Neuropeptide substance P alters stem cell fate to aid wound healing and promote epidermal stratification through asymmetric stem cell divisions

Loss of sensory innervation delays wound healing and administration of the neuropeptide substance P improves re-epithelialization. Keratinocyte hyperproliferation post-wounding may result from symmetric stem cell (SC) self-renewal, asymmetric SC self-renewal, committed progenitor divisions, or a combination of these. However, the effects of sensory denervation and of neuropeptides on SC proliferation are not known. Here we show that early after wounding both asymmetric and symmetric SC self-renewal increase, without significant committed progenitor (CP) activation. Decreased sensory innervation is associated with a decrease in both SC and CP proliferation. Based on previous work showing that substance P is decreased in capsaicin-treated mice and improves wound healing in normal skin, we examined the effects of substance P on SC and CP proliferation during wound healing. Substance P restored asymmetric SC proliferation in skin with decreased sensory innervation, both at baseline and following wounding. Epidermis with decreased sensory innervation was severely thinned. Consistent with this, substance P-induced asymmetric SC proliferation resulted in increased stratification in skin with both normal and decreased innervation. Lapatinib prevented the substance P-induced increase in asymmetric SC divisions in murine epidermis, as well as the increase in epidermal stratification, suggesting that asymmetric SC divisions are required for epidermal stratification.

[Diagnostic values of conventional tumor markers and their combination with chest CT for patients with stageⅠA lung cancer]

Objective: To investigate the diagnostic efficiency of conventional serum tumor markers and their combination with chest CT for stage ⅠA lung cancer. Methods: A total of 1 155 patients with stage ⅠA lung cancer and 200 patients with benign lung lesions (confirmed by surgery) treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to October 2020 were retrospectively enrolled in this study. Six conventional serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), squamous cell carcinoma associated antigen (SCCA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), and gastrin-releasing peptide precursor (ProGRP)] and chest thin-slice CT were performed on all patients one month before surgery. Pathology was taken as the gold standard to analyze the difference of positivity rates of tumor markers between the lung cancer group and the benign group, the moderate/poor differentiation group and the well differentiation group, the adenocarcinoma group and the squamous cell carcinoma group, the lepidic and non-lepidic predominant adenocarcinoma groups, the solid nodule group and the subsolid nodule group based on thin-slice CT, and subgroups of ⅠA1 to ⅠA3 lung cancers. The diagnostic performance of tumor markers and tumor markers combined with chest CT was analyzed using the receiver operating characteristic curve. Results: The positivity rates of six serum tumor markers in the lung cancer group and the benign group were 2.32%-20.08% and 0-13.64%, respectively; only the SCCA positivity rate in the lung cancer group was higher than that in the benign group (10.81% and 0, P=0.022). There were no significant differences in the positivity rates of other serum tumor markers between the two groups (all P>0.05). The combined detection of six tumor markers showed that the positivity rate of the lung cancer group was higher than that of the benign group (40.93% and 18.18%, P=0.004), and the positivity rate of the adenocarcinoma group was lower than that of the squamous cell carcinoma group (35.66% and 47.41%, P=0.045). The positivity rates in the poorly differentiated group and moderately differentiated group were higher than that in the well differentiated group (46.48%, 43.75% and 22.73%, P=0.025). The positivity rate in the non-lepidic adenocarcinoma group was higher than that in lepidic adenocarcinoma group (39.51% and 21.74%, P=0.001). The positivity rate of subsolid nodules was lower than that of solid nodules (30.01% vs 58.71%, P=0.038), and the positivity rates of stageⅠA1, ⅠA2 and ⅠA3 lung cancers were 33.33%, 48.96% and 69.23%, respectively, showing an increasing trend (P=0.005). The sensitivity and specificity of the combined detection of six tumor markers in the diagnosis of stage ⅠA lung cancer were 74.00% and 56.30%, respectively, and the area under the curve (AUC) was 0.541. The sensitivity and specificity of the combined detection of six serum tumor markers with CT in the diagnosis of stage ⅠA lung cancer were 83.0% and 78.3%, respectively, and the AUC was 0.721. Conclusions: For stage ⅠA lung cancer, the positivity rates of commonly used clinical tumor markers are generally low. The combined detection of six markers can increase the positivity rate. The positivity rate of markers tends to be higher in poorly differentiated lung cancer, squamous cell carcinoma, or solid nodules. Tumor markers combined with thin-slice CT showed limited improvement in diagnostic efficiency for early lung cancer.

Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue

PURPOSE

The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma.

PATIENTS AND METHODS

Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage.

RESULTS

Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002).

CONCLUSION

This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.

[Diagnostic value of the combinations of bronchoalveolar lavage fluid pathogen detection and cryptococcal antigen test in pulmonary cryptococcosis]

Objective: To evaluate the diagnostic value of bronchoalveolar lavage fluid pathogen detection combined with cryptococcal antigen test(CrAg) for pulmonary cryptococcosis(PC). Methods: A retrospective case analysis was performed on non-acquired immunodeficiency syndrome patients admitted to Ninghai First Hospital for suspected PC from January 2018 to December 2019. Fifty-nine patients were included. Sixteen cases (8 males and 8 females) were diagnosed with PC, aged from 18 to 76 years[an average age of (52±14) years], while 43 cases were diagnosed as having Non-PC. All patients had undergone both serum CrAg test and BALF pathogen detection(cultures and direct examination) combined with BALF-CrAg test. The sensitivity and specificity of the combined method of BALF was evaluated, and a parallel comparison of the diagnostic efficiencies of the two methods were made. Results: Of the 16 confirmed PC cases, serum CrAg tests were positive in 11 and negative in 5 cases, while the combined method showed that 14 were positive and 2 were negative. Compared with the clinical final diagnosis, the sensitivity, specificity, positive predictive value and negative predictive value showed that the serum CrAg tests were 68.8% (11/16), 97.7% (42/43), 91.7% (11/12), 89.3% (42/47) respectively, versus 87.5% (14/16), 100.0% (43/43), 100% (14/14), 95.6% (43/45) by the combined method of BALF. The results displayed no statistical difference between the two diagnostic methods (P =1.000). Among the 5 initially serum CrAg-negative cases, 4 were later confirmed as proven PC via the combined method of BALF and the other one by percutaneous lung biopsy. Conclusion: The combined method of BALF pathogen detection with BALF-CrAg showed a similar statistical efficiency rate for diagnosing pulmonary cryptococcosis compared with serum CrAg tests. It may serve as an efficient diagnosis method for PC cases with negative serum CrAg tests.

