The molecular subtypes of autoimmune diseases

Autoimmune diseases (ADs) are characterized by their complexity and a wide range of clinical differences. Despite patients presenting with similar symptoms and disease patterns, their reactions to treatments may vary. The current approach of personalized medicine, which relies on molecular data, is seen as an effective method to address the variability in these diseases. This review examined the pathologic classification of ADs, such as multiple sclerosis and lupus nephritis, over time. Acknowledging the limitations inherent in pathologic classification, the focus shifted to molecular classification to achieve a deeper insight into disease heterogeneity. The study outlined the established methods and findings from the molecular classification of ADs, categorizing systemic lupus erythematosus (SLE) into four subtypes, inflammatory bowel disease (IBD) into two, rheumatoid arthritis (RA) into three, and multiple sclerosis (MS) into a single subtype. It was observed that the high inflammation subtype of IBD, the RA inflammation subtype, and the MS "inflammation & EGF" subtype share similarities. These subtypes all display a consistent pattern of inflammation that is primarily driven by the activation of the JAK-STAT pathway, with the effective drugs being those that target this signaling pathway. Additionally, by identifying markers that are uniquely associated with the various subtypes within the same disease, the study was able to describe the differences between subtypes in detail. The findings are expected to contribute to the development of personalized treatment plans for patients and establish a strong basis for tailored approaches to treating autoimmune diseases.

Single-cell ionic current phenotyping explains stem cell-derived cardiomyocyte action potential morphology

Human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) are a promising tool to study arrhythmia-related factors, but the variability of action potential (AP) recordings from these cells limits their use as an in vitro model. In this study, we use recently published brief (10 s), dynamic voltage-clamp (VC) data to provide mechanistic insights into the ionic currents contributing to AP heterogeneity; we call this approach rapid ionic current phenotyping (RICP). Features of this VC data were correlated to AP recordings from the same cells, and we used computational models to generate mechanistic insights into cellular heterogeneity. This analysis uncovered several interesting links between AP morphology and ionic current density: both L-type calcium and sodium currents contribute to upstroke velocity, rapid delayed rectifier K+ current is the main determinant of the maximal diastolic potential, and an outward current in the activation range of slow delayed rectifier K+ is the main determinant of AP duration. Our analysis also identified an outward current in several cells at 6 mV that is not reproduced by iPSC-CM mathematical models but contributes to determining AP duration. RICP can be used to explain how cell-to-cell variability in ionic currents gives rise to AP heterogeneity. Because of its brief duration (10 s) and ease of data interpretation, we recommend the use of RICP for single-cell patch-clamp experiments that include the acquisition of APs.NEW & NOTEWORTHY We present rapid ionic current phenotyping (RICP), a current quantification approach based on an optimized voltage-clamp protocol. The method captures a rich snapshot of the ionic current dynamics, providing quantitative information about multiple currents (e.g., ICa,L, IKr) in the same cell. The protocol helped to identify key ionic determinants of cellular action potential heterogeneity in iPSC-CMs. This included unexpected results, such as the critical role of IKr in establishing the maximum diastolic potential.

Benefit and harm of low-dose aspirin in pregnancy: a balancing act

Linked article: This Correspondence comments on Souter et al. Click here to view the article.

A review of disease risk prediction methods and applications in the omics era

Risk prediction and disease prevention are the innovative care challenges of the 21st century. Apart from freeing the individual from the pain of disease, it will lead to low medical costs for society. Until very recently, risk assessments have ushered in a new era with the emergence of omics technologies, including genomics, transcriptomics, epigenomics, proteomics, and so on, which potentially advance the ability of biomarkers to aid prediction models. While risk prediction has achieved great success, there are still some challenges and limitations. We reviewed the general process of omics-based disease risk model construction and the applications in four typical diseases. Meanwhile, we highlighted the problems in current studies and explored the potential opportunities and challenges for future clinical practice.

Enhanced ability of toluene oxidation by controlling inversion degree of spinel composed of only Co, Mn

Exploring the single relationship between the inversion degree of spinel and its catalytic performance is a great challenge, but has important significance for further structural design and application. A series of CoMn inverse spinels were prepared and the general formula [Formula: see text] was deduced through X-ray diffraction refinement to find a decreased inversion degree x as calcination temperature rose. Catalytic oxidation of toluene showed that higher inversion degree (S-300 with x ≈ 0.95) can reach larger conversion rate (90 % at about 250 °C for 400 ppm toluene) with greater reaction stability (140 h). Density Functional Theory (DFT) calculations on density of states indicated its metallic nature, and found that the strength of O-p and Transition metal-d orbitals at Fermi energy is positively correlated to the inversion degree, meaning stronger electron migration ability. Along with the adsorption calculation analysis that lattice oxygen species are proved to work dominantly (S-300 with lowest adsorption energy but highest performance), this work uncovered a theoretical insight into inverse spinel oxide, to provide the possibility of elevated oxidation ability through structural control.

Effects of genetic variation on the structure of RNA and protein

Changes in the structure of RNA and protein, have an important impact on biological functions and are even important determinants of disease pathogenesis and treatment. Some genetic variations, including copy number variation, single nucleotide variation, and so on, can lead to changes in biological function and increased susceptibility to certain diseases by changing the structure of RNA or protein. With the development of structural biology and sequencing technology, a large amount of RNA and protein structure data and genetic variation data resources has emerged to be used to explain biological processes. Here, we reviewed the effects of genetic variation on the structure of RNAs and proteins, and investigated their impact on several diseases. An online resource (http://www.onethird-lab.com/gems/) to support convenient retrieval of common tools is also built. Finally, the challenges and future development of the effects of genetic variation on RNA and protein were discussed.

Full sample analysis of cerebral venous sinus thrombosis in ophthalmology inpatients

PURPOSE

We hope that by analyzing the clinical features of cerebral venous sinus thrombosis (CVST), we can help ophthalmologists reduce misdiagnosis or delayed diagnosis.

DESIGN

We evaluated 47 patients with CVST in terms of clinical manifestations.

METHODS

All cases were analyzed in terms of risk factors, clinical symptoms, ophthalmic examination, imaging examination and lumbar puncture.

