Improving image quality of triple-low-protocol renal artery CT angiography with deep-learning image reconstruction: a comparative study with standard-dose single-energy and dual-energy CT with adaptive statistical iterative reconstruction

AIM

To investigate the improvement in image quality of triple-low-protocol (low radiation, low contrast medium dose, low injection speed) renal artery computed tomography (CT) angiography (RACTA) using deep-learning image reconstruction (DLIR), in comparison with standard-dose single- and dual-energy CT (DECT) using adaptive statistical iterative reconstruction-Veo (ASIR-V) algorithm.

MATERIALS AND METHODS

Ninety patients for RACTA were divided into different groups: standard-dose single-energy CT (S group) using ASIR-V at 60% strength (60%ASIR-V), DECT (DE group) with 60%ASIR-V including virtual monochromatic images at 40 keV (DE40 group) and 70 keV (DE70 group), and the triple-low protocol single-energy CT (L group) with DLIR at high level (DLIR-H). The effective dose (ED), contrast medium dose, injection speed, standard deviation (SD), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of abdominal aorta (AA), and left/right renal artery (LRA, RRA), and subjective scores were compared among the different groups.

RESULTS

The L group significantly reduced ED by 37.6% and 31.2%, contrast medium dose by 33.9% and 30.5%, and injection speed by 30% and 30%, respectively, compared to the S and DE groups. The L group had the lowest SD values for all arteries compared to the other groups (p<0.001). The SNR of RRA and LRA in the L group, and the CNR of all arteries in the DE40 group had highest value compared to others (p<0.05). The L group had the best comprehensive score with good consistency (p<0.05).

CONCLUSIONS

The triple-low protocol RACTA with DLIR-H significantly reduces the ED, contrast medium doses, and injection speed, while providing good comprehensive image quality.

Two-Dimensional Conjugated Metal-Organic Frameworks with a Ring-in-Ring Topology and High Electrical Conductance

Electrically conducting two-dimensional (2D) metal-organic frameworks (MOFs) have garnered significant interest due to their remarkable structural tunability and outstanding electrical properties. However, the design and synthesis of high-performance materials face challenges due to the limited availability of specific ligands and pore structures. In this study, we have employed a novel highly branched D3h symmetrical planar conjugated ligand, dodechydroxylhexabenzotrinaphthylene (DHHBTN) to fabricate a series of 2D conductive MOFs, named M-DHHBTN (M = Co, Ni, and Cu). This new family of MOFs offers two distinct types of pores, elevating the structural complexity of 2D conductive MOFs to a more advanced level. The intricate tessellation patterns of the M-DHHBTN are elucidated through comprehensive analyses involving powder X-ray diffraction, theoretical simulations, and high-resolution transmission electron microscope. Optical-pump terahertz-probe spectroscopic measurements unveiled carrier mobility in DHHBTN-based 2D MOFs spanning from 0.69 to 3.10 cm2 V-1 s-1. Among M-DHHBTN famility, Cu-DHHBTN displayed high electrical conductivity reaching 0.21 S cm-1 at 298 K with thermal activation behavior. This work leverages the "branched conjugation" of the ligand to encode heteroporosity into highly conductive 2D MOFs, underscoring the significant potential of heterogeneous double-pore structures for future applications.

Gas-Induced Electrical and Magnetic Modulation of Two-Dimensional Conductive Metal-Organic Framework

Controlled modulation of electronic and magnetic properties in stimuli-responsive materials provides valuable insights for the design of magnetoelectric or multiferroic devices. This paper demonstrates the modulation of electrical and magnetic properties of a semiconductive, paramagnetic metal-organic framework Cu3(C6O6)2 with small gaseous molecules, NH3, H2S, and NO. This study merges chemiresistive and magnetic tests to reveal that the MOF undergoes simultaneous changes in electrical conductance and magnetization that are uniquely modulated by each gas. The features of response, including direction, magnitude, and kinetics, are modulated by the physicochemical properties of the gaseous molecules. This study advances the design of multifunctional materials capable of undergoing simultaneous changes in electrical and magnetic properties in response to chemical stimuli.

Prediction of tumor-reactive T cell receptors from scRNA-seq data for personalized T cell therapy

The identification of patient-derived, tumor-reactive T cell receptors (TCRs) as a basis for personalized transgenic T cell therapies remains a time- and cost-intensive endeavor. Current approaches to identify tumor-reactive TCRs analyze tumor mutations to predict T cell activating (neo)antigens and use these to either enrich tumor infiltrating lymphocyte (TIL) cultures or validate individual TCRs for transgenic autologous therapies. Here we combined high-throughput TCR cloning and reactivity validation to train predicTCR, a machine learning classifier that identifies individual tumor-reactive TILs in an antigen-agnostic manner based on single-TIL RNA sequencing. PredicTCR identifies tumor-reactive TCRs in TILs from diverse cancers better than previous gene set enrichment-based approaches, increasing specificity and sensitivity (geometric mean) from 0.38 to 0.74. By predicting tumor-reactive TCRs in a matter of days, TCR clonotypes can be prioritized to accelerate the manufacture of personalized T cell therapies.

The combination treatment of oncolytic adenovirus H101 with nivolumab for refractory advanced hepatocellular carcinoma: an open-label, single-arm, pilot study

BACKGROUND

H101, an innovative oncolytic adenovirus, has shown potential in modifying the tumor microenvironment from immunologically 'cold' to 'hot'. When combined with nivolumab, a programmed cell death protein 1 inhibitor, this synergy may offer substantial therapeutic benefits beyond the capabilities of each agent alone.

PATIENTS AND METHODS

In this pilot study, we assessed the efficacy and safety of combining H101 with nivolumab in advanced hepatocellular carcinoma (HCC) patients who failed prior systemic therapy. The participants received initial oncolytic virus (OV) pretreatment with intratumoral H101 injections (5.0 × 1011 vp/0.5 ml/vial, two vials per lesion) on days 1 and 3. Combination therapy started on day 8, with H101 administered every 2 or 4 weeks and nivolumab (240 mg) injections every 2 weeks. Treatment continued up to 12 months or until disease progression, intolerable toxicity, consent withdrawal, or study conclusion. The primary endpoint was the objective response rate (ORR).

RESULTS

Between March 2020 and March 2022, 18 of 21 screened patients were assessable, showing an ORR of 11.1% [two cases of partial response (PR) and five cases of stable disease], with extrahepatic injections often leading to favorable outcomes. The disease control rate stood at 38.9%, with a 6-month survival rate of 88.9%. Median progression-free survival was 2.69 months, and overall survival (OS) was 15.04 months. Common adverse events included low-grade fever (100%) and pain related to centesis (33.3%), and no grade 3/4 events were reported. Significantly, local H101 injection showed potential in reversing immune checkpoint inhibitor resistance, evidenced by over 2.5 years of extended OS in PR cases with low α-fetoprotein. Additionally, decreasing neutrophil-to-lymphocyte ratio during OV pretreatment may predict positive outcomes.

