversity and Enterobacteriaceae abundance compared with silage treated with molasses. Molasses addition reduced the relative concentration of structural carbohydrates (neutral and acid detergent fiber, and hemicellulose) after 30 days of ensiling. Finally, there was spoilage after 2 days and 4 days of aerobic exposure in C and LM silages respectively, whereas L silage had not spoiled after 4 days.

CONCLUSIONS

Although the combination of L. plantarum and molasses further optimized fermentation characteristics, L silage had better aerobic stability. © 2021 Society of Chemical Industry.

Measurements of neutral particle energy spectrum on EAST using a time-of-flight low-energy neutral particle analyzer

The neutral particles generated by charge exchange reactions can play an important role in erosion of first wall materials in fusion devices. In order to measure the flux and energy of neutral particles to the first wall, a low-energy neutral particle analyzer (LENPA) based on the time-of-flight method has been developed and successfully applied on the Experimental Advanced Superconducting Tokamak (EAST)' to measure the neutrals with an energy of 20-3000 eV. The LENPA works in the counting mode, and the signal of photons is used as the reference for the flight time of neutrals. The energy spectrum of low-energy neutral particles on EAST has been obtained for the first time. The new diagnostics can help in understanding the neutral particle generation and deposition on the first wall materials in tokamaks under different plasma conditions.

Tunable Terahertz Plasmons in Graphite Thin Films

Tunable terahertz plasmons are essential for reconfigurable photonics, which have been demonstrated in graphene through gating, though with relatively weak responses. Here we demonstrate strong terahertz plasmons in graphite thin films via infrared spectroscopy, with dramatic tunability by even a moderate temperature change or an in situ bias voltage. Meanwhile, through magnetoplasmon studies, we reveal that massive electrons and massless Dirac holes make comparable contributions to the plasmon response. Our study not only sets up a platform for further exploration of two-component plasmas, but also opens an avenue for terahertz modulation through electrical bias or all-optical means.

Plasmons in the van der Waals charge-density-wave material 2H-TaSe2

Plasmons in two-dimensional (2D) materials beyond graphene have recently gained much attention. However, the experimental investigation is limited due to the lack of suitable materials. Here, we experimentally demonstrate localized plasmons in a correlated 2D charge-density-wave (CDW) material: 2H-TaSe2. The plasmon resonance can cover a broad spectral range from the terahertz (40 μm) to the telecom (1.55 μm) region, which is further tunable by changing thickness and dielectric environments. The plasmon dispersion flattens at large wave vectors, resulted from the universal screening effect of interband transitions. More interestingly, anomalous temperature dependence of plasmon resonances associated with CDW excitations is observed. In the CDW phase, the plasmon peak close to the CDW excitation frequency becomes wider and asymmetric, mimicking two coupled oscillators. Our study not only reveals the universal role of the intrinsic screening on 2D plasmons, but also opens an avenue for tunable plasmons in 2D correlated materials.

Eicosapentaenoic acid enhances skeletal muscle hypertrophy without altering the protein anabolic signaling pathway

This study aimed to examine the effect of eicosapentaenoic acid (EPA) on skeletal muscle hypertrophy induced by muscle overload and the associated intracellular signaling pathways. Male C57BL/6J mice were randomly assigned to oral treatment with either EPA or corn oil for 6 weeks. After 4 weeks of treatment, the gastrocnemius muscle of the right hindlimb was surgically removed to overload the plantaris and soleus muscles for 1 or 2 weeks. We examined the effect of EPA on the signaling pathway associated with protein synthesis using the soleus muscles. According to our analysis of the compensatory muscle growth, EPA administration enhanced hypertrophy of the soleus muscle but not hypertrophy of the plantaris muscle. Nevertheless, EPA administration did not enhance the expression or phosphorylation of Akt, mechanistic target of rapamycin (mTOR), or S6 kinase (S6K) in the soleus muscle. In conclusion, EPA enhances skeletal muscle hypertrophy, which can be independent of changes in the AKT-mTOR-S6K pathway.