Migration towards Bangladesh coastlines projected to increase with sea-level rise through 2100

To date, projections of human migration induced by sea-level change (SLC) largely suggest large-scale displacement away from vulnerable coastlines. However, results from our model of Bangladesh suggest counterintuitively that people will continue to migrate toward the vulnerable coastline irrespective of the flooding amplified by future SLC under all emissions scenarios until the end of this century. We developed an empirically calibrated agent-based model of household migration decision-making that captures the multi-faceted push, pull and mooring influences on migration at a household scale. We then exposed ~4800 000 simulated migrants to 871 scenarios of projected 21st-century coastal flooding under future emissions pathways. Our model does not predict flooding impacts great enough to drive populations away from coastlines in any of the scenarios. One reason is that while flooding does accelerate a transition from agricultural to non-agricultural income opportunities, livelihood alternatives are most abundant in coastal cities. At the same time, some coastal populations are unable to migrate, as flood losses accumulate and reduce the set of livelihood alternatives (so-called 'trapped' populations). However, even when we increased access to credit, a commonly-proposed policy lever for incentivizing migration in the face of climate risk, we found that the number of immobile agents actually rose. These findings imply that instead of a straightforward relationship between displacement and migration, projections need to consider the multiple constraints on, and preferences for, mobility. Our model demonstrates that decision-makers seeking to affect migration outcomes around SLC would do well to consider individual-level adaptive behaviors and motivations that evolve through time, as well as the potential for unintended behavioral responses.

Testicular transcriptome analysis under the dietary inclusion of l-carnitine reveals potential key genes associated with oxidative defense and the semen quality factor in aging roosters

l-carnitine (LC) has been widely studied as a natural antioxidant molecule for treating low-fertility gametes. However, the molecular mechanism of the effect of LC supplementation on the testes of aging cocks has not been evaluated. Therefore, the objective of this study was to reveal the mechanism of testicular oxidative defense induced by LC supplementation in relation to the semen quality factor (SQF) in the aging cock through a transcriptome study conducted from a new perspective. A total of 24 Jinghong cocks at 55 wk of age were randomly divided into 2 groups (n = 12). All cocks were fed a standard isocaloric and isonitrogenic breeder diet (control, LC-0), and the other group was supplemented with LC at 150 mg/kg/d (treated, LC-150) for 12 wk. Remarkably, seminal characteristics and enzymes, sex hormones, and cock fertility related to testicular oxidative defense were considerably improved by LC supplementation. LC-150 testes showed the differential upregulation and downregulation of 97 and 90 transcripts, respectively, compared with LC-0 testes. Most upregulated transcripts were involved in testicular oxidative defense and spermiogenesis optimization, whereas the downregulated genes were responsible for oxidative stress, in contrast to the SQF. Functional analysis of the transcriptionally altered genes indicated the testicular deregulation of long-chain fatty acid and lipid peroxidation, enhancing fatty acid breakdown to release ATP production via β-oxidation. These findings could lay the foundation for the discovery of new molecular markers of SQF-associated LC supplementation and potential targets for therapeutic intervention to optimize fertility in aging cocks.

Fuels, power and chemical periodicity

The insatiable-and ever-growing-demand of both the developed and the developing countries for power continues to be met largely by the carbonaceous fuels comprising coal, and the hydrocarbons natural gas and liquid petroleum. We review the properties of the chemical elements, overlaid with trends in the periodic table, which can help explain the historical-and present-dominance of hydrocarbons as fuels for power generation. However, the continued use of hydrocarbons as fuel/power sources to meet our economic and social needs is now recognized as a major driver of dangerous global environmental changes, including climate change, acid deposition, urban smog and the release of many toxic materials. This has resulted in an unprecedented interest in and focus on alternative, renewable or sustainable energy sources. A major area of interest to emerge is in hydrogen energy as a sustainable vector for our future energy needs. In that vision, the issue of hydrogen storage is now a key challenge in support of hydrogen-fuelled transportation using fuel cells. The chemistry of hydrogen is itself beautifully diverse through a variety of different types of chemical interactions and bonds forming compounds with most other elements in the periodic table. In terms of their hydrogen storage and production properties, we outline various relationships among hydride compounds and materials of the chemical elements to provide some qualitative and quantitative insights. These encompass thermodynamic and polarizing strength properties to provide such background information. We provide an overview of the fundamental nature of hydrides particularly in relation to the key operating parameters of hydrogen gravimetric storage density and the desorption/operating temperature at which the requisite amount of hydrogen is released for use in the fuel cell. While we await the global transition to a completely renewable and sustainable future, it is also necessary to seek CO2 mitigation technologies applied to the use of fossil fuels. We review recent advances in the strategy of using hydrocarbon fossil fuels themselves as compounds for the high capacity storage and production of hydrogen without any CO2 emissions. Based on these advances, the world may end up with a hydrogen economy completely different from the one it had expected to develop; remarkably, with 'Green hydrogen' being derived directly from the hydrogen-stripping of fossil fuels. This article is part of the theme issue 'Mendeleev and the periodic table'.

[Analysis of drug - resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province in 2015 and 2016]

OBJECTIVE

To investigate the drug-resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province.

METHODS

From 2015 to 2016, blood samples were collected from imported P. falciparum malaria patients returning from Equatorial Guinea to Shandong Province, and genome DNA of the malaria parasite was extracted. The drug-resistant Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum were amplified using a PCR assay, followed by DNA sequencing, and the sequences were aligned.

RESULTS

The target fragments of all 5 drug-resistant genes of P. falciparum were successfully amplified and sequenced. There were 72.8%, 18.6%, and 8.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfcrt gene, respectively, and all mutant haplotypes were CVIET (the underline indicates the mutation site). There were 20.0%, 61.4% and 18.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfmdr1 gene, respectively, and the mutant haplotypes mainly included YF and NF (the underlines indicate the mutation sites). There were 1.4%, 98.6%, and 0 of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhfr gene, respectively, and AIRNI was the predominant mutant haplotype (the underline indicates the mutation site). There were 1.4%, 94.3%, and 4.3% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhps gene, respectively, and SGKAA was the predominant mutant haplotype (the underline indicates the mutation site). The complete drug-resistant IRNGE genotype consisted of 8.6% of the Pfdhfr and Pfdhps genes, and the K13 gene A578S mutation occurred in 1.4% of the parasite samples.

CONCLUSIONS

There are mutations in the Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum imported from Equatorial Guinea to Shandong Province, with a low frequency in the Pfcrt gene mutation and a high frequency in the Pfmdr1, Pfdhfr, and Pfdhps gene mutations, and the K13 gene A578S mutation is detected in the parasite samples.

Experimental atopic dermatitis is dependent on the TWEAK/Fn14 signaling pathway

Tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) acts through its receptor fibroblast growth factor inducible 14 (Fn14), and participates in skin inflammation. Both TWEAK and Fn14 are highly expressed in skin lesions of patients with atopic dermatitis. The purpose of this study was to further explore the effect of Fn14 inhibition on experimental atopic dermatitis. Experimental atopic dermatitis was induced in the wild-type and Fn14 knock-out BALB/c mice. The effect of TWEAK/Fn14 interaction on keratinocytes was studied in an in-vitro model of atopic dermatitis. Fn14 deficiency ameliorates skin lesions in the mice model, accompanied by less infiltration of inflammatory cells and lower local levels of proinflammatory cytokines, including TWEAK, TNF-α and interleukin (IL)-17. Fn14 deficiency also attenuates the up-regulation of TNFR1 in skin lesions of atopic dermatitis. Moreover, topical TWEAK exacerbates skin lesion in the wild-type but not in the Fn14 knock-out mice. In vitro, TWEAK enhances the expressions of IL-17, IL-18 and IFN-γ in keratinocytes under atopic dermatitis-like inflammation. These results suggest that Fn14 deficiency protects mice from experimental atopic dermatitis, involving the attenuation of inflammatory responses and keratinocyte apoptosis. In the context of atopic dermatitis-like inflammation, TWEAK modulates keratinocytes via a TNFR1-mediated pathway.