CONCLUSIONS

This study demonstrates the potential efficacy of combining H101 with nivolumab in treating refractory advanced HCC, with well-tolerated toxicities.

Turning on Singlet Oxygen Generation by Outer-Sphere Microenvironment Modulation in Porphyrinic Covalent Organic Frameworks for Photocatalytic Oxidation

Singlet oxygen (1 O2 ) is ubiquitously involved in various photocatalytic oxidation reactions; however, efficient and selective production of 1 O2 is still challenging. Herein, we reported the synthesis of nickel porphyrin-based covalent organic frameworks (COFs) incorporating functional groups with different electron-donating/-withdrawing features on their pore walls. These functional groups established a dedicated outer-sphere microenvironment surrounding the Ni catalytic center that tunes the activity of the COFs for 1 O2 -mediated thioether oxidation. With the increase of the electron-donating ability of functional groups, the modulated outer-sphere microenvironment turns on the catalytic activity from a yield of nearly zero by the cyano group functionalized COF to an excellent yield of 98 % by the methoxy group functionalized one. Electronic property investigation and density-functional theory (DFT) calculations suggested that the distinct excitonic behaviors attributed to the diverse band energy levels and orbital compositions are responsible for the different activities. This study represents the first regulation of generating reactive oxygen species (ROS) based on the strategy of outer-sphere microenvironment modulation in COFs.

Conductive Covalent Organic Frameworks of Polymetallophthalocyanines as a Tunable Platform for Electrocatalysis

Developing an electrocatalyst platform that can control the interplay among activity, selectivity, and stability at atomic precision remains a grand challenge. Here, we have synthesized highly crystalline polymetallophthalocyanines (pMPcs, M = Fe, Co, Ni, and Cu) through the annulation of tetracyanobenzene in the presence of transition metals. The conjugated, conductive, and stable backbones with precisely installed metal sites render pMPcs a unique platform in electrochemical catalysis, where tunability emerges from long-range interactions. The construction of pCoNiPc with a Co and Ni dual-site integrates the advantageous features of pCoPc and pNiPc in electrocatalytic CO2 reduction through electronic communication of the dual-site with an unprecedented long atomic separation of ≥14 chemical bonds. This integration provides excellent activity (current density, j = -16.0 and -100 mA cm-2 in H-type and flow cell, respectively), selectivity (CO Faraday efficiency, FECO = 94%), and stability (>10 h), making it one of the best-performing reticular materials.

Characterization and profiling of the microRNA in small extracellular vesicles isolated from goat milk samples collected during the first week postpartum

Colostrum contains nutrients, immunoglobulins, and various bioactive compounds such as microRNA (miRNA). Less is known about the temporal changes in miRNA profiles in ruminant milk samples during the first week postpartum. In this study, we characterized and compared the profiles of miRNA in the small extracellular vesicles (sEV) isolated from colostrum (CM, collected immediately after parturition, n = 8) and transition milk (TM, collected 7 d postpartum, n = 8) from eight 1-yr-old Guanzhong dairy goats with a milk yield of approximately 500 kg/year. A total of 192 unique sEV-associated miRNA (transcripts per million >1 at least 4 samples in either CM or TM) were identified in all samples. There were 29 miRNA uniquely identified in the TM samples while no miRNA was uniquely identified in the CM samples. The abundance of the top 10 miRNA accounted for 82.4% ± 4.0% (± SD) of the total abundance, with let-7 families (e.g., let-7a/b/c-5p) being predominant in all samples. The top 10 miRNA were predicted to target 1,008 unique genes that may regulate pathways such as focal adhesion, TGF-β signaling, and axon guidance. The expression patterns of EV miRNA were similar between the 2 sample groups, although the abundance of let-7c-5p and miR-30a-3p was higher, whereas that of let-7i-5p and miR-103-3p was lower in CM than in TM. In conclusion, the core miRNAome identified in the samples from CM and TM may play an important role in cell proliferation, bone homeostasis, and neuronal network formation in newborn goat kids. The lack of differential miRNA expression between the CM and TM samples may be due to a relatively short sampling interval in which diet composition, intake and health status of ewes, and environment were relatively stable.

Exploring the Clinical Characteristics and Survival of Early-Onset and Late-Onset Nasopharyngeal Carcinoma

PURPOSE/OBJECTIVE(S)

Presently, early-onset and late-onset nasopharyngeal cancer (EONPC and LONPC, defined as age ≤ 50 years and > 50 years old, respectively) are seldom studied. The purpose of this study is to determine the clinical and survival characteristics between the NPC patients of these two age groups.

MATERIALS/METHODS

Patients diagnosed with NPC in The Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018 years, and in our institution from 2014 to 2017 years were reviewed in this study. Clinicopathological characteristics, treatment modalities, and survival outcomes of EONPC and LONPC patients were analyzed and compared.

RESULTS

A total of 2943 patients (including 935 patients with EONPC and 2008 patients with LONPC) in the SEER database and 833 domestic patients (including 518 patients with EONPC and 315 patients with LONPC) in our center were finally enrolled. In the SEER database, both EONPC and LONPC patients displayed a greater prevalence in men. EONPC patients presented with a worse staging of regional lymph node metastasis (p < 0.001), but had a better prognosis than that in the LONPC patients (p < 0.001). More EONPC patients received chemotherapy and radiation (p < 0.001). Similar results were validated in our center, and in addition, it was found that EONPC patients had an advanced clinical stage (stage III, IVA, 92.1% vs. 85.1%, p = 0.016) and larger primary tumor volume (41.7% vs. 35.7%, p = 0.049). Meanwhile, EONPC patients had a superior overall survival (OS) (p = 0.017) and cancer-specific survival (CSS) (p = 0.004) compared to that in the LONPC patients. In univariate and multivariate Cox regression analysis, early-onset was independently associated with a higher 5-year OS (82.4% vs. 73.3%, p = 0.006).

CONCLUSION

EONPC patients present with more advanced lymph node metastasis stage and clinical stage, but have a better survival compared to LONPC patients. Age ≤ 50 years was an independent prognostic factor for survival outcome in NPC patients. To achieved the better individualization of the therapeutic regimen, there is the need for further studies on EONPC.

Potential Predictive Value of Intravoxel Incoherent Motion Magnetic Resonance for Xerostomia of Nasopharyngeal Carcinoma

PURPOSE/OBJECTIVE(S)

Xerostomia, caused by radiation-induced parotid damage, is the most commonly reported complications of radiotherapy (RT) to nasopharyngeal carcinoma (NPC). This study aimed to evaluate the value of IVIM MR in monitoring radiation parotid gland damage and predicting the risk of xerostomia.

MATERIALS/METHODS

A total of 54 patients were enrolled and underwent IVIM MR scans at before RT, after the fifth fraction, halfway through the course of RT, and at the end of radiotherapy. The parameters of IVIM MR include pseudo-diffusion coefficient (D*), perfusion fraction (f), and pure diffusion coefficient (D). The degree of xerostomia in NPC patients was assessed before each MR examination using the acute radiation morbidity scoring criteria proposed by the Radiation Therapy Oncology Group (RTOG). Concurrently, the time when the patient first reported suffering from xerostomia was recorded. The IVIM parameters trend throughout the RT, and the relationships between IVIM parameters and xerostomia, were analyzed.

