Convolutional LSTM-LSTM model for predicting the daily number of influenza patients in South Korea using satellite images

OBJECTIVES

Influenza affects a considerable proportion of the global population each year, and meteorological conditions may have a significant impact on its transmission. In this study, we aimed to develop a prediction model for the number of influenza patients at the national level using satellite images and provide a basis for predicting influenza through satellite image data.

STUDY DESIGN

We developed an influenza incidence prediction model using satellite images and influenza patient data.

METHODS

We collected satellite images and daily influenza patient data from July 2014 to June 2019 and developed a convolutional long short-term memory (LSTM)-LSTM neural network model. The model with the lowest average of mean absolute error (MAE) was selected.

RESULTS

The final model showed a high correlation between the predicted and actual number of influenza patients, with an average MAE of 5.9010 per million population. The model performed best with a 2-week time sequence.

CONCLUSIONS

We developed a national-level prediction model using satellite images to predict influenza incidence. The model offers the advantage of nationwide analysis. These results may reduce the burden of influenza by enabling timely public health interventions.

The impact of COVID-19 on the hot food takeaway planning regulatory environment: perspectives of local authority professionals in the North East of England

AIMS

Planning regulations have been used to prevent the over-proliferation of hot food takeaways, minimising the impact of local obesogenic environments. To help mitigate the effects of lockdown, the UK government introduced temporary changes in March 2020 to Planning Regulations for England, allowing food retailers to open for takeaway services beyond 'ancillary' level without needing to apply for planning permission through permitted development rights (PDR). Businesses are required to notify their local authority (LA) when they implement PDRs. To better understand the impact of regulations on the policy and practice of key professional groups, Public Health England commissioned Teesside University to undertake scoping research in the North East of England.

METHODS

A focus group and interviews were conducted with 15 professionals from 7 of 12 North East LAs. Professions included Planners, Public Health Leads, Environmental Health Officers and Town Centre Managers. Data were analysed using a codebook thematic analysis approach. An interpretation meeting with some participants was conducted.

RESULTS

LAs were not aware of most businesses notifying them of new regulation adherence despite taking up PDRs, but were considered low-priority with many lacking formal recording procedures. There were concerns about health consequences of the changes, and consensus relating to ongoing issues with capacity across all professional groups, largely due to the continuing pandemic and absence of a strategy out of temporary measures. Concerns existed around ensuring cessation of restaurants trading as takeaways, and hygiene inspections backlog. Many (personally) saw new takeaways as a lifeline, offering broader menus and preserving local economies.

CONCLUSION

Lack of information around the number of restaurants/pubs using PDR to trade as takeaway services, ongoing capacity issues of LAs and, at the time, the absence of a strategy post regulation changes, meant there were high levels of uncertainty regarding the impacts of these temporary measures.

Preventing Teen Pregnancy: A Qualitative Study of the Perspectives of Parenting and Expecting Latino Adolescents

STUDY OBJECTIVE

Latino youths in the United States experience disproportionately high rates of teen pregnancy. The aim of this study was to obtain expecting and parenting Latino adolescents' perspectives regarding factors contributing to teen pregnancy and pregnancy prevention.

METHODS

Expecting/parenting Latino adolescents were recruited from high schools with high proportions of Latino youths and teen pregnancy. Participants completed a questionnaire on sociodemographic and background characteristics. Focus groups were stratified by age and gender and audio recorded. Grounded theory was used to identify themes from the transcribed audio recordings.

RESULTS

Thirty-two expecting/parenting Latino adolescents (20 females, 12 males) 14-19 years old participated in four focus groups. Quantitative results revealed that two-thirds of participants at birth had adolescent mothers. Over three-quarters of participants reported that their pregnancies had occurred too soon. Qualitative themes for factors contributing to teen pregnancy included lack of contraceptive knowledge/access, belief of invincibility, influence within relationships, male decisions on contraceptive use, desire to belong among peers, lack of parental support for contraceptive use, lack of parental attention, rebellion, normalization of adolescent parenthood in Latino culture, and media. Themes for pregnancy prevention included time alone with physicians, parenting teens as mentors, reproductive health education, and community pregnancy-prevention programs.

CONCLUSION

Multiple factors contribute to teen pregnancy in Latino youth, including influences from Latino culture, family, peers, partners, and social determinants of health. Pregnancy prevention should incorporate interventions to address these aspects, including disseminating culturally sensitive education materials, providing parenting teens as peer mentors, encouraging time alone with health care providers, and addressing various social determinants of health.

From association to gist: Some critical tests

We report the first evidence that the gist mechanism of fuzzy-trace theory and the associative mechanism of activation monitoring theory operate in parallel, in the recall version of the Deese/Roediger/McDermott illusion. In three experiments, we implemented a new methodology that allows their respective empirical indexes, gist strength (GS) and backward associative strength (BAS), to each be manipulated while the other is held constant. In Experiment 1, increasing GS increased false recall of missing words, but increasing BAS did not. In Experiments 2 and 3, however, increasing GS and increasing BAS both increased recall of missing words, and those effects were independent and additive. In all three experiments, GS and BAS affected true recall of list words in qualitatively different ways: (a) Increasing GS always improved true recall, regardless of whether BAS was high or low, but (b) increasing BAS impaired true recall when GS was high and improved true recall when GS was low. To pinpoint the retrieval loci of the two variables' effects, we analyzed the data of all experiments with the dual-retrieval model. Those analyses showed that the variables' respective effects were due to different retrieval processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Regulatory mechanisms to create healthier environments: planning appeals and hot food takeaways in England

AIMS

To explore existing regulatory mechanisms to restrict hot food takeaway (HFT) outlets through further understanding processes at local and national levels.

