Determination of Spin-Parity Quantum Numbers of X(2370) as 0^{-+} from J/ψ→γK_{S}^{0}K_{S}^{0}η^{'}

Based on (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, a partial wave analysis of the decay J/ψ→γK_{S}^{0}K_{S}^{0}η^{'} is performed. The mass and width of the X(2370) are measured to be 2395±11(stat)_{-94}^{+26}(syst)  MeV/c^{2} and 188_{-17}^{+18}(stat)_{-33}^{+124}(syst)  MeV, respectively. The corresponding product branching fraction is B[J/ψ→γX(2370)]×B[X(2370)→f_{0}(980)η^{'}]×B[f_{0}(980)→K_{S}^{0}K_{S}^{0}]=(1.31±0.22(stat)_{-0.84}^{+2.85}(syst))×10^{-5}. The statistical significance of the X(2370) is greater than 11.7σ and the spin parity is determined to be 0^{-+} for the first time. The measured mass and spin parity of the X(2370) are consistent with the predictions of the lightest pseudoscalar glueball.

Observation of Structures in the Processes e^{+}e^{-}→ωχ_{c1} and ωχ_{c2}

We present measurements of the Born cross sections for the processes e^{+}e^{-}→ωχ_{c1} and ωχ_{c2} at center-of-mass energies sqrt[s] from 4.308 to 4.951 GeV. The measurements are performed with data samples corresponding to an integrated luminosity of 11.0  fb^{-1} collected with the BESIII detector operating at the Beijing Electron Positron Collider storage ring. Assuming the e^{+}e^{-}→ωχ_{c2} signals come from a single resonance, the mass and width are determined to be M=(4413.6±9.0±0.8)  MeV/c^{2} and Γ=(110.5±15.0±2.9)  MeV, respectively, which is consistent with the parameters of the well-established resonance ψ(4415). In addition, we also use one single resonance to describe the e^{+}e^{-}→ωχ_{c1} line shape and determine the mass and width to be M=(4544.2±18.7±1.7)  MeV/c^{2} and Γ=(116.1±33.5±1.7)  MeV, respectively. The structure of this line shape, observed for the first time, requires further understanding.

Coupled-Channel Analysis of the χ_{c1}(3872) Line Shape with BESIII Data

We perform a study of the χ_{c1}(3872) line shape using the data samples of e^{+}e^{-}→γχ_{c1}(3872), χ_{c1}(3872)→D^{0}D[over ¯]^{0}π^{0}, and π^{+}π^{-}J/ψ collected with the BESIII detector. The effects of the coupled channels and the off-shell D^{*0} are included in the parametrization of the line shape. The line shape mass parameter is obtained to be M_{X}=(3871.63±0.13_{-0.05}^{+0.06})  MeV. Two poles are found on the first and second Riemann sheets corresponding to the D^{*0}D[over ¯]^{0} branch cut. The pole location on the first sheet is much closer to the D^{*0}D[over ¯]^{0} threshold than the other, and is determined to be 7.04±0.15_{-0.08}^{+0.07}  MeV above the D^{0}D[over ¯]^{0}π^{0} threshold with an imaginary part -0.19±0.08_{-0.19}^{+0.14}  MeV.

Observation of the Anomalous Shape of X(1840) in J/ψ→γ3(π^{+}π^{-}) Indicating a Second Resonance Near pp[over ¯] Threshold

Using a sample of (10087±44)×10^{6}  J/ψ events, which is about 45 times larger than that was previously analyzed, a further investigation on the J/ψ→γ3(π^{+}π^{-}) decay is performed. A significant distortion at 1.84  GeV/c^{2} in the line shape of the 3(π^{+}π^{-}) invariant mass spectrum is observed for the first time, which could be resolved by two overlapping resonant structures, X(1840) and X(1880). The new state X(1880) is observed with a statistical significance larger than 10σ. The mass and width of X(1880) are determined to be 1882.1±1.7±0.7  MeV/c^{2} and 30.7±5.5±2.4  MeV, respectively, which indicates the existence of a pp[over ¯] bound state.

Study of the f_{0}(980) and f_{0}(500) Scalar Mesons through the Decay D_{s}^{+}→π^{+}π^{-}e^{+}ν_{e}

Using e^{+}e^{-} collision data corresponding to an integrated luminosity of 7.33  fb^{-1} recorded by the BESIII detector at center-of-mass energies between 4.128 and 4.226 GeV, we present an analysis of the decay D_{s}^{+}→π^{+}π^{-}e^{+}ν_{e}, where the D_{s}^{+} is produced via the process e^{+}e^{-}→D_{s}^{*±}D_{s}^{∓}. We observe the f_{0}(980) in the π^{+}π^{-} system and the branching fraction of the decay D_{s}^{+}→f_{0}(980)e^{+}ν_{e} with f_{0}(980)→π^{+}π^{-} measured to be (1.72±0.13_{stat}±0.10_{syst})×10^{-3}, where the uncertainties are statistical and systematic, respectively. The dynamics of the D_{s}^{+}→f_{0}(980)e^{+}ν_{e} decay are studied with the simple pole parametrization of the hadronic form factor and the Flatté formula describing the f_{0}(980) in the differential decay rate, and the product of the form factor f_{+}^{f_{0}}(0) and the c→s Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| is determined for the first time to be f_{+}^{f_{0}}(0)|V_{cs}|=0.504±0.017_{stat}±0.035_{syst}. Furthermore, the decay D_{s}^{+}→f_{0}(500)e^{+}ν_{e} is searched for the first time but no signal is found. The upper limit on the branching fraction of D_{s}^{+}→f_{0}(500)e^{+}ν_{e}, f_{0}(500)→π^{+}π^{-} decay is set to be 3.3×10^{-4} at 90% confidence level.

Observation of D^{+}→K_{S}^{0}a_{0}(980)^{+} in the Amplitude Analysis of D^{+}→K_{S}^{0}π^{+}η

We perform for the first time an amplitude analysis of the decay D^{+}→K_{S}^{0}π^{+}η and report the observation of the decay D^{+}→K_{S}^{0}a_{0}(980)^{+} using 2.93  fb^{-1} of e^{+}e^{-} collision data taken at a center-of-mass energy of 3.773 GeV with the BESIII detector. As the only W-annihilation-free decay among D to a_{0}(980) pseudoscalar, D^{+}→K_{S}^{0}a_{0}(980)^{+} is the ideal decay in extracting the contributions of the W-emission amplitudes involving a_{0}(980) and to study the final-state interactions. The absolute branching fraction of D^{+}→K_{S}^{0}π^{+}η is measured to be (1.27±0.04_{stat}±0.03_{syst})%. The branching fractions of intermediate processes D^{+}→K_{S}^{0}a_{0}(980)^{+} with a_{0}(980)^{+}→π^{+}η and D^{+}→π^{+}K[over ¯]_{0}^{*}(1430)^{0} with K[over ¯]_{0}^{*}(1430)^{0}→K_{S}^{0}η are measured to be (1.33±0.05_{stat}±0.04_{syst})% and (0.14±0.03_{stat}±0.01_{syst})%, respectively.

