Early-life risk factors, accelerated biological aging and the late-life risk of mortality and morbidity

BACKGROUND

Early-life exposure increases health risks throughout an individual's lifetime. Biological aging is influenced by early-life risks as a key process of disease development, but whether early-life risks could accelerate biological aging and elevate late-life mortality and morbidity risks remains unknown. Knowledge is also limited on the potential moderating role of healthy lifestyle.

METHODS

We investigate associations of three early-life risks around birth, breastfeeding, maternal smoking and birth weight, with biological aging of 202 580 UK Biobank participants (54.9 ± 8.1 years old). Biological aging was quantified as KDM-BA, PhenoAge and frailty. Moderate alcohol intake, no current smoking, healthy diet, BMI <30 kg/m2 and regular physical activity were considered as healthy lifestyles. Mortality and morbidity data were retrieved from health records.

RESULTS

Individual early-life risk factors were robustly associated with accelerated biological aging. A one-unit increase in the 'early-life risk score' integrating the three factors was associated with 0.060 (SE=0.0019) and 0.036-unit (SE = 0.0027) increase in z-scored KDM-BA acceleration and PhenoAge acceleration, respectively, and with 22.3% higher odds (95% CI: 1.185-1.262) of frailty. Increased chronological age and healthy lifestyles could mitigate the accelerations of KDM-BA and PhenoAge, respectively. Associations of early-life risk score with late-life mortality and morbidity were mediated by biological aging (proportions: 5.66-43.12%). KDM-BA and PhenoAge accelerations could significantly mediate the impact on most outcomes except anxiety, and frailty could not mediate the impact on T2D.

CONCLUSION

Biological aging could capture and mediate the late-life health risks stemming from the early-life risks, and could be potentially targeted for healthy longevity promotion.

Dynamic Reversible Oxidation-Reduction of Iodide Ions for Operationally Stable Perovskite Solar Cells under ISOS-L-3 Protocol

Despite rapid advancements in the photovoltaic efficiencies of perovskite solar cells (PSCs), their operational stability remains a significant challenge for commercialization. This instability mainly arises from light-induced halide ion migration and subsequent oxidation into iodine (I2). The situation is exacerbated when considering the heat effects at elevated temperatures, leading to the volatilization of I2 and resulting in irreversible device degradation. Mercaptoethylammonium iodide (ESAI) is thus incorporated into perovskite as an additive to inhibit the oxidation of iodide anion (I-) and  the light-induced degradation pathway of FAPbI3→FAI+PbI2. Additionally, the formation of a thiol-disulfide/I--I2 redox pair within the perovskite film provides a dynamic mechanism for the continuous reduction of I2 under light and thermal stresses, facilitating the healing of iodine-induced degradations. This approach significantly enhances the operational stability of PSCs. Under the ISOS-L-3 testing protocol (maximum power point (MPP) tracking in an environment with relative humidity of ≈50% at ≈65 °C), the treated PSCs maintain 97% of their original power conversion efficieney (PCE) after 300 h of aging. In contrast, control devices exhibit almost complete degradation, primarily due to rapid thermal-induced I2 volatilization. These results demonstrate a promising strategy to overcome critical stability challenges in PSCs, particularly in scenarios involving thermal effects.

Causal relationship between cigarette smoking behaviors and the risk of hernias: a Mendelian randomization study

PURPOSE

As the global population continues to age, there is a noticeable yearly rise in the incidence of hernias. Simultaneously, smoking, a widespread addictive behavior and a significant contributor to mortality, has evolved into a pervasive public health concern. Existing literature has already established a connection between smoking and an increased risk of postoperative recurrence and postoperative infections following hernia surgery. However, there remains a dearth of research exploring the association between smoking and hernia morbidity. In this study, our objective is to systematically evaluate the causal relationship between cigarette smoking behaviors and hernia morbidity using a Mendelian randomization (MR) approach.

METHODS

Hernia-related data were sourced from the FinnGen Biobank database, while cigarette smoking behavior data were gathered from the GWAS and Sequencing Consortium of Alcohol and Nicotine Use. To assess the causal relationship, we employed five methods: the weighted median, the weighted mode the inverse variance weighted (IVW), MR-Egger, and the simple mode. Sensitivity analysis was conducted, incorporating Cochran's Q test, the MR-Egger intercept test, leave-one-out analysis, and funnel plot. The presentation of the causal relationship is expressed as an odds ratio (OR) along with their corresponding 95% confidence intervals (CI).

RESULTS

Employing the IVW method as the reference standard, we found that smoking intensity is associated with an increased risk of diaphragmatic hernia (OR = 1.21, 95% CI 1.00-1.46, P = 0.047). These consistent findings were further corroborated by the weighted median and weighted mode methods (OR = 1.26, 95% CI 1.03-1.54, P = 0.026; OR = 1.25, 95% CI 1.02-1.52, P = 0.045). Conversely, when applying the IVW method, we identified no statistically significant causal relationship between smoking age, smoking initiation status, smoking cessation status, and the incidence of hernia.

CONCLUSIONS

Our MR study has uncovered genetic evidence linking smoking intensity and the occurrence of diaphragmatic hernia. The risk of developing diaphragmatic hernia rises in tandem with the intensity of smoking. This emphasizes the crucial role of regularly advising patients to cease smoking in clinical settings.

[Use of the ETV6/RUNX1 probe to verify the performance of the fluorescence in situ hybridization probe before clinical detection]

Objective: To explore the standardized performance of a FISH probe before clinical detection. Methods: The probe sensitivity and specificity of ETV6/RUNX1 were analyzed via interphase and metaphase FISH in 20 discarded healthy bone marrow samples. The threshold system of the probe was established using an inverse beta distribution, and an interpretation standard was established. Finally, a parallel-controlled polymerase chain reaction detection study was conducted on 286 bone marrow samples from patients at our hospital. The clinical sensitivity, specificity, and diagnostic coincidence rate of ETV6/RUNX1 FISH detection were analyzed, and the diagnostic consistency of the two methods was analyzed by the kappa test. Results: The probe sensitivity and specificity of the ETV6/RUNX1 probe were 98.47% and 100%, respectively. When 50, 100, and 200 cells were counted, the typical positive signal pattern cutoffs were 5.81%, 2.95%, and 1.49%, respectively, and the atypical positive signal pattern cutoffs were 13.98%, 9.75%, and 6.26%, respectively. The clinical sensitivity of FISH was 96.1%, clinical specificity was 99.6%, diagnostic coincidence rate was 99.00%, diagnostic consistency test kappa value was 0.964, and P value was <0.001. Conclusion: For FISH probes without a national medical device registration certificate, standardized performance verification and methodology performance verification can be performed using laboratory developed test verification standards to ensure a reliable and accurate reference basis for clinical diagnosis and treatment.

ITGB4 upregulation is associated with progression of lower grade glioma

Gliomas originating in the neuroepithelium account for about 80% of brain malignancies and are the most common cancer of the central nervous system. Clinical management of gliomas remains challenging despite significant advances in comprehensive therapies, including radiotherapy, chemotherapy, and surgery. The ITGB4 (Integrin subunit beta 4) gene encodes a receptor for laminins and its upregulation in tumor tissues is associated with poor prognosis. However, its role in glioma is not well understood. First, we performed a pan cancer analysis of ITGB4 expression in The Cancer Genome Atlas (TCGA) dataset. Survival analysis was done on Chinese Glioma Genome Atlas (CGGA) and TCGA. Immunohistochemistry was then used to validate the expression and role of ITGB4 in glioma. We finally analyzed the possible mechanism by immune infiltration and single-cell sequencing analysis. Here, we found that ITGB4 is upregulated in glioma and accurately predicts the prognosis of lower grade glioma (LGG). Univariate and multivariate Cox regression analyses showed that ITGB4 is a risk factor for LGG. Immunohistochemical analysis confirmed that ITGB4 accurately predicts LGG prognosis. Non-negative matrix factorization (NMF) cluster analysis showed that ITGB4 was closely related to immune related genes. Immune cell infiltration and single cell sequencing analyses indicated that ITGB4 may be closely related to the microenvironment of gliomas, especially tumor-associated fibroblasts. ITGB4 is a promising diagnostic and therapeutic factor in LGG patients.