Risk screening of mycotoxins and their derivatives in dairy products using a stable isotope dilution assay and LC-MS/MS

An liquid chromatography-tandem mass spectrometry method coupled with a stable isotope dilution assay was established for the simultaneous detection of 17 mycotoxins and their derivatives (aflatoxins B₁ , B₂ , G₁ , G₂ , M₁ , and M₂ ; fumonisins B₁ and B₂ ; ochratoxin A; zearalenone; zearalanone; α-zearalanol; α-zearalenol; T-2 toxin; deoxynivalenol; deepoxy-deoxynivalenol; and sterigmatocystin) in milk and dairy products. The mycotoxins were extracted with acidified acetonitrile and the lipids were removed using a Captiva EMR-lipid column. The average recoveries of the target compounds from samples spiked at three different concentrations were 67-102%, and the relative standard deviations of the peak areas were less than 10%. Limits of quantification (S/N = 10) of 0.004-1.25 μg/kg were achieved, which are significantly lower than the maximum levels allowed in various countries and regions for each regulated mycotoxin. Milk and yogurt products from local markets and e-commercial platforms were analyzed using the optimized method. The screening showed that aflatoxin M₁ , deoxynivalenol, fumonisins B₁ and B₂ , and zearalenone could be found in milk and yogurt products, especially those products also containing grains or jujube ingredients, indicating that there is a risk of mycotoxins in dairy products.

Obesity prevalence and risks among Chinese adults: findings from China PEACE Million Persons Project, 2014–2018

Background

With demographic and epidemiologic transitions, China has become home to the greatest number of obese individuals in the world. Effective policy intervention requires a contemporary assessment of obesity across broad socio-demographic subgroups.

Purpose

We aim to assess the prevalence of overall and abdominal obesity by socio-demographic characteristics and the associations of these characteristics with obesity in China.

Methods

Using the data of 2.7-million community-dwelling participants aged 35–75 years in the China PEACE Million Persons Project, a nationwide cross-sectional screening project from 2014 to 2018, we calculated the prevalence of overall and abdominal obesity based on national guideline definitions (body mass index ≥28 kg/m2, waist circumference ≥85/90 cm for women/men). We examined 12 available socio-demographic variables that are potentially associated with obesity, in addition to self-reported co-morbidities, and quantified the associations of these socio-demographic characteristics with obesity using multivariable mixed models.

Results

The prevalence of overall and abdominal obesity were 15.8% and 37.6% in women and 15.0% and 36.3% in men (Figure). Compared to individuals with normal weight, those with overall obesity had a higher prevalence of hypertension, dyslipidemia, and diabetes (in women: by 30.4, 16.1, and 6.0 percent points; in men, by 29.9, 31.2, and 5.8 percent points). A similar pattern was observed with abdominal obesity. In women, those aged 55–64 years constituted the largest age group with overall and abdominal obesity (33.7% and 35.0%), while in men, those aged 45–54 and 55–64 years constituted the largest age group with overall obesity (30.4%) and abdominal obesity (30.5%), respectively. Older women were at substantially higher risk for obesity (e.g., adjusted relative risk [95% CI] of women aged 65–75 vs. 35–44 years: 1.29 [1.27–1.31] for overall obesity and 1.76 [1.74–1.77] for abdominal obesity) while older men were not. Higher education was associated with lower risk in women (e.g., those with college or university education vs. less than primary school: 0.47 [0.46–0.48] for overall obesity and 0.61 [0.60–0.62] for abdominal obesity) but higher risk in men (1.07 [1.05–1.10] and 1.17 [1.16–1.19]). In both women and men, current smoking was associated with lower risk for obesity, and current drinking was associated with higher risk, but the magnitude of associations was smaller in women than men.

Conclusions

In China, over one in seven individuals meet criteria for overall obesity, and one in three for abdominal obesity. Wide variation exists across socio-demographic subgroups. The associations of age and education with obesity are significant and differ by sex. Understanding obesity in contemporary China has broad domestic policy implications and provides a valuable international reference.

Figure 1

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): The National Key Research and Development Program from the Ministry of Science and Technology of China, the CAMS Innovation Fund for Medical Science

Age-dependent cardiac remodelling – role of sex hormones

Background

While cardiovascular mortality in women has exceeded those in men, women continue to be underrepresented in cardiovascular clinical trials. Further, preclinical experiments are predominantly conducted in male animals, rendering sex-specific variables contributing to cardiovascular disease largely unknown. As age and menopause remain to be key risk factors for cardiovascular disease in women, the aim of this study was to identify key variables of cardiac remodelling in the aging female and male heart, as well as to assess effects of sex hormone deprivation on left ventricular (LV) morphology, LV function and cardiac sympathetic activity.