Observation of Significant Flavor-SU(3) Breaking in the Kaon Wave Function at 12<Q^{2}<25 GeV^{2} and Discovery of the Charmless Decay ψ(3770)→K_{S}^{0}K_{L}^{0}

We present cross sections for the reaction e^{+}e^{-}→K_{S}^{0}K_{L}^{0} at center-of-mass energies ranging from 3.51 to 4.95 GeV using data samples collected in the BESIII experiment, corresponding to a total integrated luminosity of 26.5  fb^{-1}. The ratio of neutral-to-charged kaon form factors at large momentum transfers (12 Collapse

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Investigation of the ΔI=1/2 Rule and Test of CP Symmetry through the Measurement of Decay Asymmetry Parameters in Ξ^{-} Decays

Using (10087±44)×10^{6}  J/ψ events collected with the BESIII detector, numerous Ξ^{-} and Λ decay asymmetry parameters are simultaneously determined from the process J/ψ→Ξ^{-}Ξ[over ¯]^{+}→Λ(pπ^{-})π^{-}Λ[over ¯](n[over ¯]π^{0})π^{+} and its charge-conjugate channel. The precisions of α_{Λ0} for Λ→nπ^{0} and α[over ¯]_{Λ0} for Λ[over ¯]→n[over ¯]π^{0} compared to world averages are improved by factors of 4 and 1.7, respectively. The ratio of decay asymmetry parameters of Λ→nπ^{0} to that of Λ→pπ^{-}, ⟨α_{Λ0}⟩/⟨α_{Λ-}⟩, is determined to be 0.873±0.012_{-0.010}^{+0.011}, where the first and the second uncertainties are statistical and systematic, respectively. The ratio is smaller than unity more than 5σ, which signifies the existence of the ΔI=3/2 transition in Λ for the first time. Besides, we test for CP symmetry in Ξ^{-}→Λπ^{-} and in Λ→nπ^{0} with the best precision to date.

Observation of D_{s}^{+}→η^{'}μ^{+}ν_{μ}, Precision Test of Lepton Flavor Universality with D_{s}^{+}→η^{(')}l^{+}ν_{l}, and First Measurements of D_{s}^{+}→η^{(')}μ^{+}ν_{μ} Decay Dynamics

By analyzing 7.33  fb^{-1} of e^{+}e^{-} annihilation data collected at center-of-mass energies between 4.128 and 4.226 GeV with the BESIII detector, we report the observation of the semileptonic decay D_{s}^{+}→η^{'}μ^{+}ν_{μ}, with a statistical significance larger than 10σ, and the measurements of the D_{s}^{+}→ημ^{+}ν_{μ} and D_{s}^{+}→η^{'}μ^{+}ν_{μ} decay dynamics for the first time. The branching fractions of D_{s}^{+}→ημ^{+}ν_{μ} and D_{s}^{+}→η^{'}μ^{+}ν_{μ} are determined to be (2.235±0.051_{stat}±0.052_{syst})% and (0.801±0.055_{stat}±0.028_{syst})%, respectively, with precision improved by factors of 6.0 and 6.6 compared to the previous best measurements. Combined with the results for the decays D_{s}^{+}→ηe^{+}ν_{e} and D_{s}^{+}→η^{'}e^{+}ν_{e}, the ratios of the decay widths are examined both inclusively and in several ℓ^{+}ν_{ℓ} four-momentum transfer ranges. No evidence for lepton flavor universality violation is found within the current statistics. The products of the hadronic form factors f_{+,0}^{η^{(')}}(0) and the c→s Cabibbo-Kobayashi-Maskawa matrix element |V_{cs}| are determined. The results based on the two-parameter series expansion are f_{+,0}^{η}(0)|V_{cs}|=0.452±0.010_{stat}±0.007_{syst} and f_{+,0}^{η^{'}}(0)|V_{cs}|=0.504±0.037_{stat}±0.012_{syst}, which help to constrain present models on f_{+,0}^{η^{(')}}(0). The forward-backward asymmetries are determined to be ⟨A_{FB}^{η}⟩=-0.059±0.031_{stat}±0.005_{syst} and ⟨A_{FB}^{η^{'}}⟩=-0.064±0.079_{stat}±0.006_{syst} for the first time, which are consistent with the theoretical calculation.

Determination of the Σ^{+} Timelike Electromagnetic Form Factors

Based on data samples collected with the BESIII detector at the BEPCII collider, the process e^{+}e^{-}→Σ^{+}Σ[over ¯]^{-} is studied at center-of-mass energies sqrt[s]=2.3960, 2.6454, and 2.9000 GeV. Using a fully differential angular description of the final state particles, both the relative magnitude and phase information of the Σ^{+} electromagnetic form factors in the timelike region are extracted. The relative phase between the electric and magnetic form factors is determined to be sinΔΦ=-0.67±0.29(stat)±0.18(syst) at sqrt[s]=2.3960  GeV, ΔΦ=55°±19°(stat)±14°(syst) at sqrt[s]=2.6454  GeV, and 78°±22°(stat)±9°(syst) at sqrt[s]=2.9000  GeV. For the first time, the phase of the hyperon electromagnetic form factors is explored in a wide range of four-momentum transfer. The evolution of the phase along with four-momentum transfer is an important input for understanding its asymptotic behavior and the dynamics of baryons.

First Measurement of the Decay Asymmetry in the Pure W-Boson-Exchange Decay Λ_{c}^{+}→Ξ^{0}K^{+}

Based on 4.4  fb^{-1} of e^{+}e^{-} annihilation data collected at the center-of-mass energies between 4.60 and 4.70 GeV with the BESIII detector at the BEPCII collider, the pure W-boson-exchange decay Λ_{c}^{+}→Ξ^{0}K^{+} is studied with a full angular analysis. The corresponding decay asymmetry is measured for the first time to be α_{Ξ^{0}K^{+}}=0.01±0.16(stat)±0.03(syst). This result reflects the noninterference effect between the S- and P-wave amplitudes. The phase shift between S- and P-wave amplitudes has two solutions, which are δ_{p}-δ_{s}=-1.55±0.25(stat)±0.05(syst)  rad or 1.59±0.25(stat)±0.05(syst)  rad.