RESULTS

All of the IVIM parameters increased from pre-RT to post-RT significantly (all p < 0.001). The increase rate of D from pre-RT to halfway through the RT was 32.61%, which was significantly higher than 15.64% from halfway to post-RT (p<0.001), indicating that cell necrosis in the first half of treatment is significantly higher than that in the second half. Both D* and F had significantly increased from pre-RT to halfway through the radiotherapy (p<0.001), with an increase rate of 19.58% and 29.38%, respectively. However, no significant increase was observed from Halfway to post-RT (p>0.05), with an increase rate of 4.10% and 8.30%, respectively. This may be due to radiation-induced vasculitic dilation that is significant in the first half of the radiotherapy but plateaus in the second half. Pre-D (OR = 23.85; 95% CI = 2.39, 237.82; p = .007) and pre-D* (OR = 0.75; 95% CI = 0.63, 0.91; p = 0.003) are independent influencing factors for xerostomia at 3 months after the completion of RT. D and F were significantly higher after the fifth fraction compared with Pre-RT (both p<0.05), respectively increased 31.25% and 25.16%. D* increase by 15% (p = 0.081). IVIM scans can assess parotid gland damage early. And the average time of parotid damage underwent IVIM scan was 5.99 ± 0.84 (day), much earlier than 11.84 ± 2.74 (day) according to RTOG.

CONCLUSION

Our study indicates that IVIM MR can dynamically monitor radiotherapy-induced parotid gland damage, and much earlier and objectively than RTOG.

Public acceptance of residential photovoltaic installation: A case study in China

Residential photovoltaics (PV) presents an effective means of achieving low-carbon development, owing to its installation flexibility and resource-saving properties. To explore the residents' behavioral intentions to purchase and install residential PV systems, this study collected 1424 samples and analyze the impact of different policies on residents' adoption of residential PV using the theory of TPB and the Partial Least Squares Structural Equation Model (PLS-SEM). The main conclusions are summarized as follows: (1) Bungalow residents exhibit a stronger inclination to install residential PV than building residents. (2) Perceived reward (PR) affects installation intention (II) more than perceived guide (PG) among bungalow residents. (3) Both PR and PG indirectly affect II through Perceived behavioral control (PBC) among bungalow residents. Economic policies, represented by PR, are likely to have more substantial indirect effects than propaganda and guidance policies. The findings suggest that China's recent residential PV installation policies should increase users' trust and guide the future decline of subsidy policy.

The Feasibility of Level Ib Sparing Intensity Modulated Radiation Therapy in Nasopharyngeal Carcinoma Patients with High-Risk Factors: Based on International Guideline

PURPOSE/OBJECTIVE(S)

In spite of the rarity of level Ib recurrence after intensity-modulated radiation therapy, the International Guideline (IG) provides the risk factors for prophylactic coverage. In practice, however, there are significant differences between institutions. The purpose of this study is to examine the feasibility of sparing level Ib IMRT in NPC patients with high-risk factors based on IG.

MATERIALS/METHODS

From January 2014 to October 2017, newly-diagnostic, non-metastatic NPC patients in our center were retrospectively reviewed. According to the risk factors of prophylactic level Ib coverage in patients with negative level Ib recommended by IG, the characteristics of pre-treatment MRI were analyzed. Four high-risk factors were identified: a. involvement of the structures that drain to level Ib as first echelon (FES), including anterior half of nasal cavity, oral cavity, b. involvement of submandibular gland (SMG), c. with radiologic extranodal extension (rENE) in level II LNs, or d. maximal axial diameter (MAD)≧2 cm in level II LNs. Patients with risk factors were divided into Cohort A (with risk factors a), Cohort B (with risk factor b, but without a), and Cohort C (only with risk factors c and/or d). Recurrence rates of level Ib and regional relapse-free survival (RRFS) rates were evaluated in different cohorts.

RESULTS

A total of 961 patients were finally included. Thirty-six cases (3.7%) presented with radiologically positive level Ib metastasis. For the other patients with negative Ib LNs, there were 18, 65, 421, and 444 cases classified as FES involvement, SMG involvement, level II LNs with rENE, and level II nodal with MAD ≧2 cm. Excluding overlap, a total of 571 patients with risk factors were divided into three groups: Cohort A (n = 18), Cohort B (n = 49) and Cohort C (n = 504). Nine patients (9/961, 0.94%) developed level Ib recurrence. Except for 1 patient with positive Ib LNs at diagnosis, 2 did not meet any of the risk factors, while the other six (6/9, 66.7%) met at least one risk factor. The rate of recurrence at neck level Ib was highest in Cohort A (11.1%, 2/18; Ib-sparing group: 0/10, 0.0% vs Ib-covering group: 2/8, 25.0%; P = 0.183). In Cohort B, no cases were found with level Ib recurrence (0.0%, 0/49). In Cohort C, the rates were rare (0.8%, 4/504) in both groups (0.7%, 2/276 vs 0.9%, 2/228; P > 0.999). Among the three Cohorts, there were no significant differences in 5-year RRFS between two groups, which were 90.0% vs 62.5% (p = 0.248), 90.9% vs 92.0% (p = 0.905), and 92.6% vs 90.1% (p = 0.445), respectively. Among patients with high-risk factors, the incidence of grade 3-4 late dry mouth symptom was higher in the level Ib-covering group (3.1% vs 7.5%, P = 0.033).

CONCLUSION

Level Ib sparing appears safe and feasible for NPC patients with negative level Ib LNs, even if combined with risk factors: SMG involvement, and/or level II with rENE, and/or level II MAD ≧2 cm. Level Ib-sparing irradiation reduces dry mouth symptoms compared with level Ib-irradiation.

Turning on Asymmetric Catalysis of Achiral Metal-Organic Frameworks by Imparting Chiral Microenvironment

The development of heterogeneous asymmetric catalysts has attracted increasing interest in synthetic chemistry but mostly relies on the immobilization of homogeneous chiral catalysts. Herein, a series of chiral metal-organic frameworks (MOFs) have been fabricated by anchoring similar chiral hydroxylated molecules (catalytically inactive) with different lengths onto Zr-oxo clusters in achiral PCN-222(Cu). The resulting chiral MOFs exhibit regulated enantioselectivity up to 83 % ee in the asymmetric ring-opening of cyclohexene oxide. The chiral molecules furnished onto the catalytic Lewis sites in the MOF create multilevel microenvironment, including the hydrogen interaction between the substrate and the chiral -OH group, the steric hindrance endowed by the benzene ring on the chiral molecules, and the proximity between the catalytic sites and chiral molecules confined in the MOF pores, which play crucial roles and synergistically promote chiral catalysis. This work nicely achieves heterogeneous enantioselective catalysis by chiral microenvironment modulation around Lewis acid sites.