First Measurement of Near-Threshold J/ψ Exclusive Photoproduction off the Proton

We report on the measurement of the γp→J/ψp cross section from E_{γ}=11.8  GeV down to the threshold at 8.2 GeV using a tagged photon beam with the GlueX experiment. We find that the total cross section falls toward the threshold less steeply than expected from two-gluon exchange models. The differential cross section dσ/dt has an exponential slope of 1.67±0.39  GeV^{-2} at 10.7 GeV average energy. The LHCb pentaquark candidates P_{c}^{+} can be produced in the s channel of this reaction. We see no evidence for them and set model-dependent upper limits on their branching fractions B(P_{c}^{+}→J/ψp) and cross sections σ(γp→P_{c}^{+})×B(P_{c}^{+}→J/ψp).

Pharmacological inhibition of β-catenin/BCL9 interaction overcomes resistance to immune checkpoint blockades by modulating Treg cells

The Wnt/β-catenin (β-cat) pathway plays a critical role in cancer. Using hydrocarbon-stapled peptide technologies, we aim to develop potent, selective inhibitors targeting this pathway by disrupting the interaction of β-cat with its coactivators B-cell lymphoma 9 (BCL9) and B-cell lymphoma 9-like (B9L). We identified a set of peptides, including hsBCL9CT-24, that robustly inhibits the activity of β-cat and suppresses cancer cell growth. In animal models, these peptides exhibit potent anti-tumor effects, favorable pharmacokinetic profiles, and minimal toxicities. Markedly, these peptides promote intratumoral infiltration of cytotoxic T cells by reducing regulatory T cells (Treg) and increasing dendritic cells (DCs), therefore sensitizing cancer cells to PD-1 inhibitors. Given the strong correlation between Treg infiltration and APC mutation in colorectal cancers, it indicates our peptides can reactivate anti-cancer immune response suppressed by the oncogenic Wnt pathway. In summary, we report a promising strategy for cancer therapy by pharmacological inhibition of the Wnt/β-cat signaling.

Preparation and evaluation of tilmicosin microspheres and lung-targeting studies in rabbits

Tilmicosin (TMS) is a macrolide used extensively for pulmonary infections in clinical veterinary medicine. However, TMS has frequent administration and short elimination half-life. Therefore, tilmicosin-gelatine microspheres (TMS-GMS) were prepared by an emulsion-chemical cross-linking technique as a sustained-release formulation to extend drug half-life. The particle size distribution, in-vitro sustained-release properties, stability, and physical characteristics, as well as pharmacokinetic (PK) characteristics, were evaluated in rabbits. TMS-GMS were spherical in shape and had a mean diameter of 11.34±1.20μm; 95.65% of the microspheres varied in size from 5.0 to 25.0μm. Light and thermal stability tests indicated no significant changes in all observed indices. Importantly, compared to crude TMS, slower release of TMS from TMS-GMS was noted in drug release studies (in vitro). Pharmacokinetic (PK) characteristics were examined in the lung, liver, heart, kidney and muscle tissue of rabbits following IM injection of TMS-GMS or TMS-injection at a dose of 10mg/kg. The elimination half-life of TMS-GMS (59.21±0.21h) was longer than that of TMS-injection (38.56±0.13h) in the lung. The ratio of peak concentration (C_e) of TMS-GMS to TMS-injection was 2.19 (>1) in the lung, demonstrating the selectivity of TMS-GMS to target the lung compared to that of other tissues (C_e<1). Interestingly, the uptake value of TMS from TMS-GMS was 8.48 times higher in the lung than that for the TMS-injection, and was slightly higher than in the liver (1.85), heart (1.72), kidney (2.44) and muscle (2.79) tissues. TMS-GMS is a sustained-release formulation of TMS with potential to be used in veterinary clinical applications; possible benefits include lung-targeting and prolonged elimination half-life.

[Structural change of the corpus callosum fibers in toddlers with autism spectrum disorder: two-year follow-up]

Objective: To conduct a follow-up investigation of structural changes of the corpus callosum fibers of toddlers (2 to 5 years of age) with autism spectrum disorder(ASD) and to explore the associations with clinical symptoms. Method: In this prospective randomized controlled study, ASD children who were diagnosed in the Child Mental Health Research Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University from May 2011 to November 2012 were included in the ASD group, and developmentally delayed children were included in the control group (DD group). Diffusion tensor imaging (DTI) data from the two groups were obtained at two age levels: 2-3 years of age, and 4-5 years of age. Region of interest analysis was applied to assess characteristic values of total area and sub-regions of corpus callosum: the fraction anisotropy (FA), the mean diffusivity (MD), the radial diffusivity (RD) and the axial diffusivity (AD). All children were assessed using the Autism Diagnostic Interview-Revised (ADI-R) and Autism Treatment Evaluation Checklist (ATEC). The characteristic values of total area and sub-regions of corpus callosum of ASD group at two age levels were analyzed by paired sample t test; the characteristic values of total area and sub-regions of corpus callosum of ASD group and DD group were analyzed by independent-sample t test; the correlations between FA values of the total area and sub-regions of corpus callosum and ADI-R or ATEC scores were analyzed by Pearson correlation analysis. Result: Forty cases meeting inclusion criteria were enrolled in ASD group, and 31 eligible cases were enrolled in the control group. Four children in the ASD group were lost to follow-up, and 5 children in the control group were lost to follow-up. Longitudinal comparison between the two age subgroups of ASD patients showed that the FA values of the total corpus callosum increased (0.499 55±0.027 59 vs. 0.505 83±0.086 64, t=4.88, P<0.05), but MD values, RD values and AD values of the total corpus callosum area decreased (0.000 89±0.000 03 vs. 0.000 81±0.000 14, 0.000 61±0.000 04 vs. 0.000 55±0.000 09, 0.001 43±0.000 03 vs. 0.001 38±0.000 03, t=9.31, 7.90, 8.66, P<0.05 for all comparisons). In the area of corpus callosum genu, FA and AD values increased (t=5.59, 8.48, P<0.05 for both comparisons), but MD and RD values decreased (t=12.67, 11.28, P<0.05 for both comparisns). In the area of corpus callosum body, FA and RD values increased(t=5.46, 8.48, P<0.05 for both comparisons), but MD and AD values decreased (t=8.08, 6.22, P<0.05 for both comparisons). In the area of corpus callosum splenium, MD, RD and AD values decreased (t=6.81, 4.44, 5.51, P < 0.05 for all comparisons). Among the participants 2 to 3 years of age, there were no significantly differences in FA values of total area and sub-regions of corpus callosum between ASD group and the DD group (P > 0.05 for all comparisons); as compared with the DD group, ASD group had higher AD values of total area and splenium of corpus callosum (0.001 43±0.000 03 vs. 0.001 40±0.000 04, 0.001 34±0.000 03 vs. 0.001 32±0.000 04, t=1.56, 1.14, P < 0.05 for both comparisons); ASD group had lower AD values but higher RD and MD values of corpus callosum genu (t=0.07, 0.55, 0.07, P < 0.05 for all comparisons); ASD group had lower RD values of corpus callosum body (t=0.07, P < 0.05). Among the participants 4 to 5 years of age, as compared with the DD group, ASD group had higher FA value of total corpus callosum area(0.505 83±0.086 64 vs. 0.483 77±0.099 30, t=8.56, P < 0.05), lower RD value of total corpus callosum(0.000 55±0.000 09 vs. 0.000 56±0.000 12, t=14.44, P < 0.05), lower RD values of corpus callosum body (t=2.20, P < 0.05), higher FA values (t=3.35, P < 0.05) but lower AD values of corpus callosum splenium (t=2.20, P < 0.05). A correlation analysis between FA values of total area and sub-regions of corpus callosum and clinical variables showed that the FA values of total area and splenium of corpus callosum in ASD group at 2 to 3 years of age were negatively correlated with the scores of language skills in ATEC (r=-0.35,-0.36, P < 0.05 for both comparisons). And after two years, FA values of total corpus callosum were positively correlated with the scores of social communication in ATEC (r=0.34, P < 0.05). There was no significant correlation between FA values of sub-regions of corpus callosum and the scores of ATEC (P > 0.05 for all comparisons). There was no significant correlation between FA values of total area and sub-regions of corpus callosum and the scores of ADI-R (P > 0.05 for all comparisons). Conclusion: The fiber structure of corpus callosum was still in the process of maturing during the age of 2 to 5 years; however, compared with DD group, ASD group had more extensive structural abnormalities of the corpus callosum fibers as age increased, and the structural abnormalities had correlation with the core symptoms of ASD. Trial registration Chinese Clinical Trial Registry, ChiCTR-OPC-17011995.