Test of CP Symmetry in Hyperon to Neutron Decays

The quantum entangled J/ψ→Σ^{+}Σ[over ¯]^{-} pairs from (1.0087±0.0044)×10^{10}  J/ψ events taken by the BESIII detector are used to study the nonleptonic two-body weak decays Σ^{+}→nπ^{+} and Σ[over ¯]^{-}→n[over ¯]π^{-}. The CP-odd weak decay parameters of the decays Σ^{+}→nπ^{+} (α_{+}) and Σ[over ¯]^{-}→n[over ¯]π^{-} (α[over ¯]_{-}) are determined to be 0.0481±0.0031_{stat}±0.0019_{syst} and -0.0565±0.0047_{stat}±0.0022_{syst}, respectively. The decay parameter α[over ¯]_{-} is measured for the first time, and the accuracy of α_{+} is improved by a factor of 4 compared to the previous results. The simultaneously determined decay parameters allow the first precision CP symmetry test for any hyperon decay with a neutron in the final state with the measurement of A_{CP}=(α_{+}+α[over ¯]_{-})/(α_{+}-α[over ¯]_{-})=-0.080±0.052_{stat}±0.028_{syst}. Assuming CP conservation, the average decay parameter is determined as ⟨α_{+}⟩=(α_{+}-α[over ¯]_{-})/2=-0.0506±0.0026_{stat}±0.0019_{syst}, while the ratios α_{+}/α_{0} and α[over ¯]_{-}/α[over ¯]_{0} are -0.0490±0.0032_{stat}±0.0021_{syst} and -0.0571±0.0053_{stat}±0.0032_{syst}, where α_{0} and α[over ¯]_{0} are the decay parameters of the decays Σ^{+}→pπ^{0} and Σ[over ¯]^{-}→p[over ¯]π^{0}, respectively.

Measurement of Energy-Dependent Pair-Production Cross Section and Electromagnetic Form Factors of a Charmed Baryon

We study the process e^{+}e^{-}→Λ_{c}^{+}Λ[over ¯]_{c}^{-} at twelve center-of-mass energies from 4.6119 to 4.9509 GeV using data samples collected by the BESIII detector at the BEPCII collider. The Born cross sections and effective form factors (|G_{eff}|) are determined with unprecedented precision after combining the single and double-tag methods based on the decay process Λ_{c}^{+}→pK^{-}π^{+}. Flat cross sections around 4.63 GeV are obtained and no indication of the resonant structure Y(4630), as reported by Belle, is found. In addition, no oscillatory behavior is discerned in the |G_{eff}| energy dependence of Λ_{c}^{+}, in contrast to what is seen for the proton and neutron cases. Analyzing the cross section together with the polar-angle distribution of the Λ_{c}^{+} baryon at each energy point, the moduli of electric and magnetic form factors (|G_{E}| and |G_{M}|) are extracted and separated. For the first time, the energy dependence of the form factor ratio |G_{E}/G_{M}| is observed, which can be well described by an oscillatory function.

Reactive cutaneous capillary endothelial proliferation predicted the efficacy of camrelizumab in patients with recurrent/metastatic head and neck squamous cell carcinoma

BACKGROUND

Reactive cutaneous capillary endothelial proliferation (RCCEP), a special adverse event (AE) only observed in patients treated with camrelizumab, was reported to be correlated with the efficacy of camrelizumab in patients with advanced hepatocellular carcinoma. This study to analyze the possible correlation between the occurrence of RCCEP and efficacy of camrelizumab in patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC).

MATERIAL AND METHODS

In this study, we retrospectively analyzed the efficacy and RCCEP occurrence of camrelizumab in 58 patients with R/M HNSCC in the Shanghai Ninth People's Hospital affiliated to Shanghai JiaoTong University School of Medicine between January 2019 and June 2022. Kaplan-Meier analysis was used to assess the correlation between the occurrence of RCCEP and the survival of enrolled patients, and COX multifactor analysis was adopted to evaluate associated factors that affected the efficacy of camrelizumab immunotherapy.

RESULTS

A significant correlation between the incidence of RCCEP and a higher objective response rate was observed in this study (p=0.008). The occurrence of RCCEP was associated with better median overall survival (17.0 months vs. 8.7 months, p<0.0001, HR=5.944, 95% CI:2.097-16.84) and better median progression-free survival (15.1 months vs. 4.0 months, p<0.0001, HR=4.329,95% CI:1.683-11.13). In COX multifactor analysis, RCCEP occurrence was also an independent prognostic factor affecting OS and PFS in patients with R/M HNSCC.

CONCLUSIONS

The occurrence of RCCEP can show a better prognosis, it could be used as a clinical biomarker to predict the efficacy of camrelizumab treatment.

Ultrasound guidance versus landmark guidance for intrathecal baclofen pump refill: A randomized pilot study

BACKGROUND

Refilling difficult-to-access intrathecal baclofen (ITB) pumps by a trainee can result in longer procedures, more needle punctures, and more frequent attending interventions. Though ultrasound guidance can be used, there has not been an investigation into the impact of ultrasound guidance on refill outcomes.

OBJECTIVE

To determine the feasibility of ultrasound guidance during difficult ITB refills to improve the experience of patients and providers.

DESIGN

Nonblinded, randomized controlled trial with crossover element.

SETTING

Outpatient clinic at a tertiary academic rehabilitation hospital.

PARTICIPANTS

Patients ≥18 years old with historically difficult refills who were scheduled for repeat refills. "Difficult" was defined as body mass index > 30.0, a deep/tilted pump, previously requiring >1 skin puncture, or previously needing special positioning to access.

INTERVENTIONS

Consented participants were randomized into a template-guided group (control) or an ultrasound-guided group (experimental) using a coin flip. Patients were crossed over if (1) a second refill occurred during the study period or (2) the randomized technique failed.

MAIN OUTCOME MEASURES

The primary measure was time spent with needle under skin (seconds). Number of needle punctures and needle passes, frequency of attending intervention, pain during and after the procedure, patient satisfaction, and practitioner perceived difficulty were investigated.

RESULTS

Seventeen patients underwent 21 refills (12 template guided and 9 ultrasound guided). No patients experienced adverse events. Although without statistically significant difference, the average time in the experimental group was shorter than the control (175 seconds vs 401 seconds), there were fewer episodes of multiple needle punctures (0 vs 2), multiple needle passes (2 vs 5), and attending interventions (0 vs 3) in the experimental group. No significant/clinical difference was found in pain during procedure, pain after procedure, patient satisfaction, or practitioner subjective difficulty.

CONCLUSIONS

This pilot study demonstrates that ultrasound-guided ITB refills may reduce time spent with the needle in the skin, number of needle punctures, number of needle passes, and frequency of attending intervention during trainee refilling of pumps that are difficult to access.

Determination of Spin-Parity Quantum Numbers for the Narrow Structure near the pΛ[over ¯] Threshold in e^{+}e^{-}→pK^{-}Λ[over ¯]+c.c

A narrow structure in the pΛ[over ¯] system near the mass threshold, named as X(2085), is observed in the process e^{+}e^{-}→pK^{-}Λ[over ¯] with a statistical significance greater than 20σ. Its spin and parity are determined for the first time to be J^{P}=1^{+} in an amplitude analysis, with a statistical significance greater than 5σ over other quantum numbers (0^{-},1^{-} and 2^{+}). The pole positions of X(2085) are measured to be M_{pole}=(2084_{-2}^{+4}±9)  MeV and Γ_{pole}=(58_{-3}^{+4}±25)  MeV, where the first uncertainties are statistical and the second ones are systematic. The analysis is based on the study of the process e^{+}e^{-}→pK^{-}Λ[over ¯] and uses the data samples collected with the BESIII detector at the center-of-mass energies sqrt[s]=4.008, 4.178, 4.226, 4.258, 4.416, and 4.682 GeV with a total integrated luminosity of 8.35  fb^{-1}.