Combining HD-tDCS with music stimulation for patients with prolonged disorders of consciousness: Study protocol for an RCT trial

BACKGROUND

Patients with prolonged disorders of consciousness (pDOC) pose significant challenges to healthcare workers due to their severe motor impairments and limited interaction with the environment. Non-invasive brain stimulation such as high-definition transcranial direct current stimulation (HD-tDCS) and music stimulation show promise in awakening this population.

OBJECTIVE

In this study, we present a protocol aiming at investigating the efficacy of combined HD-tDCS and music stimulation in awakening patients with pDOC through a single-blind, randomized controlled trial.

METHODS

Ninety patients with pDOC will be randomly divided into three groups: active HD-tDCS with music stimulation, active HD-tDCS, and sham HD-tDCS. All participants will receive 20 treatment sessions over a period of 10 days and the Coma Recovery Scale-Revised, Glasgow Outcome Scale and electroencephalogram will be used as assessment measures to evaluate their level of consciousness throughout the study. Adverse events and complications will be recorded during treatment. Within-group pre-post comparisons and between-group efficacy comparisons will be conducted to identify the most effective intervention approach. Statistical analysis will be performed using SPSS software with a significance level set at P < 0.05.

CONCLUSION

The pursuit of awakening therapy for patients with pDOC remains a clinical research challenge. This study protocol is designed with the aim of introducing an innovative non-pharmacological approach which combined HD-tDCS and music stimulation to facilitate the reinstatement of consciousness in patients with pDOC.

Deciphering the interaction between Twist1 and PPARγ during adipocyte differentiation

Obesity, a worldwide epidemic in recent years, is mainly due to the uncontrolled development of adipose tissues, which includes adipocyte hypertrophy and hyperplasia. Adipocyte differentiation is a process involving multiple transcription factor cascades, and the exact mechanism has not yet been defined. As a bHLH transcription factor, Twist1 exerts its activity by forming homo- or heterodimers with other factors. In this study, we showed Twist1 restricts adipogenesis through PPARγ. Expression of various differentiation markers (including PPARγ and adiponectin) and triglyceride-containing lipid droplets were decreased with overexpression of Twist1. Pathway enrichment analysis of RNA-seq data showed that differentially expressed genes (DEGs) caused by Twist1 overexpression were significantly related to lipolysis and PPARγ signaling. This implicates that Twist1 plays important regulatory roles in these processes. ChIP and dual luciferase assays showed that Twist1 could bind either PPARγ or adiponectin promoter to repress their respective transcription or directly to PPARγ protein to regulate its transcriptional activity. Furthermore, Twist1 directly interacted RXRα, which usually forms heterodimer with PPARγ to regulate adipogenesis. Taken together, our results suggest that Twist1 is an inhibitory modulator of adipogenesis and its function is likely through direct interaction with PPARγ protein or its gene promoter.

[Evaluation of the clinical manifestations of COVID-19 in patients with aplastic anemia undergoing immunosuppressive therapy: a prospective cohort study (NICHE)]

Objective: To investigate the clinical features of coronavirus disease 2019 (COVID-19) in patients with aplastic anemia (AA) undergoing immunosuppressive therapy (IST) . Methods: In this prospective cohort study, we collected the demographic and clinical data of patients with AA and COVID-19 from December 1, 2022, to January 31, 2023. We described the clinical features of COVID-19 among patients with AA and evaluated the effects of IST on the signs and severity of COVID-19. Results: A total of 170 patients with AA and COVID-19 were included. The common early symptoms, including fever, dizziness or headache, muscle or body aches, and sore throat, disappeared within 1-2 weeks. Approximately 25% of the patients had persistent fatigue within 2 weeks. Many patients experienced cough after an initial 1-3 days of infection, which lasted for more than 2 weeks. There were no differences in the duration of total fever episodes and maximum body temperature when patients were stratified according to whether or not they underwent IST, by IST duration, or by use of anti-lymphocyte globulin (ALG) (P>0.05). No differences were observed in the occurrence of symptoms in either the early or recovery stages when patients with AA were stratified according to whether or not they underwent IST, or by IST duration (P>0.05). However, patients who received ALG had fewer fever episodes within 1 week after infection (P=0.035) and more sore throat episodes within 2 weeks after infection (P=0.015). There were no other significant differences in clinical symptoms between patients who did and patients who did not receive ALG (P>0.05) . Conclusion: The majority of patients with AA and COVID-19 recovered within 2 weeks of noticing symptoms when treated with IST.

Visualization of the elevated levels of hypochlorous acid in Alzheimer's disease with a ruthenium(II) complex-based luminescence probe

Alzheimer's disease (AD) is an age-related neurodegenerative disorder that devastatingly affects people's lives. Accumulating evidence indicates that the pathological progression of AD is inseparably connected with hypochlorous acid (HClO). However, further exploring the biological function remains an open challenging due to a lack of effective tools to image HClO in AD brains. To this end, a ruthenium(II) luminescence probe, Ru-HClO, is developed for quantitative detection and visualization of HClO in nerve cells and AD brains. Ru-HClO shows quenched luminescence due to the PET process (excited electron transfer from Ru(II) center to diaminomaleonitrile) and the CN bond isomerization in the excited state. The HClO-triggered specific cleavage reaction with Ru-HClO cleaves the CN bond to form highly luminescent Ru-COOH. Ru-HClO shows rapid response speed, high sensitivity and selectivity, excellent biocompatibility, which makes the probe to be applied to semi-quantitative analysis of HClO in nerve cells and high-throughput screening of anti-AD drugs in the AD cell model. Moreover, using Ru-HClO as a probe, present work further validated that the elevated levels of HClO secretion were accompanied by the AD progressed. These findings may provide valuable results for figuring out the biological roles that HClO played in AD but also for accelerating anti-AD therapeutic discovery.

Effect of dietary lutein on the egg production, fertility, and oxidative injury indexes of aged hens

OBJECTIVE

The present study aimed to investigate the effect of dietary lutein on egg production, follicles, reproductive hormones, fertility, hatchability, and oxidative injury indexes of hens.

METHODS

Treatments consisted of a control diet (CON) and three lutein-supplementing diets at 25 (L1), 50 (L2), or 75 (L3) mg/kg of diet. Egg production was measured using 576 Arbor Acres breeder hens at 61 to 65 wk and follicles grades, reproductive hormones, fertility, hatchability, tissue lutein contents, and oxidative injury indexes were determined at 65 wk.

RESULTS

The results showed that at 65 wk, lutein- supplementing diets increased (p<0.05) egg production, follicular grades, fertility, hatchability, estradiol (E2), luteinizing hormone, progesterone (PROG), lutein content in the serum and yolk, compared to CON. L2 and L3 showed more pronounced (p<0.05) effects on egg production, PROG, and yolk lutein content than L1. With the increase of lutein doses from 25 to 75 mg/kg, there were linear increases (p<0.05) in egg production, lutein content, and PROG, and a quadratic trend (p<0.05) in E2. For the oxidative injury products, lutein-supplementing diets decreased (p<0.05) malondialdehyde (MDA) and protein carbonyl (PCO) in the serum, MDA and 8-hydroxy 2 deoxyguanosine (8-OHdG) in the yolk. There were linear decreases (p<0.05) in 8-OHdG in the serum, MDA, PCO, and 8-OHdG in the yolk, a quadratic trend (p<0.05) on serum 8-OHdG.

CONCLUSION

It is concluded that lutein supplementation can improve egg production and fertility by beneficially regulating reproductive hormones and oxidative status in aged hens.

Krill oil treatment ameliorates lipid metabolism imbalance in chronic unpredicted mild stress-induced depression-like behavior in mice

The pathology of depression involves various factors including the interaction between genes and the environment. The deficiency of n-3 polyunsaturated fatty acids (n-3 PUFAs) in the brain and depressive symptoms are closely related. Krill oil contains abundant amounts of n-3 PUFAs incorporated in phosphatidylcholine. However, the effect of krill oil treatment on depression-like behaviors induced by chronic stress and its molecular mechanism in the brain remain poorly understood. Here, we used a chronic unpredictable mild stress (CUMS) model to evaluate the effect of krill oil on depression-like behaviors and explored its molecular mechanism through lipid metabolomics and mRNA profiles in the whole brain. We observed that CUMS-induced depression-like behaviors were ameliorated by krill oil supplementation in mice. The metabolism of glycerophospholipids and sphingolipids was disrupted by CUMS treatment, which were ameliorated after krill oil supplementation. Further analysis found that differently expressed genes after krill oil supplementation were mainly enriched in the membrane structures and neuroactive ligand-receptor interaction pathway, which may be responsible for the amelioration of CUMS-induced depression-like behaviors. Altogether, our results uncovered the relationship between lipid metabolism and CUMS, and provided new strategies for the prevention and treatment of depression.