Bioinspired microenvironment modulation of metal-organic framework-based catalysts for selective methane oxidation

Inspiration from natural enzymes enabling creationary catalyst design is appealing yet remains extremely challenging for selective methane (CH4) oxidation. This study presents the construction of a biomimetic catalyst platform for CH4 oxidation, which is constructed by incorporating Fe-porphyrin into a robust metal-organic framework, UiO-66, furnished with saturated monocarboxylic fatty acid bearing different long alkyl chains. The catalysts demonstrate the high efficiency in the CH4 to methanol (CH3OH) conversion at 50 °C. Moreover, the selectivity to CH3OH can be effectively regulated and promoted through a fine-tuned microenvironment by hydrophobic modification around the Fe-porphyrin. The long-chain fatty acids anchored on the Zr-oxo cluster of UiO-66 can not only tune the electronic state of the Fe sites to improve CH4 adsorption, but also restrict the amount of H2O2 around the Fe sites to reduce the overoxidation. This behavior resembles the microenvironment regulation in methane monooxygenase, resulting in high CH3OH selectivity.

Dual Microenvironment Modulation of Pd Nanoparticles in Covalent Organic Frameworks for Semihydrogenation of Alkynes

The chemical microenvironment modulation of metal nanoparticles (NPs) holds promise in tackling the long-lasting challenge of trade-off effect between activity and selectivity in catalysis. Herein, ultrafine PdCu2 NPs incorporated into covalent organic frameworks (COFs) with diverse groups on their pore walls have been fabricated for semihydrogenation of alkynes. The Cu species as the primary microenvironment of Pd active sites greatly improves the selectivity. The functional groups as the secondary microenvironment around PdCu2 NPs effectively regulate the activity, in which PdCu2 NPs encapsulated in the COF bearing -CH3 groups exhibit the highest activity with 100% conversion and >96% selectivity. Both experimental and calculation results suggest that the functional group affects the electron-donating ability of the COFs, which successively impacts the charge transfer between COFs and Pd sites, giving rise to modulated Pd electronic state and excellent catalytic performance.

Anterolateral thigh flap with a central hole for the repair of extensive oral defects in patients treated for chemotherapy-induced trismus

Trismus is a rare complication of chemotherapy. The usefulness of a modified anterolateral thigh (ALT) flap for the repair of extensive oral defects in patients treated for chemotherapy-induced trismus was evaluated. Between 2019 and 2021, three patients with chemotherapy-induced trismus underwent scar excision. A thinned ALT flap with a central hole was designed to repair the resultant oral mucosal defects. The patients were followed up for a mean 9.3 months (range 4-18 months). The mean pre- and intraoperative maximum inter-incisal opening (MIO) was 0.7 cm (range 0-2.0 cm) and 3.6 cm (range 3.4-3.7 cm), respectively, indicating a significant operative effect. MIO at the latest follow-up was 2.4 cm (range 1.5-3.5 cm). All of the flaps survived without complications. All patients achieved a good diet and were satisfied with the aesthetics. Thorough excision of the perioral scar and restoration with a modified ALT flap achieved satisfactory mouth opening and cosmetic effects in patients with chemotherapy-induced trismus.

Resource exergy analysis of the Chinese society in 2017

China has made huge efforts to increase the efficiency of its resources and change its resource-intensive economic trajectory. A question which should be raised is whether the impacts of such shifts can be measured. Exergy analysis provides a unified method of ecological diagnosis of resource allocation and metabolism in social systems from a biophysical perspective. This paper explores the resource utilization pattern within Chinese society by employing an exergy-based accounting method. Nationally total resource consumption amounted to 153.7 EJ in 2017, and non-biological resources reached 137.1 EJ. China's resource self-sufficiency rate was revealed as 79.1%. After China experienced a transition period with a medium-high economic growth rate, the total net resource input into Chinese society marked an increase of around 1% from 2012 to 2017. The per capita resource consumption dropped from 112.0 GJ in 2012 to 110.6 GJ in 2017. The proportion of resource exergy consumption in the tertiary sector was upregulated from 10.0% in 2012 to 17.6% in 2017. To be specific, the exergy conversion efficiency of the domestic sector rose from 1.3% in 2012 to 20.6% in 2017. The results confirm that the resource exergy utilization structures and the conversion efficiencies of the main social sectors in China's economic transition period were significantly optimized towards a more sustainable future. A reasonable analysis of the resource exergy utilization pattern provides a solid reference for assessing the comprehensive effect of the changed development speed, industrial structure, and driving force of a developing society.

Fabrication of Multifunctional Electronic Textiles Using Oxidative Restructuring of Copper into a Cu-Based Metal-Organic Framework

This paper describes a novel synthetic approach for the conversion of zero-valent copper metal into a conductive two-dimensional layered metal-organic framework (MOF) based on 2,3,6,7,10,11-hexahydroxytriphenylene (HHTP) to form Cu₃(HHTP)₂. This process enables patterning of Cu₃(HHTP)₂ onto a variety of flexible and porous woven (cotton, silk, nylon, nylon/cotton blend, and polyester) and non-woven (weighing paper and filter paper) substrates with microscale spatial resolution. The method produces conductive textiles with sheet resistances of 0.1-10.1 MΩ/cm², depending on the substrate, and uniform conformal coatings of MOFs on textile swatches with strong interfacial contact capable of withstanding chemical and physical stresses, such as detergent washes and abrasion. These conductive textiles enable simultaneous detection and detoxification of nitric oxide and hydrogen sulfide, achieving part per million limits of detection in dry and humid conditions. The Cu₃(HHTP)₂ MOF also demonstrated filtration capabilities of H₂S, with uptake capacity up to 4.6 mol/kg_MOF. X-ray photoelectron spectroscopy and diffuse reflectance infrared spectroscopy show that the detection of NO and H₂S with Cu₃(HHTP)₂ is accompanied by the transformation of these species to less toxic forms, such as nitrite and/or nitrate and copper sulfide and S_x species, respectively. These results pave the way for using conductive MOFs to construct extremely robust electronic textiles with multifunctional performance characteristics.

China's Trade of Agricultural Products Drives Substantial Greenhouse Gas Emissions

China's trade of agricultural products has expanded rapidly over the past two decades, resulting in considerable shifts in greenhouse gas (GHG) emissions worldwide. This study aims to explore the evolution of GHG emissions embodied in China's trade of agricultural products from 1995 to 2015. The GHG emissions embodied in China's exports of agricultural products experienced three stages of fluctuation, showing a significant upward trend (1995-2003), a fluctuating trend (2004-2007), and a fall back to the previous level (2008-2015). The embodied GHG emissions in China's imports were witnessed at times of sustained growth, rising from 10.5 Mt CO₂-eq in 1995 to 107.7 Mt CO₂-eq in 2015. The net import of embodied GHG emissions has grown at an average annual rate of 25.1% since 2008. In terms of regional contribution, the distribution of China's trading partners tended to be diversified. The increasing net imports of oil crops to China resulted in a significant GHG emissions shift from China to the US and Brazil. Asian countries contributed to 76.9% of the total GHG emissions embodied in China's agricultural exports. The prominent impacts of China's trade of agricultural products on global GHG emissions provide important implications for climate-related policy choices.