METHODS

The Planning Appeals Portal was utilised to identify recent HFT appeal cases across England between December 2016 and March 2020. Eight case study sites were identified using a purposive sampling technique and interviews carried out with 12 professionals involved in planning and health to explore perceptions of and including factors that may impact on the HFT appeal process. Additionally, documents applicable to each case were analysed and a survey completed by seven Local Authority (LA) health professionals. To confirm findings, interpretation meetings were conducted with participants and a wider group of planning and public health professionals, including a representative from the Planning Inspectorate.

RESULTS

Eight case study sites were identified, and 12 interviews conducted. Participants perceived that LAs would be better able to work on HFT appeal cases if professionals had a good understanding of the planning process/the application of local planning policy and supplementary planning documents; adequate time and capacity to deal with appeals cases; access to accurate, robust, and up to date information; support and commitment from elected members and senior management; good lines of communication with local groups/communities interested in the appeal; information and resources that are accessible and easy to interpret across professional groups.

CONCLUSIONS

Communication across professional groups appeared to be a key factor in successfully defending decisions. Understanding the impact of takeaway outlets on health and communities in the long term was also important. To create a more robust appeals case and facilitate responsiveness, professionals involved in an appeal should know where to locate current records and statistical data. The enthusiasm of staff and support from senior management/elected officials will play a significant role in driving these agendas forward.

Memory effects of semantic attributes: A method of controlling attribute contamination

Rating norms for semantic attributes (e.g., concreteness, familiarity, valence) are widely used to study the content that people process as they encode meaningful material. Intensity ratings of individual attributes have been manipulated in numerous experiments with a range of memory paradigms, but those manipulations are contaminated by substantial correlations with the intensity ratings of other attributes. A method of controlling such contamination is needed, which requires a determination of how many distinct attributes there are among the large collection of attributes for which published norms are available. Identification of overlapping words in multiple rating projects yielded a data base containing normed values for each word's perceived intensity (M rating) and ambiguity (rating SD) on 20 different attributes. Principal component analyses then revealed that the intensity space was spanned by just three latent semantic attributes, and the ambiguity space was spanned by five. Psychologically, the big three intensity factors (emotional valence, size, age) were highly interpretable, as were the big five ambiguity factors (discrete emotion, emotional valence, age, meaningfulness, and verbatim memory). We provide a data base of intensity and ambiguity factor scores that can be used to conduct uncontaminated studies of the memory effects of the intensity and ambiguity of latent semantic attributes.

Genomic features of recombinant CHO clones arising from transposon-based and randomized integration

The use of transposase in cell line development (CLD) programs has experienced increased popularity over the past decade. However, few studies have described the mechanism of action and the genomic and phenotypic characteristics of clones derived from transposase. Additionally, how these traits impact long-term bioproduction is unknown. Here, we use chromosome painting, deep sequencing, and ddPCR to characterize the unique fingerprints associated with transposase-derived clones. Transposase reduces the cellular pool of transient vector as early as three days post transfection following transfection and expedites stable pool establishment by up to two weeks. Furthermore, recombinant DNA expression is significantly improved up to ∼3 fold along with a greater balance of antibody heavy and light chain transcripts, resulting in higher titers in transposase generated pools. Transposase derived pools contained an often innumerable number of integration sites, representing a vast increase in integration site diversity over randomly generated pools, which were bottlenecked at 1-3 integration sites per pool. These transposase mediated integrations typically occurred in clean singlets, free of genomic scars such as deletions, inversions, and other modifications associated with legacy transfection methods which exhibited higher copy numbers per integration site. Relative declines in gene expression occur with copy number increase in the randomly generated, but not the transposase derived clones. Furthermore, transposase-derived clones were more likely to exhibit enhanced a long term stability profile, including product quality attributes such as mannose-5. This improved stability may result from circumventing mechanisms associated with the silencing of tandem repeats. Thus, transposase-mediated approaches can provide multifaceted molecular and phenotypic advantages in cell line development when compared to legacy random-integration methods.

[Clinical observation of bow-tie adjustable suture technique for overcorrection in intermittent exotropia]

