Generative adversarial network-based synthesis of contrast-enhanced MR images from precontrast images for predicting histological characteristics in breast cancer

Objective. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a sensitive tool for assessing breast cancer by analyzing tumor blood flow, but it requires gadolinium-based contrast agents, which carry risks such as brain retention and astrocyte migration. Contrast-free MRI is thus preferable for patients with renal impairment or who are pregnant. This study aimed to investigate the feasibility of generating contrast-enhanced MR images from precontrast images and to evaluate the potential use of synthetic images in diagnosing breast cancer.Approach. This retrospective study included 322 women with invasive breast cancer who underwent preoperative DCE-MRI. A generative adversarial network (GAN) based postcontrast image synthesis (GANPIS) model with perceptual loss was proposed to generate contrast-enhanced MR images from precontrast images. The quality of the synthesized images was evaluated using the peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). The diagnostic performance of the generated images was assessed using a convolutional neural network to predict Ki-67, luminal A and histological grade with the area under the receiver operating characteristic curve (AUC). The patients were divided into training (n= 200), validation (n= 60), and testing sets (n= 62).Main results. Quantitative analysis revealed strong agreement between the generated and real postcontrast images in the test set, with PSNR and SSIM values of 36.210 ± 2.670 and 0.988 ± 0.006, respectively. The generated postcontrast images achieved AUCs of 0.918 ± 0.018, 0.842 ± 0.028 and 0.815 ± 0.019 for predicting the Ki-67 expression level, histological grade, and luminal A subtype, respectively. These results showed a significant improvement compared to the use of precontrast images alone, which achieved AUCs of 0.764 ± 0.031, 0.741 ± 0.035, and 0.797 ± 0.021, respectively.Significance. This study proposed a GAN-based MR image synthesis method for breast cancer that aims to generate postcontrast images from precontrast images, allowing the use of contrast-free images to simulate kinetic features for improved diagnosis.

Post-death Vesicles of Senescent Bone Marrow Mesenchymal Stromal Polyploids Promote Macrophage Aging and Breast Cancer

Potential systemic factors contributing to aging-associated breast cancer (BC) remain elusive. Here, we reveal that the polyploid giant cells (PGCs) that contain more than two sets of genomes prevailing in aging and cancerous tissues constitute 5-10% of healthy female bone marrow mesenchymal stromal cells (fBMSCs). The PGCs can repair DNA damage and stimulate neighboring cells for clonal expansion. However, dying PGCs in advanced-senescent fBMSCs can form "spikings" which are then separated into membraned mtDNA-containing vesicles (Senescent PGC-Spiking Bodies; SPSBs). SPSB-phagocytosed macrophages accelerate aging with diminished clearance on BC cells and protumor M2 polarization. SPSB-carried mitochondrial OXPHOS components are enriched in BC of elder patients and associated with poor prognosis. SPSB-incorporated breast epithelial cells develop aggressive characteristics and PGCs resembling the polyploid giant cancer cells (PGCCs) in clonogenic BC cells and cancer tissues. These findings highlight an aging BMSC-induced BC risk mediated by SPSB-induced macrophage dysfunction and epithelial cell precancerous transition.

SIGNIFICANCE

Mechanisms underlying aging-associated cancer risk remain unelucidated. This work demonstrates that polyploid giant cells (PGCs) in bone marrow mesenchymal stromal cells (BMSCs) from healthy female bone marrow donors can boost neighboring cell proliferation for clonal expansion. However, the dying-senescent PGCs in the advanced-senescent fBMSCs can form "spikings" which are separated into mitochondrial DNA (mtDNA)-containing spiking bodies (senescent PGC-spiking bodies; SPSBs). The SPSBs promote macrophage aging and breast epithelial cell protumorigenic transition and form polyploid giant cancer cells. These results demonstrate a new form of ghost message from dying-senescent BMSCs, that may serve as a systemic factor contributing to aging-associated immunosuppression and breast cancer risk.

Graphic Abstract

A prospective, single-arm trial of PD-1 inhibitors plus chemoradiotherapy for solitary metachronous metastasis nasopharyngeal carcinoma

PURPOSE

Initial treatment for Recurrent/Metastatic Nasopharyngeal Carcinoma (R/M NPC) often involves Gemcitabine plus cisplatin with or without PD-1 inhibitors. However, PD-1 inhibitors' effectiveness varies, prompting for better treatments. This study explores effect and safety of combining PD-1 inhibitors with chemoradiotherapy for oligometastatic NPC patients.

METHODS

Oligometastatic NPC patients underwent radical treatment with PD-1 inhibitors and chemotherapy, followed by concurrent PD-1 inhibitors and chemoradiotherapy, and then maintenance PD-1 inhibitors. Objective response rate (ORR) and disease control rate (DCR) were calculated by irRECIST-1.1, and CTCAE-4.0 was used to evaluate the toxicity.

RESULTS

The study enrolled 47 patients with a median age of 46. The median follow-up lasted 16.5 months, with metastatic lesions receiving a median radiation dose of 45 Gy. The median courses of PD-1 inhibitors and chemotherapy were 9.5 and 5 respectively. The metastasis sites included lung (40.8 %), liver (21.1 %), mediastinal lymph node (7.9 %), abdominal lymph nodes (3.9 %), bone (21.1 %), adrenal gland (3.9 %), and brain (1.3 %). ORR and DCR were 85.1 % and 100 % at 3 months after radiotherapy. The median survival was not reached yet, and 1 and 2-year OS rates were 93.1 % and 78.4 %. The median PFS was 18 months, with 1 and 2-year PFS rates of 70.2 % and 47.7 % respectively. PD-L1 expression showed a positive correlation for PFS. Twenty-five patients experienced grade 3 or 4 adverse events (AE) that were possibly related to chemotherapy. No grade 5 AE was observed.

CONCLUSIONS

The synergy of concurrent PD-1 inhibitors and chemoradiotherapy shows promising efficacy and an acceptable toxicity for oligometastasis NPC patients.

Comparing and validating air sampling methods for SARS-CoV-2 detection in HVAC ducts of student dorms

The Coronavirus disease 2019 (COVID-19) pandemic demonstrated the threat of airborne pathogenic respiratory viruses such as the airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The ability to detect circulating viruses in a workplace or dormitory setting allows an early warning system that can alert occupants to implement precautions (e.g. masking) and/or trigger individual testing to allow isolation and quarantine measures to halt contagion. This work extends and validates the first successful detection of SARS-CoV-2 virus in dormitory Heating, Ventilation, and Air Conditioning (HVAC) systems and compares different air sampling methods and media types combined with optimized quantitative Reverse-Transcription PCR (qRT-PCR) analysis. The study was performed in two environments; large dormitories of students who underwent periodic testing for COVID-19 (unknown environment) and the HVAC air from a suite with a student who had tested positive for COVID-19 (known dorm). The air sampling methods were performed using Filter Cassettes, BioSampler, AerosolSense Sampler and Button Sampler (with four media types with different pore sizes of 5 μm, 3 μm, 3 μm (gelatin), and 1.2 μm). The SARS-CoV-2 positive air samples were compared with the positive samples collected by individual student campus track tracing methods using PCR testing on saliva and nasopharyngeal samples. The results show a detection rate of 73% in the unknown environment and a 78% detection rate in the known dorm. Our data show that the virus was detectable with all the sampling methods we employed. However, the AerosolSense sampler and BioSampler performed the best at 63% and 61% detection rates, compared to 25% for the Filter Cassettes and 23% for the Button Sampler. Despite the success rate, it is not possible to definitively conclude which method is most sensitive due to the limited number of samples. These results show that with careful sampling and optimized PCR methods, pathogenic respiratory viruses can be detected in large buildings using HVAC return air.

Intermittent hypoxia training effectively protects against cognitive decline caused by acute hypoxia exposure

Intermittent hypoxia training (IHT) is a promising approach that has been used to induce acclimatization to hypoxia and subsequently lower the risk of developing acute mountain sickness (AMS). However, the effects of IHT on cognitive and cerebrovascular function after acute hypoxia exposure have not been characterized. In the present study, we first confirmed that the simplified IHT paradigm was effective at relieving AMS at 4300 m. Second, we found that IHT improved participants' cognitive and neural alterations when they were exposed to hypoxia. Specifically, impaired working memory performance, decreased conflict control function, impaired cognitive control, and aggravated mental fatigue induced by acute hypoxia exposure were significantly alleviated in the IHT group. Furthermore, a reversal of brain swelling induced by acute hypoxia exposure was visualized in the IHT group using magnetic resonance imaging. An increase in cerebral blood flow (CBF) was observed in multiple brain regions of the IHT group after hypoxia exposure as compared with the control group. Based on these findings, the simplified IHT paradigm might facilitate hypoxia acclimatization, alleviate AMS symptoms, and increase CBF in multiple brain regions, thus ameliorating brain swelling and cognitive dysfunction.