Exogenous niacin treatment increases NADPH oxidase in kiwifruit

Kiwifruit are a popular fruit worldwide; however, plant growth is threatened by abiotic stresses such as drought and high temperatures. Niacin treatment in plants has been shown to increase NADPH levels, thus enhancing abiotic stresses tolerance. Here, we evaluate the effect of niacin solution spray treatment on NADPH levels in the kiwifruit cultivars Hayward and Xuxiang. We found that spray treatment with niacin solution promoted NADPH and NADP+ levels and decreased both O2·- production and H2O2 contents in leaves during a short period. In fruit, NADPH contents increased during early development, but decreased later. However, no effect on NADP+ levels has been observed throughout fruit development. In summary, this report suggests that niacin may be used to increase NADPH oxidases, thus increasing stress-tolerance in kiwifruit during encounter of short-term stressful conditions.

High energy product chemically synthesized exchange coupled Nd2Fe14B/α-Fe magnetic powders

The excellent hard magnetic properties of Nd₂Fe₁₄B based magnets have an enormous range of technological applications. Exchange-coupled Nd₂Fe₁₄B/α-Fe magnets were chemically synthesized by a microwave assisted combustion process to produce mixed oxides, followed by a reduction diffusion process to form magnetic nano-composite powder. This synthesis technique offers an inexpensive and facile platform to produce exchange coupled hard magnets. The size dependent magnetic properties were investigated. The formation mechanisms of the oxide powders and the reduction diffusion mechanism were identified. The microwave power was found to play a crucial role in determining the crystallite size. The coercivity of the powder increased with increasing particle size. Room temperature coercivity (H_c) values greater than 9 kOe and magnetization of 110 emu g^-1 was obtained in particles with a mean size of ∼62 nm. An energy product of 5.2 MGOe was obtained, which is the highest reported value for chemically synthesized hard magnetic Nd₂Fe₁₄B/α-Fe powders.

Inhibition of Nkcc1 promotes axonal growth and motor recovery in ischemic rats

Bumetanide is a selective inhibitor of the Na⁺-K⁺-Cl^--co-transporter 1(NKCC1). We studied whether bumetanide could affect axonal growth and behavioral outcome in stroke rats. Adult male Wistar rats were randomly assigned to four groups: sham-operated rats treated with vehicle or bumetanide, and ischemic rats treated with vehicle or bumetanide. Endothelin-1 was used to induce focal cerebral ischemia. Bumetanide administration (i.c.v.) started on postoperative day 7 and continued for 3 weeks. Biotinylated dextran amine (BDA) was injected into the right imotor cortex on postoperative day 14 to trace corticospinal tract (CST) fibers sprouting into the denervated cervical spinal cord. Nogo-A, NKCC1, KCC2 and BDNF in the perilesional cortex and BDA, PSD-95 and vGlut1 in the denervated spinal cord were measured by immunohistochemistry and/or Western blot. Behavioral outcome of rats was assessed by the beam walking and cylinder tests. The total length of CST fibers sprouting into the denervated cervical spinal cord significantly increased after stroke and bumetanide further increased this sprouting. Bumetanide treatment also decreased the expressions of NKCC1 and Nogo-A, increased the expressions of KCC2 and BDNF in the perilesional cortex and enhanced the synaptic plasticity in the denervated cervical spinal cord after cerebral ischemia. The behavioral performance of ischemic rats was significantly improved by bumetanide. In conclusion, bumetanide promoted post-stroke axonal sprouting together accompanied by an improved behavioral outcome possibly through restoring and maintaining neuronal chloride homeostasis and creating a recovery-promoting microenvironment by overcoming the axonal growth inhibition encountered after cerebral ischemia in rats.

Xuezhikang reduced arterial stiffness in patients with essential hypertension: a preliminary study

This study aimed to test the effects of xuezhikang, a cholestin extract that contains statin-like components, on arterial stiffness in patients with essential hypertension. One hundred hypertensive patients from the Chinese PLA General Hospital were randomly allocated to receive xuezhikang (1200 mg/day, orally) or placebo (same capsules containing only pharmaceutical excipients). Physical examination outcomes, lipid profile, high sensitivity C-reactive protein (hs-CRP) levels, matrix metalloproteinases-9 (MMP-9) levels, and arterial outcomes, including stiffness parameter (β), pressure-strain elasticity modulus (Ep), arterial compliance (AC), augmentation index (AI), and one-point pulse wave velocity (PWVβ) were obtained at baseline and after 6 months of the intervention. Xuezhikang significantly reduced β (8.4±3.1 vs 6.8±2.1, P=0.007), Ep (122.8±43.9 vs 100.7±33.2, P=0.009), PWVβ (6.7±1.2 vs 6.1±1.0, P=0.013), low-density lipoprotein cholesterol (3.4±0.6 vs 2.9±0.5, P=0.001), hs-CRP [2.1 (0.4-10.0) vs 1.4 (0.3-4.1), P=0.020], and MMP-9 (17.2±2.4 vs 12.7±3.8, P <0.001) compared to baseline. The placebo had no effect on these parameters. The changes of PWVβ in the xuezhikang group was significantly associated with the changes of hs-CRP and MMP-9 (r=0.144, P=0.043; r=0.278, P=0.030, respectively) but not with lipid profile changes. Our research showed xuezhikang can improve the parameters of arterial stiffness in hypertensive patients, and its effect was independent of lipid lowering.