Objective: To investigate the clinical effects of the bow-tie adjustable suture technique in managing overcorrection in patients with intermittent exotropia after surgery. Methods: This was a retrospective case series study. Clinical data were collected from children with intermittent exotropia who underwent strabismus correction surgery, including the bow-tie adjustable suture technique and conventional techniques, at the Department of Strabismus and Pediatric Ophthalmology, Shanxi Eye Hospital, from January 2020 to September 2021. Children with postoperative esodeviation≥15 prism diopters (PD) within the first 6 days were treated differently based on the surgical technique and their individual conditions, including suture adjustment and conservative treatment. The overcorrection rate and its changes among different surgical groups, the recovery of ocular alignment and binocular visual function after different treatment methods in children with overcorrection on the sixth postoperative day, and the postoperative complications in different surgical groups were observed. Statistical analysis was performed using independent samples t-test, Wilcoxon rank-sum test, repeated-measures analysis of variance, Bonferroni test, chi-square test, or Fisher's exact probability test, as appropriate. Results: A total of 643 children who underwent intermittent exotropia correction surgery were included in the study. Among them, 325 children underwent the bow-tie adjustable suture technique, with 185 males and 140 females, and the mean age was (9.50±2.69) years. The remaining 318 children underwent conventional techniques, with 176 males and 142 females, and the mean age was (9.90±2.67) years. There were no statistically significant differences in age and gender distribution between the two surgical groups (all P>0.05). On the first postoperative day, among children who underwent the bow-tie adjustable suture technique, 40 had an esodeviation of≥10 PD, resulting in an overcorrection rate of 12.3% (40/325), while among children who underwent conventional techniques, 32 had an esodeviation of≥10 PD, resulting in an overcorrection rate of 10.1% (32/318). On the sixth postoperative day, these rates decreased to 5.5% (18/325) and 3.1% (10/318) in the two groups, respectively. At 1, 6, and 12 months postoperatively, the overcorrection rate in children who underwent the bow-tie adjustable suture technique was 0, while in children who underwent conventional techniques, the overcorrection rate did not show a significant decrease compared to before surgery. The differences between the two surgical groups were statistically significant (all P<0.05). On the sixth postoperative day, among children with an esodeviation of≥15 PD, 13 underwent suture adjustment and 7 received conservative treatment. The results of repeated-measures analysis of variance showed statistically significant differences in near and distance esodeviation angles among children who received different treatment methods (F=145.20, 106.87, both P<0.001), as well as statistically significant differences in near and distance esodeviation angles at different time points within each group of children (F=81.67, 35.09, both P<0.001). There were also significant differences in the trends of change in near and distance esodeviation angles at different time points among children who received different treatment methods (F=79.90, 36.73, both P<0.001). Further pairwise comparisons showed significant differences in near and distance esodeviation angles between the sixth postoperative day and 1, 6, and 12 months postoperatively in children who underwent suture adjustment (all P<0.05), while no statistically significant differences were observed in children who received conservative treatment (all P>0.05). At 12 months postoperatively, among the 13 children who underwent suture adjustment, 12 achieved stereopsis, while among the 7 children who received conservative treatment, all became stereo-blind after removing the prismatic correction. No serious complications occurred in any of the children postoperatively. Conclusion: The proportion of children with intermittent exotropia who achieved orthotropic alignment one year after surgery was relatively low among those who had an overcorrection of≥15 PD on the sixth postoperative day. The bow-tie adjustable suture technique is a simple and effective approach for managing overcorrection in patients with intermittent exotropia. Adjusting the sutures on the sixth postoperative day can reduce the overcorrection rate and is considered a safe and effective method.

The big three: Accuracy, organization, and retrieval effects of latent semantic attributes

Rating norms for semantic attributes (e.g., concreteness, dominance, familiarity, and valence) are widely used in many psychological literatures to study the effects of processing specific types of semantic content. Word and picture norms for many attributes are available for thousands of items, but there is a contamination problem in experimentation. When an attribute's ratings are varied, how the semantic content that people process changes is unclear because ratings of individual attributes are correlated with ratings of so many other attributes. To solve this problem, the psychological space that 20 attributes occupy has been mapped, and factor score norms have been published for the latent attributes that generate that space (emotional valence, age-of-acquisition, and symbolic size). These latent attributes have yet to be manipulated in experimentation, and hence, their effects are unknown. We conducted a series of experiments that focused on whether they affect accuracy, memory organization, and specific retrieval processes. We found that (a) all three latent attributes affected recall accuracy, (b) all three affected memory organization in recall protocols, and (c) all three affected direct verbatim access, rather than reconstruction or familiarity. The memory effects of two of them (valence and age-of-acquisition) were unconditional, but memory effects were only detected for the third at particular levels of the other two. The key implications are that semantic attributes can now be cleanly manipulated, and when they are, they have broad downstream effects on memory. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A fundamental asymmetry in human memory: Old ≠ not-new and new ≠ not-old

In recognition memory, anything that is objectively new is necessarily not-old, and anything that is objectively old is necessarily not-new. Therefore, judging whether a test item is new is logically equivalent to judging whether it is old, and conversely. Nevertheless, a series of 10 experiments showed that old? and new? judgments did not produce equivalent recognition accuracy. In Experiments 1-4, wherein subjects made old? or new? judgments about test items, new? judgments yielded more accurate performance for old items than old? judgments did, and old? judgments yielded more accurate performance for new items than new? judgments did. This same violation of logical equivalence was observed in Experiments 5-10, wherein subjects made similar? judgments as well as old? and new? ones. In short, old? and new? judgments displayed consistent Judgment × Item crossovers, rather than equivalence. Response latencies were used to test the hypothesis that Judgment × Item crossovers were due to certain judgment-item combinations provoking more deliberate, thorough retrieval than other combinations. There was no support for that hypothesis, but the data were consistent with an earlier theory, which posits that latency depends on the extent to which judgments or items slant retrieval toward accessing verbatim traces. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Minimum standards of pelvic exenterative practice: PelvEx Collaborative guideline

This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.

[Short-term outcomes of prism treatment in a manner of reducing prism diopters step by step for small-angle acute acquired concomitant esotropia]