Deconvolution-Based Pharmacokinetic Analysis to Improve the Prediction of Pathological Information of Breast Cancer

Pharmacokinetic (PK) parameters, revealing changes in the tumor microenvironment, are related to the pathological information of breast cancer. Tracer kinetic models (e.g., Tofts-Kety model) with a nonlinear least square solver are commonly used to estimate PK parameters. However, the method is sensitive to noise in images. To relieve the effects of noise, a deconvolution (DEC) method, which was validated on synthetic concentration-time series, was proposed to accurately calculate PK parameters from breast dynamic contrast-enhanced magnetic resonance imaging. A time-to-peak-based tumor partitioning method was used to divide the whole tumor into three tumor subregions with different kinetic patterns. Radiomic features were calculated from the tumor subregion and whole tumor-based PK parameter maps. The optimal features determined by the fivefold cross-validation method were used to build random forest classifiers to predict molecular subtypes, Ki-67, and tumor grade. The diagnostic performance evaluated by the area under the receiver operating characteristic curve (AUC) was compared between the subregion and whole tumor-based PK parameters. The results showed that the DEC method obtained more accurate PK parameters than the Tofts method. Moreover, the results showed that the subregion-based Ktrans (best AUCs = 0.8319, 0.7032, 0.7132, 0.7490, 0.8074, and 0.6950) achieved a better diagnostic performance than the whole tumor-based Ktrans (AUCs = 0.8222, 0.6970, 0.6511, 0.7109, 0.7620, and 0.5894) for molecular subtypes, Ki-67, and tumor grade. These findings indicate that DEC-based Ktrans in the subregion has the potential to accurately predict molecular subtypes, Ki-67, and tumor grade.

A review of methods for assessment of cognitive function in high-altitude hypoxic environments

Hypoxic environments like those present at high altitudes may negatively affect brain function. Varying levels of hypoxia, whether acute or chronic, are previously shown to impair cognitive function in humans. Assessment and prevention of such cognitive impairment require detection of cognitive changes and impairment using specific cognitive function assessment tools. This paper summarizes the findings of previous research, outlines the methods for cognitive function assessment used at a high altitude, elaborates the need to develop standardized and systematic cognitive function assessment tools for high-altitude hypoxia environments.

NamiRNA-mediated high expression of KNSTRN correlates with poor prognosis and immune infiltration in hepatocellular carcinoma

Introduction

Mutations of kinetochore-localized astrin/sperm-associated antigen 5 (KNSTRN) can interfere with chromatid cohesion, increase aneuploidy in tumours, and enhance tumourigenesis. However, the role of the KNSTRN-binding protein in hepatocellular carcinoma (HCC) remains unclear.

Material and methods

Using The Cancer Genome Atlas databases, we investigated the potential oncogenic functions of KNSTRN in HCC along with R and various computational tools.

Results

Detailed results revealed that elevated expression of KNSTRN was considerably associated with poor overall survival (HR = 1.48, 95% CI: 1.05-2.09, p = 0.027) and progress-free interval (HR = 1.41, 95% CI: 1.05-1.89, p = 0.021) in HCC. Gene ontology/Kyoto Encyclopedia of Genes and Genomes functional enrichment analysis showed that KNSTRN is closely related to organelle fission, chromosomal region, tubulin binding, and cell cycle signalling pathway. TIMER database analysis showed the correlations between KNSTRN expression and tumour-infiltrating immune cells, biomarkers of immune cells, and immune checkpoint expression. Moreover, the KNSTRN level was significantly positively associated with immunosuppressive cells in the tumour microenvironment, including regulatory T-cells, myeloid-derived suppressor cells, and cancer-associated fibrocytes. Finally, a possible nuclear activating miRNA (NamiRNA)-enhancer network of hsa-miR-107, which activates the KNSTRN expression in liver hepatocellular carcinoma, was constructed by correlation analysis.

Conclusions

NamiRNA-mediated upregulation of KNSTRN correlated with poor prognosis and tumour immune infiltration in HCC. KNSTRN could serve as an effective biomarker for the diagnosis and prognosis of HCC and support the development of novel therapeutic strategies.

Efficient estimation of pharmacokinetic parameters from breast dynamic contrast-enhanced MRI based on a convolutional neural network for predicting molecular subtypes

Objective. Tracer kinetic models allow for estimating pharmacokinetic (PK) parameters, which are related to pathological characteristics, from breast dynamic contrast-enhanced magnetic resonance imaging. However, existing tracer kinetic models subject to inaccuracy are time-consuming for PK parameters estimation. This study aimed to accurately and efficiently estimate PK parameters for predicting molecular subtypes based on convolutional neural network (CNN).Approach. A CNN integrating global and local features (GL-CNN) was trained using synthetic data where known PK parameters map was used as the ground truth, and subsequently used to directly estimate PK parameters (volume transfer constantKtransand flux rate constantKep) map. The accuracy assessed by the peak signal-to-noise ratio (PSNR), structural similarity (SSIM), and concordance correlation coefficient (CCC) was compared between the GL-CNN and Tofts-based PK parameters in synthetic data. Radiomic features were calculated from the PK parameters map in 208 breast tumors. A random forest classifier was constructed to predict molecular subtypes using a discovery cohort (n= 144). The diagnostic performance evaluated on a validation cohort (n= 64) using the area under the receiver operating characteristic curve (AUC) was compared between the GL-CNN and Tofts-based PK parameters.Main results. The average PSNR (48.8884), SSIM (0.9995), and CCC (0.9995) between the GL-CNN-basedKtransmap and ground truth were significantly higher than those between the Tofts-basedKtransmap and ground truth. The GL-CNN-basedKtransobtained significantly better diagnostic performance (AUCs = 0.7658 and 0.8528) than the Tofts-basedKtransfor luminal B and HER2 tumors. The GL-CNN method accelerated the computation by speed approximately 79 times compared to the Tofts method for the whole breast of all patients.Significance. Our results indicate that the GL-CNN method can be used to accurately and efficiently estimate PK parameters for predicting molecular subtypes.

Radiogenomic analysis of cellular tumor-stroma heterogeneity as a prognostic predictor in breast cancer

BACKGROUND

The tumor microenvironment and intercellular communication between solid tumors and the surrounding stroma play crucial roles in cancer initiation, progression, and prognosis. Radiomics provides clinically relevant information from radiological images; however, its biological implications in uncovering tumor pathophysiology driven by cellular heterogeneity between the tumor and stroma are largely unknown. We aimed to identify radiogenomic signatures of cellular tumor-stroma heterogeneity (TSH) to improve breast cancer management and prognosis analysis.

METHODS

This retrospective multicohort study included five datasets. Cell subpopulations were estimated using bulk gene expression data, and the relative difference in cell subpopulations between the tumor and stroma was used as a biomarker to categorize patients into good- and poor-survival groups. A radiogenomic signature-based model utilizing dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was developed to target TSH, and its clinical significance in relation to survival outcomes was independently validated.

RESULTS

The final cohorts of 1330 women were included for cellular TSH biomarker identification (n = 112, mean age, 57.3 years ± 14.6) and validation (n = 886, mean age, 58.9 years ± 13.1), radiogenomic signature of TSH identification (n = 91, mean age, 55.5 years ± 11.4), and prognostic (n = 241) assessments. The cytotoxic lymphocyte biomarker differentiated patients into good- and poor-survival groups (p < 0.0001) and was independently validated (p = 0.014). The good survival group exhibited denser cell interconnections. The radiogenomic signature of TSH was identified and showed a positive association with overall survival (p = 0.038) and recurrence-free survival (p = 3 × 10-4).

CONCLUSION

Radiogenomic signatures provide insights into prognostic factors that reflect the imbalanced tumor-stroma environment, thereby presenting breast cancer-specific biological implications and prognostic significance.