Precise Measurement of the e^{+}e^{-}→D_{s}^{*+}D_{s}^{*-} Cross Sections at Center-of-Mass Energies from Threshold to 4.95 GeV

The process e^{+}e^{-}→D_{s}^{*+}D_{s}^{*-} is studied with a semi-inclusive method using data samples at center-of-mass energies from threshold to 4.95 GeV collected with the BESIII detector operating at the Beijing Electron Positron Collider. The Born cross sections of the process are measured for the first time with high precision in this energy region. Two resonance structures are observed in the energy-dependent cross sections around 4.2 and 4.4 GeV. By fitting the cross sections with a coherent sum of three Breit-Wigner amplitudes and one phase-space amplitude, the two significant structures are assigned masses of (4186.8±8.7±30) and (4414.6±3.4±6.1)  MeV/c^{2}, widths of (55±15±53) and (122.5±7.5±8.1)  MeV, where the first errors are statistical and the second ones are systematic. The inclusion of a third Breit-Wigner amplitude is necessary to describe a structure around 4.79 GeV.

First Experimental Study of the Purely Leptonic Decay D_{s}^{*+}→e^{+}ν_{e}

Using 7.33  fb^{-1} of e^{+}e^{-} collision data taken with the BESIII detector at the BEPCII collider, we report the first experimental study of the purely leptonic decay D_{s}^{*+}→e^{+}ν_{e}. Our data contain a signal of this decay with a statistical significance of 2.9σ. The branching fraction of D_{s}^{*+}→e^{+}ν_{e} is measured to be (2.1_{-0.9_{stat}}^{+1.2}±0.2_{syst})×10^{-5}, corresponding to an upper limit of 4.0×10^{-5} at the 90% confidence level. Taking the total width of the D_{s}^{*+} [(0.070±0.028)  keV] predicted with the radiative D_{s}^{*+} decay from the lattice QCD calculation as input, the decay constant of the D_{s}^{*+} is determined to be f_{D_{s}^{*+}}=(214_{-46_{stat}}^{+61}±44_{syst})  MeV, corresponding to an upper limit of 354 MeV at the 90% confidence level.

m6A Reader YTHDC1 Inhibits Ferroptosis and Radiosensitivity by Promoting SREBF1 mRNA Nuclear Export in Nasopharyngeal Carcinoma

PURPOSE/OBJECTIVE(S)

Radioresistance is the main reason for nasopharyngeal carcinoma (NPC) recurrence leading to treatment failure, and inducing ferroptosis has gradually been a new way to enhance radiosensitivity. N6-methyladenosine (m6A) is involved in regulation of numerous biological processes. However, whether m6A affects ferroptosis in NPC is still unclear. In this study, we conducted a siRNA library screening to identify m6A reader YTHDC1 as an essential oncogene that suppressed ferroptosis and radiosensitivity by promoting SREBF1 mRNA nuclear export in nasopharyngeal carcinoma.

MATERIALS/METHODS

The expression and function of YTHDC1 were assessed via CCK8 cell viability assay, immunostaining, real-time PCR, western blot, radiation clonogenic assay and fluorescence in situ hybridization assay. Ferroptosis was determined by detecting cell viability, lipid peroxidation, abnormal mitochondrial and cell death rate. The in vivo effects of YTHDC1 were examined with RSL3 treatment or lentivirus modification of YTHDC1 expression in radiated mouse models.

RESULTS

Based on RSL3-induced ferroptotic cell death model and a siRNA library about m6A modification associated gene screening, we identified m6A reader YTHDC1 could inhibit ferroptosis as well as radiosensitivity of NPC, both in vivo and in vitro. Mechanistically, YTHDC1 protein could recognize m6A sites in the CDS region and 3' untranslated region (3'UTR) of SREBF1 mRNA and promote SREBF1 mRNA nuclear export, which finally resulted in transcriptional upregulation of genes key to ferroptosis such as SCD and FASN. Furthermore, the high expression of YTHDC1 was negatively regulated by ZNF598 via ubiquitination and associated with unfavorable survival in NPC patients due to radioresistance.

CONCLUSION

Our findings reveal the critical role of YTHDC1 specifically in inhibiting ferroptosis and radiosensitivity via m6A-dependent mechanism and provide an exploitable target and therapeutic strategy for overcoming radioresistance in NPC.

[Expression and protective effect of chemerin in idiopathic pulmonary fibrosis]

Objective: To explore the expression and the role of chemerin in idiopathic pulmonary fibrosis (IPF). Methods: Quantitative PCR and Western blotting were used to determine the mRNA and protein levels of chemerin in lung tissues from IPF patients and the controls. Clinical serum level of chemerin was analyzed by enzyme-linked immunosorbent assay. The mouse lung fibroblasts isolated and cultured in vitro were divided into the control, TGF-β, TGF-β+chemerin and chemerin groups. Immunofluorescence staining was used to observe the expression of α-smooth muscle actin (α-SMA). C57BL/6 mice were randomly divided into the control, bleomycin, bleomycin+chemerin, and chemerin groups. Masson and immunohistochemical staining were performed to evaluate the severity of pulmonary fibrosis. Expression of epithelial to mesenchymal transition (EMT) markers was detected by quantitative PCR and immunohistochemical staining in the in vitro and in vivo models of pulmonary fibrosis, respectively. Results: Compared with the control group, the expression of chemerin was downregulated in both the lung tissue and the serum of IPF patients. Immunofluorescence showed that treatment of fibroblasts with TGF-β alone resulted in a robust expression of α-SMA, whereas treatment with TGF-β and chemerin together exhibited the similar expression levels of α-SMA as the control group. Masson staining indicated that the bleomycin-induced pulmonary fibrosis model was constructed successfully, while treatment of chemerin partially alleviated the damage of lung tissue. Immunohistochemical staining showed that the expression of chemerin in the lung tissue was significantly decreased in the bleomycin group. Quantitative PCR and immunohistochemistry showed that chemerin attenuated EMT induced by TGF-β and bleomycin both in vitro and in vivo. Conclusions: The expression of chemerin was reduced in patients with IPF. Chemerin may play a protective role in the development of IPF by regulating EMT, providing a new idea for the clinical treatment of IPF.