Prognostic significance of tumour regression grade after neoadjuvant chemoradiotherapy for a cohort of patients with locally advanced rectal cancer: an 8-year retrospective single-institutional study

AIM

Locally advanced rectal cancer (LARC) is frequently treated with neoadjuvant chemoradiotherapy (NACRT) to reduce the risk of local recurrence and improve survival. Tumour response to NACRT is variable and may influence the prognosis after subsequent surgery. This study compared the prognostic values of tumour regression grade (TRG) and neoadjuvant pathological (ypTNM) downstaging in patients with Stage II and III rectal cancer treated with NACRT followed by curative surgery.

METHOD

This study included 185 patients with LARC treated with long-course radiotherapy (45 Gy in 25 fractions) plus 5-fluorouracil over 5 weeks between 2005 and 2013. We used multivariate analysis to assess the relationship of Dworak's five-tier TRG, ypTNM stage and ypTNM downstaging with clinicopathological factors, 5-year disease-free survival (DFS) and 5-year overall survival (OS).

RESULTS

Total regression (TRG4), good regression (TRG3), moderate regression (TRG2), minor regression (TRG1) and no regression (TRG0) were seen in 38 (20.6%), 65 (35.2%), 43 (23.2%), 28 (15.1%) and 11 (5.9%) patients, respectively. TNM downstaging following NACRT occurred in 109 (58.9%) patients. The 5-year DFS rates after NACRT for TRG0, TRG1, TRG2, TRG3 and TRG4 were 0%, 58.5%, 66.4%, 80.4% and 82.6%, respectively (P < 0.001). The ypTNM stage correlated with 5-year DFS (P = 0.004) but not 5-year OS (P = 0.075). Multivariate analysis demonstrated that TRG was related to both DFS and OS (P < 0.001).

CONCLUSION

TRG measured on a five-tier system was better than ypTNM stage for predicting outcome in patients with LARC treated with NACRT and surgery.

Butyrate and retinoic acid imprint mucosal-like dendritic cell development synergistically from bone marrow cells

Accumulating data show that the phenotypes and functions of distinctive mucosal dendritic cells (DCs) in the gut are regulated by retinoic acid (RA). Unfortunately, the exact role of butyrate in RA-mediated mucosal DC differentiation has not been elucidated thoroughly to date. Mucosal-like dendritic cell differentiation was completed in vitro by culturing bone marrow cells with growth factors [granulocyte-macrophage colony-stimulating factor (GM-CSF/interleukin (IL)-4], RA and/or butyrate. The phenotypes, cytokine secretion, immune functions and levels of retinal dehydrogenase of different DCs were detected using quantitative polymerase chain reaction (qPCR), enzyme-linked immunosorbent assay (ELISA) and flow cytometry, respectively. The results showed that RA-induced DCs (RA-DCs) showed mucosal DC properties, including expression of CD103 and gut homing receptor α₄ β₇ , low proinflammatory cytokine secretion and low priming capability to antigen-specific CD4⁺ T cells. Butyrate-treated RA-DCs (Bu-RA-DCs) decreased CD11c, but increased CD103 and α₄ β₇ expression. Moreover, the CD4⁺ T priming capability and the levels of retinal dehydrogenase of RA-DCs were suppressed significantly by butyrate. Thus, butyrate and retinoic acid have different but synergistic regulatory functions on mucosal DC differentiation, indicating that immune homeostasis in the gut depends largely upon RA and butyrate to imprint different mucosal DC subsets, both individually and collectively.

Correlation between athlete training intensity and cardiac performance

OBJECTIVE

An effective analysis of correlation between training intensity of athletes and cardiac performance is done to develop scientific and reasonable exercise program and to promote health of athletes.

METHODS

During December 2013-December 2015, 3600 students from different sports schools were selected for the test. All the athletes were randomly grouped, that is half-hour running group, one-hour running group and 90 -minute running group, which are named A, B, C groups respectively. The three groups of athletes received 5 days of testing per week, and took rest in the remaining two days, maintaining a total of 10 days. Exercise intensity of personnel accepting test was detected by RPE, and effective analysis was made on cardiac function change before and after test of three groups of the college students.

RESULTS

Resting heart rates of B, C group students were considerably decreased after exercise. In comparison of falling range of group C and group A, there is a statistically significant difference, P <0.05.

CONCLUSION

By strengthening athletes' training intensity, we can effectively enhance athletes' cardiac performance. t As a result, athletes' body becomes healthier, which is conducive to athletes' physical and mental development.

Phosphorylation of NFAT3 by CDK3 induces cell transformation and promotes tumor growth in skin cancer

The nuclear factor of activated T cells (NFAT) family proteins are transcription factors that regulate the expression of pro-inflammatory cytokines and other genes during the immune response. Although the NFAT proteins have been extensively investigated in the immune system, their role in cancer progression remains controversial. Here, we report that NFAT3 is highly expressed in various skin cancer cell lines and tumor tissues. Knockdown of endogenous NFAT3 expression by short hairpin RNA (shRNA) significantly inhibited tumor cell proliferation, colony formation and anchorage-independent cell growth. Furthermore, results of the mammalian two-hybrid assay showed that cyclin-dependent kinase 3 (CDK3) directly interacted with NFAT3 and phosphorylated NFAT3 at serine 259 (Ser259), which enhanced the transactivation and transcriptional activity of NFAT3. The phosphorylation site of NFAT3 was critical for epidermal growth factor (EGF)-stimulated cell transformation of the HaCaT immortalized skin cell line and mutation of NFAT3 at Ser259 led to a reduction of colony formation in soft agar. We also found that overexpressing wildtype NFAT3, but not mutant NFAT3-S259A, promoted A431 xenograft tumor growth. Importantly, we showed that CDK3, NFAT3 and phosphorylated NFAT3-Ser259 were highly expressed in skin cancer compared with normal skin tissues. These results provided evidence supporting the oncogenic potential of NFAT3 and suggested that CDK3-mediated phosphorylation of NFAT3 has an important role in skin tumorigenesis.