Cross-Parametric Generative Adversarial Network-Based Magnetic Resonance Image Feature Synthesis for Breast Lesion Classification

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) contains information on tumor morphology and physiology for breast cancer diagnosis and treatment. However, this technology requires contrast agent injection with more acquisition time than other parametric images, such as T2-weighted imaging (T2WI). Current image synthesis methods attempt to map the image data from one domain to another, whereas it is challenging or even infeasible to map the images with one sequence into images with multiple sequences. Here, we propose a new approach of cross-parametric generative adversarial network (GAN)-based feature synthesis (CPGANFS) to generate discriminative DCE-MRI features from T2WI with applications in breast cancer diagnosis. The proposed approach decodes the T2W images into latent cross-parameter features to reconstruct the DCE-MRI and T2WI features by balancing the information shared between the two. A Wasserstein GAN with a gradient penalty is employed to differentiate the T2WI-generated features from ground-truth features extracted from DCE-MRI. The synthesized DCE-MRI feature-based model achieved significantly (p = 0.036) higher prediction performance (AUC = 0.866) in breast cancer diagnosis than that based on T2WI (AUC = 0.815). Visualization of the model shows that our CPGANFS method enhances the predictive power by levitating attention to the lesion and the surrounding parenchyma areas, which is driven by the interparametric information learned from T2WI and DCE-MRI. Our proposed CPGANFS provides a framework for cross-parametric MR image feature generation from a single-sequence image guided by an information-rich, time-series image with kinetic information. Extensive experimental results demonstrate its effectiveness with high interpretability and improved performance in breast cancer diagnosis.

A weakly supervised NMF method to decipher molecular subtype-related dynamic patterns in breast DCE-MR images

Objective. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is an important imaging modality for breast cancer diagnosis. Intratumoral heterogeneity causes a major challenge in the interpretation of breast DCE-MRI. Previous studies have introduced decomposition methods on DCE-MRI to reveal intratumoral heterogeneity by analyzing distinct dynamic patterns within each tumor. However, these methods estimated the dynamic patterns and their corresponding component coefficients in an unsupervised manner, without considering any clinically relevant information.Approach. To decipher molecular subtype-related dynamic patterns, we propose a weakly supervised nonnegative matrix factorization method (WSNMF), which is able to decompose the pixel kinetics of DCE-MRI with image-level subtype labels. The WSNMF is developed based on a discriminant nonnegative matrix factorization (NMF) to utilize coarse-grained subtype information, in which between- and within-class scatters are defined on the mean vector of component coefficients over all pixels in each tumor, rather than directly on the vector of component coefficients of each pixel.Main results. Experiments demonstrated that the dynamic patterns identified by WSNMF had superior performance in distinguishing between luminal A and the other subtype tumors. The classification performance was evaluated using the area under the receiver operating characteristic curve (AUC). WSNMF yielded better classification performance (AUC = 0.822) than other heterogeneity analysis methods, including two partitioning-based methods (KPC with AUC = 0.697 and TTP with AUC = 0.760) and two unsupervised decomposition-based methods (PCA with AUC = 0.774 and NMF with AUC = 0.797).Significance. Our method adds a valuable new perspective into DCE-MRI decomposition-based heterogeneity analysis by taking advantage of intrinsic tumor characteristics to improve the diagnosis of breast cancer.

Plasma Exosomal miRNAs as Response Biomarkers of Immunotherapy in Extensive-Stage Small-Cell Lung Cancer

PURPOSE/OBJECTIVE(S)

Immunotherapy combined with chemotherapy has become the first-line standard treatment for patients with extensive-stage small-cell lung cancer (ES-SCLC). The reliable biomarkers stratifying true responders of immunotherapy effectively are unknown, and it is urgent to identify novel biomarkers in clinical. Exosomal miRNAs are considered to play a role in intercellular communication among immune cells and interaction between immune cells and tumor cells. The purpose of this study was to explore the possibility of using plasma-derived exosomal miRNAs as potential biomarkers for identifying responses to immunotherapy in ES-SCLC.

MATERIALS/METHODS

From March 2020 to September 2021, 24 patients with ES-SCLC who received PD-L1 inhibitors were enrolled. Tumor assessments were conducted after every two treatment cycles according to RECIST 1.1. Plasma samples of these patients were collected before administering PD-L1 inhibitors as the baseline, and after every four cycles until the occurrence of disease progression. Plasma exosomes were isolated by ultracentrifugation, then total RNA was extracted. The miRNA profile was analyzed with small RNA next-generation sequencing followed by differential expression analysis.

RESULTS

Of the 24 patients, 15 underwent immunotherapy maintenance after completing four cycles of PD-L1 inhibitor plus chemotherapy. In order to identify biomarkers for a better response to immunotherapy, all five responders (patients achieving PR) and four non-responders (patients achieving PD) at tumor assessment within eight cycles of the maintenance phase were included for differential expression analysis. Surprisingly, hsa-miR-320c, hsa-miR-320d, and hsa-miR-320e showed a trend of increased expression in the non-responders compared with the responders at baseline and were significantly downregulated in the post-treatment plasma exosomes compared with pre-treatment samples of the responders.

CONCLUSION

Exosomal miRNA profiles are discordant between responders and non-responders of anti-PD-L1 treatment. Hsa-miR-320c, hsa-miR-320d, and hsa-miR-320e were identified as potential biomarkers for predicting the efficacy of immunotherapy in patients with ES-SCLC.

Exosomal circ_HIPK3 reduces apoptosis in H2O2-induced AC16 cardiomyocytes through miR-33a-5p/IRS1 axis

BACKGROUND

Exosomal circular RNAs (circRNAs) has been revealed to participate in the processes of cellular angiogenesis, growth and metastasis. Herein, the goal of this work was to investigate the role of exosomal circ_HIPK3 in cardiomyocyte apoptosis.

METHODS

Exosomes were isolated using ultracentrifugation method and observed by transmission electron microscopy (TEM). Western blot was used to detect exosomes markers. The experimental group AC16 cells were exposed to hydrogen peroxide (H2O2). Levels of genes and proteins was detected by qRT-PCR and Western blot. EdU assay, CCK8 assay, flow cytometry, and Western blot were utilized to detect the function of exosomal circ_HIPK3 in proliferation, and apoptosis. The target relationship between miR-33a-5p and circ_HIPK3 or IRS1 (insulin receptor substrate 1).

RESULTS

Circ_HIPK3 was packaged into exosomes and derived from AC16 cells. The expression of circ_HIPK3 was decreased by H2O2 treatment in AC16 cells, which also led to the decrease of circ_HIPK3 in exosomes. Functional analysis showed exosomal circ_HIPK3 promoted AC16 cell proliferation and reduced cell apoptosis under H2O2 treatment. Mechanistically, circ_HIPK3 acted as a sponge of miR-33a-5p to up-regulate the expression of its target IRS1. Functionally, forced expression of miR-33a-5p reversed the reduction of exosomal circ_HIPK3 in apoptosis of H2O2-stimulated AC16 cells. Moreover, miR-33a-5p inhibition contributed to the proliferation of H2O2-stimulated AC16 cells, which was abolished by IRS1 silencing.

CONCLUSION

Exosomal circ_HIPK3 reduced H2O2-induced AC16 cardiomyocyte apoptosis through miR-33a-5p/IRS1 axis, suggesting a novel insight into the pathology of myocardial infarction.

Stereotactic Radiotherapy (SRT) in Combination with Aumolertinib to Treat Intracranial Oligometastatic Non-Small Cell Lung Cancer (NSCLC): An Update of a Phase II, Prospective Study

PURPOSE/OBJECTIVE(S)

Stereotactic radiotherapy (SRT) is highly effective and less toxic for limited intracranial metastases. Aumolertinib is a tolerable third-generation epidermal growth factor receptor tyrosine kinase inhibitor that has CNS efficacy in patients with EGFR-mutant NSCLC. We aim to investigate the efficacy and safety of aumolertinib followed by SRT in patients with intracranial oligometastatic NSCLC.

MATERIALS/METHODS

Intracranial oligometastatic Patients with EGFR sensitive mutations (EGFR-TKIs naive) were enrolled and received aumolertinib 110mg daily until intracranial disease progression. Then SRT (32-40 Gy total, 8 Gy/f) was given to intracranial oligo-progression disease if possible. The primary endpoint was intracranial objective response rate (iORR). Secondary endpoints included intracranial progression-free survival (iPFS), intracranial duration of response (iDOR)according to RECIST 1.1, cerebral radiation necrosis rate (CRNR) and overall survival (OS). Safety was evaluated according to Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). This trial is registered with ClinicalTrials.gov, NCT04519983.