First Study of Reaction Ξ^{0}n→Ξ^{-}p Using Ξ^{0}-Nucleus Scattering at an Electron-Positron Collider

Using (1.0087±0.0044)×10^{10}  J/ψ events collected with the BESIII detector at the BEPCII storage ring, the process Ξ^{0}n→Ξ^{-}p is studied, where the Ξ^{0} baryon is produced in the process J/ψ→Ξ^{0}Ξ[over ¯]^{0} and the neutron is a component of the ^{9}Be, ^{12}C, and ^{197}Au nuclei in the beam pipe. A clear signal is observed with a statistical significance of 7.1σ. The cross section of the reaction Ξ^{0}+^{9}Be→Ξ^{-}+p+^{8}Be is determined to be σ(Ξ^{0}+^{9}Be→Ξ^{-}+p+^{8}Be)=(22.1±5.3_{stat}±4.5_{sys})  mb at the Ξ^{0} momentum of 0.818  GeV/c, where the first uncertainty is statistical and the second is systematic. No significant H-dibaryon signal is observed in the Ξ^{-}p final state. This is the first study of hyperon-nucleon interactions in electron-positron collisions and opens up a new direction for such research.

Precision Measurement of the Decay Σ^{+}→pγ in the Process J/ψ→Σ^{+}Σ[over ¯]^{-}

Using (10 087±44)×10^{6} J/ψ events collected with the BESIII detector, the radiative hyperon decay Σ^{+}→pγ is studied at an electron-positron collider experiment for the first time. The absolute branching fraction is measured to be (0.996±0.021_{stat}±0.018_{syst})×10^{-3}, which is lower than its world average value by 4.2 standard deviations. Its decay asymmetry parameter is determined to be -0.652±0.056_{stat}±0.020_{syst}. The branching fraction and decay asymmetry parameter are the most precise to date, and the accuracies are improved by 78% and 34%, respectively.

Measurements of the Electric and Magnetic Form Factors of the Neutron for Timelike Momentum Transfer

We present the first measurements of the electric and magnetic form factors of the neutron in the timelike (positive q^{2}) region as function of four-momentum transfer. We explored the differential cross sections of the reaction e^{+}e^{-}→n[over ¯]n with data collected with the BESIII detector at the BEPCII accelerator, corresponding to an integrated luminosity of 354.6  pb^{-1} in total at twelve center-of-mass energies between sqrt[s]=2.0-2.95  GeV. A relative uncertainty of 18% and 12% for the electric and magnetic form factors, respectively, is achieved at sqrt[s]=2.3935  GeV. Our results are comparable in accuracy to those from electron scattering in the comparable spacelike region of four-momentum transfer. The electromagnetic form factor ratio R_{em}≡|G_{E}|/|G_{M}| is within the uncertainties close to unity. We compare our result on |G_{E}| and |G_{M}| to recent model predictions, and the measurements in the spacelike region to test the analyticity of electromagnetic form factors.

The association of serum testosterone with dyslipidemia is mediated by obesity: the Henan Rural Cohort Study

BACKGROUND AND AIMS

This study aimed to evaluate the relationships of serum testosterone with dyslipidemia and blood lipid levels and test whether obesity mediated these associations by gender in Chinese rural population.

METHODS AND RESULTS

A total of 6150 subjects were finally analyzed in this study. Serum testosterone for each subject was detected by liquid chromatography equipped with tandem mass spectrometry. Logistic regression and linear regression were employed to evaluate the associations of serum testosterone with the prevalence of dyslipidemia and blood lipid levels. Mediation analysis was conducted to identify the mediation effects of obesity on the relationship between serum testosterone and dyslipidemia. After adjusting for multiple confounders, per unit change in serum ln-testosterone levels was associated with a decreased prevalent dyslipidemia in men (odds ratio (OR): 0.785, 95% confidence interval (CI) (0.708, 0.871)). Males with the levels of serum testosterone in the third or fourth quartiles had a 49.4% (OR: 0.506, 95% CI 0.398, 0.644) or 67.1% (OR: 0.329, 95% CI 0.253, 0.428) significantly lower odds of prevalence of dyslipidemia. In addition, a onefold increase in ln-testosterone was related to a 0.043 mmol/L (95% CI 0.028, 0.059) increase in high-density lipoprotein cholesterol (HDL-C) in men. Results of the mediation analysis suggested that obesity played a partial role in the association of testosterone with dyslipidemia in men.

CONCLUSIONS

These findings suggested that serum testosterone levels were negatively associated with lipid levels and prevalent dyslipidemia, and obesity mediated the effects of serum testosterone on dyslipidemia in men, implying that obesity prevention should be highlighted to decrease the prevalence of dyslipidemia related to changes in testosterone levels.

Observation of Three Charmoniumlike States with J^{PC}=1^{--} in e^{+}e^{-}→D^{*0}D^{*-}π^{+}

The Born cross sections of the process e^{+}e^{-}→D^{*0}D^{*-}π^{+} at center-of-mass energies from 4.189 to 4.951 GeV are measured for the first time. The data samples used correspond to an integrated luminosity of 17.9  fb^{-1} and were collected by the BESIII detector operating at the BEPCII storage ring. Three enhancements around 4.20, 4.47, and 4.67 GeV are visible. The resonances have masses of 4209.6±4.7±5.9  MeV/c^{2}, 4469.1±26.2±3.6  MeV/c^{2}, and 4675.3±29.5±3.5  MeV/c^{2} and widths of 81.6±17.8±9.0  MeV, 246.3±36.7±9.4  MeV, and 218.3±72.9±9.3  MeV, respectively, where the first uncertainties are statistical and the second systematic. The first and third resonances are consistent with the ψ(4230) and ψ(4660) states, respectively, while the second one is compatible with the ψ(4500) observed in the e^{+}e^{-}→K^{+}K^{-}J/ψ process. These three charmoniumlike ψ states are observed in the e^{+}e^{-}→D^{*0}D^{*-}π^{+} process for the first time.

Atherogenic lipoprotein profile associated with anthropometric indices of obesity and their association with cardiometabolic risk markers: a cross-sectional study in community

Background

Obesity, especially abdominal fat accumulation, is strongly associated with various metabolic comorbidities. Whether simple anthropometric measures are independently associated with atherogenic lipoproteins is not completely clear.

Methods

We randomly recruited 505 participants (51.5% women; mean age: 48.8 years) from the Flemish community, who had undergone lipoprotein particle measurements by nuclear magnetic resonance spectroscopy and conventional lipid measurements. Each lipoprotein fraction was subgrouped into large, medium, and small subclass. Anthropometric measures included body mass index (BMI) and waist-to-hip ratio (WHR), and defined BMI obesity as BMI ≥30 kg/m2, and WHR obesity as WHR ≥0.85 (women) or 0.9 (men).