Poly(methacrylate citric acid) as a Dual Functional Carrier for Tumor Therapy

Owing to its pH-sensitive property and chelating Cu²⁺ effect, poly(methacrylate citric acid) (PCA) can be utilized as a dual functional nanocarrier to construct a nanodelivery system. Negatively charged carboxyl groups can interact with positively charged antineoplastic drugs through electrostatic interaction to form stable drug nanoparticles (NPs). Through drug experimental screening, doxorubicin (DOX) was selected as the model drug, PCA/DOX NPs with a diameter of 84 nm were prepared, and the drug-loading content was 68.3%. PCA/DOX NPs maintained good stability and a sustained release profile. Cell experiments presented that PCA/DOX NPs could inhibit effectively the growth of 4T1 cells; the IC₅₀ value was decreased by approximately 15-fold after incubation for 72 h. The cytotoxicity toward H9C2 was decreased significantly. Moreover, based on its ability to efficiently adsorb copper ions, PCA showed good vascular growth inhibition effect in vitro. Furthermore, animal experiments showed that PCA/DOX NPs presented stronger anticancer effects than DOX; the tumor inhibition rate was increased by 1.5-fold. Myocardial toxicity experiments also confirmed that PCA reduced the cardiotoxicity of DOX. In summary, PCA/DOX NPs show good antitumor efficacy and low toxicity, and have good potential for clinical application.

The mechanism of Epimedium in the treatment of coronary atherosclerotic heart disease based on network pharmacology, molecular docking, and in vitro studies

OBJECTIVE

There are many challenges related to the treatment of coronary atherosclerotic heart disease (CAD). Studies have confirmed that Epimedium extract inhibits myocardial injury induced by myocardial ischaemia, but the mechanism of action remains unclear. This study aimed at analysed the effective components and mechanisms of Epimedium in treating CAD based on network pharmacology and molecular docking studies and to verify the mechanism in vitro.

MATERIALS AND METHODS

The TCMSP and UniProt databases were used to filter for the active components and drug targets of Epimedium. The GeneCards database was used to screen disease targets associated with CAD. The intersection of the drug targets of Epimedium and the disease targets of coronary heart disease was studied to identify the targets of Epimedium in the treatment of CAD. Cytoscape software was used to establish and analyse an activity-target network. The STRING database was used to analyse a protein-protein interaction (PPI) network, and proteins in the PPI network were visualized in the R language. Bioconductor software was used for GO function and KEGG pathway enrichment analyses, and visualization analysis was performed in the R language. PyMOL software was used to verify the molecular docking between selected active components of Epimedium and the targets of CAD, and the potential key effective components of Epimedium in the treatment of coronary heart disease were identified. The involvement of the PI3K/Akt pathway was validated by Western blot analysis.

RESULTS

(1) Twenty-three active compounds, including Epimedium glycoside, quercetin, luteolin, and olive resin, were screened out. There were 68 common targets of Epimedium and CAD, including IL-6, ESR1, RELA, FOS, NCOA1, CCND1, EGFR, MAPK8, VEGFA, and CASP8. The potential signaling pathways involved in the treatment of CAD by Epimedium included the human cytomegalovirus infection pathway, the PI3K-Akt signaling pathway, the TNF signaling pathway, and the HIF-1 signaling pathway. (2) Luteolin, quercetin, sitosterol, and anhydroicaritin showed strong binding to targets of CAD based on molecular docking studies. (3) Epimedium extract increased the expression of PI3K, Akt and P-Akt but decreased the expression of IL-6  in vitro.

CONCLUSIONS

(1) Icariin, quercetin and luteolin may act on target proteins, including IL-6, ESR1, EGFR, MAPK8, VEGFA and CASP8, to participate in the regulation of the human cytomegalovirus infection pathway, the PI3K-Akt signaling pathway, the TNF signaling pathway and other signaling pathways in order to effectively treat CAD. (2) In vitro studies confirmed that Epimedium extract can treat CAD by upregulating PI3K, Akt and P-Akt protein expression and downregulating IL-6 protein expression in SD rat cardiomyocytes.

OsMADS14 and NF-YB1 cooperate in the direct activation of OsAGPL2 and Waxy during starch synthesis in rice endosperm

Starch synthesis makes a dramatic contribution to the yield and nutritional value of cereal crops. Although several starch synthesis enzymes and related regulators have been reported, the underlying regulatory mechanisms of starch synthesis remain largely unknown. OsMADS14 is a FRUITFULL (FUL)-like MADS-box gene in rice (Oryza sativa). Here we show that two null mutations of OsMADS14 result in a shrunken and chalky grain phenotype. It is caused by obviously defective compound starch granules and a significantly reduced content of both total starch and amylose in the endosperm. Transcriptomic profiling analyses revealed that the loss-of-function of OsMADS14 leads to significantly downregulated expression of many core starch synthesis genes, including OsAGPL2 and Waxy. Both in vitro and in vivo assays demonstrate that the OsMADS14 protein directly binds to stretches of DNA with a CArG-box consensus in the putative regulatory regions of OsAGPL2 and Waxy. Protein-protein interaction experiments also suggest that OsMADS14 interacts with nuclear factor NF-YB1 to promote the transcription of OsAGPL2 and Waxy. Our study thus demonstrates that OsMADS14 plays an essential role in the synthesis of storage starch and provides novel insights into the underlying molecular mechanism that may be used to improve rice cultivars by molecular breeding.

A205 IS REPEAT ERCP REQUIRED AFTER INITIAL ENDOSCOPIC MANAGEMENT OF POST-SURGICAL BILE LEAKS? MULTI-CENTER VALIDATION OF THE CALGARY BILE LEAK RULE

Background

The Calgary Bile Leak Rule was developed to identify patients in whom biliary stent removal via gastroscopy could be safely performed in lieu of ERCP for post-surgical bile leaks.

Aims

This study aimed to evaluate a Modified Calgary Bile Leak Rule (MCBLR) for a cohort of patients who underwent laparoscopic cholecystectomy complicated by bile leak.

Methods

This retrospective cohort study included patients who underwent ERCP for management of laparoscopic cholecystectomy-induced bile leaks between 2005 and 2017. The primary outcome was defined as the absence of persisting bile leak or other pathology on follow-up ERCP. The MCBLR includes a) normal post-surgical serum alkaline phosphatase, b) small or absent leak with no other biliary pathology on initial ERCP, and c) time between initial and follow-up ERCP was 4–8 weeks. Test performance of the prediction rule was analyzed by calculating sensitivity, specificity, positive predictive value and negative predictive value.