RESULTS

To February 10, 2023, a total of 38 patients were enrolled and 35 patients were assessable followed for 3 months to 18 months. All patients received 110mg aumolertinib daily and received at least one independent imaging evaluation by a radiologist. After oral administration of aumolertinib, the best response of 94% patients in intracranial and extracranial lesions was partial response (PR). Two patients had stable intracranial disease. At data cut-off, one patient developed intracranial primary lesion progression at 12 months after oral administration of aumolertinib but stable in extracranial lesions. SRT treatment was given to this patient. No grade ≥3 adverse events occurred after continued oral administration of aumolertinib. The most common adverse reactions were rash and abnormal liver enzymes, 1 patient had grade 2 CK elevation.

CONCLUSION

This report showed pronounced intracranial objective response benefit in patients with intracranial oligometastatic disease followed by SRT after intracranial oligo-progression and no new safety signals. Aumolertinib has promising efficacy and good tolerability in intracranial oligometastatic EGFR mutated NSCLC. [Keywords] Non-small cell lung cancer; epidermal growth factor receptor tyrosine kinase inhibitor; Aumolertinib; Stereotactic radiotherapy.

Low-Dose Fractionated Radiotherapy Combined with Neoadjuvant Chemotherapy for T3-4 Nasopharyngeal Carcinoma Patients: The Preliminary Results of a Phase II Randomized Controlled Trial

PURPOSE/OBJECTIVE(S)

Over 70% of NPC patients were local advanced NPC (LANPC). The 5-year local recurrence-free survival rate is only 70% in T3-4 patients. Neoadjuvant chemotherapy (NACT) followed with concurrent chemoradiotherapy (CCRT) was recommended for LANPC patients. Low-dose fractionated radiotherapy (LDFRT), which is <100cGy, induces enhanced cell killing by the hyper-radiation sensitivity phenomenon and potentiates effects of chemotherapy. The synergy of LDFRT and NACT has not been used in the clinical practice and few studies focused on it. A single arm study found the ORR of primary site was improved to 90% for head and neck squamous carcinoma patients treated with LDFRT and NACT. Our previous study found the ORR of lymph nodes was higher in LDFRT group for high-risk LANPC patients. However, another study showed there was no significant difference between LDFRT and control group for LANPC patients. So, we aimed to investigate the potential efficacy of this novel neoadjuvant therapy for T3-4 NPC patients.

MATERIALS/METHODS

A total of 60 pathological confirmed T3-4 (UICC/AJCC8th) NPC patients were prospectively enrolled in our study. They were randomly assigned to two groups. For the LDFRT group, the patients received 3 cycles of NACT (docetaxel 75mg/m2 D1, cisplatin 80mg/m2 D1) with LDFRT, and followed with CCRT. LDFRT was delivered as 50cGy per fraction twice a day to primary site on D1,2 for each cycle of NACT. The patients in the control group only received NACT and followed with CCRT. All the patients underwent IGRT. RECIST criteria and CTCAE 5.0 was used to evaluate the ORR and toxicity at post-NACT and the completion of CCRT.

RESULTS

From February 2022 to December 2022, 60 T3-4 NPC patients were included, and 30 patients for each group. For the primary site, the median volume reduction rate and the ORR after NACT was significantly improved in LDFRT group (69.27% vs 40.10%, p<0.001;93.33% vs 73.33%, p = 0.038). For the median volume reduction rate of primary site and lymph node, it was also obviously improved in LDFRT group (86.59% vs 55.43%, p<0.001). Though there was a tendency of ORR improvement in LDFRT group, but no significant difference (96.67% vs 83.33%, p = 0.195). After the completion of CCRT, the median volume reduction rate of primary site had an increased tendency in LDFRT group (96.16% vs 88.3%, p = 0.065), but the ORR had no statistical significance (LDFRT group: CR 45.8%, PR 54.2%; control group: CR 37.5%, PR 62.5%). For the toxicity, the incidence of grade 3-4 adverse events had no difference between two groups (p = 0.786). No grade 5 adverse events occurred.

CONCLUSION

LDFRT combined with NACT could obviously improve the median volume reduction rate and ORR of primary tumor for T3-4 NPC patients, and the toxicity was similar and tolerable. This novel treatment could be a promising strategy to improve treatment response and needed to be confirmed further.

Long-Term Survival Outcome for Metastatic Nasopharyngeal Carcinoma Patients Receiving Radiation to Primary and Metastatic Sites with Palliative Chemotherapy

PURPOSE/OBJECTIVE(S)

A total of 6% - 8% of NPC patients were initial diagnosed as distant metastatic disease. The median overall survival (OS) is only 10-15 months with palliative chemotherapy for these patients. A phase III study showed that palliative chemotherapy combined with radical radiotherapy to primary site could be a newly effective treatment method for metastatic NPC. Another phase 2, RCT found that the patients who had the solid tumors with 1-5 metastases received standard palliative care plus stereotactic body radiation therapy (SABR), and the 5-year OS were improved to 42.3%. Nevertheless, there was few studies focus on the radiation to both primary site and metastatic lesions. Therefore, we aimed to investigate the potential clinical benefits for initial diagnosed metastatic NPC patients with radiation to both primary site and distant metastatic lesions plus palliative chemotherapy.

MATERIALS/METHODS

Metastatic NPC patients treated with radiation to both primary site and distant metastatic lesions plus palliative chemotherapy were retrospectively collected in our hospital from May 2008 to May 2022. For treatment group, all patients underwent IGRT according to ICRU reports 50 and 62. The prescribed dose for primary site: GTVT: ≥66Gy, GTVn: ≥66Gy, CTV1: 60-66Gy, CTV2 54-60Gy, CTVln 50-54Gy. And the prescribed dose for distant metastatic lesions was more than 30Gy. For the control group, the patients treated with palliative chemotherapy were selected by propensity score matching from our hospital. The regimen for palliative chemotherapy was cisplatin-based chemotherapy every three weeks (100mg/m2 D1) for both groups. Kaplan-Meier method was used to analyze the OS. Cox regression model was used for multivariate analysis.

RESULTS

A total of 54 metastatic NPC patients with radiation to both primary site and distant metastatic lesions were retrospectively included in the treatment group, and another 54 patients were selected as the control group. The median follow-up time was 52 months. In the treatment group, the median age was 52 years (37-82), male (68%), female (32%), the main metastatic sites were bone (36 cases, 66%), lung (18 cases, 33%) and liver (10 cases, 18%). There were 23 oligometastasis cases and 31 cases. 3-year and 5-year OS in the treatment group were both dramatically improved than control group (63.2% vs 50.6%, p<0.05; 49.6% vs 38.9%, p<0.05). Multivariate analysis showed that T stage, liver metastatic lesion and oligometastases were the independent prognostic factors for them.

CONCLUSION

Palliative chemotherapy combined with radiation to primary sites and distant metastatic lesions might improve the OS for initial diagnosed distant metastatic NPC patients. More prospective clinical trials were needed to confirm it further.

Learning Common and Task-Specific Radiomic Features via Graph Regularized NMF for the Joint Prediction of Multiple Clinical Indicators in Breast Cancer

Assessments of multiple clinical indicators based on radiomic analysis of magnetic resonance imaging (MRI) are beneficial to the diagnosis, prognosis and treatment of breast cancer patients. Many machine learning methods have been designed to jointly predict multiple indicators for more accurate assessments while using original clinical labels directly without considering the noisy and redundant information among them. To this end, we propose a multilabel learning method based on label space dimensionality reduction (LSDR), which learns common and task-specific features via graph regularized nonnegative matrix factorization (CTFGNMF) for the joint prediction of multiple indicators in breast cancer. A nonnegative matrix factorization (NMF) is adopted to map original clinical labels to a low-dimensional latent space. The latent labels are employed to exploit task correlations by using a least square loss function with [Formula: see text]-norm regularization to identify common features, which help to improve the generalization performance of correlated tasks. Furthermore, task-specific features were retained by a multitask regression formulation to increase the discrimination power for different tasks. Common and task-specific features are incorporated by dynamic graph Laplacian regularization into a unified model to learn complementary features. Then, a multilabel classification is built to predict multiple clinical indicators including human epidermal growth factor receptor 2 (HER2), Ki-67, and histological grade. Experimental results show that CTFGNMF achieves AUCs of 0.823, 0.691 and 0.776 in the three indicator predictions, outperforming other counterparts that consider only task-independent features or common features. It indicates CTFGNMF is a promising application for multiple classification tasks in breast cancer.