Materials and methods

Gonadectomized and sham-operated FVB/N mice of both sexes were subjected to positron emission tomography (PET) and cardiac magnetic resonance (CMR) imaging at the age of 4 (young cohort) and 20 (aged cohort) months (total n=123, 55% females). Following tail-vein injection of [11C]meta-hydroxynorephedrine ([11C]mHED), a widely used PET probe in preclinical and clinical assessment of cardiac sympathetic integrity, animals were scanned and cardiac sympathetic outflow was derived from myocardial [11C]mHED uptake. Cardiac parameters including LV volumes and left ventricular ejection fraction (LVEF) were obtained from electrocardiogram (ECG)-gated CMR imaging.

Results and discussion

A significant increase of LVEF was observed in aging females (p=0.012, Figure 1), but not in males. The latter was not associated with a higher cardiac output, and was a consequence of reduced LV end-systolic volumes (p=0.008), unveiling a substantial reduction of size in the aging female heart. As this age-dependent observation was not present in gonadectomized animals (p=0.414), the lack of growth-stimulating estrogen might account for reduction of cardiac size in aging females. Thus, despite a significantly heightened body weight, female heart size is reduced with age. Accordingly, sufficient cardiac output was maintained via increased heart rate (p=0.005) and cardiac sympathetic activity (p=0.040, Figure 1). Gonadectomy accelerated age-dependent changes in LV morphology and function in female mice. While sex hormone deprivation blunted cardiac sympathetic activity and norepinephrine levels in male mice, an opposite trend was observed in females.

Conclusion

Despite increasing body weight with age, aged female and male hearts maintain a stable circulatory blood supply, however, by distinct mechanisms. While the “shrinking” female heart requires an increased heart rate and cardiac sympathetic activity to compensate for smaller ventricular volumes, aging males maintain cardiac size. Importantly, sex hormone deprivation at a young age accelerates age-dependent changes in LV morphology and function in female mice, but not in male mice. The increased sympathetic activity reflects a higher stress level in aged females that might expose them to a higher cardiac vulnerability at postmenopausal age.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation; Swissheart Foundation

From Anomalous to Normal: Temperature Dependence of the Band Gap in Two-Dimensional Black Phosphorus

The temperature dependence of the band gap is crucial to a semiconductor. Bulk black phosphorus is known to exhibit an anomalous behavior. Through optical spectroscopy, here we show that the temperature effect on black phosphorus band gap gradually evolves with decreasing layer number, eventually turns into a normal one in the monolayer limit, rendering a crossover from the anomalous to the normal. Meanwhile, the temperature-induced shift in optical resonance also differs with different transition indices for the same thickness sample. A comprehensive analysis reveals that the temperature-tunable interlayer coupling is responsible for the observed diverse scenario. Our study provides a key to the apprehension of the anomalous temperature behavior in certain layered semiconductors.

Differentiated cancer cell-originated lactate promotes the self-renewal of cancer stem cells in patient-derived colorectal cancer organoids

Tumors harbor diverse compartments of cells with distinct metabolic properties and phenotypes, but the mechanism by which metabolic commensalism among distinct subsets of cancer cells affects tumor progression remains unclear. Colorectal cancer (CRC) has been reported to consist of cancer stem cells (CSCs) and differentiated cancer cells (non-CSCs). In the present study, organoid models were employed to show that CSCs and non-CSCs in CRC were characterized by distinct metabolic phenotypes. Treatment with either non-CSC-derived conditioned medium or exogenous lactate enhanced organoid-forming and tumor-initiating capacity of CSCs. In tumor regeneration assays with co-implanted CSCs and non-CSCs, the tumor-initiating activity was reduced when either monocarboxylate transporter (MCT)4 in non-CSCs or MCT1 in CSCs was silenced or inhibited. Mechanistically, oxiadative phosphorylation-derived reactive oxygen species in CSCs activated AKT-Wnt/β-catenin signaling, which could be induced by lactate from non-CSCs. Overall, these results suggest that CSCs and non-CSCs possess distinct metabolic profiles and, unexpectedly, non-CSC-originated lactate promotes self-renewal of CSCs and thus contributes to CRC progression. Our findings establish a rationale for developing novel therapies targeting the metabolic commensalism between different cell populations in CRC.