[Value of Improved Mayo Endoscopic Score for evaluating treatment efficacy for active ulcerative colitis]

OBJECTIVE

To assess the value of Improved Mayo Endoscopic Score (IMES) for evaluation of treatment efficacy for active ulcerative colitis (UC).

METHODS

We retrospectively analyzed the clinical and endoscopic data of 103 patients diagnosed with active UC in Beijing Tsinghua Changgung Hospital from January, 2015 to December, 2020. The severity of endoscopic lesions was determined by Mayo Endoscopic Score and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and the area of the endoscopic lesions was evaluated based on the Montreal classification system. The IMES was established by combining the MES with the Montreal classification.

RESULTS

Univariate analysis suggested that young patients (<40 years old), patients with extensive disease type (E3), patients with high endoscopic scores (MES=3, UCEIS>4, and IMES>4), and patients receiving advanced drug therapy (with systemic hormones, immunosuppressants, immunomodulators, and biological agents, etc.) had lower clinical and endoscopic remission rates. COX survival analysis showed that IMES≤4 was an independent risk factor for clinical and endoscopic remission. ROC curve indicated that the predictive value of IMSE≤4 for clinical and endoscopic remission (AUC=0.7793 and 0.7095, respectively; P<0.01) was better than that of Montreal (AUC=0.7357 and 0.6847, respectively; P<0.01), MES=2 (AUC=0.6671 and 0.5929, respectively; P<0.01), and UCEIS≤4 (AUC=0.6823 and 0.6459, respectively; P<0.01); IMES=5 had a better predictive value for patients with active UC undergoing colectomy tham E3 and MES=3.

CONCLUSION

IMES has good value in evaluating treatment efficacy for active UC.

[Genomics of next generation sequencing in pediatric B-acute lymphoblastic leukemia and its impact on minimal residual disease]

Objective: To describe the gene mutation profile of newly diagnosed pediatric B-acute lymphoblastic leukemia (B-ALL) and analyze its effect on minimal residual disease (MRD). Methods: A total of 506 newly diagnosed B-ALL children treated in Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences from September 2018 to July 2021 were enrolled in this retrospective cohort study. The enrolled children were divided into MRD ≥1.00% group and <1.00% group according to MRD results on the 19th day since chemotherapy, and MRD ≥0.01% group and <0.01% group according to MRD results on the 46th day. Clinical characteristics and gene mutations of two groups were compared. Comparisons between groups were performed with chi-square test or Fisher's exact test. Independent risk factors of MRD results on the 19th day and the 46th day were analyzed by Logistic regression model. Results: Among all 506 patients, there were 318 males and 188 females. On the 19th day, there were 114 patients in the MRD ≥1.00% group and 392 patients in the MRD <1.00% group. On the 46th day, there were 76 patients in the MRD ≥0.01% group and 430 patients in the MRD <0.01% group. A total of 187 gene mutations were detected in 487 (96.2%) of 506 children. The most common gene mutations were signal transduction-related KRAS gene mutations in 111 cases (22.8%) and NRAS gene mutations in 99 cases (20.3%). Multivariate analysis showed that PTPN11 (OR=1.92, 95%CI 1.00-3.63), KMT2A (OR=3.51, 95%CI 1.07-11.50) gene mutations and TEL-AML1 (OR=0.48, 95%CI 0.27-0.87), BCR-ABL1 (OR=0.27, 95%CI 0.08-0.92) fusion genes and age >10 years (OR=1.91, 95%CI 1.12-3.24) were independent influencing factors for MRD ≥1.00% on the 19th day. BCORL1 (OR=2.96, 95%CI 1.18-7.44), JAK2 (OR=2.99, 95%CI 1.07-8.42) and JAK3 (OR=4.83, 95%CI 1.50-15.60) gene mutations and TEL-AML1 (OR=0.43, 95%CI 0.21-0.87) fusion gene were independent influencing factors for MRD ≥0.01% on the 46th day. Conclusions: Children with B-ALL are prone to genetic mutations, with abnormalities in the RAS signaling pathway being the most common. Signal transduction related PTPN11, JAK2 and JAK3 gene mutations, epigenetic related KMT2A gene mutation and transcription factor related BCORL1 gene mutation are independent risk factors for MRD.

Rational design on high-performance triboelectric nanogenerator consisting of silicon carbide@silicon dioxide nanowhiskers/polydimethylsiloxane (SiC@SiO2/PDMS) nanocomposite films

The relatively low output performance of triboelectric nanogenerator (TENG), which faces a challenge in performance improvement, limits its practical applications. Here, a high-performance TENG consisting of a silicon carbide@silicon dioxide nanowhiskers/polydimethylsiloxane (SiC@SiO2/PDMS) nanocomposite film and a superhydrophobic aluminum (Al) plate as triboelectric layers is demonstrated. The 7 wt% SiC@SiO2/PDMS TENG presents a peak voltage of 200 V and a peak current of 30 μA, which are ~ 300 and ~ 500% over that of the PDMS TENG, owing to an increase in dielectric constant and a decrease in dielectric loss of the PDMS film because of electric insulated SiC@SiO2 nanowhiskers. Furthermore, a 10 μF capacitor can be charged up to 3 V within ~ 87 s, which can be continuously operated on the electronic watch for 14 s. The work provides an effective strategy for improving output performance of TENG by adding core-shell nanowhiskers to modulate the dielectric properties of organic materials.

LncRNA RASSF8-AS1 knockdown displayed antiproliferative and proapoptotic effects through miR-188-3p/ATG7 pathway in ox-LDL-treated vascular smooth muscle cells

BACKGROUND

Long noncoding RNA (lncRNA)-mediated changes in gene expression contribute to atherosclerosis (AS) development. However, the roles of numerous lncRNAs in AS have not been fully elucidated. Here, we aimed to investigate the potential role of lncRNA RASSF8-AS1 (RASSF8-AS1) in autophagy of human aortic vascular smooth muscle cells (HA-VSMCs).

METHODS

RASSF8-AS1 expression in patients with AS was extracted from the Gene Expression Omnibus (GEO) database. RASSF8-AS1 and microRNA-188-3p (miR-188-3p) expression was analyzed in 20 enrolled patients with AS. HA-VSMCs were treated with oxidized low-density lipoprotein (ox-LDL) (25, 50, 75, and 100 µg/mL) for 24 h. Loss- or gain-of-function of RASSF8-AS1, miR-1883p, and autophagy-related 7 (ATG7) was studied using the transfected HA-VSMCs. Cell viability was assessed using Cell Counting Kit-8 (CCK-8). Apoptosis was detected with annexin V-fluorescein isothiocyanate (FITC) and propidium iodide (PI). Relative luciferase reporter assay was used to confirm the targeting relationship of miR-188-3p to RASSF8-AS1 or ATG7. Gene expression was detected by quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot.

RESULTS

RASSF8-AS1 was enriched in the serum of patients with AS and ox-LDL-treated HA-VSMCs. Ox-LDL induced proliferation and autophagy while inhibiting the apoptosis of HA-VSMCs, which was abated by RASSF8-AS1 knockdown. RASSF8-AS1 downregulated miR-188-3p of ox-LDL-treated HA-VSMCs. RASSF8-AS1 knockdown caused an increase in miR-188-3p, which inhibited proliferation and autophagy and induced the apoptosis of ox-LDL-treated HA-VSMCs. miR-188-3p inhibited ATG7 expression in ox-LDL-treated HA-VSMCs. RASSF8-AS1 elevated ATG7 and induced autophagy through sponging miR-188-3p in ox-LDL-treated HA-VSMCs.

CONCLUSIONS

RASSF8-AS1 regulated autophagy by targeting miR-188-3p, a messenger RNA-binding miRNA that increases ATG7 level, which may be a new target molecule for the prevention and prognosis of AS.