Results

In the multivariable logistic regression analysis, total very-low-density lipoprotein (VLDL) particle and its subclasses were positively associated with BMI obesity (adjusted odds ratio [OR] for total VLDL: 2.37; 95% confidence interval [CI]: 1.70–3.31) and WHR obesity (OR for total VLDL: 2.06 [95% CI: 1.55–2.73]). The level of total high-density lipoprotein (HDL) particle and its subclass was negatively associated with BMI (OR for total HDL: 0.63 [95% CI: 0.45–0.90), but not with WHR (P≥0.11). None of the low-density lipoprotein (LDL) particles was associated with the two types of obesity (P≥0.092). BMI was inversely associated with the size of LDL and HDL particles, whereas high WHR was significantly associated with smaller VLDL and HDL sizes. For conventional lipid measures, both BMI and WHR were independently associated with high triglyceride and remnant cholesterol, both mainly driven from VLDL particles, and low HDL cholesterol (P≤0.008). These associations were confirmed in multivariable linear regression analysis, except the association of BMI with HDL number and the association of WHR with HDL size. With partial least squares analysis, the lipoprotein profiles of BMI and WHR were significantly associated with a high 10-year cardiovascular disease risk score, the homeostasis model assessment-estimated insulin resistance (HOMA-IR), and C-reactive protein.

Conclusion

BMI and WHR were independently associated with high triglyceride-rich lipoproteins, decreased HDL cholesterol. The size of LDL and HDL was more consistently associated with BMI than WHR. The lipoprotein alterations may link obesity with high cardiometabolic risk.

Funding Acknowledgement

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): The European Research Council; the European Research Area Net for Cardiovascular Diseases

Association of fatal and non-fatal adverse health outcomes with urinary peptides reflecting collagen I turnover

Background

Imbalance of collagen I (COL1) turnover, featured by increased synthesis and decreased degradation of collagen fibers, is a hallmark of fibrosis in the heart and blood vessels that associates with poor cardiovascular outcomes. Such as imbalance of COL1 turnover could be reflected in urine and serve as fingerprint for future adverse outcomes in general population, and high risk subjects.

Purpose

We hypothesize that imbalance of proteomic signatures of urinary peptides (UPs) reflecting COL1 turnover relate to adverse health outcomes in participants from a general population

Methods

We randomly recruited 776 participants (51.2% women; 50.5 years) from the Flemish Study on Environment, Genes and Health Outcomes cohort and measured UPs proteome by capillary electrophoresis coupled with mass spectrometry. Our analyses focused on 148 peptides of COL1 alpha-1 (COL1A1) chain that retained ≥70% signal in the whole sample. The primary endpoint included fatal and nonfatal cardiovascular endpoints. Secondary endpoints consisted of total mortality, fatal and nonfatal cardiac, coronary, and heart failure endpoints. Multivariate Cox proportional models, partial least squares analysis (PLS), log-likelihood test, and receiver operating characteristics (ROC) curve were applied.

Results

Over a median follow up of 12.4 years, 110 primary endpoints occurred, 61 participants died, 81, 41 and 24 experienced cardiac, coronary, and heart failure endpoints; respectively. In PLS analyses, upregulation of UPs signatures closer to C- and N-terminal locations of the COL1A1 chain whereas downregulation of mid-region UPs were associated with lower risk of adverse health outcomes. This pattern was inverted in subjects with cardiovascular disease, as upregulation of terminal and downregulation of mid region UPs increased risk. Adding UPs to a basic model including sex, age and usual cardiovascular risk factors significantly improved model performance between 2.54% to 4.93% (P≤0.001) for prediction of adverse health outcomes. In ROC plots, adding UPs to the basic model increased the area under the curve up to 4.00% (P&lt;0.012).

Conclusions

UPs reflecting COL1 turnover predicted adverse health outcomes. The inverted up- and down regulations of UPs in between participants with and without previous cardiovascular diseases might be explained by a shift in the UPs signatures of COL1 fragments linked to distinct fibrotic processes. Urinary proteomic might have clinical importance in documenting the extent of collagen accumulation that relates to adverse health outcomes. In patients at high cardiovascular risk, modification of collagen I fibers turnover might be a potential treatment target

Funding Acknowledgement

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): The European Union the European Research Council and the European Research Area Net for Cardiovascular Diseases.

[Prolonged epidural labor analgesia increases risks of epidural analgesia failure for conversion to cesarean section]

OBJECTIVE

To explore the effect of epidural labor analgesia duration on the outcomes of different anesthetic approaches for conversion to cesarean section.

METHODS

We retrospectively collected the clinical data of pregnant women undergoing conversion from epidural labor analgesia to cesarean section at Sichuan Maternal and Child Health Hospital and Jinjiang District Maternal and Child Health Care Hospital between July, 2019 and June, 2020. For cesarean section, the women received epidural anesthesia when the epidural catheter was maintained in correct position with effective analgesia, spinal anesthesia at the discretion of the anesthesiologists, or general anesthesia in cases requiring immediate cesarean section or following failure of epidural anesthesia or spinal anesthesia. Receiver-operating characteristic curve analysis was performed to determine the cutoff value of the analgesia duration using Youden index. The women were divided into two groups according to the cut off value for analyzing the relative risk using cross tabulations.

RESULTS

A total of 820 pregnant women undergoing conversion to cesarean section were enrolled in this analysis, including 615 (75.0%) in epidural anesthesia group, 186 (22.7%) in spinal anesthesia group, and 19 (2.3%) in general anesthesia group; none of the women experienced failure of epidural or spinal anesthesia. The mean anesthesia duration was 8.2±4.7 h in epidural anesthesia, 10.6±5.1 h in spinal anesthesia group, and 6.7 ± 5.2 h in general anesthesia group. Multivariate logistic regression analysis showed that prolongation of analgesia duration by 1 h (OR=1.094, 95% CI: 1.057-1.132, P < 0.001) and an increase of cervical orifice by 1 cm (OR=1.066, 95% CI: 1.011-1.124, P=0.017) were independent risk factors for epidural analgesia failure. The cutoff value of analgesia duration was 9.5 h, and beyond that duration the relative risk of receiving spinal anesthesia was 1.204 (95% CI: 1.103-2.341, P < 0.001).

CONCLUSION

Prolonged epidural labor analgesia increases the risk of failure of epidural analgesia for conversion to epidural anesthesia. In cases with an analgesia duration over 9.5 h, spinal anesthesia is recommended if immediate cesarean section is not required.

AB0788 The International Map of Axial Spondyloarthritis (IMAS): a US patient perspective on diagnosis and burden of disease

Background

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease encompassing radiographic (traditionally known as ankylosing spondylitis) and non-radiographic forms that lead to chronic pain, structural damage, and disability.1 The International Map of Axial Spondyloarthritis (IMAS) survey is an initiative developed to generate insights into the real-life experiences of people living with axSpA to ultimately improve quality of life.2

Objectives

To assess the burden and daily experience of patients with axSpA in the United States.