Development of a quartz crystal microbalance diagnostic for measuring material erosion and deposition on the first wall in EAST

A quartz crystal microbalance (QMB) diagnostic system has been established in Experimental Advanced Superconducting Tokamak (EAST) for real-time and in situ measurements of erosion and deposition rates of plasma-facing materials at the first wall. A ∼70 nm aluminum (Al) film has been coated on the QMB crystal surface to measure the erosion rate by charge exchange neutral particles. Dual sensors of the QMB system have been used with a closed sensor for reference. The stability and light sensitivity of the QMB system have been tested in the lab, demonstrating its feasibility on the application of EAST experiments. The QMB system with cooling water has been successfully applied in the 2018 EAST campaign. The net erosion thickness measured by the QMB has been well validated by thickness measurements using the Rutherford backscattering spectrometry. The developed QMB systems can help us to understand the physics processes of material erosion and deposition at main chamber walls for long pulse operations in EAST.

OP0093 FREQUENCIES AND PREDICTORS OF THE LUPUS LOW DISEASE ACTIVITY STATE AND REMISSION IN TREATMENT-NAÏVE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS -- A REAL-WORLD COHORT STUDY

Background:

After the introduction of treat-to-target strategy in systemic lupus erythematosus (SLE), Lupus Low Disease Activity State (LLDAS) and definitions of remission in SLE (DORIS) were developed and validated. Several studies had demonstrated that the achievement and maintenance of LLDAS or DORIS was associated with good prognosis.

Objectives:

To evaluate the attainability of LLDAS and DORIS in a treatment-naïve cohort of SLE.

Methods:

LDAS5 was defined as LLDAS with a prednisone dose ≤5 mg/d. There were 4 definitions in DORIS: clinical remission on treatment (RONT), complete RONT, clinical remission off treatment (ROFT) and complete ROFT. The treatment-naïve patients from Peking University First Hospital SLE cohort were enrolled. The time to each state and their annual cumulative probabilities were estimated by Kaplan-Meier approach. The frequencies of patients who achieved each component of LLDAS or DORIS during follow-up were determined.

Results:

A total of 218 treatment-naïve patients were included, with a median follow-up of 4.48 years. Respectively, 190 (87.2%), 160 (73.4%), 148 (67.9%), 94 (43.1%), 23 (10.6%) and 18 (8.3%) patients achieved LLDAS, LLDAS5, clinical RONT, complete RONT, clinical ROFT and complete ROFT at least once during the follow-up time. The median time to LLDAS, LLDAS5, clinical RONT and complete RONT were 1.4, 2.3, 2.6 and 4.7 years, respectively.

Table 1.

Frequencies, time to achieve and annual cumulative probabilities of each state by Kaplan-Meier approach

StatesAchieved patientsNumber (%)Time to achieve(years)Cumulative probabilities of achievement (%)Year 1Year 2Year 3Year 4Year 5LLDAS190 (87.2)1.418.869.786.789.192.6LLDAS5160 (73.4)2.36.940.763.376.082.3Clinical RONT148 (67.9)2.65.536.156.168.876.6Complete RONT94 (43.1)4.74.122.637.545.350.4Clinical ROFT23 (10.6)NA1.42.95.46.710.6Complete ROFT18 (8.3)NA0.92.54.84.88.8Table 2.

Patients who achieved each component of LLDAS or DORIS during follow-up

ComponentsNumber (%)SLEDAI-2K ≤4, with no activity in major organ systems (renal, central nervous system, cardiopulmonary, vasculitis, fever), and no haemolytic anaemia or gastrointestinal active213 (97.7)Clinical SLEDAI-2K =0210 (96.3)PGA ≤1217 (99.5)PGA <0.5199 (91.3)Serology (anti-dsDNA and complement) negative148 (67.9)Prednisone dose ≤7.5 mg/day201 (92.2)Prednisone dose ≤5 mg/day171 (78.4)No prednisone dose40 (18.3)No prednisone dose and Immunosuppressants32 (14.7)

Conclusion:

Our data confirmed that LLDAS is an attainable early treatment target for SLE. Though with more difficulty, RONT can be achieved in two-thirds of our patients. ROFT may not be an ideal treatment target at present as it is only attained in few patients.

References:

[1]Franklyn, K. et al. Ann Rheum Dis. 2016 Sep;75(9):1615-21.

[2]van Vollenhoven, R. et al. Ann Rheum Dis. 2017 Mar;76(3):554-561.