RESULTS

The body mass indices (BMIs) of 41 patients (87.2%; 95% CI, 77.7-96.8%) were≥24, which is overweight by Chinese standards. There were 22 patients (46.8%; 95% CI, 32.5-61.1%) with BMIs≥28, who were considered obese. Thirteen were hypertensive (27.7%; 95% CI, 14.9-40.5%). The initial symptoms included blurred vision (23, 48.9%; 95% CI, 34.6-63.2%), amaurosis fugax (13, 27.7%; 95% CI, 14.9-40.5%), headache (11 patients, 23.4%; 95% CI, 11.3-35.5%), dizziness (3, 6.4%; 95% CI, -0.6-13.4%), and bilateral diplopia (3, 6.4%; 95% CI, -0.6-13.4%). There were 9 patients (9, 19.2%; 95% CI, 7.9-30.4%) with blindness, 23 patients (48.9%; 95% CI, 34.6-63.2%) with pupillary abnormalities, and 40 patients (85.1%; 95% CI, 74.9-95.2%) with papilledema. Forty-three of the 45 patients who successfully underwent a routine lumbar puncture showed high intracranial pressure (91.7%; 95.6% CI, 89.6-101.6%). Finally, two cases are reported in greater detail for illustrative purposes.

CONCLUSION

The main reasons interfering with the diagnosis of CVST might be its nonspecific ocular symptoms and the physicians' clinical thought process being limited to the scope of common ophthalmological diseases.

Flexible, foldable and transparent SERS film with high sensitivity and signal homogeneity via silver ion exchange and in-situ reduction

The adhesion between metal plasma and substrate was the key of surface-enhanced Raman scattering (SERS) technology. The preparation of ideal SERS substrate with multiple advantages such as high sensitivity and good signal reproducibility was still the focus of research. A flexible foldable and transparent fluorinated polyimide/silver NPs (FPI@Ag) SERS film was fabricated by the ion exchange and in-situ reduction method in this work. The effects of KOH hydrolysis time, AgNO3 ion exchange time and concentration, the type and concentration of reducing agents on the SERS performance of the FPI@Ag film were systematically discussed. As a result, the hydrolysis time of KOH affected the thickness of the metallic silver layer, the concentration of AgNO3 affected the size and spacing of Ag NPs, and the Raman signal of was remarkably enhanced when borane dimethylamine complex (DMAB) was used as reducing agent. When the detection limit of 4-Aminothiophenol was as low as 1 × 10-11 mol·L-1, the obvious Raman characteristic peak still appeared. The enhancement factor (EF) was up to 9.4 × 107. The linear quantification range was achieved in the range from 10-3-10-11 mol·L-1, R2 = 0.9987. In addition, we also performed multi-cycle bending and torsion test on the FPI@Ag film, and obtained stable Raman signals. The prepared FPI@Ag film can be attached to the surface of uneven samples, which can be used for on-site Raman detection and analysis.

Prognostic value of DNA methylation subclassification, aneuploidy, and CDKN2A/B homozygous deletion in predicting clinical outcome of IDH mutant astrocytomas

INTRODUCTION

IDH mutant astrocytoma grading, until recently, has been entirely based on morphology. The 5th edition of the Central Nervous System WHO introduces CDKN2A/B homozygous deletion as a biomarker of grade 4. We sought to investigate the prognostic impact of DNA methylation-derived molecular biomarkers for IDH mutant astrocytoma.

METHODS

We analyzed 98 IDH mutant astrocytomas diagnosed at NYU Langone Health between 2014 and 2022. We reviewed DNA methylation subclass, CDKN2A/B homozygous deletion, and ploidy and correlated molecular biomarkers with histological grade, progression free (PFS), and overall (OS) survival. Findings were confirmed using two independent validation cohorts.

RESULTS

There was no significant difference in OS or PFS when stratified by histologic WHO grade alone, copy number complexity, or extent of resection. OS was significantly different when patients were stratified either by CDKN2A/B homozygous deletion or by DNA methylation subclass (p-value=0.0286 and 0.0016, respectively). None of the molecular biomarkers were associated with significantly better progression free survival (PFS), although DNA methylation classification showed a trend (p-value= 0.0534).

CONCLUSIONS

The current WHO recognized grading criteria for IDH mutant astrocytomas show limited prognostic value. Stratification based on DNA methylation shows superior prognostic value for OS.

Development of a two-step pretreatment and UPLC-MS/MS-based method for simultaneous determination of acrylamide, 5-hydroxymethylfurfural, advanced glycation end products and heterocyclic amines in thermally processed foods

A two-step pretreatment and UPLC-MS/MS-based method was established to extract and determine 17 thermal processing hazards (TPHs) simultaneously. The first step was to extract acrylamide (AA), 5-hydroxymethylfurfural (HMF) and free heterocyclic amines (HAs). The bound HAs and advanced glycation end products (AGEs) were released by acid hydrolysis in the second step. A fairly good separation was achieved within 7 min. Almost all TPHs showed high correlation coefficients (R2 >0.999) in their respective linear ranges. The accuracy ranged from 98.13 to 100.96%. LODs and LOQs were in the range of 0.01-0.89 µg/L and 0.02-2.96 µg/L, respectively. The method was successfully applied to four representative food products, including high-starch, high-protein, high-fat and high-sugar foods, showing acceptable recoveries, intra-day and inter-day precisions. Moreover, PCA was performed to visualize the association between TPHs and food matrices. The developed method provided technical support for the formation and control researches of TPHs.

Epigenome-wide methylation haplotype association analysis identified HLA-DRB1, HLA-DRB5 and HLA-DQB1 as risk factors for rheumatoid arthritis

The aim of this study was to compare nonrandom associations between physically adjacent single methylation polymorphism loci among rheumatoid arthritis (RA) and normal subjects for investigating RA-risk methylation haplotypes (meplotype). With 354 ACPA-positive RA patients and 335 normal controls selected from a case-control study based on Swedish population, we conducted the first RA epigenome-wide meplotype association study using our software EWAS2.0, mainly including (i) converted the β value to methylation genotype (menotype) data, (ii) identified methylation disequilibrium (MD) block, (iii) calculated frequent of each meplotypes in MD block and performed case-control association test and (iv) screened for RA-risk meplotypes by odd ratio (OR) and p-values. Ultimately, 545 meplotypes on 334 MD blocks were identified significantly associated with RA (p-value < .05). These meplotypes were mapped to 329 candidate genes related to RA. Subsequently, combined with gene optimization, eight RA-risk meplotypes were identified on three risk genes: HLA-DRB1, HLA-DRB5 and HLA-DQB1. Our results reported the relationship between DNA methylation pattern on HLA-DQB1 and the risk of RA for the first time, demonstrating the co-demethylation of 'cg22984282' and 'cg13423887' on HLA-DQB1 gene (meplotype UU, p-value = 2.90E - 6, OR = 1.68, 95% CI = [1.35, 2.10]) may increase the risk of RA. Our results demonstrates the potential of methylation haplotype analysis to identify RA-related genes from a new perspective and its applicability to the study of other disease.