Objective: To investigate the short-term efficacy of the prism treatment in a manner of reducing prism diopters step by step for small-angle acute acquired concomitant esotropia (AACE). Methods: Retrospective case series study. The clinical data of 17 AACE patients with strabismus ≤25 prism degrees (PD) including 6 males and 11 females, aged 14 to 60 years, who underwent the prism treatment in the Strabismus and Pediatric Ophthalmology Clinic of Shanxi Eye Hospital from October 2018 to June 2020 were collected. The prism treatment was conducted by a step-by-step reduction of prism diopters. An under-corrected prism was applied to the patient for the first time, and the degree of the prism was reduced gradually with the decrease in the degree of strabismus. Statistical analysis was performed after 6 months of treatment. The treatment success was defined as obtaining orthotropia and deleting diplopia when prism glasses were weaned off. The strabismus degree, Worth 4 dot test results, near stereopsis (Titmus stereopsis) and synoptophore fusion function before and after treatment were compared, and the factors affecting the curative effect were analyzed. Statistical methods mainly included paired t-test, Wilcoxon rank sum test, the Fisher exact test and univariate logistic regression analysis. Results: Among these 17 patients, 15 had myopia and 2 had emmetropia. Pretherapeutic esodeviation was (13.94±5.83) PD at near (33 cm), and was (15.76±5.24) PD at distance (6 m). After 6 months of treatment, 7 patients were successfully cured. The deviation angle at distance [(10.60±7.16) PD] and near [(9.80±6.00) PD] of the remaining 10 patients at 6 months after prismatic treatment was significantly smaller than that before treatment [(17.50±5.40) PD and (16.10±5.47) PD; t=3.69, 4.10; both P<0.01]. The Titmus stereogram showed that 2 cases had no stereopsis, 6 cases had peripheral stereopsis, 3 cases had macular stereopsis, and 6 cases had foveal stereopsis before treatment. Stereopsis was significantly improved at 6 months after prismatic treatment, with 3 cases havimg macular stereopsis and 14 cases having foveal stereopsis (Z=-2.99; P<0.01). The Worth-4-dot test disclosed that, the number of patients who saw four lamps at distance and near was 0 and 2 before treatment, and 7 and 9 after treatment, respectively, and the difference was statistically significant (both P<0.05). The divergent fusional amplitude and convergent fusional amplitude in the synoptophore at 6 month after treatment was not significantly different from that before treatment (both P>0.05). The efficacy of treatment was not significantly related to the duration from onset to treatment, the pretherapeutic esodeviation, the Titmus stereoacuity, cycloplegic refractive error, and age (all P>0.05). None of the 7 patients, who were successfully cured had a recurrence of esotropia or diplopia during the observation period of 6 to 24 months (median, 11 months). Conclusions: Prism treatment in a manner of step-by-step reduction of prism diopters can significantly diminish the degree of esotropia and improve the binocular function in small-angle AACE. Furthermore, some patients could be cured, achieving orthophoria without diplopia.

Factor analyses of the ADNI neuropsychological battery: An examination of diagnostic and longitudinal invariance

OBJECTIVE

In the Alzheimer's Disease Neuroimaging Initiative (ADNI), cognitive function was tracked across multiple years by a comprehensive neuropsychological battery. In this study, we examined the latent structure of the ADNI battery and evaluated the invariance of that structure among diagnostic groups and over time.

METHOD

We used exploratory and confirmatory factor analyses to investigate the invariance of the ADNI battery's latent factor structure among three diagnostic groups (healthy controls, patients with mild cognitive impairment, patients with Alzheimer's disease) over a 2-year interval (baseline, 6 months, 12 months, 24 months).

RESULTS

The results revealed a five-factor structure for the ADNI battery (memory, visuospatial processing, attention, language, executive function). This structure displayed configural invariance but not weak, strong, or strict invariance across the three diagnostic groups. Longitudinally, configural, weak, strong, and strict invariance were all established within each diagnostic group, except that strict invariance was rejected in healthy controls.

CONCLUSIONS

The ADNI battery assesses the same cognitive abilities in the three diagnostic groups, but test scores do not calibrate to these abilities equally in the respective groups, making certain statistics (e.g., factor scores) noncomparable between groups. Within each group, the latent structure and the numerical relations between individual tests and underlying factors remained invariant over 2 years, suggesting that this battery is a reliable tool for tracking longitudinal changes in specific cognitive abilities within individual diagnostic groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Beneficial effects of endophytic Pantoea ananatis with ability to promote rice growth under saline stress

AIMS

Soil salinization severely inhibits plant growth, leading to a low crop yield. The aim of the current study was to isolate endophytic bacteria with the ability to promote rice growth under saline conditions.

METHODS AND RESULTS

We isolated eight salt-tolerant endophytic bacteria from rice roots. An isolated strain D1 was selected due to its ability to stimulate rice seed germination in the presence of NaCl, which was identified as Pantoea ananatis D1. It exhibited multiple plant growth-promoting traits including phosphate solubilization, production of indole-3-acetic acid, 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase and siderophore. Inoculation of P. ananatis D1 obviously enhanced the rice root and shoot growth under normal and saline conditions. It also significantly increased the contents of chlorophyll, total soluble protein, and proline in salt-stressed rice seedlings. Moreover P. ananatis D1 could ameliorate the oxidative stress in rice induced by NaCl and Na₂ CO₃ treatment. The malondialdehyde content and various antioxidant enzyme activities were decreased by P. ananatis D1 inoculation in salt-affected rice. In addition, P. ananatis D1 showed a positive potential for limiting the Na⁺ accumulation and enhancing the K⁺ uptake, leading to an increase of 1·2-1·7 fold in K⁺ /Na⁺ ratio under saline environment.

CONCLUSIONS

Pantoea ananatis D1 has the ability to improve the salt tolerance of rice seedlings.

SIGNIFICANCE AND IMPACT OF THE STUDY

The application of plant growth-promoting bacteria (PGPB) is an eco-friendly strategy to improve plant tolerance towards abiotic stresses. We demonstrated that P. ananatis D1 could be used as an effective halotolerant PGPB to enhance rice growth in different salt-affected soils.