Disclosure of Interests:

None declared

AB0380 THERAPEUTIC CHOICES AND OUTCOMES IN CHINESE PATIENTS WITH SEROLOGICALLY ACTIVE CLINICALLY QUIESCENT SYSTEMIC LUPUS ERYTHEMATOSUS

Background:

Patients with systemic lupus erythematosus (SLE) who achieved the clinical state as serologically active clinically quiescent (SACQ). It appears to account for 6–12% of all patients with SLE, but there is disagreement about whether such patients are indeed clinically stable [1-3], especially in Chinese patients. And there is no conclusion as to what kind of treatment should be taken for such patients.

Objectives:

To clarify the frequency and outcome of SACQ patients in lupus. And to identify factors associated with the flare of disease.

Methods:

Clinical data of patients diagnosed as SLE and followed in Peking University First Hospital from 2009 to 2015 were retrospectively reviewed. 682 patients with systemic lupus erythematosus who were followed up for more than 6 months at Peking University First Hospital from January 2007 to December 2015 were summarized. SACQ was defined as an at least a 6-month period with persistent serologic activity and without clinical activity and could be taking a daily dose of prednisone or equivalent less than 7.5 mg. Serologically quiescent clinically quiescent (SQCQ) patients and serologically active clinically active (SACA) patients served as control groups. Data including demographics, initial symptoms, duration to SACQ, treatments before and after SACQ, and characteristics of the flare group were analyzed.

Results:

Of the 682 patients, 170 were SACQ patients (24.9%), 187 were SQCQ patients, and 325 were SACA patients (47.7%). SQCQ patients (38.61±15.08 years old) were older at study start than SACQ patients (38.61±15.08 years vs. 32.09±14.35 years, p<0.001), but there was no significant difference between that of SACQ and SACA patients. 56 of the 170 SACQ patients (32.9%) experienced flare. Corticosteroids (OR 1.317, 95% CI 1.131 to 1.534; p<0.001) was an independent risk factor for flare, while antimalarials (OR 0.265, 95% CI 0.118 to 0.599; p=0.001) and immunosuppressants (OR 0.316, 95% CI 0.149 to 0.670; p=0.003) were protective factors.

Conclusion:

About one third of SLE patients with SACQ experience flare, more than that of patients with SQCQ. Thus, approach to prevent relapse in SACQ patient is required. Maintenance therapy of hydroxychloroquine and immunosuppressant agents may be protective and beneficial treatment strategy in these patients need further investigation.

References:

[1]Gladman DD, Urowitz MB, Keystone EC. Serologically active clinically quiescent systemic lupus erythematosus: a discordance between clinical and serologic features. Am J Med 1979; 66:210-5.

[2]Huang WN, Tso TK, Wu HC, Yang HF, Tsay GJ. Impaired phagocytosis of apoptotic cell material in serologically active clinically quiescent patients with systemic lupus erythematosis. Int J Rheum Dis 2016; 19:1310-6.

[3]Steiman AJ, Gladman DD, Ibañez D, Urowitz MB. Prolonged serologically active clinically quiescent systemic lupus erythematosus: frequency and outcome. J Rheumatol 2010; 37:1822-7.

Disclosure of Interests:

None declared

THU0247 FREQUENCY AND PREDICTORS OF THE LUPUS LOW DISEASE ACTIVITY STATE IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: AN OBSERVATIONAL COHORT STUDY

Background:

As a consensus-based definition of minimally acceptable disease activity in systemic lupus erythematosus (SLE), Lupus Low Disease Activity State (LLDAS) has been well-validated and widely accepted. However, no data about the time to LLDAS in Asian ethnicity has been reported so far.

Objectives:

To estimate the time to LLDAS and the predictors of time to LLDAS in our prospective observational cohort of Chinese patients with SLE.

Methods:

Patients were from Peking University First Hospital SLE cohort and those having not fulfilled LLDAS at enrolment were included in this study. The time to LLDAS and annual cumulative probabilities of LLDAS achievement were estimated by the Kaplan-Meier approach. The predictors of time to LLDAS were identified by univariate and multivariable Cox proportional hazards.