Detection of pesticide residues on flexible and transparent fluorinated polyimide film based on surface-enhanced Raman spectroscopy technology

BACKGROUND

Excessive pesticide residues will seriously endanger human health. The complexity and lag of the current popular analytical methods hinder the timeliness of food safety analysis. Surface-enhanced Raman scattering (SERS) was an ultra-sensitive vibration spectroscopy technology with the advantages of less time cost, non-destructive and semi-quantitative detection, which has attracted much attention in the rapid field detection of pesticide residue. It was clear that we need an efficient and convenient substrate for pesticide residue detection based on SRES technology, which needs to be portable, flexible, transparent and easy to detect irregular object surfaces.

RESULTS

A novel SERS sensor was designed to detect single and multi-component pesticide residues on irregular fruit and vegetable surfaces by in-situ growth of silver nanoparticles on a flexible and transparent fluorinated polyimide (FPI) substrate. Among them, Ag NPs were synthesized by liquid phase reduction method (AgNO3-PVP and NaBH4). The results showed that the detection limit of 1-4 BDT was down to 10-10 mol L-1, the enhancement factor (EF) was up to 1.57 × 107, and relative standard deviation (RSD) was 7.49 %. By this method, tricyclazole solution at a concentration of 0.01 mg L-1 was still detectable by the FPI@Ag SERS substrate. The linear quantification was achieved in the range from 100 mg L-1 to 0.01 mg L-1. Two mixed pesticides, tricyclazole and imazalil, were also successfully distinguished.

SIGNIFICANCE

This represents the formation of a flexible, foldable and transparent substrate for rapid on-site detection. Results can be obtained in <5 min by attaching the substrate to the substance to be tested. And the SERS substrate prepared with high sensitivity, stability, portable and convenient analysis, which provided new ideas for efficient and rapid household food safety detection.

Genome-wide identification of m6A-associated single nucleotide polymorphisms in complex diseases of nervous system

N6-methyladenosine (m6A) is one of the most abundant chemical modifications on RNA and can affect the occurrence and development of diseases. Some studies have shown that the expressions of some m6A-related genes are significantly regulated by single nucleotide variants (SNV). However, the function of m6A-associated single nucleotide polymorphisms (m6A-SNP) remains unclear in multiple sclerosis (MS), Alzheimer's disease (AD) and Parkinson's disease (PD). Here, we identified the disease-associated m6A-SNPs by integrating genome-wide association study (GWAS) and m6A-SNPs from the RMVar database, and confirmed the relationship between these identified m6A-SNPs and their target genes in eQTL analysis and gene differential expression analysis. Finally, 26 genes corresponding to 20 m6A-SNPs with eQTL signals were identified and differentially expressed (P < 0.05) in MS, 15 genes corresponding to 12 m6A-SNPs (P < 1e-04) were differentially expressed in AD, and 27 PD-associated m6A-SNPs that regulated the expression of 31 genes were identified. There were 5 HLA genes with eQTL signals (HLA-DQB1, HLA-DRB1, HLA-DQA1, HLA-DQA2 and HLA-DQB1-AS1) to be detected in the three diseases. In summary, our study provided new insights into understanding the potential roles of these m6A-SNPs in disease pathogenesis as well as therapeutic target.

LESION MIMIC MUTANT 1 confers basal resistance to Sclerotinia sclerotiorum in rapeseed via a salicylic acid-dependent pathway

Rapeseed (Brassica napus) is a major edible oilseed crop consumed worldwide. However, its yield is seriously affected by infection from the broad-spectrum non-obligate pathogen Sclerotinia sclerotiorum due to a lack of highly resistant germplasm. Here, we identified a Sclerotinia-resistant and light-dependent lesion mimic mutant from an ethyl methanesulfonate-mutagenized population of the rapeseed inbred Zhongshuang 11 (ZS11) named lesion mimic mutant 1 (lmm1). The phenotype of lmm1 is controlled by a single recessive gene, named LESION MIMIC MUTANT 1 (LMM1), which mapped onto chromosome C04 by bulked segregant analysis within a 2.71-Mb interval. Histochemical analysis indicated that H2O2 strongly accumulated and cell death occurred around the lesion mimic spots. Among 877 differentially expressed genes (DEGs) between ZS11 and lmm1 leaves, 188 DEGs were enriched in the defense response, including 95 DEGs involved in systemic acquired resistance, which is consistent with the higher salicylic acid levels in lmm1. Combining bulked segregant analysis and transcriptome analysis, we identified a significantly up-regulated gene, BnaC4.PR2, which encodes β-1,3-glucanase, as the candidate gene for LMM1. Overexpression of BnaC4.PR2 may induce a reactive oxygen species burst to trigger partial cell death and systemic acquired resistance. Our study provides a new genetic resource for S. sclerotiorum resistance as well as new insights into disease resistance breeding in B. napus.

Rapid ionic current phenotyping (RICP) identifies mechanistic underpinnings of iPSC-CM AP heterogeneity

As a renewable, easily accessible, human-derived in vitro model, human induced pluripotent stem cell derived cardiomyocytes (iPSC-CMs) are a promising tool for studying arrhythmia-related factors, including cardiotoxicity and congenital proarrhythmia risks. An oft-mentioned limitation of iPSC-CMs is the abundant cell-to-cell variability in recordings of their electrical activity. Here, we develop a new method, rapid ionic current phenotyping (RICP), that utilizes a short (10 s) voltage clamp protocol to quantify cell-to-cell heterogeneity in key ionic currents. We correlate these ionic current dynamics to action potential recordings from the same cells and produce mechanistic insights into cellular heterogeneity. We present evidence that the L-type calcium current is the main determinant of upstroke velocity, rapid delayed rectifier K+ current is the main determinant of the maximal diastolic potential, and an outward current in the excitable range of slow delayed rectifier K+ is the main determinant of action potential duration. We measure an unidentified outward current in several cells at 6 mV that is not recapitulated by iPSC-CM mathematical models but contributes to determining action potential duration. In this way, our study both quantifies cell-to-cell variability in membrane potential and ionic currents, and demonstrates how the ionic current variability gives rise to action potential heterogeneity. Based on these results, we argue that iPSC-CM heterogeneity should not be viewed simply as a problem to be solved but as a model system to understand the mechanistic underpinnings of cellular variability.