Results

124 cases met inclusion criteria, of which 116 (94%) of bile leak cases had no leak identified during the follow-up ERCP. 8 (6.4%) had a persisting bile leak on follow-up ERCP. Bivariate analysis found no factors significantly associated with the primary outcome. The MCBLR demonstrated a sensitivity of 100% (95% CI 63% - 100%), a specificity of 35% (95% CI 26% - 44%), a positive predictive value of 10% (95% CI 4% - 18%), and a negative predictive value of 100.0% (91% to 100%).

Conclusions

The MCBLR demonstrated high sensitivity and negative predictive value for determining the need for repeat ERCP following endoscopic management of laparoscopic cholecystectomy-induced bile leaks.

Funding Agencies

None

Bimetallic Two-Dimensional Metal-Organic Frameworks for the Chemiresistive Detection of Carbon Monoxide

This paper describes the demonstration of a series of heterobimetallic, isoreticular 2D conductive metal-organic frameworks (MOFs) with metallophthalocyanine (MPc, M=Co and Ni) units interconnected by Cu nodes towards low-power chemiresistive sensing of ppm levels of carbon monoxide (CO). Devices achieve a sub-part-per-million (ppm) limit of detection (LOD) of 0.53 ppm toward CO at a low driving voltage of 0.1 V. MPc-based Cu-linked MOFs can continuously detect CO at 50 ppm, the permissible exposure limit required by the Occupational Safety and Health Administration (OSHA), for multiple exposures, and realize CO detection in air and in humid environment. Diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS), density functional theory (DFT) calculations, and comparison experiments suggest the contribution of Cu nodes to CO binding and the essential role of MPc units in tuning and amplifying the sensing response.

Preparation of Naringenin Nanosuspension and Its Antitussive and Expectorant Effects

Naringenin (NRG) is a natural flavonoid compound abundantly present in citrus fruits and has the potential to treat respiratory disorders. However, the clinical therapeutic effect of NRG is limited by its low bioavailability due to poor solubility. To enhance the solubility, naringenin nanosuspensions (NRG-NSps) were prepared by applying tocopherol polyethylene glycol succinate (TPGS) as the nanocarrier via the media-milling method. The particle size, morphology, and drug-loading content of NRG-NSps were examined, and the stability was evaluated by detecting particle size changes in different physiological media. NRG-NSps exhibited a flaky appearance with a mean diameter of 216.9 nm, and the drug-loading content was 66.7%. NRG-NSps exhibited good storage stability and media stability. NRG-NSps presented a sustainable release profile, and the cumulative drug-release rate approached approximately 95% within 7 d. NRG-NSps improved the antitussive effect significantly compared with the original NRG, the cough frequency was decreased from 22 to 15 times, and the cough incubation period was prolonged from 85.3 to 121.6 s. Besides, NRG-NSps also enhanced expectorant effects significantly, and phenol red secretion was increased from 1.02 to 1.45 μg/mL. These results indicate that NRG-NSps could enhance the bioavailability of NRG significantly and possess a potential clinical application.

Conductive Stimuli-Responsive Coordination Network Linked with Bismuth for Chemiresistive Gas Sensing

This paper describes the design, synthesis, characterization, and performance of a novel semiconductive crystalline coordination network, synthesized using 2,3,6,7,10,11-hexahydroxytriphenylene (HHTP) ligands interconnected with bismuth ions, toward chemiresistive gas sensing. Bi(HHTP) exhibits two distinct structures upon hydration and dehydration of the pores within the network, Bi(HHTP)-α and Bi(HHTP)-β, respectively, both with unprecedented network topology (2,3-c and 3,4,4,5-c nodal net stoichiometry, respectively) and unique corrugated coordination geometries of HHTP molecules held together by bismuth ions, as revealed by a crystal structure resolved via microelectron diffraction (MicroED) (1.00 Å resolution). Good electrical conductivity (5.3 × 10^-3 S·cm^-1) promotes the utility of this material in the chemical sensing of gases (NH₃ and NO) and volatile organic compounds (VOCs: acetone, ethanol, methanol, and isopropanol). The chemiresistive sensing of NO and NH₃ using Bi(HHTP) exhibits limits of detection 0.15 and 0.29 parts per million (ppm), respectively, at low driving voltages (0.1-1.0 V) and operation at room temperature. This material is also capable of exhibiting unique and distinct responses to VOCs at ppm concentrations. Spectroscopic assessment via X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared spectroscopic methods (i.e., attenuated total reflectance-infrared spectroscopy (ATR-IR) and diffuse reflectance infrared Fourier transformed spectroscopy (DRIFTS)), suggests that the sensing mechanisms of Bi(HHTP) to VOCs, NO, and NH₃ comprise a complex combination of steric, electronic, and protic properties of the targeted analytes.

Covalent organic frameworks as multifunctional materials for chemical detection

Sensitive and selective detection of chemical and biological analytes is critical in various scientific and technological fields. As an emerging class of multifunctional materials, covalent organic frameworks (COFs) with their unique properties of chemical modularity, large surface area, high stability, low density, and tunable pore sizes and functionalities, which together define their programmable properties, show promise in advancing chemical detection. This review demonstrates the recent progress in chemical detection where COFs constitute an integral component of the achieved function. This review highlights how the unique properties of COFs can be harnessed to develop different types of chemical detection systems based on the principles of chromism, luminescence, electrical transduction, chromatography, spectrometry, and others to achieve highly sensitive and selective detection of various analytes, ranging from gases, volatiles, ions, to biomolecules. The key parameters of detection performance for target analytes are summarized, compared, and analyzed from the perspective of the detection mechanism and structure-property-performance correlations of COFs. Conclusions summarize the current accomplishments and analyze the challenges and limitations that exist for chemical detection under different mechanisms. Perspectives on how future directions of research can advance the COF-based chemical detection through innovation in novel COF design and synthesis, progress in device fabrication, and exploration of novel modes of detection are also discussed.

Unraveling the Electrical and Magnetic Properties of Layered Conductive Metal-Organic Framework With Atomic Precision

This paper describes structural elucidation of a layered conductive metal-organic framework (MOF) material Cu₃ (C₆ O₆ )₂ by microcrystal electron diffraction with sub-angstrom precision. This insight enables the first identification of an unusual π-stacking interaction in a layered MOF material characterized by an extremely short (2.73 Å) close packing of the ligand arising from pancake bonding and ordered water clusters within pores. Band structure analysis suggests semiconductive properties of the MOF, which are likely related to the localized nature of pancake bonds and the formation of a singlet dimer of the ligand. The spin of Cu^II within the Kagomé arrangement dominates the paramagnetism of the MOF, leading to strong geometrical magnetic frustration.

Can echocardiographic parameters predict mortality in COVID-19?

Introduction

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), otherwise known as the coronavirus (COVID-19) pandemic presents one of the greatest medical challenges of our generation. Whilst commonly causing a viral pneumonitis, myocardial damage has also been suggested by elevated serum troponin values greater than the 99th centile in up to 30% of individuals who require hospitalisation and correlates with increased mortality.