Proteomics and Metabolomics Analysis Reveals the Toxicity of ZnO Quantum Dots on Human SMMC-7721 Cells

Purpose

ZnO quantum dots (QDs) are composed of less toxic metals than other QDs but have the same interesting photochemical properties. Thus, they have received considerable attention recently. Nevertheless, their toxicity cannot be ignored.

Methods

In this study, we incubated ZnO QDs with human SMMC-7721 cells for 24 h to assess their nanotoxicity through proteomics (Fold change >1.5 and p-value <0.05) and metabolomics (Fold change ≥ 1.5; VIP ≥ 1; p-value < 0.05) analyses.

Results

Both of 174 and 219 significantly changed metabolites were identified in human SMMC-7721 cells treated with 20 and 50 µg/mL ZnO QDs, respectively. ZnO QDs significantly modified metabolic pathways, including purine metabolism, ferroptosis, morphine addiction, alcoholism, cGMP-PKG signaling, and Cushing syndrome. Moreover, we identified 105 and 8 differentially expressed proteins in cells treated with 20 and 50 µg/mL ZnO QDs, and the pathways of alcoholism and Cushing syndrome were enriched.

Conclusion

ZnO QDs did not affect cell viability in a CCK8 assay, but disturbed the level of intracellular metabolites and proteins at 20 µg/mL. The KEGG analyses of the metabolomics and proteomics data both enriched the alcoholism and Cushing syndrome pathways. These results provide an experimental basis for future research on the safe use of nanomaterials.

Non-human primate models and systems for gait and neurophysiological analysis

Brain-computer interfaces (BCIs) have garnered extensive interest and become a groundbreaking technology to restore movement, tactile sense, and communication in patients. Prior to their use in human subjects, clinical BCIs require rigorous validation and verification (V&V). Non-human primates (NHPs) are often considered the ultimate and widely used animal model for neuroscience studies, including BCIs V&V, due to their proximity to humans. This literature review summarizes 94 NHP gait analysis studies until 1 June, 2022, including seven BCI-oriented studies. Due to technological limitations, most of these studies used wired neural recordings to access electrophysiological data. However, wireless neural recording systems for NHPs enabled neuroscience research in humans, and many on NHP locomotion, while posing numerous technical challenges, such as signal quality, data throughout, working distance, size, and power constraint, that have yet to be overcome. Besides neurological data, motion capture (MoCap) systems are usually required in BCI and gait studies to capture locomotion kinematics. However, current studies have exclusively relied on image processing-based MoCap systems, which have insufficient accuracy (error: ≥4° and 9 mm). While the role of the motor cortex during locomotion is still unclear and worth further exploration, future BCI and gait studies require simultaneous, high-speed, accurate neurophysiological, and movement measures. Therefore, the infrared MoCap system which has high accuracy and speed, together with a high spatiotemporal resolution neural recording system, may expand the scope and improve the quality of the motor and neurophysiological analysis in NHPs.

Alleviating effect of mulberry leaf 1-deoxynojirimycin on resistin-induced hepatic steatosis and insulin resistance in mice

Resistin is upregulated in obese humans and mice, and elevated serum resistin induces insulin resistance and hepatic steatosis. Previous studies have revealed that mulberry 1-deoxynojirimycin (DNJ) is important for a variety of physiological processes, especially carbohydrate and lipid metabolism. However, it remains unclear whether DNJ has a positive effect on insulin resistance and hepatic steatosis, and what the exact mechanism is. Male C57BL/6J mice were treated with resistin with or without DNJ. DNJ reversed the homeostasis model assessment of insulin resistance (HOMA-IR)-induced by resistin and significantly decreased triglyceride levels both in the serum and liver. A histological analysis demonstrated that lipid accumulation significantly decreased in the DNJ group compared to the resistin group. A mechanistic analysis showed that DNJ significantly inhibited the resistin-induced decline in enzyme activities of hormone-sensitive lipase (HSL) and hepatic lipase (HL) in serum and lipoprotein lipase (LPL) in liver. FAS and Acox13α were significantly altered by resistin but restored by DNJ. Furthermore, DNJ partially but significantly restored insulin-stimulated glucose uptake compared with the resistin group, suggesting that DNJ reversed the insulin sensitivity impaired by hyperresistinemia. Treatment of AML12 cells with DNJ significantly restored the expression level and phosphorylation of Akt. The transcriptional levels of InsR and IRS1, as well as the protein levels of InsR and Glut4 and phosphorylation of PI3K and GSK3β, were also normalized in the DNJ-treated group. In conclusion: mulberry DNJ significantly alleviated liver steatosis and insulin resistance in hyperresistinemia.

Predictive model for deep venous thrombosis caused by closed lower limb fracture after thromboprophylactic treatment

OBJECTIVE

Currently, there are still no convincing clinical models predicting closed lower extremity fracture-associated deep vein thrombosis in patients treated through thromboprophylactic methods. We aimed at using two retrospective cohorts to develop and externally verify a clinical prediction model for deep vein thrombosis in patients treated with anticoagulants after suffering closed lower extremity fractures.

PATIENTS AND METHODS

We evaluated the patients' pre- and post-operatively, to accurately determine the predictive power of the biomarkers and clinical risk factors. Two retrospective cohorts were used for the development and external verification of a pre-operative clinical prediction model (development: n = 2,253; verification: n = 833) and post-operative clinical prediction model (development: n = 1,422; verification: n = 449), respectively.

RESULTS

The C-indices were used to show the predicted incidence of objective thrombosis at the pre- and post-operative stage, which were then compared with the observed incidence of thrombosis in both cohorts. Biomarkers and clinical indicators were included in pre- and post-operative nomograms, which were adequately calibrated in both cohorts. The cross-validated C-indices of the pre- and post-operative clinical prediction models in the verification cohort were 0.706 (95% Cl, 0.67-0.74) and 0.875 (95% Cl, 0.84-0.91), respectively.

CONCLUSIONS

We present our findings of novel pre- and post-operative nomograms for the prediction of deep venous thrombosis in patients who received thromboprophylaxis after suffering closed lower extremity fractures.

Exceptional spectrum and dynamic magnetization

A macroscopic effect can be induced by a local non-Hermitian term in a many-body system, when it manifests simultaneously level coalescence of a full real degeneracy spectrum, leading to exceptional spectrum. In this paper, we propose a family of systems that support such an intriguing property. It is generally consisted of two arbitrary identical Hermitian sub-lattices in association with unidirectional couplings between them. We show exactly that all single-particle eigenstates coalesce in pairs even only single unidirectional coupling appears. It means that all possible initial states obey the exceptional dynamics, resulting in some macroscopic phenomena, which never appears in a Hermitian system. As an application, we study the dynamic magnetization induced by complex fields in an itinerant electron system. It shows that an initial saturated ferromagnetic state at half-filling can be driven into its opposite state according to the dynamics of high-order exceptional point. Any Hermitian quench term cannot realize a steady opposite saturated ferromagnetic state. Numerical simulations for the dynamical processes of magnetization are performed for several representative situations, including lattice dimensions, global random and local impurity distributions. It shows that the dynamic magnetization processes exhibit universal behavior.

Chronic unpredictable mild stress-induced mouse ovarian insufficiency by interrupting lipid homeostasis in the ovary

Ovarian insufficiency results from a number of disorders, and a certain causal relationship between psychological stress and ovarian insufficiency has been reported, but the underlying mechanism remains unclear. In our study, C57BL/6J female mice were subjected to chronic unpredictable mild stress (CUMS), and depression-like mice were selected and identified according to the behavioral tests. The defective ovarian follicle development, low 17 β-estradiol (E₂), and anti-Mullerian hormone (AMH) levels, which were consistent with the clinical characteristics of ovarian insufficiency, indicated that depression-like mice may be used to assess the effects of psychological stress on female reproductive function. To investigate a possible mechanism, lipid homeostasis of the ovary was detected by liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis, and the decreased abundance of cholesteryl ester (CE 24:4) was supported to be associated with the downregulated E₂. Moreover, granulosa cells did undergo more apoptosis in response to psychological stress, which was caused by downregulated Bcl2 and Bcl2/Bax in granulosa cells. Additionally, the disorder of cell death and growth-related pathways in depression-like mouse ovaries was confirmed by RNA-seq analysis. Taken together, this study will provide a better understanding of the female reproductive problem under psychological stress.