Climate warming negatively affects plant water-use efficiency in a seasonal hydroperiod wetland

Climate warming has substantial influences on plant water-use efficiency (PWUE), which is defined as the ratio of plant CO2 uptake to water loss and is central to the cycles of carbon and water in ecosystems. However, it remains uncertain how does climate warming affect PWUE in wetland ecosystems, especially those with seasonally alternating water availability during the growing season. In this study, we used a continuous 10-year (2011-2020) eddy covariance (EC) dataset from a seasonal hydroperiod wetland coupled with a 15-year (2003-2017) satellite-based dataset (called PML-V2) and an in situ warming experiment to examine the climate warming impacts on wetland PWUE. The 10-year EC observational results revealed that rising temperatures had significant negative impacts on the interannual variations in wetland PWUE, and increased transpiration (Et) rather than changes in gross primary productivity (GPP) dominated these negative impacts. Furthermore, the 15-year satellite-based evidence confirmed that, in the study region, climate warming had significant negative consequences for the interannual variations in wetland PWUE by enhancing wetland Et. Lastly, at the leaf-scale, the light response curves of leaf photosynthesis, leaf Et, and leaf-scale PWUE indicated that wetland plants need to consume more water during the photosynthesis process under warmer conditions. These findings provide a fresh perspective on how climate warming influences carbon and water cycles in wetland ecosystems.

CCDC43 as a potential therapeutic target of Tian Yang Wan for the treatment of hepatocellular carcinoma by activating the hippo pathway

Introduction

Hepatocellular carcinoma (HCC) prevalence is rising annually, but the existing treatment strategies are limited; therefore, it is crucial to explore new therapeutic approaches.

Methods

Here, we investigate the potential anti-cancer mechanism of an herbal medicine called Tian Yang Wan (TYW) in the treatment of HCC. The relationship of CCDC43 with immunity and cell death was analyzed by bioinformatics. Confirming the tumor suppressor effect of TYW on HCC cells by proliferation, invasion, migration and apoptosis assays.

Results

First, we analyzed by proteomics that CCDC43 expression was downregulated after TYW administration and promoted the hippo pathway. Then, a large sample's transcriptome study demonstrated that elevated CCDC43 expression was strongly correlated with clinical traits and a bad prognosis in HCC patients. Next, we observed through multiple advanced algorithms that CCDC43 is involved in a variety of oncology and immunology related pathways. Notably, we found higher tumor immune microenvironment with high CCDC43 expression. Furthermore, we demonstrated that CCDC43 is associated with immune checkpoints and found that it is a sensitive indicator of a large number of chemotherapeutic agents. Subsequently, we conducted experimental investigations to demonstrate the capacity of TYW to impede proliferation and migration, while inducing apoptosis in human HCC cell lines. Finally, we performed analysis of two cell death patterns which showed CCDC43 to be strongly correlated with multiple ferroptosis factors and cuproptosis factors.

Discusion

In conclusion, our study comprehensively examined the prognostic, immunological, and therapeutic implications of CCDC43 in HCC, thereby elucidating the therapeutic mechanism of action in TYW.

Leak current, even with gigaohm seals, can cause misinterpretation of stem cell-derived cardiomyocyte action potential recordings

AIMS

Human-induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have become an essential tool to study arrhythmia mechanisms. Much of the foundational work on these cells, as well as the computational models built from the resultant data, has overlooked the contribution of seal-leak current on the immature and heterogeneous phenotype that has come to define these cells. The aim of this study is to understand the effect of seal-leak current on recordings of action potential (AP) morphology.

METHODS AND RESULTS

Action potentials were recorded in human iPSC-CMs using patch clamp and simulated using previously published mathematical models. Our in silico and in vitro studies demonstrate how seal-leak current depolarizes APs, substantially affecting their morphology, even with seal resistances (Rseal) above 1 GΩ. We show that compensation of this leak current is difficult due to challenges with obtaining accurate measures of Rseal during an experiment. Using simulation, we show that Rseal measures (i) change during an experiment, invalidating the use of pre-rupture values, and (ii) are polluted by the presence of transmembrane currents at every voltage. Finally, we posit that the background sodium current in baseline iPSC-CM models imitates the effects of seal-leak current and is increased to a level that masks the effects of seal-leak current on iPSC-CMs.

CONCLUSION

Based on these findings, we make recommendations to improve iPSC-CM AP data acquisition, interpretation, and model-building. Taking these recommendations into account will improve our understanding of iPSC-CM physiology and the descriptive ability of models built from such data.

Ambient precipitation determines the sensitivity of soil respiration to precipitation treatments in a marsh

The effects in field manipulation experiments are strongly influenced by amplified interannual variation in ambient climate as the experimental duration increases. Soil respiration (SR), as an important part of the carbon cycle in terrestrial ecosystems, is sensitive to climate changes such as temperature and precipitation changes. A growing body of evidence has indicated that ambient climate affects the temperature sensitivity of SR, which benchmarks the strength of terrestrial soil carbon-climate feedbacks. However, whether SR sensitivity to precipitation changes is influenced by ambient climate is still not clear. In addition, the mechanism driving the above phenomenon is still poorly understood. Here, a long-term field manipulation experiment with five precipitation treatments (-60%, -40%, +0%, +40%, and +60% of annual precipitation) was conducted in a marsh in the Yellow River Delta, China, which is sensitive to soil drying-wetting cycle caused by precipitation changes. Results showed that SR increased exponentially along the experimental precipitation gradient each year and the sensitivity of SR (standardized by per 100 mm change in precipitation under precipitation treatments) exhibited significant interannual variation from 2016 to 2021. In addition, temperature, net radiation, and ambient precipitation all exhibited dramatic interannual variability; however, only ambient precipitation had a significant negative correlation with SR sensitivity. Moreover, the sensitivity of SR was significantly positively related to the sensitivity of belowground biomass (BGB) across 6 years. Structural equation modeling and regression analysis also showed that precipitation treatments significantly affected SR and its autotrophic and heterotrophic components by altering BGB. Our study demonstrated that ambient precipitation determines the sensitivity of SR to precipitation treatments in marshes. The findings underscore the importance of ambient climate in regulating ecosystem responses in long-term field manipulation experiments.