Emotional ambiguity and memory

The emotional ambiguity hypothesis introduced the principle that uncertainty about items' valence determines how emotional content affects memory and other psychological processes. It was formulated to explain why correlations between the perceived valence and arousal of memory items range from weak to unreliable, but it also makes novel predictions. Although data are consistent with those predictions, the hypothesis does not provide a process model of how valence ambiguity causes the valence-arousal relation to fluctuate. We tested 2 such models-a quantitative one, which assumes that increasing ambiguity lowers the reliability of valence judgments, and a categorical/quantitative one, which assumes that increasing ambiguity restricts the range of valence judgments. These models predict different mathematical relations between measures of ambiguity and intensity for valence and other semantic attributes (e.g., arousal, concreteness, familiarity, imagery, meaningfulness). In Experiments 1-3, tests of those predictions favored the categorical/quantitative model-showing that ambiguity is an inverted-U function for valence and other attributes. Experiments 4 and 5 were designed to investigate whether the memory effects of valence ambiguity are similar to the known effects of valence intensity. In both experiments, recall improved when ambiguity was increased, as well as when intensity was increased. A mathematical model revealed that increases in ambiguity produced large increases in items' familiarity, whereas increases in intensity produced smaller increases in both recollection and familiarity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Lifestyle and 25-hydroxy-vitamin D among community-dwelling old adults with dementia, mild cognitive impairment, or normal cognitive function

BACKGROUND

Several studies have indicated that older adults with cognitive impairment have a poorer lifestyle than their healthy peers including lower 25-hydroxy-vitamin D levels (25OHD).

AIM

To investigate the associations between lifestyle and 25OHD depending on cognitive status among old adults.

METHODS

Community-dwelling old adults (65-96 years) participated in this cross-sectional study based on the Age-Gene/Environment-Susceptibility-Reykjavik-Study. The analytical sample included 5162 subjects who were stratified by cognitive status, i.e., dementia (n = 307), mild cognitive impairment (MCI, n = 492), and normal cognitive status (NCS, n = 4363). Lifestyle variables were assessed and 25OHD was measured. The associations between lifestyle and 25OHD were calculated using linear models correcting for potential confounders.

RESULTS

According to linear regression models, 25OHD was significantly lower in older people with dementia (53.8 ± 19.6 nmol/L) than in NCS participants (57.6 ± 17.7 nmol/L). Cod liver oil (7.1-9.2 nmol/L, P < 0.001) and dietary supplements (4.4-11.5 nmol/L, P < 0.001) were associated with higher 25OHD in all three groups. However, physical activity ≥ 3 h/week (2.82 nmol/L, P < 0.001), BMI < 30 kg/m² (5.2 nmol/L, P < 0.001), non-smoking (4.8 nmol/L, P < 0.001), alcohol consumption (2.7 nmol/L, P < 0.001), and fatty fish consumption ≥ 3x/week (2.6 nmol/L, P < 0.001) were related to higher 25OHD in NCS only, but not in participants with dementia or MCI.

DISCUSSION

Older people living in Iceland with dementia are at higher risk for 25OHD deficiency when compared to healthy individuals. Physical activity reported among participants with dementia, and MCI is low and is not significantly associated with 25OHD.

CONCLUSIONS

Lifestyle factors among NCS participants are associated with 25OHD levels. Importantly, healthy lifestyle should be promoted among individuals with MCI and dementia.

From association to gist

We removed a key uncertainty in the Deese/Roediger/McDermott (DRM) illusion. The mean backward associative strength (MBAS) of DRM lists is the best-known predictor of this illusion, but it is confounded with semantic relations between lists and critical distractors. Thus, it is unclear whether associative relations, semantic relations, or both foment the illusion. In Experiment 1, we developed a tool for investigating this question-a normed pool of materials in which subjects rated the gist strength of 120 DRM lists that varied widely in MBAS. This produced a mean gist strength (MGS) statistic for each list, which allowed MGS and MBAS to be manipulated factorially. In Experiment 2, we conducted the first MGS (high vs. low) × MBAS (high vs. low) factorial study of the DRM illusion. To measure how MGS and MBAS affect underlying retrieval processes, we implemented a conjoint recognition design. For raw memory performance, MGS affected both true and false recognition of critical distractors, and it affected both true and false recognition of list words. MBAS did not affect true or false recognition of list words or true recognition of critical distractors. With false recognition of critical distractors, it had a reliable effect in one condition when MGS was low, but it had no effect in another condition. At the level of retrieval processes, increasing MGS increased the familiarity of critical distractors' semantic content, and it also increased the familiarity of list words' semantic content. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Salivary dysbiosis and the clinical spectrum in anti-Ro positive mothers of children with neonatal lupus

Mothers giving birth to children with manifestations of neonatal lupus (NL) represent a unique population at risk for the development of clinically evident pathologic autoimmunity since many are asymptomatic and only become aware of anti-SSA/Ro positivity (anti-Ro+) based on heart block in their fetus. Accordingly, we hypothesized that the microbiome in saliva is associated with the development of autoreactivity and in some cases the progression in health status from benign to overt clinical disease including Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE). The study comprised a clinical spectrum of anti-Ro+ mothers, all of whom gave birth to a child with NL: 9 were asymptomatic or had an undifferentiated autoimmune disease (Asym/UAS) and 16 fulfilled criteria for SS and/or SLE. Microbial diversity was reduced across all levels from kingdom to species for the anti-Ro+ mothers vs healthy controls; however, there were no significant differences between Asym/UAS and SS/SLE mothers. Relative abundance of Proteobacteria and more specifically class Betaproteobacteria decreased with clinical severity (healthy controls < Asym/UAS < SS/SLE). These ordered differences were maintained through the taxonomic hierarchy to three genera (Lautropia, Comamonas, and Neisseria) and species within these genera (L. mirabilis, N. flavescens and N. oralis). Biometric analysis comparing von Willebrand Factor domains present in human Ro60 with L. mirabilis proteins support the hypothesis of molecular mimicry. These data position the microbiome in the development of anti-Ro reactivity and subsequent clinical spectrum of disease.