Results:

A total of 574 patients with SLE were included and 435 (75.8%) of them achieved LLDAS during a median 4.2 years of follow-up. The median time to LLDAS was 19.0 months and the cumulative probabilities at 1, 2, 3, 5 and 10 years were 19.8%, 57.6%, 72.0%, 85.1% and 98.0%, respectively. In multivariable Cox models, older age at disease onset, treatment-naïve and hydroxychloroquine prescription were found to be independent predictors of shorter time to LLDAS, after adjusted by daily prednisone dose, SLE Disease Activity Index 2000 and physician’s global assessment. Finally, we developed a matrix model based on the identified independent predictors to present the time to LLDAS in patients with respective characteristics.

Conclusion:

Our study proved that LLDAS is attainable as an early treatment target for SLE in Chinese patients. The older age at disease onset, treatment-naïve and hydroxychloroquine prescription were independent predictors of shorter time to LLDAS.

References:

[1]Franklyn K, Lau CS, Navarra SV, Louthrenoo W, Lateef A, Hamijoyo L, Wahono CS, Chen SL, Jin O, Morton S, Hoi A, Huq M, Nikpour M, Morand EF; Asia-Pacific Lupus Collaboration. Ann Rheum Dis. 2016 Sep;75(9):1615-21.

Table 1

Baseline variables associated with LLDAS achievement based on multivariable Cox models

CharacteristicsModel 1Model 2Model 3HR (95% CI)pvalueHR (95% CI)pvalueHR (95% CI)pvalueAge at disease onset, years1.010 (1.003-1.016)0.0051.009 (1.002-1.016)0.0101.010 (1.003-1.017)0.004Treatment-naïve1.346 (1.105-1.641)0.0031.425 (1.161-1.749)0.0011.484 (1.204-1.830)<0.001Nephritis0.776 (0.641-0.939)0.0091.066 (0.820-1.385)0.6340.925 (0.737-1.160)0.498SLEDAI0.968 (0.950-0.987)0.001PGA0.685 (0.551-0.853)0.001Daily prednisone (or equivalent) dose, mg/d1.003 (0.998-1.007)0.2661.005 (0.999-1.010)0.093HCQ1.638 (1.263-2.123)<0.0011.713 (1.318-2.225)<0.0011.664 (1.284-2.157)<0.001

Disclosure of Interests:

None declared

Developing Interpreting Competence Scales in China

Tertiary-level interpreter training and education have developed rapidly in China, and over 200 undergraduate and over 200 postgraduate T&I programs have been launched over the past decade. Despite the rapid development, there has been no standardized framework allowing for the reliable and valid measurement of interpreting competence in China. Against this background, the China Standards of English (CSE), which are the Chinese counterpart to the Common European Framework of Reference (CEFR), were unveiled in 2018 after 4 years of government-funded research and validation. One vital component of the CSE is the descriptor-referenced interpreting competence scales. This article provides a systematic account of the design, development, and validation of the interpreting competence scales in China. Within the CSE, the construct of interpreting competence was defined according to an interactionist approach. It not only encompasses cognitive abilities, interpreting strategies, and subject-matter knowledge but also considers performance in typical communicative settings. Based on the construct definition, a corpus of relevant descriptors was built from three main sources, including: (a) interpreting training syllabuses, curricular frameworks, rating scales, and professional codes of conduct; (b) previous literature on interpreting performance assessment, competence development, and interpreter training and education; and (c) exemplar-generation data on assessing interpreting competence and typical interpreting activities, which were collected from interpreting professionals, trainers, and trainees. The corpus contains 9,208 descriptors of interpreting competence. A mixed-method survey was then conducted to analyze, scale, and validate the descriptors among 30,682 students, 5,787 teachers, and 139 interpreting professionals from 28 provinces, municipalities, and regions in China. The finalized set included 369 descriptors that reference interpreting competence. The CSE—Interpreting Competence Scales with theoretically and empirically based descriptors represent a major effort in research on interpreting competence and its assessment, and they have significant potential to be applied widely in interpreting training, research, and assessment.

[Application of totally extraperitoneal renal autotransplantation with Boari flap-pelvis anastomosis in upper urinary tract urothelial carcinomas treatment]

OBJECTIVE

To evaluate the feasibility and effectiveness of the totally extraperitoneal renal autotransplantation with boari flap-pelvis anastomosis in the treatment of upper urinary tract urothelial carcinoma (UTUC), and to review the experience of renal autotransplantation for UTUC treatment.