Dynamic changes of inulin utilization associated with longitudinal development of gut microbiota

Inulin is a typical kind of fermentable polysaccharide and has emerged as a promising dietary supplement due to its multiple health-promoting effects. This study aimed to unveil the dynamic change pattern of inulin utilizability as a fermentation substrate during gut microbiota development and illuminate its potential association with gut microbiota in Chinese Jinhua native pig models via longitudinal analyses. Herein, fresh feces were collected at one week pre- and post-weaning as well as 3rd month post-weaning, respectively. Targeted metabolomics and in vitro simulated fermentation revealed increasing concentrations of fecal short-chain fatty acids (SCFAs) and elevating utilizability of inulin as a fermentation substrate. Microbiomic analyses demonstrated the conspicuous longitudinal alteration in gut microbial composition and a significant rise in microbial community diversity during gut microbiota development. Furthermore, gut microbial functional analyses showed a remarkable increase in the relative abundances of carbohydrate metabolism pathways, including pentose phosphate pathway, galactose metabolism pathway, butanoate metabolism pathway as well as fructose and mannose metabolism pathway. Notably, relative abundances of bacterial genera Bifidobacterium, Roseburia, Faecalibacterium and Enterococcus displayed significantly positive correlations with the production of microbial fermentation-derived SCFAs. Collectively, these findings offer novel insights into understanding inulin utilizability variations from the perspective of gut microbiota development.

RABC: Rheumatoid Arthritis Bioinformatics Center

Advances in sequencing technologies have led to the rapid growth of multi-omics data on rheumatoid arthritis (RA). However, a comprehensive database that systematically collects and classifies the scattered data is still lacking. Here, we developed the Rheumatoid Arthritis Bioinformatics Center (RABC, http://www.onethird-lab.com/RABC/), the first multi-omics data resource platform (data hub) for RA. There are four categories of data in RABC: (i) 175 multi-omics sample sets covering transcriptome, epigenome, genome, and proteome; (ii) 175 209 differentially expressed genes (DEGs), 105 differentially expressed microRNAs (DEMs), 18 464 differentially DNA methylated (DNAm) genes, 1 764 KEGG pathways, 30 488 GO terms, 74 334 SNPs, 242 779 eQTLs, 105 m6A-SNPs and 18 491 669 meta-mQTLs; (iii) prior knowledge on seven types of RA molecular markers from nine public and credible databases; (iv) 127 073 literature information from PubMed (from 1972 to March 2022). RABC provides a user-friendly interface for browsing, searching and downloading these data. In addition, a visualization module also supports users to generate graphs of analysis results by inputting personalized parameters. We believe that RABC will become a valuable resource and make a significant contribution to the study of RA.

An in silico-in vitro pipeline for drug cardiotoxicity screening identifies ionic pro-arrhythmia mechanisms

BACKGROUND AND PURPOSE

Before advancing to clinical trials, new drugs are screened for their pro-arrhythmic potential using a method that is overly conservative and provides limited mechanistic insight. The shortcomings of this approach can lead to the mis-classification of beneficial drugs as pro-arrhythmic.

EXPERIMENTAL APPROACH

An in silico-in vitro pipeline was developed to circumvent these shortcomings. A computational human induced pluripotent stem cell-derived cardiomyocyte (iPSC-CM) model was used as part of a genetic algorithm to design experiments, specifically electrophysiological voltage clamp (VC) protocols, to identify which of several cardiac ion channels were blocked during in vitro drug studies. Such VC data, along with dynamically clamped action potentials (AP), were acquired from iPSC-CMs before and after treatment with a control solution or a low- (verapamil), intermediate- (cisapride or quinine) or high-risk (quinidine) drug.

KEY RESULTS

Significant AP prolongation (a pro-arrhythmia marker) was seen in response to quinidine and quinine. The VC protocol identified block of IKr (a source of arrhythmias) by all strong IKr blockers, including cisapride, quinidine and quinine. The protocol also detected block of ICaL by verapamil and Ito by quinidine. Further demonstrating the power of the approach, the VC data uncovered a previously unidentified If block by quinine, which was confirmed with experiments using a HEK-293 expression system and automated patch-clamp.

CONCLUSION AND IMPLICATIONS

We developed an in silico-in vitro pipeline that simultaneously identifies pro-arrhythmia risk and mechanism of ion channel-blocking drugs. The approach offers a new tool for evaluating cardiotoxicity during preclinical drug screening.

Impacts of menopause hormone therapy on mood disorders among postmenopausal women

OBJECTIVE

This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women.

METHODS

A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status.

RESULTS

A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety.

CONCLUSION

Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.

Video-assisted superior mediastinal lymphadenectomy for papillary thyroid cancer: a case report

Superior mediastinal lymph node metastases in papillary thyroid cancer are uncommon. The clinical characteristics and surgical strategy of superior mediastinal lymph node metastases remain unclear. Superior mediastinal lymphadenectomy can be accomplished either by a transcervical or transsternal approach. Transsternal approach for superior mediastinal lymphadenectomy can cause great damage; transcervical approach sometimes results in inadequate exposure. Here we report our experience of a papillary thyroid cancer patient with superior mediastinal lymph node metastases who underwent video-assisted superior mediastinal lymphadenectomy. A 49-year-old woman diagnosed with papillary thyroid cancer in left thyroid underwent unilateral lobectomy and ipsilateral central and lateral node dissection in the local hospital 4 years ago. Currently lymph node metastases were found in mediastinum and the right neck, some of which were adjacent to the right innominate vein. Unilateral lobectomy, ipsilateral central and lateral node dissection, and video-assisted superior mediastinal lymphadenectomy were successfully performed by transcervical approach. Subsequently, the patient received thyroxine suppression therapy and adjuvant radioiodine treatment. Video-assisted superior mediastinal lymphadenectomy, providing adequate exposure for a complete superior mediastinal lymphadenectomy, is proved to be safe and feasible.

CARBONATED BEVERAGES AFFECT LEVELS OF ANDROGEN RECEPTOR AND TESTOSTERONE SECRETION IN MICE

Objectives

This work aimed to study the influences of carbonated beverages (CBs) on the testis growth and the expression levels of androgen receptor (AR) of mice.

Methods

Two experimental groups of 30 mice each PEP-1 and PEP-2 drank 50% and 100% Pepsi-Cola, respectively for 15 days. Other 2 experimental groups of 30 mice each COC-1 and COC-2 drank 50% and 100% Coca-Cola, respectively for 15 days. The control group (CG) of 30 mice drank water. Bilateral testes were harvested aseptically on days 0, 5, 7, 10, 13 and 15. Real-time PCR and Western blot were implemented to detect levels of androgen receptor (AR) mRNA and protein in testis tissues.