Changes in APRI and FIB-4 in HBeAg-negative treatment-naive chronic hepatitis B patients with significant liver histological lesions receiving 5-year entecavir therapy

According to guidelines, antiviral therapy for adults with immune-active chronic hepatitis B (CHB) should be adopted to decrease the risk of liver-related complications. Fibrosis assessment during antiviral treatment is a key step in antiviral therapy evaluation. Liver biopsy is the gold standard for assessing the degree of liver necroinflammation and fibrosis. However, because of its cost and the risk of life-threatening complications, performing a liver biopsy more than once after long-term effective treatment is difficult. In this study, we aimed to evaluate changes in liver fibrosis during 5 years of entecavir (ETV) treatment using noninvasive fibrosis markers in hepatitis B e-antigen (HBeAg)-negative treatment-naive CHB patients who require antiviral therapy. A total of 303 HBeAg-negative treatment-naive patients were enrolled in this study. Liver biopsy was performed before initiation of antiviral therapy. The diagnosis of CHB was made according to Chinese guidelines for the management of CHB. Patients requiring antiviral therapy (liver fibrosis stage ≥ F2, METAVIR scoring system) were treated with ETV for at least 5 years. These patients were followed up at 6-month intervals. A clinical and virological evaluation was performed at baseline and again at 12, 24, 36, 48, and 60 months during ETV treatment. Aspartate Aminotransferase to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) index were used to assess dynamic changes in liver fibrosis in HBeAg-negative CHB patients after 1, 2, 3, 4, and 5 years of ETV treatment. All enrolled patients underwent liver biopsy at baseline. Using the METAVIR fibrosis stages, there were 107, 125, 54, and 17 patients in F1, F2, F3, and F4 stages, respectively. The APRI and FIB-4 indexes enabled the correct identification of patients with severe fibrosis (METAVIR F3-F4), with an area under the receiver operating characteristic curve of 0.77 (95% confidence interval [CI] 0.72-0.83) and 0.76 (95% CI 0.70-0.82), respectively. The APRI values decreased significantly in F2 and F3 patients after 1 year of ETV therapy (P < 0.01). However, for F4 patients, APRI values decreased significantly at year 3 (P < 0.05). The FIB-4 values of F2, F3, and F4 patients who received ETV treatment were significantly decreased after 1, 3, and 5 years of ETV therapy, respectively (P < 0.05). APRI and FIB-4 values decreased significantly during 5-year ETV treatment in HBeAg-negative CHB patients, indicating that these noninvasive fibrosis tests might be useful for monitoring improvement in liver fibrosis and assessing treatment efficacy during long-term ETV treatment.

Abstract OT1-12-01: Exploration of factors associated with imminent risk of late recurrence in hormone receptor positive breast cancer

Research objectives: To conduct a prospective observational study of patient and tumor-related factors in women with high risk hormone receptor (HR)+/HER2- breast cancer (BC) following at least 5 years of adjuvant hormonal therapy, in order to identify risk factors for imminent recurrence.

Rationale: Many of the life-threatening BC recurrences in women with HR+HER2- BC take place more than 5 years post-diagnosis, often after completion of adjuvant hormonal therapy. The identification of a biomarker(s) for late BC recurrence could lead to interventional trials to evaluate preventive therapies. We will evaluate whether the presence of blood-based biomarkers [(i) Circulating Tumor Cells (CTCs), (ii) circulating tumor DNA (ctDNA), (iii) tumor markers (CA 15-3, CEA)] and patient factors may predict BC recurrence.

Trial design: A prospective cohort of eligible women with previously treated HR+HER2- BC who have not experienced a distant recurrence will be enrolled; patient and circulating factors will be measured annually until distant recurrence or study completion. Host factors (including BMI, lifestyle, medical illness, surgery, trauma and stress, as well as circulating PlGF, VEGF-1 and inflammatory markers) that may contribute to exit of BC cells from dormancy will also be assessed.

The primary outcome is distant BC recurrence. Any BC event, including loco-regional recurrence, new breast or other primary cancer will be evaluated as a secondary endpoint. Outcomes will be ascertained by regular self-report (via annual telephone calls) and/or physician report and confirmed by medical record review.

Key eligibility criteria: i) Diagnosis of ER and/or PR positive (either or both 10% positive), HER2 negative invasive BC, ii) predicted &gt;1.5-2% annual risk of recurrence (T2, T3 or T4 with any N+;T1 N2+; T2N0 or T1 N1 cancers with high risk genomic scores), iii) receipt of adjuvant endocrine therapy for at least 4 years, with discontinuation planned in the next 12 months or completion of endocrine therapy within the last 5 years, iv) prior adjuvant chemotherapy, targeted therapy and bone targeted therapies are allowed provided they have been completed.

Specific aims: 1) Determine if the presence of (i) CTCs, (ii) ctDNA, (iii) CA15-3 and CEA are associated with imminent risk (within 1-2 years) of distant recurrence in the study population. 2) Identify host factors associated with these blood-based biomarkers, as well as clinical outcomes.

Statistical methods: A matched case control design (matching for time since completion of adjuvant hormone therapy, baseline T, N and grade) will be used to investigate associations of key study variables with imminent risk of distant recurrence within the next 1-2 years. Measurements of patients who do versus do not recur will be compared over the 1-2 years prior to relapse. Each variable will be allocated one third of a study-wide type one error of 0.05 (2-sided). ROC analyses and multivariable modelling will be used to optimize sensitivity, specificity, PPV and NPV. Available questionnaire data will be summarized at all time-points to generate descriptive survivorship data.