Effect of Coating Shell on High-Frequency Polarization Loss of Core-Shell Filler Dielectric Composites: An Alternating-Field Polarization Phase-Field Simulation of BN@SiO2/PTFE Composite

Introducing a coating shell between the filler and matrix is an effective way to reduce the dielectric loss of the particle/matrix dielectric composites. It found that besides the improvement in interface compatibility, there may be some other effects of the coating shell, such as the elimination of the dielectric mismatch. However, the specific mechanism is still unclear due to the absence of an effective model for the quantitative analysis of the relationship between core-shell structure and dielectric loss, hindering the progress of the dielectric composite design. Here, a phase-field model for simulating high-frequency, alternating-field polarization is employed to study the relationship between high-frequency polarization loss and the coating shell in the silicon dioxide coating boron nitride polytetrafluoroethylene-based (BN@SiO2/PTFE) composite. The results show that the dielectric mismatch makes the high-frequency polarization loss spatially localized and periodically time-variant. The reduction of polarization loss depends on the polarization loss of SiO2. To reduce the high-frequency dielectric loss of the composite, the coating shell should not only eliminate the dielectric mismatch, but its dielectric loss must also be lower than that of the core filler. Furthermore, the model provided in this work has the potential to extend the quantitative calculation of non-intrinsic polarization loss and conduction loss.

Initial analysis of the synergy of programmed cell death-1 (PD-1) inhibitor and concurrent chemoradiotherapy treatment for recurrent/metastatic head and neck squamous cell carcinoma patients

BACKGROUND

Programmed cell death-1 (PD-1) inhibitor was proven to be useful for the recurrent/metastatic head and neck squamous carcinoma (R/M HNSCC) patients. Though both PD-1 inhibitor alone and combination with chemotherapy showed some benefit for PFS and OS, the survival outcome was still not satisfactory. Some studies showed the possible benefit for PD-1 inhibitors combination with radiation for head and neck squamous carcinoma, however there was few studies concerned about synergy of concurrent PD-1 inhibitor combination with chemoradiotherapy for R/M HNSCC. So, we aimed to explore the potential effect and toxicity of the concurrent PD-1 inhibitor and chemoradiotherapy for R/M HNSCC.

METHODS

We consecutively enrolled the R/M HNSCC patients treated with concurrent PD-1 inhibitor and chemoradiotherapy from August 2018 to April 2022 in Sichuan Cancer hospital. All the patients received the combination of PD-1 inhibitor and chemotherapy, and followed with synergy of concurrent PD-1 inhibitor and chemoradiotherapy, then maintenance PD-1 inhibitor. ORR and DCR was calculated by immune-related Response Evaluation Criteria in Solid Tumors (irRECIST-1.1), and Common terminology criteria for adverse events (CTCAE-4.0) was used to evaluate the toxicity.The Kaplan-Meier method was used to analyze OS and PFS.

RESULTS

40 R/M HNSCC patients were enrolled in our stuty. The median follow up time was 14 months. 22 patients had recurrent disease only, 16 patients had metastatic disease only, and 2 patients had both recurrence and metastasis disease. For the recurrent lesions, 23 patients received a median radiation dose of 64 Gy (range 50-70 Gy). 18 patients received a median dose of 45 Gy (range 30-66 Gy) for metastatic lesions. The median courses of PD-1 inhibitors and chemotherapy were 8 and 5 respectively. After the treatment, the ORR and DCR were 70.0% and 100%. The median OS was 19 months (range 6.3-31.7 months), with 1 and 2-years OS rates of 72.8% and 33.3%. The median PFS was 9 months (range 3.1-14.9 months), with 6 and 12 months PFS rates of 75.5% and 41.4% respectively. The PFS had no statistical significance in PD-L1 negative and positive group (7 vs 12 months, p = 0.059). The most common grade 3 or 4 adverse events(AE) were leucopenia (25.0%), neutropenia (17.5%), anemia (10.0%), thrombocytopenia (5.0%), hyponatremia (2.5%), and pneumonia(2.5%). No grade 5 AE was observed.

CONCLUSIONS

The synergy of concurrent PD-1 inhibitor treatment with chemoradiotherapy shows promise as a treatment strategy and an acceptable toxicity for the R/M HNSCC patients.

[Genotype-environment interaction on arterial stiffness: A pedigree-based study]

OBJECTIVE

To utilized the baseline data of the Beijing Fangshan Family Cohort Study, and to estimate whether the association between a healthy lifestyle and arterial stiffness might be modified by genetic effects.

METHODS

Probands and their relatives from 9 rural areas in Fangshan district, Beijing were included in this study. We developed a healthy lifestyle score based on five lifestyle behaviors: smoking, alcohol consumption, body mass index (BMI), dietary pattern, and physical activity. The measurements of arterial stiffness were brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI). A variance component model was used to determine the heritability of arterial stiffness. Genotype-environment interaction effects were performed by the maximum likelihood methods. Subsequently, 45 candidate single nucleotide polymorphisms (SNPs) located in the glycolipid metabolism pathway were selected, and generalized estimated equations were used to assess the gene-environment interaction effects between particular genetic loci and healthy lifestyles.

RESULTS

A total of 6 302 study subjects across 3 225 pedigrees were enrolled in this study, with a mean age of 56.9 years and 45.1% male. Heritability of baPWV and ABI was 0.360 (95%CI: 0.302-0.418) and 0.243 (95%CI: 0.175-0.311), respectively. Significant genotype-healthy diet interaction on baPWV and genotype-BMI interaction on ABI were observed. Following the findings of genotype-environment interaction analysis, we further identified two SNPs located in ADAMTS9-AS2 and CDH13 might modify the association between healthy dietary pattern and arterial stiffness, indicating that adherence to a healthy dietary pattern might attenuate the genetic risk on arterial stiffness. Three SNPs in CDKAL1, ATP8B2 and SLC30A8 were shown to interact with BMI, implying that maintaining BMI within a healthy range might decrease the genetic risk of arterial stiffness.

CONCLUSION

The current study discovered that genotype-healthy dietary pattern and genotype-BMI interactions might affect the risk of arterial stiffness. Furthermore, we identified five genetic loci that might modify the relationship between healthy dietary pattern and BMI with arterial stiffness. Our findings suggested that a healthy lifestyle may reduce the genetic risk of arterial stiffness. This study has laid the groundwork for future research exploring mechanisms of arterial stiffness.

Insights into the multirole CoAl layered double hydroxide on boosting photoelectrochemical activity of hematite: Application to hydrogen peroxide sensing

As an important compound in many industrial and biological processes, hydrogen peroxide (H₂O₂) would cause harmfulness to human health at high concentration level. It thus is urgent to develop highly sensitive and selective sensors for practical H₂O₂ detection in the fields of water monitoring, food quality control, and so on. In this work, CoAl layered double hydroxide ultrathin nanosheets decorated hematite (CoAl-LDH/α-Fe₂O₃) photoelectrode was successfully fabricated by a facile hydrothermal process. CoAl-LDH/α-Fe₂O₃ displays the relatively wide linear range from 1 to 2000 μM with a high sensitivity of 132.0 μA mM^-1 cm^-2 and a low detection limit of 0.04 μM (S/N ≥ 3) for PEC detection of H₂O₂, which is superior to other similar α-Fe₂O₃-based sensors in literatures. The (photo)electrochemical characterizations, such as electrochemical impedance spectroscopy, Mott-Schottky plot, cyclic voltammetry, open circuit potential and intensity modulated photocurrent spectroscopy, were used to investigate the roles of CoAl-LDH on the improved PEC response of α-Fe₂O₃ toward H₂O₂. It revealed that, CoAl-LDH could not only passivate the surface states and enlarge the band bending of α-Fe₂O₃, but also could act as trapping centers for holes and followed by as active sites for H₂O₂ oxidation, thus facilitated the charge separation and transfer. The strategy for boosting PEC response would be help for the further development of semiconductor-based PEC sensors.