Methods

The IMAS survey generates a report on patient-reported aspects of disease burden and experience with axSpA using adaptations of the original Atlas of axSpA questionnaire developed in collaboration with patients, the Axial Spondyloarthritis International Federation, and clinical academic experts. In this US adaptation of the IMAS survey, a 30-minute quantitative online survey was administered to US patients aged ≥18 years who completed screening questions, self-reported having been diagnosed with axSpA by a healthcare provider, and were under the care of a healthcare provider between July 22, 2021, and November 10, 2021. Survey questions were tailored to reflect differences in the US healthcare systems and the availability of treatments. This analysis presents a portion of the US data describing patient demographics, clinical characteristics, journey to axSpA diagnosis, and the emotional impact and overall burden of disease on quality of life using the General Health Questionnaire 12 (GHQ-12), the Assessment of SpondyloArthritis international Society – Health Index (ASAS-HI), and a global limitation index of 18 activities of daily living. All results were reported descriptively using summary statistics.

Results

Survey data from 228 US patients with axSpA were collected in this analysis. The mean age was 45 years, 60% of patients were female, and the mean BMI was 27.7 kg/m2 (Table 1). Participating patients had an average of 5.6 comorbidities, with anxiety (43%), depression (41%), and hypertension (32%) as the most commonly reported comorbidities. Among all patients, the mean age at onset of first symptoms was 26 years and the mean age at diagnosis was 35 years; overall, mean diagnostic delay was greater in female than in male patients (11.2 vs 5.2 years; Figure 1A). According to the validated GHQ-12, over half of the patients (57%) were at risk for psychological distress (GHQ-12 score ≥3; Figure 1B). Patients who were older (>40 years old), physically inactive, or who had active disease (BASDAI ≥4) were at risk for psychological distress. Most patients (82%) suffered from a high degree of impairment (ASAS-HI ≥6), 47% had a medium or high limitation in activities of daily living, and 46% of patients were not employed at the time of the survey.

Table 1.

Patient Demographic and Clinical Characteristics

CharacteristicPatients with axSpA(N=228)Mean age, years45Female, %60White, %86Mean body mass index, kg/m227.7Nonsmoker, %62Alcohol consumption behavior, %Never19Every day9Mean number of comorbidities5.6Common comorbidities (≥20% of patients), %aAnxiety43Depression41Hypertension32Obesity/overweight31Sleep disorders30Hypercholesterolemia29Uveitis24Psoriatic arthritis23Fibromyalgia20Spinal or other fractures20Psoriasis20Employed, %54

axSpA, axial spondyloarthritis.

aRespondents could have selected ≥1 answer.

Conclusion

This study showed that a high proportion of US patients with axSpA report impaired function and are at risk for psychological distress. Patients also experienced a substantial delay in the time to axSpA diagnosis, with longer delays than those reported in the European Union. Delays were twice as long in women compared to men. These findings highlight the large impact of disease on daily activities and mental distress in US patients with axSpA.

References

[1]Sieper J, Poddubnyy D. Lancet. 2017;390:73-84.

[2]Garrido-Cumbrera M, et al. Curr Rheumatol Rep. 2019;21:19.

Acknowledgements

This study was funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA. Medical writing support was provided by Charli Dominguez, PhD, of Health Interactions, Inc, Hamilton, NJ, USA, and was funded by Novartis Pharmaceuticals Corporation. This abstract was developed in accordance with Good Publication Practice (GPP3) guidelines. Authors had full control of the content and made the final decision on all aspects of this publication.

Disclosure of Interests

Marina Magrey Consultant of: Received consulting fees from Eli Lilly and Novartis, Grant/research support from: Received research grants from AbbVie, Amgen, and UCB, Jessica A. Walsh Consultant of: Received consulting fees from Amgen, Janssen, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: Received research funding from AbbVie, Merck, and Pfizer, Sandra Flierl Employee of: Employee of Ipsos, Renato Calheiros Employee of: Employee of Novartis, David Wei Employee of: Employee of Novartis, Muhammad Asim Khan Consultant of: Has served as a consultant for Novartis

POS0966 DEVELOPMENT AND VALIDATION OF AN ANKYLOSING SPONDYLITIS RISK PREDICTION MODEL USING LONGITUDINAL REAL-WORLD DATA FROM A LARGE INTEGRATED HEALTHCARE DELIVERY SYSTEM

Background

Early detection and diagnosis of Ankylosing spondylitis (AS) is challenging due to heterogeneity in disease presentation, lack of specific biomarkers and high prevalence of mechanical back-pain that is difficult to distinguish from inflammatory back-pain. However, if diagnosed and treated early, the risk of AS complications and disease progression can be slowed.

Objectives

To develop and validate a risk prediction model for early identification of patients at high risk of AS, using a large longitudinal real-world clinical data in the US.

Methods

This retrospective study included all members aged ≥ 21 years with back pain symptoms who were enrolled in the Kaiser Permanente Southern California health plan between 01/2009-12/2013. Patients who presented with back pain symptoms at a physician visit were followed until 12/2020 to see if they subsequently developed AS. The cohort was randomly divided into a training (60%) and a validation (40%) sample. A proportional odds model was specified to create a risk score for AS in the training sample. Best fit model was determined based on Area Under the Curve (AUC) and Akaike Information Criterion (AIC). The cut off threshold of “high-risk” was based on Youden’s (1950) index.1 We assessed the model performance for internal validity using split-samples. The model was further validated using manual chart review of 900 patient records. These 900 records were selected such that 70% (N=630) met the high-risk cut-off and the remainder had scores below the cut-off. We also derived the probability of AS in each chart reviewed case using the method proposed by Feldtkeller et al. (2013) and Rudwaleit et al. (2006).2,3

Results

The cohort comprised 527,509 members with mean age 54 years and majority female (58%). Sixty-six percent were White race and 33% were Hispanic ethnicity. The crude incidence of AS was 1% and increased steadily during the follow-up period (Figure 1). The final risk prediction model included 15 risk factors and had an AUC of 0.72 (Table 1). Using Youden’s index, a cut-off value of 11 or higher was identified as the threshold to define high-risk. No evidence of overfitting to our training sample was observed based on the split-sample analysis. The model validation based on manual chart review of 900 records showed sufficient ability to discriminate between those at high-risk vs those not identified to be high-risk. When a concrete rule out or rule in determination could be made using Feldtkeller et al. approach, our model correctly classified 75% of such records.

Table 1.

Final Model Coefficients and Derived Risk Score

Model CoefficientPr(>|z|)Risk ScoreAge above 45 years0.1460.0111.46Male Sex-0.292<0.001-2.92White Race0.259<0.0012.59Non-Hispanic Ethnicity0.177<0.0011.77Corticosteroid Use (Yes/No)0.235<0.0012.35*NSAID User (Yes/No)0.202<0.0012.02Opioid Analgesic User (Yes/No)0.416<0.0014.16Had Enthesitis (Yes/No)0.298<0.0012.98Had Disorders of the Back (Yes/No)0.973<0.0019.73Had Fatigue and/or Malaise (Yes/No)0.1550.0561.55Had Psoriasis (Yes/No)0.2880.0082.88Had Spondylosis (Yes/No)0.838<0.0018.38Had Synovitis (Yes/No)0.1430.0661.43Had Uveitis (Yes/No)0.6210.0076.21Depression Diagnosis (Yes/No)0.0990.0170.99

* NSAID: Non-steroidal anti-inflammatory drugs

Figure 1.