Accrual: Starting in August 2018, we plan to recruit 1,000 patients over 2 years at selected Canadian cancer centres.

Citation Format: Jerzak KJ, Cescon DW, Chia SK, Bratman S, Ennis M, Stambolic V, Chang M, Dowling R, Goodwin PJ. Exploration of factors associated with imminent risk of late recurrence in hormone receptor positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-12-01.

The ventromedial hypothalamic nucleus plays an important role in anxiolytic-like effect of neuropeptide S

Neuropeptide S (NPS), the endogenous neuropeptide ligand of NPSR, has been reported to regulate anxiety-related behavior involved in multiple brain regions, including amygdale, locus coeruleus and Barrington's nucleus. However, little research has been conducted on the anxiolytic-like behaviors of NPS on the hypothalamus, which was an important area in defensive behavior. Here, we investigated a role of hypothalamus in anxiolytic-like behaviors of NPS. We found that NPSR protein of mouse distributed mainly in the ventromedial hypothalamus (VMH). And in the single prolonged stress model (SPS), the results showed that NPS mRNA of the mice exposed to SPS was significantly higher than control, while NPSR mRNA was remarkable lower than control in hypothalamus. Further studies found that NPS intra-VMH infusion dose-dependently (1, 10 and 100pmol) induced anxiolytic effects, using elevated plus maze and open field tests. These anxiolytic effects could be blocked by NPSR antagonist (SHA68), but not by picrotoxin (a GABA_A receptor antagonist) and sacolfen (a GABA_B receptor antagonist). Meanwhile, our data showed that the expression of c-Fos was significantly increased in VMH after NPS delivered into the lateral ventricles. These results cast a new light on the hypothalamic nucleus in the anxiolytic-like effect of NPS system.

Abstract P3-17-01: Long-term rates of breast preservation after breast-conserving therapy for ductal carcinoma in situ

Background: Despite evidence that radiotherapy (RT) after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) halves the risk of recurrence, the benefit of RT in the management of DCIS continues to be a matter of controversy. One argument against the use of RT after BCS is that patients who develop ipsilateral local recurrence (LR) can be salvaged with further breast-conserving surgery such that the omission of RT will lead to high rates of breast preservation while minimizing exposure to RT. Breast preservation is an important determinant of quality of life for women with early stage breast cancer and DCIS. Yet the management of LR and the impact of RT on the resultant long-term risks of bilateral breast preservation in a population of women with DCIS are unclear. We assessed the treatment of LR, the impact of RT on the use of salvage mastectomy and the long-term risks of bilateral breast preservation achieved in a population of women with DCIS treated with BCS alone or BCS+RT.

Methods: A population-based analysis of women diagnosed with DCIS from 1994-2003 treated with BCS alone or BCS+RT with pathology review. Treatment and outcomes, including the development of LR and contralateral breast events, were determined by administrative databases with validation by review of operative or pathology reports. Median follow-up was 10.2 years for cases treated by BCS alone, 11.6 years for those treated by BCS+RT. We used a propensity-adjusted Cox proportional hazards model to evaluate factors associated with the use of salvage mastectomy for LR and to evaluate factors associated with any mastectomy. We assessed the risk of long-term breast preservation by calculating the KM 10-year risk of ipsilateral mastectomy and any mastectomy.

Results: The population cohort includes 3303 women with pure DCIS;1649 (50%) were treated by BCS alone, 1654 (50%) received BCS+RT. Women treated with RT had more high risk features of DCIS than those treated by BCS alone. LR developed in 343 (21%) women treated by BCS alone and in 257 (15.5%) women treated by BCS+RT (p&lt;0.01). Most women who developed LR received salvage mastectomy, irrespective of age at diagnosis and histology. Salvage mastectomy was used in 57.4% (197/343) of cases that recurred after BCS alone and in 67.6% (173/257) that recurred after BCS+RT. The likelihood of receiving salvage mastectomy for LR was similar in patients initially treated by BCS+RT vs. those initially treated BCS alone. Most (90%) of mastectomies were performed for a LR. Overall, individuals initially treated by BCS+RT had a 29% lower probability of having a mastectomy at 10 years compared to those treated by BCS alone (HR=0.71, 95%CI: 0.60,0.84,p&lt;0.0001). The 10 year mastectomy-free survival rates are 82.7% for women initially treated by BCS alone and 87.3% for those treated by BCS+RT (p=0.0096).

Conclusion: Women who received RT after BCS for DCIS experience a greater likelihood of long-term bilateral breast preservation. This is attributable to the lower risks of LR and that most local recurrences after breast-conserving therapy are treated by salvage mastectomy. Long-term breast preservation should be considered in discussions weighing the benefits and risks of RT after conservative surgery for DCIS.

Citation Format: Rakovitch E, Nofech-Mozes S, Hanna W, Gu S, Fong C, Tuck A, Sengupta S, Elavathil L, Jani P, Done S, Miller N, Youngson B, Bonin M, Chang M, Paszat L. Long-term rates of breast preservation after breast-conserving therapy for ductal carcinoma in situ [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-17-01.

Abstract P2-02-12: Association of inflammatory and tumor markers with circulating tumor cells in metastatic breast cancer

Background: Circulating tumor cells (CTCs) are associated with prognosis in metastatic breast cancer (BC). We evaluated the association of inflammatory/tumor markers and CTCs in women with progressing metastatic breast cancer prior to commencing a new line of systemic therapy.