[Hypoxia promotes lipopolysaccharide-induced CXCL10 expression in microglia]

This study was aimed to investigate the effect of hypoxia on lipopolysaccharide (LPS)-induced CXC-chemokine ligand-10 (CXCL10) expression and the underlying mechanism. C57BL/6J mice were randomly divided into control, hypoxia, LPS, and hypoxia combined with LPS groups. The LPS group was intraperitoneally injected with 0.5 mg/kg LPS, and the hypoxia group was placed in a hypobaric hypoxia chamber (simulated altitude of 6 000 m). The serum and hippocampal tissue samples were collected after 6 h of the treatment. The levels of CXCL10 in the serum and hippocampal tissue of mice were detected by ELISA. The microglia cell line BV2 and primary microglia were stimulated with hypoxia (1% O₂) and/or LPS (100 ng/mL) for 6 h. The mRNA expression level of CXCL10 and its content in culture supernatant were detected by real-time quantitative PCR and ELISA, respectively. The phosphorylation levels of nuclear factor κB (NF-κB) signaling pathway-related proteins, p65 and IκBα, were detected by Western blot. Moreover, after NF-κB signaling pathway being blocked with a small molecular compound, PDTC, CXCL10 mRNA expression level was detected in the BV2 cells. The results showed that in the LPS-induced mouse inflammatory model, hypoxia treatment could promote LPS-induced up-regulation of CXCL10 in both serum and hippocampus. Compared with the cells treated with LPS alone, the expression of CXCL10 mRNA and the content of CXCL10 in the culture supernatant of BV2 cells treated with hypoxia combined with LPS were significantly increased. The CXCL10 mRNA level of primary microglial cells treated with hypoxia combined with LPS was significantly up-regulated. Compared with the cells treated with hypoxia or LPS alone, the phosphorylation levels of p65 and IκBα in the BV2 cells treated with hypoxia combined with LPS were significantly increased. PDTC blocked the induction of CXCL10 gene expression by LPS in the BV2 cells. These results suggest that hypoxia promotes LPS-induced expression of CXCL10 in both animal and cell models, and NF-κB signaling pathway plays an important role in this process.

[The role of the high-level public health school in the development of the Center for Disease Control and Prevention]

The Ministry of Education and other four departments jointly issued the Notice on the Construction of high-level schools of public Health, proposing that "it will take ten years to build a number of high-level schools of public health, and form a high-quality education development system to adapt to the construction of modern public health system". At present, the construction of high-level public health schools in various universities in China is in full swing. The high-level School of Public Health and the CDC have played an important role in constructing the national public health system and the human health community. The high-level public health schools are of strategic significance and important value to the development of the CDC. The review presents reflections and insights on the role of high-level public health schools in the development of the CDC and the challenges they might face.

A Predictive Model of Capillary Forces and Contact Diameters between Two Plates Based on Artificial Neural Network

Many efforts have been devoted to the forecasting of the capillary force generated by capillary adsorption between solids, which is fundamental and essential in the fields of micro-object manipulation and particle wetting. In this paper, an artificial neural network (ANN) model optimized by a genetic algorithm (GA-ANN) was proposed to predict the capillary force and contact diameter of the liquid bridge between two plates. The mean square error (MSE) and correlation coefficient (R²) were employed to evaluate the prediction accuracy of the GA-ANN model, theoretical solution method of the Young-Laplace equation and simulation approach based on the minimum energy method. The results showed that the values of MSE of capillary force and contact diameter using GA-ANN were 10.3 and 0.0001, respectively. The values of R² were 0.9989 and 0.9977 for capillary force and contact diameter in regression analysis, respectively, demonstrating the accuracy of the proposed predictive model. The sensitivity analysis was conducted to investigate the influence of input parameters, including liquid volume and separation distance, on the capillary force and contact diameter. The liquid volume and separation distance played dominant roles in affecting the capillary force and contact diameter.

Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3)

BACKGROUND

Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology.

METHODS

We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator.

RESULTS

The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults.

CONCLUSIONS

To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.

[Progress in research of risk prediction of non-syndromic oral clefts using genetic information]

Non-syndromic oral cleft (NSOC), a common birth defect, remains to be a critical public health problem in China. In the context of adjustment of childbearing policy for two times in China and the increase of pregnancy at older childbearing age, NSOC risk prediction will provide evidence for high-risk population identification and prenatal counseling. Genome-wide association study and second generation sequencing have identified multiple loci associated with NSOC, facilitating the development of genetic risk prediction of NSOC. Despite the marked progress, risk prediction models of NSOC still faces multiple challenges. This paper summarizes the recent progress in research of NSOC risk prediction models based on the results of extensive literature retrieval to provide some insights for the model development regarding research design, variable selection, model-build strategy and evaluation methods.

Autophagy Is Essential for Neural Stem Cell Proliferation Promoted by Hypoxia

Hypoxia as a microenvironment or niche stimulates proliferation of neural stem cells (NSCs). However, the underlying mechanisms remain elusive. Autophagy is a protective mechanism by which recycled cellular components and energy are rapidly supplied to the cell under stress. Whether autophagy mediates the proliferation of NSCs under hypoxia and how hypoxia induces autophagy remain unclear. Here, we report that hypoxia facilitates embryonic NSC proliferation through HIF-1/mTORC1 signaling pathway-mediated autophagy. Initially, we found that hypoxia greatly induced autophagy in NSCs, while inhibition of autophagy severely impeded the proliferation of NSCs in hypoxia conditions. Next, we demonstrated that the hypoxia core regulator HIF-1 was necessary and sufficient for autophagy induction in NSCs. Considering that mTORC1 is a key switch that suppresses autophagy, we subsequently analyzed the effect of HIF-1 on mTORC1 activity. Our results showed that the mTORC1 activity was negatively regulated by HIF-1. Finally, we provided evidence that HIF-1 regulated mTORC1 activity via its downstream target gene BNIP3. The increased expression of BNIP3 under hypoxia enhanced autophagy activity and proliferation of NSCs, which was mediated by repressing the activity of mTORC1. We further illustrated that BNIP3 can interact with Rheb, a canonical activator of mTORC1. Thus, we suppose that the interaction of BNIP3 with Rheb reduces the regulation of Rheb toward mTORC1 activity, which relieves the suppression of mTORC1 on autophagy, thereby promoting the rapid proliferation of NSCs. Altogether, this study identified a new HIF-1/BNIP3-Rheb/mTORC1 signaling axis, which regulates the NSC proliferation under hypoxia through induction of autophagy.

Multiparametric MRI radiomics fusion for predicting the response and shrinkage pattern to neoadjuvant chemotherapy in breast cancer

Purpose

During neoadjuvant chemotherapy (NACT), breast tumor morphological and vascular characteristics are usually changed. This study aimed to evaluate the tumor shrinkage pattern and response to NACT by preoperative multiparametric magnetic resonance imaging (MRI), including dynamic contrast-enhanced MRI (DCE-MRI), diffuse weighted imaging (DWI) and T2 weighted imaging (T2WI).

Method

In this retrospective analysis, female patients with unilateral unifocal primary breast cancer were included for predicting tumor pathologic/clinical response to NACT (n=216, development set, n=151 and validation set, n=65) and for discriminating the tumor concentric shrinkage (CS) pattern from the others (n=193; development set, n=135 and validation set, n=58). Radiomic features (n=102) of first-order statistical, morphological and textural features were calculated on tumors from the multiparametric MRI. Single- and multiparametric image-based features were assessed separately and were further combined to feed into a random forest-based predictive model. The predictive model was trained in the testing set and assessed on the testing dataset with an area under the curve (AUC). Molecular subtype information and radiomic features were fused to enhance the predictive performance.

Results

The DCE-MRI-based model showed higher performance (AUCs of 0.919, 0.830 and 0.825 for tumor pathologic response, clinical response and tumor shrinkage patterns, respectively) than either the T2WI or the ADC image-based model. An increased prediction performance was achieved by a model with multiparametric MRI radiomic feature fusion.

Conclusions

All these results demonstrated that multiparametric MRI features and their information fusion could be of important clinical value for the preoperative prediction of treatment response and shrinkage pattern.