Results

Testes masses of PEP-2, COC-1 and COC-2 were greater than those of PEP-1 and CG (P < 0.05). On day 15, testis longitudinal diameter (TLD) of CBs-treated mice was increased as compared to CG. TLD, testes transverse diameters (TTD) and AR proteins levels of PEP-2 and COC-2 were increased in comparison with CG (P<0.05). Serum testosterone concentrations of PEP-2 were higher than that of COC-1 and CG (P < 0.05). Levels of AR mRNAs of four CBs-treated mice were increased by 60.18%, 67.26%, 65.93% and 78.76%.

Conclusions

A high concentration of Coca-Cola and Pepsi-Cola could raise TLD and TDD, enhance testosterone secretion, and increase serum EGF concentrations.

The adaptation to freezing tolerance of hydrated lettuce seeds: effects of regional climate and of seed characteristics

BACKGROUND

With global warming, soil seed banks at high altitudes face dual challenges, excessive water absorption and thinner snow cover that increase underground temperature. A better understanding of freezing tolerance of hydrated seeds provides insights for conservation in natural soil seed banks.

OBJECTIVE

To understand the adaptation mechanisms of seed freezing tolerance under various climates, in relation to cooling rate and seed size.

MATERIALS AND METHODS

Twelve ecotypes of lettuce (Lactuca sativa) seeds were collected from different geographical locations around the world. Seeds were fully hydrated and tested for their freezing tolerance using programmed cooling methods.

RESULTS

The size of seeds from different climate regions varied, and was correlated with the freezing tolerance of the hydrated seeds (P < 0.05). Larger seeds showed poorer freezing tolerance. The local climates of maternal plants were also well correlated to seed freezing tolerance (P < 0.05), especially under slow cooling conditions. The seeds collected in regions with high spring rainfall exhibited greater freezing tolerance.

CONCLUSION

Freezing tolerance of hydrated seeds is affected by the climate of maternal plants and by seed size. Our data revealed the existence of an adaptation mechanism of freezing tolerance among various ecotypes of lettuce seeds. doi.org/10.54680/fr22410110412.

Mobile-Based and Self-Service Tool (iPed) to Collect, Manage, and Visualize Pedigree Data: Development Study

Background

Pedigree data (family history) are indispensable for genetics studies and the assessment of individuals' disease susceptibility. With the popularity of genetics testing, the collection of pedigree data is becoming more common. However, it can be time-consuming, laborious, and tedious for clinicians to investigate all pedigree data for each patient. A self-service robot could inquire about patients' family history in place of professional clinicians or genetic counselors.

Objective

The aim of this study was to develop a mobile-based and self-service tool to collect and visualize pedigree data, not only for professionals but also for those who know little about genetics.

Methods

There are 4 main aspects in the iPed construction, including interface building, data processing, data storage, and data visualization. The user interface was built using HTML, JavaScript libraries, and Cascading Style Sheets (version 3; Daniel Eden). Processing of the submitted data is carried out by PHP programming language. MySQL is used to document and manage the pedigree data. PHP calls the R script to accomplish the visualization.

Results

iPed is freely available to all users through the iPed website. No software is required to be installed, no pedigree files need to be prepared, and no knowledge of genetics or programs is required. The users can easily complete their pedigree data collection and visualization on their own and through a dialogue with iPed. Meanwhile, iPed provides a database that stores all users’ information. Therefore, when the users need to construct new pedigree trees for other genetic traits or modify the pedigree trees that have already been created, unnecessary duplication of operations can be avoided.

Conclusions

iPed is a mobile-based and self-service tool that could be used by both professionals and nonprofessionals at any time and from any place. It reduces the amount of time required to collect, manage, and visualize pedigree data.

Maternal consumption of a fermented diet protects offspring against intestinal inflammation by regulating the gut microbiota

The neonatal intestinal tract is immature and can be easily infected by pathogens causing inflammation. Maternal diet manipulation is a promising nutritional strategy to enhance the gut health of offspring. A fermented diet is a gut microbiota targeting diet containing live probiotics and their metabolites, which benefit the gut and overall health host. However, it remains unclear how a maternal fermented diet (MFD) affects neonatal intestinal inflammation. Here, in vivo and in vitro models together with multi-omics analysis were applied to investigate the impacts and the underlying mechanism through which an MFD prevents from gut inflammation in neonates. An MFD remarkably improved the performance of both sows and piglets and significantly altered the gut microbiome and milk metabolome of sows. In addition, the MFD significantly accelerated the maturation of the gut microbiota of neonates and increased the abundance of gut Lactobacillus and the microbial functions of amino acid-related enzymes and glucose metabolism on the weaning day. Notably, the MFD reduced susceptibility to colonic inflammation in offspring. The fecal microbiota of sows was then transplanted into mouse dams and it was found that the mouse dams and pups in the MFD group alleviated the LPS-induced decrease in gut Lactobacillus abundance and barrier injury. Milk L-glutamine (GLN) and gut Lactobacillus reuteri (LR) were found as two of the main MFD-induced sow effectors that contributed to the gut health of piglets. The properties of LR and GLN in modulating gut microbiota and alleviating colonic inflammation by inhibiting the phosphorylation of p38 and JNK and activation of Caspase 3 were further verified. These findings provide the first data revealing that an MFD drives neonate gut microbiota development and ameliorates the colonic inflammation by regulating the gut microbiota. This fundamental evidence might provide references for modulating maternal nutrition to enhance early-life gut health and prevent gut inflammation.

Integrated Microbiomic and Metabolomic Dynamics of Fermented Corn and Soybean By-Product Mixed Substrate

Microbes and their metabolites produced in fermented food have been considered as critical contributors to the quality of the final products, but the comprehensive understanding of the microbiomic and metabolomic dynamics in plant-based food during solid-state fermentation remains unclear. Here, the probiotics of Bacillus subtilis and Enterococcus faecalis were inoculated into corn and defatted soybean to achieve the two-stage solid-state fermentation. A 16S sequencing and liquid chromatography–tandem mass spectrometry were applied to investigate the dynamics of microbiota, metabolites, and their integrated correlations during fermentation. The results showed that the predominant bacteria changed from Streptophyta and Rickettsiales at 0 h to Bacillus and Pseudomonas in aerobic stage and then to Bacillus, Enterococcus, and Pseudomonas in anaerobic stage. In total, 229 notably different metabolites were identified at different fermentation times, and protein degradation, amino acid synthesis, and carbohydrate metabolism were the main metabolic pathways during the fermentation. Notably, phenylalanine metabolism was the most important metabolic pathway in the fermentation process. Further analysis of the correlations among the microbiota, metabolites, and physicochemical characteristics indicated that Bacillus spp. was significantly correlated with amino acids and carbohydrate metabolism in aerobic stage, and Enterococcus spp. was remarkably associated with amino acids metabolism and lactic acid production in the anaerobic stage. The present study provides new insights into the dynamic changes in the metabolism underlying the metabolic and microbial profiles at different fermentation stages, and are expected to be useful for future studies on the quality of fermented plant-based food.