Methods: From February 2013 to April 2015, 96 patients with metastatic BC about to start a new treatment (due to progression), without current diabetes or use of anti-inflammatory agents, were recruited from four Ontario cancer hospitals. Women provided fasting blood for inflammatory and tumor markers and CTC measurement; CTCs were assayed within 72 hours of collection using CellSearch. Blood was frozen at -80C until assays were performed in a single batch (C-reactive protein (CRP), IL-6, PAI-1, Ca15-3, Ca125, VEGF, TNFa). Associations of CTCs with blood factors were evaluated using Pearson correlation coefficients after transforming the variables to normality. For CTCs the transformation log(x+0.5) was used. Associations with categorical variables were tested using one-way analysis of variance. P values &lt;0.05 were significant.

Results: Median age of patients was 60.5 years, 87 (90.6%) were post-menopausal, 83 (86.5%) had hormone receptor positive BC, 16 (16.7%) HER2 positive BC, 10 (10.4%) triple negative; 75 (78.1%) grade II/III. At the time of CTC measurement, bone, lung, liver and brain metastases were present in 79%, 44%, 40% and 6% of patients respectively, with 54%, 37%, 35% and 3% having progression at these sites respectively. PAI-1 and CA15-3 exceeded the limit of the assay in 11 and 5 cases respectively (the upper limit of the assay was used in the analysis). 33.4% of patients were starting first line therapy, 25% second line and 16.7% third line. CTC counts (per 7.5cc) ranged from 0 to 1238 (median 2, geometric mean 3.63); none were detected in 29 (30.2%) patients, 1 to 4 in 25 (26%) and 5 or more in 42 (43.8%) patients. CTCs were not associated with age, estrogen receptor, progesterone receptor, HER2, line of treatment, lymph-vascular invasion or tumor grade. Compared to metastatic disease at other sites, CTCs were higher in the presence of bone (p=0.027) and liver metastases (p=0.002) and with progressing bone (p=0.018) and liver (p=0.012) metastases. CTCs were significantly associated with CRP (R =0.25, p=0.014), IL-6 (R=0.31, p=0.002), PAI-1 (R=0.31, p=0.002), Ca15-3 (R=0.44, p=&lt;0.0001) and Ca 125 (R=0.21, p=0.04) but not with VEGF and TNFa (R = 0.11, p= 0.29 and R = 0.16, p=0.11, respectively).

Conclusion: CTCs were associated with bone and liver metastases and with higher levels of inflammatory and tumor markers, potentially reflecting tumor burden. Additional inflammatory marker assays are underway. Future studies are warranted to confirm these findings.

Citation Format: Lohmann AE, Chang M, Dowling RJO, Ennis M, Amir E, Elser C, Brezden-Masley C, Vandenberg T, Lee E, Fazae K, Stambolic V, Goodwin PJ. Association of inflammatory and tumor markers with circulating tumor cells in metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-02-12.

Neuropeptide S Increases locomotion activity through corticotropin-releasing factor receptor 1 in substantia nigra of mice

Neuropeptide S (NPS), the endogenous ligand of NPS receptor (NPSR), was reported to be involved in the regulation of arousal, anxiety, locomotion, learning and memory. The basal ganglia play a crucial role in regulating of locomotion-related behavior. Here, we found that NPSR protein of mouse was distributed in the substantia nigra (SN) and globus pallidus (LGP) by immunohistochemical analysis. However, less is known about the direct locomotion-related effects of NPS in both SN and LGP. Therefore, we investigated the role of NPS in locomotion processes, using the open field test. The results showed that NPS infused into the SN (0.03, 0.1, 1nmol) or LGP (0.01, 0.03, 0.1nmol) dose-dependently increased the locomotor activity in mice. SHA 68 (50mg/kg), an antagonist of NPSR, blocked the locomotor stimulant effect of NPS in both nuleus. Meanwhile, these effects of NPS were also counteracted by the CRF1 receptor antagonist antalarmin (30mg/kg, i.p.). In addition, we found that the expression of c-Fos was significantly increased after NPS was delivered into SN. In conclusion, these results indicate that NPS-NPSR system may regulate locomotion together with the CRF1 system in SN.

Kisspeptin-13 enhances memory and mitigates memory impairment induced by Aβ1-42 in mice novel object and object location recognition tasks

Kisspeptin (KP), the endogenous ligand of GPR54, is a recently discovered neuropeptide shown to be involved in regulating reproductive system, anxiety-related behavior, locomotion, food intake, and suppression of metastasis across a range of cancers. KP is transcribed within the hippocampus, and GPR54 has been found in the amygdala and hippocampus, suggesting that KP might be involved in mediating learning and memory. However, the role of KP in cognition was largely unclear. Here, we investigated the role of KP-13, one of the endogenous active isoforms, in memory processes, and determined whether KP-13 could mitigate memory impairment induced by Aβ1-42 in mice, using novel object recognition (NOR) and object location recognition (OLR) tasks. Intracerebroventricular (i.c.v.) infusion of KP-13 (2μg) immediately after training not only facilitated memory formation, but also prolonged memory retention in both tasks. The memory-improving effects of KP-13 could be blocked by the GPR54 receptor antagonist, kisspeptin-234 (234), and GnRH receptors antagonist, Cetrorelix, suggesting pharmacological specificity. Then the memory-enhancing effects were also presented after infusion of KP-13 into the hippocampus. Moreover, we found that i.c.v. injection of KP-13 was able to reverse the memory impairment induced by Aβ1-42, which was inhibited by 234. To sum up, the results of our work indicate that KP-13 could facilitate memory formation and prolong memory retention through activation of the GPR54 and GnRH receptors, and suppress memory-impairing effect of Aβ1-42 through activation of the GPR54, suggesting that KP-13 may be a potential drug for enhancing memory and treating Alzheimer's disease.