Hematite decorated with nanodot-like cobalt (oxy)hydroxides for boosted photoelectrochemical water oxidation

Photoelectrochemical (PEC) water splitting has been considered as an alternative process to produce green hydrogen. However, the energy conversion efficiency of PEC systems was still limited by the inefficient photoanode. Cocatalysts decoration is regarded as an efficient strategy for improving PEC performance of photoanode. In this work, nanodot-like cobalt (oxy)hydroxides was rationally decorated on hematite to fabricate CoOOH/Fe2O3 photoanode. The resulted CoOOH/Fe2O3 exhibits a high photocurrent density of 1.92 mA cm-2 at 1.23 V vs. RHE, which is 2.6 times than that of bare Fe2O3. In addition, the onset potential displays a cathodic shift of ca. 110 mV, indicating that CoOOH can efficiently accelerate water oxidation kinetics over Fe2O3. The comprehensive PEC and electrochemical characterizations reveal that CoOOH could not only provide abundant accessible Co active sites for water oxidation, but also could passivate the surface states of Fe2O3, thus increase the carrier density and decrease the interfacial resistance. As a result, the PEC water oxidation performance over Fe2O3 was significantly boosted. This work supports that the roles of CoOOH cocatalyst is generic and such CoOOH could be used for other semiconductor-based photoanodes for outstanding PEC water splitting performance.

PERIOD 2 Regulates Low Dose Radioprotection via PER2/pGSK3β/β-Catenin/Per2 Loop

During evolution, humans are acclimatized to the stresses of natural radiation and circadian rhythmicity. Radiosensitivity of mammalian cells varies in the circadian period and adaptive radioprotection can be induced by pre-exposure to low-level radiation (LDR). It is unclear, however, if clock proteins participate in signaling LDR radioprotection. Herein, we demonstrate that radiosensitivity is increased in mice with the deficient Period 2 gene (Per2^def) due to impaired DNA repair and mitochondrial function in progenitor bone marrow hematopoietic stem cells and monocytes. Per2 induction and radioprotection are also identified in LDR-treated Per2^wt mouse cells and in human skin (HK18) and breast (MCF-10A) epithelial cells. LDR-boosted PER2 interacts with pGSK3β(S9) which activates β-catenin and the LEF/TCF mediated gene transcription including Per2 and genes involved in DNA repair and mitochondrial functions. This study demonstrates that PER2 plays an active role in LDR adaptive radioprotection via PER2/pGSK3β/β-catenin/Per2 loop, a potential target for protecting normal cells from radiation injury.

[Changes in the urine proteome in an acute hypoxic rat model]

The purpose of this study was to explore the effect of acute hypoxia on urine proteome in rats. In this study, rats were placed in a hypoxic chamber simulating a plateau environment at an altitude of 5 000 m for 24 hours. Urine samples were collected at 0, 12, and 24 h after hypoxia. Urinary proteins were profiled using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Compared with the control (before hypoxia), a total of 144 differentially expressed proteins were identified in the hypoxia 12 h group, and 129 differentially expressed proteins were identified in the hypoxia 24 h group. Functional annotation analysis revealed that these differentially expressed proteins were involved in a series of biological pathways related to hypoxic stress, such as anti-oxidative stress, glycolysis, complement and coagulation cascade. Our results suggest that the urinary proteome can reflect significant changes upon acute hypoxic stimulation. These findings may provide an approach to judge the hypoxia state of the body and help to assist the detection of hypoxia state.

Analysis of Concept Construction and Scale Development of Employee Zhengchong Behaviour in Family Firms in Jiangsu Province of China

Purpose

Some scholars have explored the connotation and structural elements of employee zhengchong behaviour based on Taiwan’s local enterprises, providing results with reference significance. However, there is a lack of accurate measurement scales. How to treat employee zhengchong behaviour (striving for a favour) and effectively deconstruct it is very important to the sustainable development of family firms.

Methods

Semistructured interviews were conducted with 62 employees of private enterprises, and the structural dimension of employee zhengchong behaviour was explored with the help of grounded theory. The researchers designed two questionnaires, collected 278 and 331 valid questionnaires in the two surveys, compiled the corresponding measurement scale, and tested it.

Results

Employee zhengchong behaviour under differential leadership was a multidimensional structure with rich connotations consisting of four dimensions: showing abilities, collaborating and sharing, excluding outsiders, and ingratiating upwards. The scale includes 16 items.

Conclusion

This study enriches the relevant theories while providing a decision reference for family firm leaders to guide employee zhengchong behaviour to reasonably improve firm performance.

Identification and Characterization of Elevated Expression of Transferrin and Its Receptor TfR1 in Mouse Models of Depression

Depression has become one of the severe mental disorders threatening global human health. In this study, we first used the proteomics approach to obtain the differentially expressed proteins in the liver between naive control and chronic social defeat stress (CSDS) induced depressed mice. We have identified the upregulation of iron binding protein transferrin (TF) in the liver, the peripheral blood, and the brain in CSDS-exposed mice. Furthermore, bioinformatics analysis of the Gene Expression Omnibus (GEO) database from various mouse models of depression revealed the significantly upregulated transcripts of TF and its receptor TfR1 in multiple brain regions in depressed mice. We also used the recombinant TF administration via the tail vein to detect its permeability through the blood-brain barrier (BBB). We demonstrated the permeability of peripheral TF into the brain through the BBB. Together, these results identified the elevated expression of TF and its receptor TfR1 in both peripheral liver and the central brain in CSDS-induced depressed mice, and peripheral administration of TF can be transported into the brain through the BBB. Therefore, our data provide a compelling information for understanding the potential role and mechanisms of the cross-talk between the liver and the brain in stress-induced depression.

Application report of automatic unlocking baseplate in radiotherapy

Purpose

To reduce the potential risk during radiotherapy treatment of patients with head and neck tumors, we improved upon the design of an existing immobilization device by adding a feature to improve patient safety during emergency releases, and we verified its clinical application.

Method

We designed an improved automatic unlocking baseplate (AUB), and conducted a dosimetry comparison with Solo Align Full Body System (SAFBS, Klarity, China). The dosimetry comparison included dose‐attenuation measurements and results from human simulation. We selected four points for measurement to allow comparison between the SAFBS and our AUB. A simulated human body model was used for CT scanning, whereby the target area and structure and simulated radiotherapy plan were conducted according to the American Academy of Pain Medicine Task Group–119 report (TG‐119), whereby the dose differences were compared. The purpose of the clinical test was to verify the reliability of the AUB system in practical clinical applications. The application tests were conducted in CT simulation (CT‐sim) and treatment rooms. The test included assessments of the stability of the system and the reliability of our device.

Results

The dose‐attenuation measurements of the two baseplates were as follows: The transmission values with our unlocking system were 0.10% higher at the first point and 0.67% lower at the third. The same dose was obtained at points 2 and 4. In the simulation study, the PTV of the AUB was lower than that of the SAFBS, including 0.39% lower D₉₉ and 0.18% lower D₉₀. Among the organ‐at‐risk doses, the average dose of the AUB in the spinal cord was 0.6% higher than that of the SAFBS, and the average dose in the left and right parotid glands was more than 1.4% lower than that of SAFBS. The clinical test results were applied in treatment room and a CT‐sim room, which show a 100% success rate after being unlocked more than 5000 times.

Conclusion

The AUB designed for head and neck patients had good functional versatility, the dose distribution met the requirements, and the automatic unlocking function was demonstrated to be stable and reliable.

[Family-based association tests for rare variants]

Next-generation sequencing has revolutionized family-based association tests for rare variants. As the lower power of genome wide association study for detecting casual rare variants, methods aggregating effects of multiple variants have been proposed, such as burden tests and variance component tests. This paper summarizes the methods of rare variants association test that can be applied for family data, introduces their principles, characteristics and applicable conditions and discusses the shortcomings and the improvement of the present methods.

PTFE Crystal Growth in Composites: A Phase-Field Model Simulation Study

We investigated, via a phase-field model simulation, the effects of a matrix's properties and a filler's characters on the polytetrafluoroethylene (PTFE) crystal growth process in composites under various supercooling degrees. The results show that the supercooling degree has a deciding influence on the crystal growth process. The intrinsic properties of PTFE polymer, such as anisotropic strength and phase transition latent heat, affect the growth rate, orientation, and interfacial integrity of the crystal trunk and the branching of the PTFE crystal growth process. The factors of the PTFE crystallization process, such as anisotropic strength and phase translation interface thickness, affect the uniformity and crystallization degree of the PTFE crystal. In the composites, the biphasic interface induces the crystal growth direction via the polymer chain segment migration rate, of which the degree depends on the shapes of the filler and the PTFE crystal nucleus. According to the results, choosing the low molecular weight PTFE and mixture filler with various particle sizes and surface curvatures as the raw materials of PTFE-based composites improves the crystallization of the PTFE matrix.

dsCellNet: A new computational tool to infer cell-cell communication networks in the developing and aging brain

Cell-cell interactions mediated by ligand-receptor complexes are critical to coordinating organismal development and functions. Majority of studies focus on the key time point, the mediator cell types or the critical genes during organismal development or diseases. However, most existing methods are specifically designed for stationary paired samples, there hasn't been a repository to deal with inferring cell-cell communications in developmental series RNA-seq data, which usually contains multiple developmental stages. Here we present a cell-cell interaction networks inference method and its application for developmental series RNA-seq data (termed dsCellNet) from the developing and aging brain. dsCellNet is implemented as an open-access R package on GitHub. It identifies interactions according to protein localizations and reinforces them via dynamic time warping within each time point and between adjacent time points, respectively. Then, fuzzy clustering of those interactions helps us refine key time points and connections. Compared to other published methods, our methods display high accuracy and high tolerance based on both simulated data and real data. Moreover, our methods can help identify the most active cell type and genes, which may provide a powerful tool to uncover the mechanisms underlying the organismal development and disease.