Wax: A benign hydrogen-storage material that rapidly releases H2-rich gases through microwave-assisted catalytic decomposition

Hydrogen is often described as the fuel of the future, especially for application in hydrogen powered fuel-cell vehicles (HFCV's). However, its widespread implementation in this role has been thwarted by the lack of a lightweight, safe, on-board hydrogen storage material. Here we show that benign, readily-available hydrocarbon wax is capable of rapidly releasing large amounts of hydrogen through microwave-assisted catalytic decomposition. This discovery offers a new material and system for safe and efficient hydrogen storage and could facilitate its application in a HFCV. Importantly, hydrogen storage materials made of wax can be manufactured through completely sustainable processes utilizing biomass or other renewable feedstocks.

Total synthesis of (-)-depyranoversicolamide B

Starting from easily prepared (R)-C3-isoprenylated pyrroloindoline, the C3-isoprenylated indolyl diketopiperazine is prepared by an efficient reductive opening of the pyrrolo ring, and undergoes biomimetic Diels-Alder reaction to generate an anti-adduct as a sole stereoisomer. Oxidation of the indoline moiety to oxindole completes the synthesis of (-)-depyranoversicolamide B.

Analysis of rectal injuries resulting from laparoscopic peritoneal vaginoplasty (Luohu operation)

OBJECTIVE

To explore the causes of rectal injuries during laparoscopic peritoneal vaginoplasty (Luohu operation) and assess measures that can be taken to increase safety of the operation.

MATERIALS AND METHODS

Data of patients with rectal injuries that occurred during Luohu vaginoplasty were analyzed retrospectively.

RESULTS

Three hundred and six patients received Luohu vaginoplasty. Rectal injuries occurred in 13 patients (4.2%). All patients recovered after intraoperative repair or postoperative rectovaginal fistula repair, performed within three to six months. Full display of the anatomical structures at the bottom of the pelvic cavity and successful construction of the vaginal tunnel are the two most important requirements for reducing the risk of rectal injury in laparoscopic vaginoplasty. In repair of fistulae postoperatively, it is important that resection of tissues or scars around the fistulae be avoided in order to reduce the chance of a injuries caused by diverting colostomy or colostomy closure.

CONCLUSION

Laparoscopic vaginoplasty is a generally safe procedure, but rectal injury can occur. Retaining the tissues or scars around the rectovaginal fistula can be successfully repaired, either when they are recognized during the operation or within a few months postoperatively.

Resistance training vs. aerobic training and role of other factors on the exercise effects on visceral fat

In the last 25 years, obesity has reached epidemic levels of prevalence. It has even affected the children such that rates of severe childhood obesity that have almost tripled in numbers. These numbers are alarming because of the known fact that obesity is associated with an increased risk of several comorbidities as well as with an increased risk of premature death. Almost since the beginning, exercise has been known to play a key role in the prevention and treatment of overweight and the non-pharmacological treatment of dyslipidemia. However, the effects of exercise on obesity seems to be dynamic and influenced by several other factors. These factors can be related to exercise or to the associated comorbidities. In this review we will address following factors: (1) The type of exercise which could be either aerobic or resistance training (2) The volume or amount of training (3) Intensity of training and (4) The effect of comorbidity of diabetes mellitus. We will observe that all of these factors modify the effect of exercise on the visceral fat.

Ligand binding and signaling by IFI16 (INM8P.400)

IFI16 plays important roles in inflammatory immune responses to viral infections as well as in autoimmune disorders such as lupus. It has been implicated in interferon induction through a STING-mediated pathway, as well as in inflammasome activation during recognition of viral DNA in the nucleus. Despite recent progress that highlighted the mechanisms of dsDNA binding by the IFI16 HINb domain, there are major gaps in our understanding of the ligand-induced structural changes, the polymerization of IFI16 mediated by dsDNA and its PYD domain, its interaction with downstream signaling partners, the regulation of IFI16 by host and microbe-derived molecules, and the cell-type specific immune responses mediated by IFI16. We have characterized the key structural determinants in both the recognition of dsDNA by IFI16 and the potential downstream signaling events. We will outline the implications of our findings and discuss future directions in clarifying the structure and function of IFI16 in infectious diseases and autoimmune disorders.

Damage modeling of small-scale experiments on dental enamel with hierarchical microstructure

Dental enamel is a highly anisotropic and heterogeneous material, which exhibits an optimal reliability with respect to the various loads occurring over years. In this work, enamel's microstructure of parallel aligned rods of mineral fibers is modeled and mechanical properties are evaluated in terms of strength and toughness with the help of a multiscale modeling method. The established model is validated by comparing it with the stress-strain curves identified by microcantilever beam experiments extracted from these rods. Moreover, in order to gain further insight in the damage-tolerant behavior of enamel, the size of crystallites below which the structure becomes insensitive to flaws is studied by a microstructural finite element model. The assumption regarding the fiber strength is verified by a numerical study leading to accordance of fiber size and flaw tolerance size, and the debonding strength is estimated by optimizing the failure behavior of the microstructure on the hierarchical level above the individual fibers. Based on these well-grounded properties, the material behavior is predicted well by homogenization of a representative unit cell including damage, taking imperfections (like microcracks in the present case) into account.

Safety, Feasibility, and Biomarker Effects of High-Dose Vitamin D Supplementation Among Women at High Risk for Breast Cancer

Vitamin D deficiency is a potentially modifiable risk factor that may be targeted for breast cancer prevention. We examined the safety, feasibility, and biomarker effects of high-dose vitamin D among women at high risk for breast cancer. Forty high-risk women, defined as a 5-year breast cancer risk ≥1.67% per the Gail model, lobular or ductal carcinoma in situ, were assigned to a 1-year intervention of vitamin D3 20,000 IU or 30,000 IU weekly. Participants were monitored for toxicity every 3 months, underwent serial blood draws at baseline, 6 and 12 months, and a digital mammogram at baseline and 12 months. Biomarker endpoints included serum 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)₂D], parathyroid hormone (PTH), insulin-like growth factor (IGF-1), IGF binding protein (IGFBP-3), and mammographic density (MD) using Cumulus software. From November 2007 to January 2011, we enrolled 40 women; 37 were evaluable at 6 months and 30 at 12 months. One patient was taken off study for hypercalciuria; otherwise, the intervention was well tolerated. From baseline to 12 months, mean serum 25(OH)D and 1,25(OH)₂D rose from 20.0 to 46.9 ng/ml and 69.7 to 98.1 pg/ml, respectively (p<0.01). Serum PTH decreased by 12% at 6 months and IGF-1/IGFBP-3 ratio decreased by 4.3% at 12 months (p<0.05). There was no significant change in MD regardless of menopausal status or dose level. We demonstrated that 1 year of high-dose vitamin D3 was associated with a significant increase in circulating vitamin D levels and favorable effects on IGF signaling, but no significant change in MD.