Molecular changes in nucleus accumbens due to amelioration of depressive-like behavior by housing with companion

Social support are positively and causally related to mental health. Higher levels of perceived social support and group memberships are shown to be associated with lower depression symptomatology and recovery from depression, but the molecular biological mechanism behind its remains largely unknown. Here, we report that accompanying with companion ameliorated chronic unpredictable mild stress (CUMS) induced depression-like behaviors in mice. Accompanying with companion altered RNA expression profiles of nucleus accumbens (NAc) in CUMS-induced susceptible and resilience mice. 117 differentially expressed genes (DEGs) were found to be associated with depression-like behaviors, 17 DEGs associated with resilient behaviors, 43 DEGs associated with accompanying with companion. Importantly, 234 differentially expressed miRNAs that associated with accompanying with companion were obtained, and the miRNA-mRNA network associated with companion was established in NAc, based on the miRNA and mRNA profiles. Taken together, our findings revealed a potential new approach to improve depression-like behaviors, as well as many potential drug targets for the prevention or treatment of depression.

[Improved Mayo Endoscopic Score has a higher value for evaluating clinical severity of ulcerative colitis]

OBJECTIVE

To assess the value of Improved Mayo Endoscopic Score (IMES) for evaluation of the clinical severity of ulcerative colitis (UC).

METHODS

We retrospectively analyzed the clinical and endoscopic data of 167 patients diagnosed with UC in Beijing Tsinghua Changgung Hospital from January, 2015 to November, 2021. The severity of endoscopic lesions was determined by Mayo Endoscopic Score (MES, 0-3 points) and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score (0-8 points), and the scope of endoscopic lesions was evaluated based on the Montreal classification system. The IMES was established by combining the MES with the Montreal classification.

RESULTS

The IMSE showed stronger correlations with modified Truelove and Witts Disease Severity, Mayo score and partial Mayo score (r=0.712, 0.784, and 0.703, respectively) than MES (r=0.642, 0.754, and 0.604, respectively), Montreal classification (r=0.598, 0.628, and 0.603, respectively) and UCEIS (r= 0.670, 0.767, and 0.677, respectively). ROC curve analysis showed that IMES was superior to MES, Montreal and UCEIS in diagnosis of severe and moderate- to-severe UC. IMES also showed stronger correlations with the laboratory indicators including CRP (r=0.583), WBC (r=0.235), HB (r=-0.280), PLT (r=0.352), ALB (r=-0.396) and ESR (r=0.471) than MES and Montreal classification. An IMES score of 5 was of greater value than a MES score of 3, E3, and UCEIS≥6 for predicting the administration of systemic hormones, immunosuppressants, or surgery in the near future.

CONCLUSION

IMES can better reflect the clinical severity of UC and has good correlations with the laboratory indicators of the patients.

[Juglone induces proliferation inhibition and apoptosis of cervical cancer cells via promoting c-Myc ubiquitination]

OBJECTIVE

To observe the expression of c-Myc protein in cervical cancer HeLa cells and explore the effect of juglone on the proliferation and apoptosis of HeLa cells by affecting c-Myc ubiquitination.

METHODS

HeLa cells treated with different concentrations (0, 10, 20, or 50 μmol/L) of juglone or with 20 μmol/L juglone for different time lengths were examined for expression of c-Myc protein with Western blotting. The half-life of c-Myc protein was determined using cycloheximide (CHX) and c-Myc protein degradation was detected using coimmunoprecipitation. We also assessed the effects of 20 μmol/L juglone combined with 0, 1.0 or 2.0 μmol/L MG132 (a proteasome inhibitor) on c-Myc expression. The effects of 20 μmol/L juglone on the proliferation and apoptosis of HeLa cells with RNA interference-mediated knockdown of c-Myc were evaluated with MTT assay and flow cytometry.

RESULTS

Treatment with juglone significantly lowered c-Myc protein expression in HeLa cells in a concentration-and time-dependent manner (P < 0.05). Juglone obviously shortened the half-life of c-Myc protein, and the addition of MG132 significantly up-regulated the expression level of c-Myc protein (P < 0.05). Juglone treatment also promoted ubiquitination of c-Myc protein in HeLa cells. Compared with the cells transfected with a negative control construct, the cells transfected with si-c-Myc showed significantly decreased proliferation inhibition and a lowered cell rate with early apoptosis after juglone treatment (P < 0.05).

CONCLUSION

Juglone inhibits proliferation and promotes apoptosis of HeLa cells by affecting the ubiquitination of c-Myc protein.

Triboelectrification-Induced Electricity in Self-Healing Hydrogel for Mechanical Energy Harvesting and Ultra-sensitive Pressure Monitoring

Triboelectric nanogenerators (TENGs) have shown huge application potential in the fields of micro-nano energy harvesting and multifunctional sensing. However, the damage of triboelectric material is one of the challenges for their practical applications. Herein, we fabricated a flexible TENG employing self-healing hydrogel and fluorinated ethylene propylene film as triboelectric materials for mechanical energy harvesting and pressure monitoring. The prepared hydrogel not only has excellent flexibility, transparency, and self-healing property but also exhibits good mechanical property without plastic deformation and damage under a large stretchable strain of 200%. The output electric signals of TENGs are as high as 33.0 V and 3 μA under a contact frequency of 0.40 Hz and a pressure of 2.9 N, respectively, which can charge a capacitor of 0.22 μF to 24.3 V within 300 s. Note that the voltage retention rate of TENGs after self-healing is up to 88.0%. Moreover, hydrogel-based TENGs can act as a wearable pressure sensor for monitoring human motion, exhibiting a high sensitivity of 105.9 mV/N or 1.73 nA/N under a contact frequency of 0.40 Hz. This research provides a reference roadmap for designing TENGs and self-powered pressure sensors with flexibility, self-healing, and robustness.

POS0330 DIFFERENCES IN GUT MICROBIOTA ASSOCIATED WITH LYMPHOCYTE SUBSETS, CYTOKINES AND DISEASE ACTIVITY IN ANKYLOSING SPONDYLITIS

Background

Ankylosing spondylitis (AS), a common chronic inflammatory disease, is a prototype of spondyloarthritis affecting sacroiliac joints and spine with or without peripheral arthritis and other systemic symptoms[1]. Environmental factors, especially microorganisms have been suggested to implicate with AS pathogenesis[2].

Objectives

Utilizing 16S rRNA genes sequencing on the feces of untreated AS patients and healthy controls (HCs), our study aimed to provide an in-depth understanding of AS gut microbiota and identifying a feasible diagnostic strategy for AS.

Methods

Fecal samples were collected from 62 AS patients and 62 age-and-gender- matched HCs. Microbial genome was extracted from approximately 250mg fresh fecal samples from all participants using QIAamp PowerFecal DNA Kit (Qiagen). The V3-V4 variable regions of bacterial 16S rRNA genes were sequenced with the Illumina Miseq PE300 system. QIIME2 based pipeline was used to process the raw sequence data. Alpha and beta diversities were assessed using result from QIIME2, and comparisons of gut microbiome profile were performed using linear discriminant analysis (LDA) effect size (LEfSe) to examine differences between AS and HCs. R (version 4. 0.1) was used for comparative statistics, and pearson’s correlation was used to assess the correlations between the relative abundances of bacterial genera and clinical parameters; correlations with p<0.05 were considered significant.

Results

AS for alpha-diversity, ACE and Chao1 indices were lower in AS compared with those HCs(Figure 1A, p<0.05), though no significant differences observed in Shannon and Simpson index. Bray curtis distance-based beta-diversity analysis revealed significant differences in the microbial community between AS and HCs (Figure 1B, p=0.003, ANOSIM). Fecal microbial communities in AS differed significantly from those in HCs, driven by higher abundances of Escherichia-Shigella, Turicibacter, Enterococcus, et al. and a lower abundance of Agathobacter, Roseburia, Eubacterium_eligens_group, et al (Figure 1C, p<0.05). There was a significant positive correlation between ESR and Klebsiella, Butyricicoccus, Roseburia, CRP and Faecalibacterium, Muribaculaceae, ASDAS-CRP score and Faecalibacterium, Ruminococcus, total lymphocyte cells and Agathobacter, Ruminococcus, T cell and Agathobacter, CD4+T cell and Agathobacter, B cell and Agathobacter, Streptococcus, Th1 and Prevotella, CAG−352, Th2 and Agathobacter, Th17 and Prevotella, Agathobacter, IL-2 and Agathobacter, IL-4 and Agathobacter, IL-6 and Lachnospiraceae_UCG−004, Muribaculaceae, IL-17 and Eubacterium_hallii_group, IFN-gama and Phascolarctobacterium.There were negative correlations between total lymphocytes and Escherichia−Shigella, CD4+T cell and Enterobacteriaceae, Th2 cell and Escherichia−Shigella, IL-10 and CAG−352, Ruminococcus (Figure 2, p<0.05).