METHODS

One case of applying the totally extraperitoneal renal autotransplantation with boari flap-pelvis anastomosis to the UTUC treatment was reported, and related literature was reviewed. The patient was a sixty-four-year old man who received right radical nephroureterectomy for right ureteral carcinoma 1 year before and diagnosed as left ureteral carcinoma(G2, high grade) this time. In order to preserve his renal function and avoid the shortness of common kidney-sparing surgery, a totally extraperitoneal procedure, including retroperitoneoscopic nephrectomy, ureterectomy, renal autotransplantation and Boari flap-pelvis anastomosis, was performed to the patient.

RESULTS

The operation was completed successfully without perioperative complications. The renal function recovered to preoperative level within 1 week. No deterioration of renal function during the follow-up and no tumor recurrence was observed under cystoscopy at the 3-month postoperative consult.

CONCLUSION

The totally extraperitoneal renal autotransplantation with Boari flap-pelvis anastomosis is a feasible and effective treatment for UTUC. The innovative procedure has several advantages compared to the former ones. The extraperitoneal procedure results in significantly less pain, shorter hospital stay, decreased overall time to recovery and lower bowel complications risk without warm ischemia time extension. Meanwhile, the Boari flap-pelvis anastomosis simplifies the follow -up protocols and creates an easy route for cystoscopy and topical therapy. From the systematic clinical analysis, as well as the related literature review, it's been concluded that the renal autotransplantation can be a reasonable option for the patients who have UTUC in solitary kidney or have bilateral UTUC. This type of treatment possesses advantages of preservation of renal function and total resection of malignant lesions. But long-term data and large cohort study on renal function or tumor recurrence are still absent which will be necessary to confirm the advantages of this approach.

Selection of Internal Standards for Quantitative Matrix-Assisted Laser Desorption/Ionization Mass Spectrometric Analysis Based on Correlation Coefficients

Matrix-assisted laser desorption/ionization mass spectrometry (MALDI MS) has shown its great success in the qualitative analysis of a wide range of organic and biological molecules. However, its application in quantitative analysis is still limited by the difficulty in the availability of isotope-labeled internal standards. The present work investigates the relationship between the correlation coefficient of the peak intensities of analyte and candidate internal standard ions and the linearity of possible quantitative analysis. Based on the two analyte examples, ciprofloxacin and substance P, the results show that the performance of the selected nonisotope-labeled internal standard is greatly related to the correlation coefficient. A high positive correlation coefficient (>0.7) between the ions of analyte and candidate standard can result in a good linearity (R ² > 0.98) and vice versa. The results provide a new way to select nonisotope-labeled internal standards for MALDI analysis and thus can be potentially applied in the rapid quantitative mass spectrometry.

Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome

PURPOSE

The effects of adipose insulin resistance on cardiovascular risk factors in polycystic ovary syndrome (PCOS) remain largely unknown. We aimed to investigate associations between adipose insulin resistance and cardiovascular risk factors in PCOS.

METHODS

A total of 207 PCOS and 47 non-PCOS women were recruited from a large reproductive medicine center in this cross-sectional study. The PCOS diagnosis was based on the Rotterdam Criteria. The subjects received a standard oral glucose tolerance test. Adipose insulin resistance was evaluated using a validated index (adipose-IR = fasting insulin × free fatty acid concentrations).

RESULTS

The women with PCOS showed a higher adipose-IR index, and the adipose-IR index was tightly associated with the blood pressure, glucose and lipid parameters. A total of 98.0% of the women with PCOS in the highest adipose-IR quartile showed cardiovascular risk factors (obesity, hypertension, glucose intolerance or dyslipidemia), and this percentage was significantly higher than the percentage of those in the lowest quartile (32.7%). In addition, the percentages of women with three (31.4%) and four (13.7%) cardiovascular risk factors were significantly elevated in the highest adipose-IR quartile. The multivariable logistic regression analysis indicated that each 1-SD increment in the adipose-IR index resulted in higher risks of obesity (OR = 3.18, 95% CI = 2.12-4.76), hypertension (OR = 1.89, 95% CI = 1.31-2.73), glucose intolerance (OR = 2.45, 95% CI = 1.73-3.48), and dyslipidemia (OR = 2.18, 95% CI = 1.57-3.01). The C-reactive protein (CRP) level was positively associated with the adipose-IR index in women with PCOS (r = 0.45, P < 0.001).

CONCLUSIONS

The adipose-IR index was associated with cardiovascular risk factors in women with PCOS. Chronic inflammation may induce insulin resistance in the adipose tissue of women with PCOS.