Catalytic dehydrogenation of propane by carbon dioxide: a medium-temperature thermochemical process for carbon dioxide utilisation

The dehydrogenation of C₃H₈ in the presence of CO₂ is an attractive catalytic route for C₃H₆ production. In studying the various possibilities to utilise CO₂ to convert hydrocarbons using the sustainable energy source of solar thermal energy, thermodynamic calculations were carried out for the dehydrogenation of C₃H₈ using CO₂for the process operating in the temperature range of 300–500 °C. Importantly, the results highlight the enhanced potential of C₃H₈ as compared to its lighter and heavier homologues (C₂H₆ and C₄H₁₀, respectively). To be utilised in this CO₂ utilisation reaction the Gibbs free energy (Δ_rGθm) of each reaction in the modelled, complete reacting system of the dehydrogenation of C₃H₈ in the presence of CO₂ also indicate that further cracking of C₃H₆ will affect the ultimate yield and selectivity of the final products. In a parallel experimental study, catalytic tests of the dehydrogenation of C₃H₈ in the presence of CO₂ over 5 wt%-Cr₂O₃/ZrO₂ catalysts operating at 500 °C, atmospheric pressure, and for various C₃H₈ partial pressures and various overall GHSV (Gas Hourly Space Velocity) values. The results showed that an increase in the C₃H₈ partial pressure produced an inhibition of C₃H₈ conversion but, importantly, a promising enhancement of C₃H₆ selectivity. This phenomenon can be attributed to competitive adsorption on the catalyst between the generated C₃H₆ and inactivated C₃H₈, which inhibits any further cracking effect on C₃H₆ to produce by-products. As a comparison, the increase of the overall GHSV can also decrease the C₃H₈ conversion to a similar extent, but the further cracking of C₃H₆ cannot be limited.

Removal of an incarcerated intrauterine device in the sigmoid colon under the assistance of hysteroscope and laparoscope: a case report

BACKGROUND/AIMS

To explore the value of hysteroscope and laparoscope in removing an incarcerated or ectopic intrauterine device (IUD).

MATERIALS AND METHODS

A 33-year-old woman was admitted to the present hospital on May 22nd, 2013. An incarcerated IUD was proven by ultrasonography. An IUD had been implanted in October 2011. Clinical case report of an incarcerated IUD in the sigmoid colon.

RESULTS

An IUD was successfully removed with the assistance of hysteroscope and laparoscope.

CONCLUSION

Ultrasonography should be performed in the follow-up of the patients after IUD implantation. Ectopic or incarcerated IUD can be successfully removed with the assistance of hysteroscope and laparoscope with minimal trauma.

Low-Resolution Refinement of the DNA and Protein Complex Structures

Macromolecular complexes of protein and DNA are often resolved in a low resolution structure (3.0 angstroms or lower). Because nucleic acids suffer radiation damage more than amino acids, the resulting temperature factors for DNA are generally higher than those for protein. Recognition of DNA-specific interactions with protein is a challenge at low resolution. The use of low-resolution refinement ([1]) or the reference high resolution model could improve DNA densities. A number of DNA/protein and nucleosome complexes (i.e. RAGE-DNA [2], CENP-C-NCP[3]) that we have recently refined demonstrated the validation of these methods.

Development of microbial-derived inhibitory peptides using structural studies of microbial TIR proteins TcpB, TcpC and host adapters TIRAP and MyD88. (INM9P.449)

Microbial pathogens have evolved mechanisms to regulate and evade innate immunity. One such mechanism involves the subversion of Toll-like receptor (TLR) signaling by bacterial TIR Interacting Proteins (TIPs). TIPs are thought to function by disruption of host Toll/IL-1 receptor (TIR) signaling proteins. For example, the TIP proteins TcpB from Brucella and TcpC from E. coli inhibit TLR signaling through direct interaction with host adapter proteins TIRAP and MyD88. We have previously reported the crystal structure of MyD88 and characterized TcpC peptides capable to inhibit TLR4 and MyD88 signaling. We now report the X-ray crystal structure of the Brucella TIR protein TcpB and characterize its interactions with TIRAP using hydrogen/ deuterium (H/D) exchange mass spectrometry, co-immunoprecipitation and NF-ΚB reporter assays. The crystal structure of TcpB reveals the BB loop microtubule-binding site as well as a symmetrical dimer involving the DD and EE loops. The dimer interface is further characterized through H/D exchange mass spectrometry, which identifies a set of candidate potential TcpB blocking peptides. A comparison between the microbial TcpB, TIRAP and MyD88 crystal structures reveal differences in the region that encompasses the BB loop. These findings lend insight into the molecular mechanisms of microbial mimicry of host signaling adapter proteins and provide a framework for identification and development of novel microbial-derived therapeutics.

Inhibition of TLR2 signaling by small molecule inhibitors targeting a novel putative pocket within the TLR2 TIR domain (INM9P.448)

Overexuberant TLR2 signaling has been implicated in numerous diseases. Visual analysis of the TLR2 TIR domain crystal structure suggested the presence of a “pocket” adjacent to the highly conserved and functionally important proline and glycine residues of the BB loop. Given the importance of the BB loop in mediating TLR signal transduction, we hypothesized that Computer-Aided Drug Design (CADD) could be used to identify a small molecule inhibitor(s) that would fit within this “pocket” and blunt TLR2 signaling. Using CADD, ~150 small compounds were identified based on their predicted ability to bind in this pocket. Based on inhibition of IL-8 mRNA induced by TLR2 agonists, compound “C29” was found to inhibit TLR2/1 and TLR2/6 signaling in human HEK-TLR2 and THP-1 cells, but only TLR2/1 signaling in murine macrophages. C29 blocks heat-killed and live bacterial TLR2 agonist-induced proinflammatory cytokine mRNA. C29 prevents the early activation of TLR2-mediated signaling, including NF-κB and MAPKs, as well as MyD88 recruitment to TLR2 in THP-1 cells. C29 is cleavable and the byproduct, o-vanillin, reproduces comparable TLR2 inhibitory activity. O-vanillin covalently interacts with recombinant human TLR2 TIR domain dose-dependently. Mutagenesis of “pocket” residues revealed an indispensable role for TLR2/1, but not TLR2/6, signaling, suggesting divergent roles. Collectively, these results provide proof-of-principle for using CADD to identify inhibitors of TLR2 signaling.

DNA sensing by innate immune receptors (INM6P.408)

Nucleic acids are amongst the most potent stimuli of host cells. Interferons and proinflammatory cytokines induced by nucleic acids have pleiotropic effects on the function of both innate and adaptive immune systems. Several families of innate immune receptors at different subcellular locations have evolved to recognize DNA and RNA molecules from both invading microbes and damaged host tissues. Recent findings on DNA sensing by cytosolic receptors AIM2, IFI16 and DHX36 helicase will be discussed. Structure-function studies of these receptors reveal a common mechanism of sequence-independent recognition through electrostatic attractions. As such, highly charged small molecules or peptides are potential candidates for therapeutic intervention of inflammatory conditions involving nucleic acid sensing. This work is supported by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.

Transvaginal repair of rectovaginal fistula by filling with bulbocavernosus fat pad and retaining scar tissue

The authors performed transvaginal repair of rectovaginal fistual (RVF) with bulbocavernosus fat pad by incising left side of the labia majora and retained scar tissues which were formed after three months for one patient. Repair of the RVF was successful and the patient had normal diet and defecation at a week after surgery. Previous gynecological surgery performed on the patient resulted in RVF accompanied by weak rectal tissues. Retaining the tissues and scars surrounding to the fistula and filling the fistula with bulbocavernosus fat pad tissue increased rectal wall thickness and facilitated healing. The efficacy of this surgical technique will need further studies with larger patient cohorts to establish a clear success rate.