Figure 1.

Feature of gut microbiota in AS patients and HCs. (A) Alpha-diversity assessed by richness (Chao1, ACE) and diversity (Shannon, Simpson), Median estimates compared across cohorts. (B) PCoA plot based on the Bray curtis distance of gut microbiota samples from AS patients vs. HC group(p=0.003, ANOSIM). (C) Panel demonstrated the average relative abundance of different genus in AS and HCs. (D) Distribution of gut microbiota at genus level.

Figure 2.

Correlations between the relative abundance of significantly different bacteria and clinical variables. *p<0.05, **p < 0.01, ***p <0 .001, ****p < 0.0001.

Conclusion

Human gut microbiome in patients with AS differed from that of the HCs. Characters of bacteria communities were associated with disease activity.

References

[1]Simone D, Al Mossawi M H, Bowness P. Progress in our understanding of the pathogenesis of ankylosing spondylitis [J]. Rheumatology (Oxford), 2018, 57(suppl_6): vi4-vi9.

[2]Zhou C, Zhao H, Xiao X Y, et al. Metagenomic profiling of the pro-inflammatory gut microbiota in ankylosing spondylitis [J]. J Autoimmun, 2020, 107(102360.

Acknowledgements

This project was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

POS1081 SERUM MPO-DNA COMPLEX LEVEL CORRELATES WITH DISEASE ACTIVITY IN PSORIATIC ARTHRITIS

Background

NETosis has been found to participate in the pathogenesis of many autoimmune diseases, however rarely reported in psoriatic arthritis (PsA).

Objectives

We aimed to explore the involvement of NETosis in the inflammation of PsA.

Methods

Serum MPO-DNA complex was detected by a modified enzyme-linked immunosorbent assay (ELISA) and compared among 74 patients with PsA, 58 patients with psoriasis (PsO) and 20 healthy controls. The association of MPO-DNA level with disease activity index at baseline and follow-up was analyzed in PsA patients. Receiver operating characteristic curve was used to evaluate the predictive value of MPO-DNA for treatment response.

Results

MPO-DNA complex level in serum was significantly increased in PsA/PsO patients compared to healthy controls (p<0.001). The level of MPO-DNA was positively associated with DAPSA score and its components (including TJC, SJC, PGA, EGA, VAS-pain and CRP, r=0.25-0.409, all p-value<0.05). Serum MPO-DNA level was downregualted at 12-week after treatment compared to baseline (p=0.022). The decrease of MPO-DNA level was more dramatic in PsA patients who achieved both ACR50 and PASI50 response than those achieving neither of them at 12 weeks (p=0.023). ROC analysis revealed that the serum MPO-DNA level predicted both ACR50 and PASI50 achievement at week 12 (p=0.04, 95% CIs 0.56-0.94). Moreover, the baseline MPO-DNA level (p=0.009, 95% CIs 0.748-1) and change of MPO-DNA at week 12 from baseline (p=0.004, 95% CIs 0.802-1) were associated with the achievement of both ACR70 and PASI75 response.

Conclusion

NETosis plays an important role in psoriatic diseases. The level of MPO-DNA complex in serum reflects disease activity. Serum MPO-DNA complex may be a useful biomarker to predict the therapeutic response in PsA.

Table 1.

Treatment response and changes of serum MPO-DNA of 29 PsA patients.

ItemsBaseline12 weeks24weeksTJC, median (IQR)3(7)3(4)2(3.5)SJC, median (IQR)2(5)2(2)1(3)ESR, median (IQR) mm/h13(15)8(10)10(14)CRP, median (IQR) mg/L3(10.2)†2.6(3.72)2.3(3.8)PGA, median (IQR)40(30)*††20(30)††10(17.5)EGA, median (IQR)30(20)††20(10)††10(20.4)VAS-pain, median (IQR)30(30)*††20(20)††10(10)PASI, median (IQR)2.8(6.2)*†0.7(1.5)0.35(1.55)DAPSA, median (IQR)15(15.1)†8.4(8.4)6.15(10.3)MPO-DNA, median (IQR)0.416(0.615)*0.231(0.321)-Minimal disease activity, n (%)4(13.7%)6(20.6%)12(41.3%)ACR50, n (%)-13(44.8%)15(51.7%)PASI50, n (%)-14(48.2%)17(58.6%)ACR70, n (%)-4(13.7%)7(24.1%)PASI75, n (%)-11(37.9%)14(48.2%)Both ACR50PASI50, n (%)-8(27.5%)13(44.8%)Both ACR70PASI75, n (%)-3(10.3%)5(17.2%)Figure 1.

ROC curves for predictions of treatment achievements at 12 and 24weeks.

Disclosure of Interests

None declared

POS0315 DIAGNOSTIC PERFORMANCE OF CASPAR CRITERIA FOR PSORIATIC ARTHRITIS WITH OR WITHOUT INTEGRATION OF ULTRASOUND

Background

Although the CASPAR criteria in the diagnosis of psoriatic arthritis (PsA) have been validated, CASPAR based on physical examination (PE) is not “gold standard”. The ultrasound (US) could improve the diagnostic accuracy as compared to clinical examination alone.

Objectives

To evaluate the diagnostic performance of CASPAR criteria for psoriatic arthritis (PsA) with or without integration of ultrasound (US).

Methods

The patients with hint of PsA were enrolled. Tender and swollen joint counts, presents of enthesitis and dactylitis were collected by physical examination (PE). US was performed to evaluate peripheral joints, entheses and tendons. The additional value of US to CASPAR criteria were analysed.

Results

326 consecutive patients were enrolled, with 164 PsA and 162 non-PsA. Significantly higher frequencies of tenosynovitis and enthesitis on US and new bone formation on X-ray were found in PsA than non-PsA patients (56.7% vs. 13.0%; 62.2% vs. 14.2%; 62.2% vs. 8.0%, p<0.01 for all). Logistic regression analysis showed that dactylitis (OR=12.0, p<0.01), family history of PsO/PsA (OR=3.1, p<0.05), nail involvement (OR=3.5, p=0.01), new bone formation (OR=14.8, p<0.01) and tenosynovitis on US (OR=21.3, p<0.01), enthesitis on US (OR=21.7, p<0.01) were independent risk factors for PsA. Adding US tenosynovitis and/or enthesitis to CASPAR criteria showed better performance by improving the specificity (91.4% vs. 67.9%) and meanwhile keeping sensitivity (92.1% vs. 96.3%). When replacing hand X-ray by US in CASPAR criteria, the sensitivity and specificity were comparable to CASPAR criteria adding with US. The diagnostic accuracy was 82.2% for CASPAR criteria based on PE, 91.7% for CASPAR integrated with US, and 91.4% for CASPAR with US to replace X-ray.

Conclusion

CASPAR criteria based on US improve the diagnosis utility of PsA than CASPAR criteria based on PE. US assessment is valuable in the diagnosis of PsA.

References

[1]Fiorenza A, Bonitta G, Gerratana E, et al. Assessment of enthesis in patients with psoriatic arthritis and fibromyalgia using clinical examination and ultrasound. Clinical and experimental rheumatology 2020;38 Suppl 123:31-9.

[2]Zabotti A, Bandinelli F, Batticciotto A, et al. Musculoskeletal ultrasonography for psoriatic arthritis and psoriasis patients: a systematic literature review. Rheumatology (Oxford) 2017;56:1518-32.

Figure 1.