Estimating Lost Gas Content for Shales Considering Real Boundary Conditions during the Core Recovery Process

Shale gas has become an important natural gas resource in recent years as the conventional oil and gas resources are depleting. Shale gas content is one of the most important parameters for reserve calculation and sweet-spot prediction. The traditional core recovery method is widely used to determine gas content. However, the estimation of lost gas content is the main factor of error and difficulty. Large errors and uncertainties occur when using the widely used methods, such as the United States Bureau of Mines (USBM) method. Hence, a more accurate method is required. In this work, a full-process model is developed in COMSOL Multiphysics to describe the lost gas with time during the core recovery process as well as the desorption stage after the core is covered. In this method, by setting the initial gas pressure and flow parameters and matching the desorbed gas volume and considering variable diffusivity with respect to temperature, the initial gas content and the gas lost with respect to time are calculated. Overall, 10 field data are tested using this full-process model, and the USBM method is also applied to compare the results. It is found that if the ratio of lost gas volume estimated using the USBM method to the desorbed gas volume of the field data is lower than 2.0, the USBM method underestimates the lost gas compared to the full-process method; if the ratio is about 2.0, the results from the USBM and the full-process methods are comparable; and if the ratio is close to 3.0, the USBM method tends to overestimate the lost gas. The modeling results indicate that this proposed full-process method is more theoretically sound than the USBM method, which has high uncertainties depending on the number of desorbed gas data points used. Nevertheless, this proposed method requires a large number of parameters, leading to the difficulty in finding true parameters. Therefore, an optimization algorithm is required. In summary, this study provides theoretical support and a mathematical model for the inversion calculation of lost gas during shale core recovery. It is helpful to evaluate the resource potential and development economics of shale gas more accurately.

[IRE1α deficiency impairs autophagy in chondrocytes by upregulating calcium homeostasis endoplasmic reticulum protein]

OBJECTIVE

To explore the mechanism by which inositol-requiring enzyme-1α (IRE1α) regulates autophagy function of chondrocytes through calcium homeostasis endoplasmic reticulum protein (CHERP).

METHODS

Cultured human chondrocytes (C28/I2 cells) were treated with tunicamycin, 4μ8c, rapamycin, or both 4μ8c and rapamycin, and the expressions of endoplasmic reticulum (ER) stress- and autophagy-related proteins were detected with Western blotting. Primary chondrocytes from ERN1 knockout (ERN1 CKO) mice and wild-type mice were examined for ATG5 and ATG7 mRNA expressions, IRE1α and p-IRE1α protein expressions, and intracellular calcium ion content using qPCR, Western blotting and flow cytometry. The effect of bafilomycin A1 treatment on LC3 Ⅱ/LC3 Ⅰ ratio in the isolated chondrocytes was assessed with Western blotting. Changes in autophagic flux of the chondrocytes in response to rapamycin treatment were detected using autophagy dual fluorescent virus. The changes in autophagy level in C28/I2 cells overexpressing CHERP and IRE1α were detected using immunofluorescence assay.

RESULTS

Tunicamycin treatment significantly up-regulated ER stress-related proteins and LC3 Ⅱ/LC3 Ⅰ ratio and down-regulated the expression of p62 in C28/I2 cells (P < 0.05). Rapamycin obviously up-regulated LC3 Ⅱ/LC3 Ⅰ ratio (P < 0.001) in C28/I2 cells, but this effect was significantly attenuated by co-treatment with 4μ8c (P < 0.05). Compared with the cells from the wild-type mice, the primary chondrocytes from ERN1 knockout mice showed significantly down-regulated mRNA levels of ERN1 (P < 0.01), ATG5 (P < 0.001) and ATG7 (P < 0.001), lowered or even lost expressions of IRE1α and p-IRE1α proteins (PP < 0.01), and increased expression of CHERP (P < 0.05) and intracellular calcium ion content (P < 0.001). Bafilomycin A1 treatment obviously increased LC3 Ⅱ/ LC3 Ⅰ ratio in the chondrocytes from both wild-type and ERN1 knockout mice (P < 0.01 or 0.05), but the increment was more obvious in the wild-type chondrocytes (P < 0.05). Treatment with autophagy dual-fluorescence virus resulted in a significantly greater fluorescence intensity of LC3-GFP in rapamycin-treated ERN1 CKO chondrocytes than in wild-type chondrocytes (P < 0.05). In C28/I2 cells, overexpression of CHERP obviously decreased the fluorescence intensity of LC3, and overexpression of IRE1α enhanced the fluorescence intensity and partially rescued the fluorescence reduction of LC3 caused by CHERP.

CONCLUSION

IRE1α deficiency impairs autophagy in chondrocytes by upregulating CHERP and increasing intracellular calcium ion content.

GP-14 protects against severe hypoxia-induced neuronal injury through the AKT and ERK pathways and its induced transcriptome profiling alteration

Gypenosides are major bioactive ingredients of G. pentaphyllum. In our previous study, we found that gypenosides had neuroprotective effects against hypoxia-induced injury. In the current study, we focused on the protective effects of gypenoside-14 (GP-14), which is one of the newly identified bioactive components, on neuronal injury caused by severe hypoxia (0.3% O₂). The results showed that GP-14 pretreatment alleviated the cell viability damage and apoptosis induced by hypoxia in PC12 cells. Moreover, GP-14 pretreatment also attenuated primary neuron injuries under hypoxic conditions. Additionally, GP-14 pretreatment significantly ameliorated neuronal damage in the hippocampal region induced by high-altitude cerebral edema (HACE). At the molecular level, GP-14 pretreatment reversed the decreased activities of the AKT and ERK signaling pathways caused by hypoxia in PC12 cells and primary neurons. To comprehensively explore the possible mechanisms, transcriptome sequencing was conducted, and these results indicated that GP-14 could alter the transcriptional profiles of primary neuron. Taken together, our results suggest that GP-14 acts as a neuroprotective agent to protect against neuronal damage induced by severe hypoxia and it is a promising compound for the development of neuroprotective drugs.

A framework for deep multitask learning with multiparametric magnetic resonance imaging for the joint prediction of histological characteristics in breast cancer

The clinical management and decision-making process related to breast cancer are based on multiple histological indicators. This study aims to jointly predict the Ki-67 expression level, luminal A subtype and histological grade molecular biomarkers using a new deep multitask learning method with multiparametric magnetic resonance imaging. A multitask learning network structure was proposed by introducing a common-task layer and task-specific layers to learn the high-level features that are common to all tasks and related to a specific task, respectively. A network pretrained with knowledge from the ImageNet dataset was used and fine-tuned with MRI data. Information from multiparametric MR images was fused using the strategy at the feature and decision levels. The area under the receiver operating characteristic curve (AUC) was used to measure model performance. For single-task learning using a single image series, the deep learning model generated AUCs of 0.752, 0.722, and 0.596 for the Ki-67, luminal A and histological grade prediction tasks, respectively. The performance was improved by freezing the first 5 convolutional layers, using 20% shared layers and fusing multiparametric series at the feature level, which achieved AUCs of 0.819, 0.799 and 0.747 for Ki-67, luminal A and histological grade prediction tasks, respectively. Our study showed advantages in jointly predicting correlated clinical biomarkers using a deep multitask learning framework with an appropriate number of fine-tuned convolutional layers by taking full advantage of common and complementary imaging features. Multiparametric image series-based multitask learning could be a promising approach for the multiple clinical indicator-based management of breast cancer.