Abstract P5-13-01: Uptake of breast cancer chemoprevention among high-risk women and those with ductal carcinoma in situ

Background: Chemoprevention with antiestrogens, such as tamoxifen, raloxifene, and aromatase inhibitors (AIs), reduces breast cancer incidence in high-risk women. However, uptake has been poor in the prevention setting. We examined demographic and clinical factors that influenced chemoprevention uptake in women with an elevated Gail risk score (≥1.67%), lobular/ductal carcinoma in situ (LCIS/DCIS), and/or BRCA mutation carriers.

Methods: We enrolled women prospectively without a diagnosis of invasive breast cancer, who were seen for an initial consultation by breast surgery or medical oncology at Columbia University Medical Center. Eligibility for chemoprevention included a 5-year Gail risk ≥1.67%, LCIS, known BRCA1 or BRCA2 mutation, or hormone receptor (HR)-positive DCIS. Demographic and risk factor data were collected from a self-administered baseline questionnaire and clinical data from medical chart review, including prior/current chemoprevention, type of antiestrogen, duration of use, and toxicities. Differences in distribution of risk factors between women who ever took chemoprevention and those who did not were examined using chi-square statistics or Fisher's exact test. We used log-binomial regression models to estimate relative risks (RRs) and 95% confidence intervals (95% CI) using chemoprevention uptake as the dependent variable. A subset of high-risk women completed questionnaires assessing their attitudes towards chemoprevention and perceived risks/benefits.

Results: Among 412 women enrolled between March 2007 and April 2013, 316 (77%) were eligible for chemoprevention. Main reasons for ineligibility included 5-year Gail risk &lt;1.67% (40%), age &lt;35 (24%), HR-negative DCIS (17%), opting for bilateral mastectomies (11%), and medical contraindications (8%). Among those eligible for chemoprevention, median age 53 (26-88); White/Hispanic/Black/Asian/other (%): 55/29/8/7/1; risk category, 5-year Gail risk ≥1.67%/LCIS/DCIS/BRCA mutation (%): 36/22/40/2. Overall, 162 (51%) women started an antiestrogen (72% for DCIS and 37% among high-risk women), including 114 on tamoxifen, 40 on raloxifene, and 11 on an AI. Early discontinuation occurred in 27 (18%) women, but 7 switched to a different antiestrogen. In univariable analysis, postmenopausal status and medical oncology referral were associated with higher chemoprevention uptake. In multivariable analysis, only higher risk was a significant predictor of chemoprevention uptake. Among the subset of women who completed additional questionnaires on attitudes towards chemoprevention, they reported that the most important factors in chemoprevention decision-making included their healthcare provider (50%), results of chemoprevention studies (44%), and knowledge about others’ experience with chemoprevention (44%). The majority (69%) were concerned about side effects, specifically blood clots with tamoxifen and raloxifene and bone fractures with AIs.

Conclusions: In high-risk women seen at an academic breast center, chemoprevention uptake was relatively high compared to the published literature. Further research is needed to determine how the risks and benefits of chemoprevention are best communicated to women to enhance informed decision-making and increase uptake of chemoprevention strategies.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-13-01.

Abstract P1-11-02: Identifying women at high-risk for breast cancer in the primary care setting

Background: Breast cancer risk assessment and available interventions for prevention, such as chemoprevention, are underutilized in the U.S. Reasons for low uptake include inability to routinely identify high-risk women in the primary care setting, inadequate time for counseling, and insufficient knowledge about risk-reducing strategies among primary care providers (PCPs) and patients. Our goal is to expand breast cancer risk counseling to a broader population of high-risk women identified in the primary care setting by developing a novel breast cancer risk navigation (BNAV) tool integrated into the electronic health record (EHR).

Methods: We propose to design the BNAV tool for PCPs, by integrating the Gail breast cancer risk assessment tool into the EHR. Our goal is to facilitate clinic workflow for the identification of high-risk women (5-year risk ≥1.7% or lifetime risk ≥20%), who may be referred for specialized risk counseling. We conducted recorded focus groups and individual interviews of PCPs (N = 20-25) at Columbia University Medical Center (CUMC), including internists, family practitioners, and gynecologists who use an EHR and see female patients, age 40-70 years, in the outpatient setting. We performed user analyses of PCPs on the characteristics of their practice and their clinic workflow. Information about the aims of BNAV and the development process were provided and PCPs were given an opportunity to ask questions and discuss the relative merits of BNAV and its potential application to clinical practice. Providers also completed a questionnaire to provide quantitative and qualitative feedback on BNAV. Verbal and written qualitative responses were condensed into themes using a qualitative approach based on grounded theory.

Results: In terms of breast cancer risk assessment, few providers routinely assessed for breast cancer risk factors apart from family history. Although some were familiar with the Gail model, no one used the risk calculator in their practice. Many PCPs were concerned about the added burden of incorporating the Gail model into the clinic visit. Potential solutions included screening for high-risk women during mammography and having patients complete the Gail model while in the waiting rooms. Most PCPs preferred referring high-risk women for specialized risk counseling, rather than directly discussing chemoprevention with their patients. Results from our interviews informed the selection of electronic resources to configure the BNAV tool. Using an open application programming interface within the EHR, the BNAV tool will incorporate the following approaches to workflow integration: 1) external decision support plug-ins for risk calculation; 2) dashboards with informatics-enabled summaries of patient history and breast cancer risk factors; 3) extracting data already available in the EHR for the Gail model breast cancer risk calculation; 4) alerts indicating high-risk patients should be referred for specialized risk counseling; 5) semi-structured referral orders for high-risk consultations.

Discussion: PCPs are on the front lines of preventive medicine and initiating the appropriate high-risk referrals. We propose to use health information technology methods to overcome barriers to breast cancer chemoprevention in the primary care setting.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-11-02.

Unsupervised Sub-tree Alignment for Tree-to-Tree Translation

This article presents a probabilistic sub-tree alignment model and its application to tree-to-tree machine translation. Unlike previous work, we do not resort to surface heuristics or expensive annotated data, but instead derive an unsupervised model to infer the syntactic correspondence between two languages. More importantly, the developed model is syntactically-motivated and does not rely on word alignments. As a by-product, our model outputs a sub-tree alignment matrix encoding a large number of diverse alignments between syntactic structures, from which machine translation systems can efficiently extract translation rules that are often filtered out due to the errors in 1-best alignment. Experimental results show that the proposed approach outperforms three state-of-the-art baseline approaches in both alignment accuracy and grammar quality. When applied to machine translation, our approach yields a +1.0 BLEU improvement and a -0.9 TER reduction on the NIST machine translation evaluation corpora. With tree binarization and fuzzy decoding, it even outperforms a state-of-the-art hierarchical phrase-based system.