ROC curves for adding US or substituting X-ray by US in CASPAR criteria. Receiver operating characteristic (ROC) curve illustrates the diagnosis performance of CASPAR criteria adding US or substituting X-ray by US in CASPAR criteria and CASPAR criteria based on PE alone. The area under the curve of the ROC curve (AUC) was 0.929 (95%CI 0.897, 0.961) (p<0.01) for adding US to CASPAR criteria. AUC was 0.908 (95%CI 0.876, 0.940) (p<0.01) for CASPAR criteria based on PE. And AUC was 0.916 (95%CI 0.880, 0.951) (p<0.01) for substituting X-ray by US in CASPAR criteria. CASPAR: ClASsification criteria for Psoriatic ARthritis; PE: physical examination; US: ultrasound.

Disclosure of Interests

None declared

Chimeric Peptides/Proteins Encoded by circRNA: An Update on Mechanisms and Functions in Human Cancers

The discovery of circular RNAs and exploration of their biological functions are increasingly attracting attention in cell bio-sciences. Owing to their unique characteristics of being highly conserved, having a relatively longer half-life, and involvement in RNA maturation, transportation, epigenetic regulation, and transcription of genes, it has been accepted that circRNAs play critical roles in the variety of cellular processes. One of the critical importance of these circRNAs is the presence of small open reading frames that enable them to encode peptides/proteins. In particular, these encoded peptides/proteins mediate essential cellular activities such as proliferation, invasion, epithelial–mesenchymal transition, and apoptosis and develop an association with the development and progression of cancers by modulating diverse signaling pathways. In addition, these peptides have potential roles as biomarkers for the prognosis of cancer and are being used as drug targets against tumorigenesis. In the present review, we thoroughly discussed the biogenesis of circRNAs and their functional mechanisms along with a special emphasis on the reported chimeric peptides/proteins encoded by circRNAs. Additionally, this review provides a perspective regarding the opportunities and challenges to the potential use of circRNAs in cancer diagnosis and therapeutic targets in clinics.

The Burden of Colorectal Cancer Attributable to Diet Low in Fiber from 1990 to 2019: A Global, Regional and National Analysis

OBJECTIVES

The colorectal cancer (CRC) burden is increasingly high. The aim of this study was to investigate temporal and geographical trends in CRC deaths and disability-adjusted life-years (DALYs) attributable to diet low in fiber globally from 1990 to 2019.

DESIGN

Cross-sectional study.

SETTING

The study based on the Global Burden of Disease Study (GBD) 2019.

PARTICIPANTS

The population comprised individuals from 204 countries and territories who were diagnosed with CRC attributable to diet low in fiber from 1990 to 2019.

MEASUREMENTS

Deaths, DALYs, age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR) for CRC attributable to diet low in fiber were described, and estimated annual percentage change (EAPC) was further calculated to assess the burden in different regions, countries, sexes, and age groups. Additionally, we explored the association between EAPC and ASMR/ASDR (in 1990) and Human Development Index (HDI, in 2019).

RESULTS

From 1990 to 2019, global ASMR and ASDR for CRC attributable to diet low in fiber decreased slightly, but the corresponding deaths and DALYs increased by 63.37% and 51.36%, respectively. Those burden varied considerably between regions and countries. The burden was higher in high, high-middle and middle SDI regions, especially in Asia and Western Europe, but when HDI > 0.7, an increasingly rapid decline in ASMR and ASDR was revealed. Unexpectedly, many less well-developed countries within the traditionally low deaths and DALYs regions of Africa, Central Latin America, and Middle East showed gradual increases in ASMR and ASDR.

CONCLUSION

The global burden of CRC attributable to diet low in fiber has decreased over the last 30 years, but remains at a high level. It is essential for decision-makers to take targeted measures for improving population awareness and intake of dietary fiber.

P–728 Can in couples with unexplained infertility the use of a prediction model to triage assisted reproduction technology save costs?

Study question

Can in couples with unexplained infertility a prognosis-tailored management strategy, that delays treatment if natural conception prospects are good, reduce costs without affecting live-birth rate?

Summary answer

In couples with unexplained infertility, use of a prognostic tool for natural conception followed by expectant management in good-prognosis couples is cost-effective.

What is known already

Few countries have guidelines for the assessment of the likelihood of natural conception to determine access to publicly funded ART. In the Netherlands and New-Zealand, couples with unexplained infertility who have a good prognosis for natural conception are encouraged to delay starting ART. However, the cost-effectiveness of this prognosis-tailored treatment strategy has not been determined.

Study design, size, duration

We studied couples with unexplained infertility to compare a prognosis-tailored strategy to care-as-usual. In the prognosis-tailored strategy, couples were assessed using Hunault’s prediction model. In good-prognosis couples (12-months natural conception &gt;40%), outcomes without ART were modelled by censoring observations after start of ART. We then assumed that poor-prognosis couples (&lt;40% natural conception) were treated, while good-prognosis couples delayed the start of treatment for 12 months. Data for the care-as-usual model were based on real observations.

Participants/materials, setting, methods

We studied 272 couples with unexplained infertility. Costs of in vitro fertilisation (IVF) and intra-uterine insemination (IUI) were calculated based on the out-of-pocket costs and Australian Medicare costs. In a cost-effectiveness model, we compared costs and effects of both strategies.

Main results and the role of chance

The prognostic model classified 272 couples with unexplained infertility as favourable (N = 107 (39.3%) or unfavourable prognosis (N = 165 (60.7%)) for natural conception. In the prognosis-tailored strategy, the cumulative live-birth rate was 71.1% (95% CI 64.7% - 76.4%) while the number of ART cycles was 393 (353 IVF; 40 IUI). In care-as-usual strategy, the cumulative conception rate leading to live-birth for the cohort of 272 couples, who underwent a total of 398 IVF cycles and 48 IUI cycles, was 72.1% (95% CI 65.7% - 77.4%). Mean time to conception leading to live birth was 388 days in the prognosis-tailored strategy and 419 days in the care-as-usual strategy.

This translated for the 272 couples into potential savings of 45 IVF cycles and eight IUI cycles, which cost a total of AUD$ 125,817 for out-of-pocket and AUD$ 264,497 for Australian Medicare. The average cost savings per couple was AUD$ 1,435 (out-of-pocket AUD$ 463 per couple and Australian Medicare AUD$ 962 per couple). The incremental cost-effectiveness ratio, which was calculated as the total costs per additional live-births, was AUD$ 143,497 per additional live birth.

Limitations, reasons for caution

This study was limited to couples at a single IVF clinic. The modelling was also based on several key assumptions, particularly the number of fresh and frozen embryo transfer cycles for each couple.

Wider implications of the findings: Our results show that in couples with unexplained infertility the use of a prognostic model guiding the start of an IVF-treatment reduces costs without compromising live birth rates.

Trial registration number

Not applicable

The efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled study

BACKGROUND

Dupilumab is an antibody against interleukin 4 receptor α, used in treating atopic dermatitis (AD).

OBJECTIVES

To evaluate the efficacy and safety of dupilumab in adult Chinese patients with moderate-to-severe AD.

METHODS

In this randomized, double-blind, placebo-controlled, parallel-group, phase III study, conducted between December 2018 and February 2020, patients with AD received dupilumab (300mg) or placebo once every 2 weeks for 16 weeks, and were followed up for 12 weeks. The primary efficacy endpoint was the proportion of patients with both Investigator's Global Assessment (IGA) score of 0-1 and a reduction from baseline of ≥2 points at week 16.

RESULTS

Overall, 165 patients (mean age: 30.6 years; 71.5% male) were randomized: 82 to dupilumab and 83 to placebo. At week 16, 26.8% of patients in the dupilumab group and 4.8% of patients in the placebo group achieved the primary endpoint (difference, 22.0%; 95% confidence interval [CI], 11.37-32.65%; p<0.0001). Compared with placebo, higher proportions of patients in the dupilumab group achieved ≥75% reduction in the Eczema Area and Severity Index score (57.3% vs 14.5%; difference, 42.9%; 95% CI, 29.75-55.97%; p<0.0001) and had ≥3-point (52.4% vs 9.6%; difference, 42.8%; 95% CI, 30.26-55.34%; p<0.0001) and ≥4-point (39.0% vs 4.8%; difference, 34.2%; 95% CI, 22.69-45.72%; p<0.0001) reductions in weekly average daily peak daily pruritus numerical rating scale scores. The incidence of TEAEs during the treatment period was similar in the two groups. The incidence of conjunctivitis, allergic conjunctivitis, and injection site reaction was higher in the dupilumab group than in the placebo group.