Association of prenatal renal ultrasound abnormalities with pathogenic copy number variants in a large Chinese cohort

OBJECTIVES

To assess the clinical utility of prenatal chromosomal microarray analysis (CMA) in fetuses with abnormal renal sonographic findings, and to evaluate the association of pathogenic or likely pathogenic copy number variants (P/LP CNVs) with different types of renal abnormality.

METHODS

This was a retrospective study of fetuses at 14-36 weeks screened routinely for renal and other structural abnormalities at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. We retrieved and analyzed data from fetuses with abnormal renal sonographic findings, examined between January 2013 and November 2019, which underwent CMA analysis using tissue obtained from chorionic villus sampling (CVS), amniocentesis or cordocentesis. We evaluated the CMA findings according to type of renal ultrasound anomaly and according to whether renal anomalies were isolated or non-isolated.

RESULTS

Ten types of renal anomaly were reported on prenatal ultrasound screening, at a mean ± SD gestational age of 24.9 ± 4.8 weeks. The anomalies were diagnosed relatively late in this series, as 64% of cases with an isolated renal anomaly underwent cordocentesis rather than CVS. Fetal pyelectasis was the most common renal ultrasound finding, affecting around one-third (34.32%, 301/877) of fetuses with a renal anomaly, but only 3.65% (n = 11) of these harbored a P/LP CNV (comprising: isolated cases, 2.37% (4/169); non-isolated cases, 5.30% (7/132)). Hyperechogenic kidney was found in 5.47% (n = 48) of fetuses with a renal anomaly, of which 39.58% (n = 19) had a P/LP CNV finding (comprising: isolated cases, 44.44% (16/36); non-isolated cases, 25.00% (3/12)), the highest diagnostic yield among the different types of renal anomaly. Renal agenesis, which accounted for 9.92% (n = 87) of all abnormal renal cases, had a CMA diagnostic yield of 12.64% (n = 11) (comprising: isolated cases, 11.54% (9/78); non-isolated cases, 22.22% (2/9); unilateral cases, 11.39% (9/79); bilateral cases, 25.00% (2/8)), while multicystic dysplastic kidney (n = 110), renal cyst (n = 34), renal dysplasia (n = 27), crossed fused renal ectopia (n = 31), hydronephrosis (n = 98), renal duplication (n = 42) and ectopic kidney (n = 99) had overall diagnostic rates of 11.82%, 11.76%, 7.41%, 6.45%, 6.12%, 4.76% and 3.03%, respectively. Compared with the combined group of CMA-negative fetuses with any other type of renal anomaly, the rate of infant being alive and well at birth was significantly higher in CMA-negative fetuses with isolated fetal pyelectasis or ectopic kidney, whereas the rate was significantly lower in fetuses with isolated renal agenesis, multicystic dysplastic kidney or severe hydronephrosis. The most common pathogenic CNV was 17q12 deletion, which accounted for 30.14% (22/73) of all positive CMA findings, with a rate of 2.51% (22/877) among fetuses with an abnormal renal finding. Fetuses with 17q12 deletion exhibited a wide range of renal phenotypes. Other P/LP CNVs in the recurrent region that were associated with prenatal renal ultrasound abnormalities included 22q11.2, Xp21.1, Xp22.3, 2q13, 16p11.2 and 1q21, which, collectively, accounted for 2.17% (19/877) of the fetuses with prenatal renal anomalies.

CONCLUSIONS

In this retrospective review of CMA findings in a large cohort of fetuses with different types of renal ultrasound abnormality, the P/LP CNV detection rate varied significantly (3.03-39.58%) among the different types of kidney anomaly. Our data may help in the decision regarding whether to perform prenatal genetic testing in fetuses with renal ultrasound findings. Specifically, prenatal CMA testing should be performed in cases of hyperechogenic kidney, regardless of whether or not the anomaly is isolated, while it should be performed postnatally rather than prenatally in cases of fetal pyelectasis. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Autonomous robotic laparoscopic surgery for intestinal anastomosis

Autonomous robotic surgery has the potential to provide efficacy, safety, and consistency independent of individual surgeon's skill and experience. Autonomous anastomosis is a challenging soft-tissue surgery task because it requires intricate imaging, tissue tracking, and surgical planning techniques, as well as a precise execution via highly adaptable control strategies often in unstructured and deformable environments. In the laparoscopic setting, such surgeries are even more challenging because of the need for high maneuverability and repeatability under motion and vision constraints. Here we describe an enhanced autonomous strategy for laparoscopic soft tissue surgery and demonstrate robotic laparoscopic small bowel anastomosis in phantom and in vivo intestinal tissues. This enhanced autonomous strategy allows the operator to select among autonomously generated surgical plans and the robot executes a wide range of tasks independently. We then use our enhanced autonomous strategy to perform in vivo autonomous robotic laparoscopic surgery for intestinal anastomosis on porcine models over a 1-week survival period. We compared the anastomosis quality criteria-including needle placement corrections, suture spacing, suture bite size, completion time, lumen patency, and leak pressure-of the developed autonomous system, manual laparoscopic surgery, and robot-assisted surgery (RAS). Data from a phantom model indicate that our system outperforms expert surgeons' manual technique and RAS technique in terms of consistency and accuracy. This was also replicated in the in vivo model. These results demonstrate that surgical robots exhibiting high levels of autonomy have the potential to improve consistency, patient outcomes, and access to a standard surgical technique.

Microbiota-gut-brain axis and nutritional strategy under heat stress

Heat stress is a very universal stress event in recent years. Various lines of evidence in the past literatures indicate that gut microbiota composition is susceptible to variable temperature. A varied microbiota is necessary for optimal regulation of host signaling pathways and disrupting microbiota-host homeostasis that induces disease pathology. The microbiota–gut–brain axis involves an interactive mode of communication between the microbes colonizing the gut and brain function. This review summarizes the effects of heat stress on intestinal function and microbiota–gut–brain axis. Heat stress negatively affects intestinal immunity and barrier functions. Microbiota-gut-brain axis is involved in the homeostasis of the gut microbiota, at the same time, heat stress affects the metabolites of microbiota which could alter the function of microbiota–gut–brain axis. We aim to bridge the evidence that the microbiota is adapted to survive and thrive in an extreme environment. Additionally, nutritional strategies for alleviating intestinal heat stress are introduced.