Purpose

We aim to identify whether transthoracic echocardiography (TTE) parameters can elucidate the phenomenon of abnormal troponin levels. Furthermore, we seek to characterise the most frequent demographic, biochemical, echocardiographic features and co-morbidities associated with adverse outcomes in this cohort.

Methods

A retrospective analysis was conducted utilising electronic patient records of consecutive hospitalised patients with a positive COVID-19 swab between 1st March and 31st October 2020 who underwent a TTE at our institution. Pertinent variables were collected including: the clinical indication, demographics including cardiovascular (CV) risk factors, peak troponin values and fundamental echocardiographic parameters.

Results

During this 8-month period, a total of 90 patients underwent a TTE. The mean age of the cohort was 63 years of age and 56% were male. More than half (56.6%) were admitted to the intensive care unit (ICU). A salient 41.1% (n=37) of our cohort succumbed to this devastating virus. Notably, 38.9% (n=35) were of black and minority ethnic origin (BAME). A striking 64.9% (n=24) of patients who died had hypertension. The mean troponin levels were 168.7 ng/L and 176.6 ng/L (0–34 ng/L) in the survivors and non-survivors group respectively. With regards to TTE, the left ventricular parameters were similar between both groups with a mean left ventricular ejection fraction (LVEF) of 60.6% in the non-survivors. Conversely, both right ventricular (RV) dysfunction (37.8%) and raised pulmonary artery systolic pressures (PASP) (51.4%) were markedly more frequent in the patients who perished due to COVID-19 infection.

Conclusion

Remarkably, in this extremely ill group of patients who died, 91.9% of patients had a preserved LVEF. There were no overt differences between troponin levels in the survivors and non-survivors. However, hypertension, RV dysfunction and raised PASP were distinctly more prominent in the non-survivors. Thus, providing insight that a normally functioning left ventricle does not preclude to poor outcomes. Overall, this single-centre retrospective study demonstrates that the echocardiographic phenotype associated with mortality is consistent with a severe respiratory illness rather than direct myocardial injury from COVID-19. A multi-modality imaging approach may facilitate the identification of adverse tissue characterisation changes associated with this novel virus as well as guiding further risk stratification and patient management on a case-by-case basis.

Funding Acknowledgement

Type of funding sources: None.

P13.15 Pre-clinical trial of T601 oncolytic virus for high grade glima via intra-tumoral injection

BACKGROUND

An effective therapeutic method still hasn’t been devised for lethal high grade glioma. Thus, a method with high anti-tumoral efficiency, tumoral targeting, and acceptable side effect needs to be designed. Oncolytic virotherapy which can specifically lyse tumor cells via mass replication and deleting nucleotide metabolism related gene, like TK, required in viral replication and overexpressed in tumor cells, provides hope for patients. However, the virus only contained TK deletion is unable to show sufficient specificity of anti-tumoral response in tumor cells. Here, the adapted strain of vaccinia virus with high tumoral specificity due to TK and RR deletion and FUC1 insertion, named T601, is chosen in this project. In clinical application, intra-tumoral injection showed improved anti-tumoral efficiency and acceptable side effect. However, intra-tumoral viral injection in orthotropic glioma model is rare. In this project, various biosafety and antitumoral efficiency parameter would be tested for confirming the biosafety and reliability of intra-tumoral T601 viral injection for future clinical trials.

MATERIAL AND METHODS

For measuring the IC50 of T601, 10 different amounts of virus was tested in vitro via calculating cell viability with CCK-8(cell counting kit-8). For measuring the further antitumoral response of FCU1, different concentration of the 5-FC was added into the medium with IC50 viral amount. To ensure the biosafety of T601, MTD (maximum tolerance dose) was measured. Based on the MTD result, for evaluating the anti-tumoral efficiency, 106 pfu,105 pfu,104 pfu of virus was intra-tumoral injected in orthotopic GBM bearing mice. Tumor size was measured once a week through in vivo bioimaging system.

RESULTS

0.022 MOI, the IC50 of T601, showed high cytotoxicity of T601. Moreover, the significantly decreased cell viability under the combined treatment of 5-FC and 0.22MOI T601 showed intact anti-tumoral function. In MTD assay, except for 107 group, no significant weight loss was found. However, in 107 pfu group, mean body weight decreased around 10% and animal fatality happened on day 9. According to the MTD result, certain amount of virus was intra-tumorally injected. In all treatment group, the tumor size was significantly shrined. At the same time, the survival rate of mice under viral treatment was significantly extended.

CONCLUSION

In summary, T601 exhibited efficient anti-tumoral function and acceptable side effect. T601 treatment prolonged the survival period of GBM mice with acceptable neurotoxicity, demonstrating that T601 contains necessary criterial for intra-tumoral injection. Ultimately, this project provided basic reference information of dose for future clinical trial.

Mechanisms of regulating NIS transport to the cell membrane and redifferentiation therapy in thyroid cancer

Iodine is an essential constituent of thyroid hormone. Active iodide accumulation in the thyroid is mediated by the sodium iodide symporter (NIS), comprising the first step in thyroid hormone biosynthesis, which relies on the functional expression of NIS on the cell membrane. The retention of NIS expressed in differentiated thyroid cancer (DTC) cells allows further treatment with post-operative radioactive iodine (RAI) therapy. However, compared with normal thyroid tissue, differentiated thyroid tumors usually show a decrease in the active iodide conveyance and NIS is generally retained within the cells, indicating that posttranslational protein transfer to the plasma membrane is abnormal. In recent years, through in vitro studies and studies of patients with DTC, various methods have been tested to increase the transport rate of NIS to the cell membrane and increase the absorption of iodine. An in-depth understanding of the mechanism of NIS transport to the plasma membrane could lead to improvements in RAI therapy. Therefore, in this review, we discuss the current knowledge concerning the post-translational mechanisms that regulate NIS transport to the cell membrane and the current status of redifferentiation therapy for patients with RAI-refractory (RAIR)-DTC.

A116 PROPHYLACTIC CLIPPING TO PREVENT DELAYED COLONIC POST-POLYPECTOMY BLEEDING: META-ANALYSIS OF RANDOMIZED AND OBSERVATIONAL STUDIES

Background

Delayed post-polypectomy bleeding (DPPB) is a commonly described adverse event following polypectomy. Prophylactic clipping may prevent DPPB in some patient subgroups. We performed a meta-analysis to assess both the efficacy and real-world effectiveness of prophylactic clipping.

Aims

We performed a meta-analysis to assess both the efficacy and real-world effectiveness of prophylactic clipping.

Methods

We performed a database search through March 2020 for clinical trials or observational studies assessing prophylactic clipping and DPPB. Pooled risk ratios (RR) were calculated using random effects models. Subgroup, sensitivity and meta-regression analyses were performed to elucidate clinical or methodological factors associated with effects on outcomes.