CONCLUSIONS

In adult Chinese patients, dupilumab was effective in improving the signs and symptoms of AD and demonstrated a favorable safety profile.

Localization transitions and mobility edges in quasiperiodic ladder

We investigate localization properties of two-coupled uniform chains (ladder) with quasiperiodic modulation on interchain coupling strength. We demonstrate that this ladder is equivalent to two Aubry-André chains when two legs are symmetric. Analytical and numerical results indicate the appearance of mobility edges in asymmetric ladder systems. We propose an easy-to-engineer quasiperiodic Moiré superlattice ladder system comprising two-coupled uniform chains. An irrational lattice constant difference results in a quasiperiodic structure. Numerical simulations indicate that such a system supports the existence of mobility edges. Furthermore, we demonstrate that the mobility edges can be detected through a dynamical method, that is based on the measurement of survival probability in the presence of a single imaginary negative potential. The results provide insights into localization transitions and mobility edges in experiments.

EphA3 promotes the proliferation of NPC cells through negatively regulating the ability of FOG2

OBJECTIVE

The purpose of this study was to investigate the expression level of EphA3 in nasopharyngeal carcinoma (NPC) and its effect on the proliferative capacity of NPC. Meanwhile, the underlying mechanism by which EphA3 prompts NPC malignant progression was further explored.

PATIENTS AND METHODS

In this study, the expression of EphA3 in 42 pairs of tumor tissue specimens and paracancerous ones collected from NPC patients was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR), and the interplay between EphA3 expression and clinical indicators, as well as prognosis of NPC patients was analyzed. Meanwhile, qRT-PCR was also applied to further verify EphA expression in NPC cell lines. In addition, EphA knockdown model was constructed in NPC cell lines, CNE2, and 6-10B, and the impacts of EphA on NPC cell functions was assessed through Cell Counting Kit-8 (CCK-8), cell colony formation, as well as 5-Ethynyl-2'- deoxyuridine (EdU) assays. Finally, a potential interplay between EphA3 and FOG2 was also investigated.

RESULTS

In this study, qRT-PCR results revealed that EphA3 expression levels in tumor tissues of patients with NPC were markedly higher than those in adjacent tissues. Compared with patients with low expression of EphA3, those with highly expressed EphA3 had a more advanced pathological stage. In addition, in vitro experiments showed that knocking down EphA3 notably attenuated the proliferation capacity of NPC cells. Subsequently, it was found that the expression of FOG2 in NPC cells was remarkably decreased both in NPC cell lines and tissues, which had a negative correlation with EphA3. Finally, cell recovery experiment revealed a mutual regulation between EphA3 and FOG2, which then together affected the malignant progression of NPC.

CONCLUSIONS

EphA3 is significantly relevant to pathological staging and poor prognosis of patients with NPC and may enhance the proliferation ability of NPC cells by modulating FOG2.

Association of disease condition with changes in intestinal flora, and plasma endotoxin and vascular endothelial growth factor levels in patients with liver cancer

OBJECTIVE

Currently, the therapeutic effect on patients with liver cancer is associated with disease development. Meanwhile, the efficacy in patients with advanced liver cancer is far from satisfactory. Therefore, the aim of this study was to explore the association of disease condition with changes in liver function indexes, intestinal flora, and plasma endotoxin (ET) and vascular endothelial growth factor (VEGF) levels in patients with liver cancer.

PATIENTS AND METHODS

A total of 300 patients with primary liver cancer in our hospital were enrolled in this study. All patients were divided into three groups, including early liver cancer group, middle liver cancer group, and advanced liver cancer group. Peripheral blood was collected from each subject to detect liver function indexes, procalcitonin (PCT), plasma ET, and VEGF levels. Furthermore, mid-posterior-segment stools were collected from 15 cases in each group, and sent to the company for detection of intestinal flora.

RESULTS

Liver function indexes in peripheral blood of patients with liver cancer changed with the changes in disease condition. With the progression of liver cancer, the level of aspartate aminotransferase (AST) increased significantly, and the highest was observed in advanced liver cancer patients [(91.18±10.34) U/L] (p=0.046). However, the level of plasma total protein declined significantly, which was (24.83±1.75) g/L in advanced liver cancer patients (p=0.035). The changes in total bilirubin were significantly associated with the progression of liver cancer (p=0.003). The abundance of Clostridiales, Firmicutes, and Streptococcus in the intestinal tract was high in early liver cancer group. The abundance of Ruminococcaceae, Pasteurellaceae, Tanticharoenia, and Vagococcus in the intestinal tract was high in middle liver cancer group. Meanwhile, the abundance of Bifidobacteriales, Actinobacteria, Barnesiella, Porphyromonadaceae, and Pseudomonadales in the intestinal tract was high in advanced liver cancer group. In patients with liver cancer, the level of Enterobacteriaceae was positively correlated with that of Firmicutes (r=0.36, p=0.003), whereas it was negatively correlated with Lactobacillus (r=-0.72, p=0.021). The level of Lactobacillus was positively correlated with that of Ruminococcaceae (r=0.39, p=0.043), whereas it was negatively correlated with that of Firmicutes (r=-0.27, p=0.019). In addition, the level of PCT markedly rose in advanced liver cancer group [(6.89±0.35) ng/mL] (p=0.021). The level of ET increased significantly with the development of liver cancer, with the highest level observed in advanced liver cancer group [(0.71±0.09) EU/mL] (p=0.004). The level of VEGF also increased remarkably with the aggravation of liver cancer, and the highest was found in advanced liver cancer group [(112.33±2.11) μmol/L], showing differences among groups (p<0.05).

CONCLUSIONS

With the progression of liver cancer, the abundance of Barnesiella, etc., rose and that of Ruminococcaceae, etc., declined in the intestinal tract. Meanwhile, the composition of intestinal flora was changed, and the levels of plasma ET and VEGF increased.

Accurate diagnosis of colorectal cancer based on histopathology images using artificial intelligence

BACKGROUND

Accurate and robust pathological image analysis for colorectal cancer (CRC) diagnosis is time-consuming and knowledge-intensive, but is essential for CRC patients' treatment. The current heavy workload of pathologists in clinics/hospitals may easily lead to unconscious misdiagnosis of CRC based on daily image analyses.

METHODS

Based on a state-of-the-art transfer-learned deep convolutional neural network in artificial intelligence (AI), we proposed a novel patch aggregation strategy for clinic CRC diagnosis using weakly labeled pathological whole-slide image (WSI) patches. This approach was trained and validated using an unprecedented and enormously large number of 170,099 patches, > 14,680 WSIs, from > 9631 subjects that covered diverse and representative clinical cases from multi-independent-sources across China, the USA, and Germany.

RESULTS

Our innovative AI tool consistently and nearly perfectly agreed with (average Kappa statistic 0.896) and even often better than most of the experienced expert pathologists when tested in diagnosing CRC WSIs from multicenters. The average area under the receiver operating characteristics curve (AUC) of AI was greater than that of the pathologists (0.988 vs 0.970) and achieved the best performance among the application of other AI methods to CRC diagnosis. Our AI-generated heatmap highlights the image regions of cancer tissue/cells.

CONCLUSIONS

This first-ever generalizable AI system can handle large amounts of WSIs consistently and robustly without potential bias due to fatigue commonly experienced by clinical pathologists. It will drastically alleviate the heavy clinical burden of daily pathology diagnosis and improve the treatment for CRC patients. This tool is generalizable to other cancer diagnosis based on image recognition.

Quantum Phase Transition in a Quantum Ising Chain at Nonzero Temperatures

We study the response of a thermal state of an Ising chain to a nonlocal non-Hermitian perturbation, which coalesces the topological Kramer-like degeneracy in the ferromagnetic phase. The dynamic responses for initial thermal states in different quantum phases are distinct. The final state always approaches its half component with a fixed parity in the ferromagnetic phase but remains almost unchanged in the paramagnetic phase. This indicates that the phase diagram at zero temperature is completely preserved at finite temperatures. Numerical simulations for Loschmidt echoes demonstrate such dynamical behaviors in finite-size systems. In addition, it provides a clear manifestation of the bulk-boundary correspondence at nonzero temperatures. This work presents an alternative approach to understanding the quantum phase transitions of quantum spin systems at nonzero temperatures.