Change of zinc mobilization and gene expression of key zinc transport proteins between the yolk sac membrane and liver of duck embryonic developing

Zinc (Zn) deposition in egg yolk is essential for the rapid growth and complete development of the avian embryo. Thus, it is crucial to obtain maximal Zn mobilization at an appropriate time during development in favor of the survival of avian embryos. The aim of this study was to study the developmental change of Zn mobilization and gene expression related to key Zn transport proteins between the yolk sac membrane and embryonic liver from the incubation d 17 (E17) to d 32 (E32) during duck embryonic developing. The weights of duck embryo, embryo without yolk sac, and embryonic liver increased as well as the yolk sac weight decreased linearly (P < 0.0001) when incubation day increased. The Zn concentration in the yolk sac did not change from E17 to E29 and only declined significantly from E29 to E32 of duck embryos, while hepatic Zn level decreased linearly as with the increased incubation time (P < 0.01). When the incubation day increased, the decreased Zn amount in the yolk sac and the increased Zn amount in the embryonic liver were observed (P < 0.0001). The calculated transfer-out rate of Zn in the yolk sac and transfer-in rate of Zn in livers were both increased from E23-26 to E29-32 (P < 0.01). Among E17, E23 and E29, the solute carrier family 39 member (ZIP) of ZIP10, ZIP13, and ZIP14 genes mRNA expressions were increased in yolk sac membrane but were decreased in the embryonic liver, while metallothionein 1 mRNA expression was increased both in the yolk sac membrane and liver (P < 0.05). In conclusion, yolk sac membrane and embryonic liver tissues displayed the similar developmental patterns of Zn mobilization and metallothionein 1 mRNA expression from E17 to E32 during duck embryonic developing. The appropriate time of the maximal rate of Zn mobilization were observed between E29 and E32 of duck embryo, associated with the significant changes of gene expression related to some key Zn transport proteins on E29 in yolk sac membrane and liver tissues.

Trial leadership by women is associated with racial diversity among heart failure clinical trial participants: a systematic bibliometric review 2000–2020

Background

For the results of randomized controlled trials (RCTs) to be generalizable, they should report on and include the broad range of patients who have the disease.

Purpose

We assessed temporal trends and trial factors associated with 1) the reporting of race or ethnicity data and 2) the enrolment of Black, Indigenous, and people of colour (BIPOC) in Heart Failure (HF) RCTs.

Methods

We searched MEDLINE, EMBASE, and CINAHL for RCTs that recruited adults with HF and were published in journals with an impact factor ≥10 between January 1, 2000 and June 17, 2020. We extracted data in duplicate and used the Cochran-Armitage and Jonchkeere-Terpstra tests to examine temporal trends. We used multivariable regression to assess the independent association between trial factors and the outcomes of interest.

Results

A total of 414 RCTs met inclusion criteria, of which a vast majority (90.6%; 95% CI 87.4–93.2%) were coordinated in either Europe or North America. Only 157 of the 414 RCTs (37.9%; 95% CI 33.2–42.8%) reported race/ethnicity data; among the 158,200 participants in these trials, only 29,512 (18.7%; 95% CI 18.5–18.9%) were BIPOC. There was a significant increase in the reporting of race or ethnicity data (from 26.9% in 2000–2001 to 54.2% in 2019–2020, p&lt;0.001) and in enrollment of BIPOC (from 16.5% in 2000–2001 to 23.9% in 2019–2020, p=0.038) between 2000–2020. Trial leadership by a woman was associated with twice the adjusted odds of reporting of race or ethnicity data (OR 2.0; 95% CI 1.1–3.8; p=0.028) and an 8.4% (95% CI 1.9–15.0%; p=0.012) adjusted increase in enrollment of BIPOC. The race/ethnicity of trial leaders was not available for analysis.

Conclusions

Among HF RCTs published between 2000–2020, &lt;38% reported data on race or ethnicity, although this increased over time. Among trials reporting such data, &lt;19% of participants were BIPOC, with modest increases in enrollment over time. Trials led by women had greater adjusted odds of reporting race/ethnicity data and enrollment of BIPOC.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CIHR

Global representation of heart failure clinical trial leaders and collaborators: a systematic bibliometric review 2000–2020

Aims

Heart Failure (HF) has a disproportionate burden in low- and middle-income countries. The geographic representation of those who lead HF randomized clinical trials (RCTs) may not reflect the geographic burden of disease. We assessed temporal trends and trial characteristics associated with leadership outside Europe and North America, and explored whether there was a geographic association between trial leadership and participant enrolment.

Methods and results

We searched MEDLINE, EMBASE, and CINAHL for HF RCTs published in journals with an impact factor ≥10 between January 1, 2000, and June 17, 2020. We used the Jonckheere-Terpstra test to assess temporal trends and multivariable logistic regression models to determine associations between predictor and outcome variables.

There were 414 eligible RCTs. Only 80 of 828 trial leaders (9.7%; 95% CI: 7.8% to 11.8%), and 453 of 4656 collaborators (9.7%; 95% CI: 8.8% to 10.6%) were from regions outside Europe and North America, with no temporal change in geographic representation. The odds of trial leadership outside Europe and North America were significantly lower with industry versus public funding (OR: 0.33; 95% CI: 0.15 to 0.75; P=0.008). Trial leadership outside Europe and North America was associated with enrolment of patients outside Europe and North America (OR: 10.0; 95% CI 5.6–19.0; P&lt;0.001).

Conclusion

Trial leadership outside Europe and North America is rare, particularly in industry funded trials, and is associated with participant enrolment in regions with disproportionate disease burden. Building research capacity and networks in under-represented regions could increase generalizability of trial results.

Funding Acknowledgement

Type of funding sources: None.

Ten Years of EWAS

Epigenome-wide association study (EWAS) has been applied to analyze DNA methylation variation in complex diseases for a decade, and epigenome as a research target has gradually become a hot topic of current studies. The DNA methylation microarrays, next-generation, and third-generation sequencing technologies have prepared a high-quality platform for EWAS. Here, the progress of EWAS research is reviewed, its contributions to clinical applications, and mainly describe the achievements of four typical diseases. Finally, the challenges encountered by EWAS and make bold predictions for its future development are presented.