Results

A total of 2,771 citations were screened, with 11 randomized controlled trials (RCTs) and 9 observational studies included, representing 24,670 colonoscopies. DPPB occurred in 2.0% of patients overall. The pooled RR of DPPB was 0.47 (95% CI 0.29 – 0.77) from RCTs enrolling only patients with polyps ≥ 20 mm. Remaining pooled RCT data did not demonstrate a benefit for clipping. The pooled RR of DPPB was 0.96 (95% CI 0.61 – 1.51) from observational studies including all polyp sizes. For patients with proximal polyps of any size, the RR was 0.73 (95% CI 0.33 - 1.62) from RCTs. Meta-regression confirmed that polyp size ≥ 20 mm significantly influenced the effect of clipping on DPPB.

Conclusions

Pooled evidence demonstrates a benefit when clipping polyps measuring ≥ 20 mm, especially in the proximal colon. In lower-risk subgroups, prophylactic clipping should not be performed.

Funding Agencies

None

Clinical utility of expanded non-invasive prenatal screening and chromosomal microarray analysis in high-risk pregnancy

OBJECTIVE

To evaluate the utility of expanded non-invasive prenatal screening (NIPS), compared with chromosomal microarray analysis (CMA), for the detection of chromosomal abnormalities in high-risk pregnancies.

METHODS

This was a multicenter retrospective study of singleton pregnancies at high risk for chromosomal abnormality. Patients who underwent expanded NIPS and CMA sequentially during pregnancy from 2015 to 2019 were included in the analysis. Pregnancies with a positive result for sex chromosome aneuploidy were excluded as the full details could not be retrieved. The utility of expanded NIPS and CMA for detection of chromosomal abnormalities in this cohort was compared by assessing the concordance between the results.

RESULTS

Of the 774 included high-risk pregnancies, 550 (71.1%) had a positive NIPS result, while a positive CMA result was detected in 308 (39.8%) cases. The rate of full or partial concordance between NIPS and CMA was 82.2%, 59.6% and 25.0% for trisomies 21, 18 and 13, respectively. For rare aneuploidies and segmental imbalances, NIPS and CMA results were fully or partially concordant in 7.5% and 33.3% of cases, respectively. Copy-number variants < 5 Mb were detected more often by CMA, with an incidence of 7.9% (61/774) compared with 3.1% (24/774) by NIPS. A genetic aberration was detected by CMA in 1 in 17 (5.8%) high-risk pregnancies that had a negative or non-reportable NIPS result.

CONCLUSION

CMA allows for comprehensive detection of genome-wide chromosomal abnormalities in high-risk pregnancies. CMA should be offered instead of expanded NIPS for high-risk pregnancies. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

Identification and validation of a hub gene prognostic index for hepatocellular carcinoma

Aims: We aim to provide new insights into the mechanisms of hepatocellular carcinoma (HCC) and identify key genes as biomarkers for the prognosis of HCC. Materials & methods: Differentially expressed genes between HCC tissues and normal tissues were identified via the Gene Expression Omnibus tool. The top ten hub genes screened by the degree of the protein nodes in the protein-protein interaction network also showed significant associations with overall survival in HCC patients. Results: A prognostic model containing a five-gene signature was constructed to predict the prognosis of HCC via multivariate Cox regression analysis. Conclusion: This study identified a novel five-gene signature (CDK1, CCNB1, CCNB2, BUB1 and KIF11) as a significant independent prognostic factor.

How common is aortic dilatation?

Funding Acknowledgements

Type of funding sources: None.

Introduction

Aortic dilatation is most commonly associated with hypertension, bicuspid aortic valve and connective tissue diseases such as Marfan’s. It is a precursor to life threatening complications such as rupture or dissection of the aorta. The current ESC Guidelines recommend surgical intervention once the aortic diameter is &gt;50 mm in patients with Marfan syndrome (Ic) and &gt;55 mm in patients with a bicuspid or normal aortic valve morphology (IIb). There is currently a lack of literature on the prevalence of aortic dilatation in the general or even hospital population although there is historical data suggesting the incidence of thoracic aortic aneurysm to be 5.9 cases per 100,000.

Purpose

The aim is to investigate the prevalence of aortic dilatation by echocardiography in our hospital population which may help lay the foundation for population studies and identify prognostic factors which may determine the time of surgical intervention.

Methods

We carried out a retrospective survey using the digital echocardiogram archive and the electronic patient record system at our hospital. This survey covered the period between 1st October 2016 and 1st November 2018. For randomisation  purposes, all transthoracic echocardiograms (TTE) performed on every Thursday during this period were included. All patients with an echocardiographic report of aortic root or ascending aorta dilatation were enrolled. Other information including echocardiographic dimensions along with demographics and past medical history was collected.

Results

During this 24-month period, we analysed a total of 3019 TTEs. 209 patients (6.9%) were reported to have aortic dilatation. 137 (66%) were male and the median age was 67 years. The mean height and weight were 169cm and 80kg, respectively.  A bicuspid aortic valve was confirmed in 10 (4.8%) patients. 132 (63%) patients had a history of hypertension. On echocardiogram, 75 (36%) patients had septal hypertrophy and 26 (12.4%) had a dilated left ventricle.  

Conclusion

Our findings are unique and for the first time, to our knowledge, we report the echocardiographic prevalence of aortic dilatation in the hospital population (6.9%). It is a staggering 40-fold increase when compared to the the prevalence of aortic aneurysm, the most likely end point of aortic dilatation. Based on our figures, there would be at least 400 patients with a dilated aorta in a year in our hospital alone. The prevalence of bicuspid aortic valve in our cohort (4.8%) was nearly three times higher than the general population where it is quoted as 1-2%. Our study also emphasised the established link between hypertension and aortic dilatation with an increased frequency in our cohort (63%) compared to the global prevalence (31%). Given the devastating sequelae of aortic dilatation and its increased prevalence in our patient population, it will be very important to keep these patients under routine surveillance and particularly those with hypertension.

Long noncoding RNA GAS5 attenuates cardiac fibroblast proliferation in atrial fibrillation via repressing ALK5

OBJECTIVE

Recently, long noncoding RNAs (lncRNAs) have caught more attention for their role in the progression of many diseases. Among them, lncRNA GAS5 (Growth Inhibition Specificity 5) was studied in this research to identify how it affects the progression of atrial fibrillation (AF).

PATIENTS AND METHODS

In 40 patients with AF and 30 patients with sinus rhythm (SR), the GAS5 expression of the right atrial appendage (RAA) tissues was detected by the quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Moreover, the cell proliferation assay was conducted in AC16 cells transfected with GAS5 inhibitor and mimics, respectively. Furthermore, the qRT-PCR was performed to uncover the mechanism.

RESULTS

In the research, the expression of GAS5 in RAA tissues was decreased significantly in AF patients than that in SR ones. Moreover, overexpression of GAS5 inhibited cell growth in AC16 cells, while knockdown of GAS5 promoted cell growth in AC16 cells. In addition, further experiments revealed that ALK5 was a target of GAS5 and its expression in AF tissues negatively correlated to GAS5 expression.

CONCLUSIONS

These results indicate that GAS5 could inhibit cell proliferation of AF via suppressing ALK5, which may offer a new vision for interpreting the mechanism of AF development.