Cumulative Incidence Over Time (in Days)

Conclusion

To aid early detection, we have developed and validated an AS risk prediction model with an easy to implement scoring system using demographics, medication use and diagnosis data that is routinely collected in clinical practice.

References:

[1]Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3(1):32-35.

[2]Feldtkeller E, Rudwaleit M, Zeidler H. Easy probability estimation of the diagnosis of early axial spondyloarthritis by summing up scores. Rheumatology (Oxford, England). 2013;52(9):1648-1650

[3]Rudwaleit M, Feldtkeller E, Sieper J. Easy assessment of axial spondyloarthritis (early ankylosing spondylitis) at the bedside. Ann Rheum Dis 2006;65:1251-2.

Disclosure of Interests

Aniket Kawatkar Grant/research support from: Novartis, Medac, Esther Yi Employee of: Novartis, Erika Estrada Grant/research support from: Novartis, Jose Pio Grant/research support from: Novartis, Cecilia Portugal Grant/research support from: Novartis, David Yi Grant/research support from: Novartis, Talar Habeshian Grant/research support from: Novartis, David Wei Employee of: Novartis, Steven Lee Grant/research support from: Novartis

Corrigendum to "Evaluation of different air distribution systems in a commercial airliner cabin in terms of comfort and COVID-19 infection risk" Build. Environ., Volume 208, January 2022, 108590

[This corrects the article DOI: 10.1016/j.buildenv.2021.108590.].

Evaluation of different air distribution systems in a commercial airliner cabin in terms of comfort and COVID-19 infection risk

The air distribution system in an airliner plays a key role in maintaining a comfortable and healthy environment in the aircraft cabin. To evaluate the performance of a novel displacement ventilation (DV) system and a traditional mixing ventilation (MV) system in an airliner cabin, this study conducted experiments and simulations in a seven-row cabin mockup. This investigation used ultrasonic anemometers and T-thermocouples to measure the air velocity, temperature and distribution of 1 μm and 5 μm particles. Simulation verifications were performed for these operating conditions, and additional scenarios with different occurrence source locations were also simulated. This study combined the Wells-Riley equation with a real case based on a COVID-19 outbreak among passengers on a long-distance bus to obtain the COVID-19 quanta value. Through an evaluation of the airflow organization, thermal comfort, and risk of COVID-19 infection, the two ventilation systems were compared. This investigation found that polydisperse particles should be used to calculate the risk of infection in airliner cabins. In addition, at the beginning of the pandemic, the infection risk with DV was lower than that with MV. In the middle and late stages of the epidemic, the infection risk with MV can be reduced when passengers wear masks, leading to an infection risk approximately equal to that of DV.

Identification of key volatile organic compounds in aircraft cabins and associated inhalation health risks

The identification of key VOCs during flights is important in creating a satisfactory aircraft cabin environment. Two VOC databases for the building indoor environment (from 251 occupied residences) and the aircraft cabin environment (from 56 commercial flights) were compared, to determine the common compounds (detection rate (DR) > 70%) in the two environments and the characteristic VOCs (only those with high DR during flights) in aircraft cabins. Possible VOC emission sources in flights were also discussed. As TVOC is usually viewed as a general indicator of air quality, the prediction of TVOC concentration was carried out using BP neural network algorithm, and the average error between the predicted and measured values was 55.35 μg/m³ (R² = 0.80). Meanwhile, the VOCs' inhalation cancer/non-cancer risks to crew members and passengers were calculated on the basis of detection rates, exposure concentrations, and health risk assessments. Six compounds (i.e., formaldehyde, benzene, tetrachloroethylene, trichloromethane, 1,2-dichloroethane, and naphthalene) were proposed as the key VOCs in the existing aircraft cabin environment, presenting a risk to crew members that is higher than the US EPA proposed acceptable level (evaluated mean value > 1E-06). The estimated lifetime excess cancer/non-cancer risks for passengers were all below the assessment criteria. Based on a summary of various VOC limits in five built environments, hierarchical design of VOC concentration limits is recommended for the aircraft environment.

Influencing factors in the simulation of airflow and particle transportation in aircraft cabins by CFD

To control the transport of particles such as the SARS-CoV-2 virus in airliner cabins, which is a significant concern for the flying public, effective ventilation systems are essential. Validated computational fluid dynamics (CFD) models are frequently and effectively used to investigate air distribution and contaminant transportation. The complex geometry and airflow characteristics in airliner cabins pose a challenge to numerical CFD validation. The objective of this investigation was to identify accurate and affordable validation processes for studying the airflow field and particulate contaminant distribution in airliner cabins during the design process for different ventilation systems. This study quantitatively evaluated the effects of ventilation system, turbulence model, particle simulation method, geometry simplification, and boundary condition assignment on airflow and particulate distributions in airliner cabins with either a mixing ventilation (MV) system or a displacement ventilation (DV) system calculated by CFD. The results showed that among four turbulence models, the standard k-ε, RNG k-ε, realizable k-ε and SST k-ω models, the prediction by the realizable k-ε model agreed most closely with the experimental data. Meanwhile, the steady Eulerian method provided a reasonable prediction of the particle concentration field with low computing cost. The computational domain should be simplified differently for the DV system and the MV system with consideration of the simulation accuracy and computing cost. For more accurate modeling results, the boundary conditions should be assigned in greater detail, taking into account the uniformity on the boundary.

Negative associations of morning serum cortisol levels with obesity: the Henan rural cohort study

AIMS

To evaluate the associations of morning serum cortisol levels with obesity defined by different indices in Chinese rural populations.

MATERIALS AND METHODS

A cross-sectional study was performed including 6198 participants (2566 males and 3632 females). Serum cortisol was collected in morning and quantified by liquid chromatography-tandem mass spectrometry. Obesity was defined by body mass index (BMI), body fat percentage (BFP), waist-to-height ratio (WHtR), waist circumference (WC), visceral fat index (VFI) and waist-to-hip ratio (WHR). Both multivariable liner regression, logistic regression and restrictive cubic splines models were used to estimate the gender-specific relationships between cortisol levels and obesity defined by different indices, respectively.

RESULTS

After adjusting for potential confounders, serum cortisol was negatively associated with different obesity measures, except obese females defined by BFP (for instance, overall obesity defined by BMI, Quartile 4 vs. Quartile 1, odds ratio (OR) = 0.25, 95% confidence interval (CI):0.15, 0.41 in males, and OR = 0.58, 95% CI: 0.42,0.80 in females, central obesity defined by WC, OR = 0.52, 95% CI:0.39,0.69 in males and OR = 0.63, 95% CI:0.51,0.77 in females). Similarly, restrictive cubic splines showed the nonlinear relationship between high levels of cortisol and different obesity indices. Furthermore, ROC curve analysis indicated that cortisol could improve the discrimination of model with common biomarkers.

CONCLUSION

Morning serum cortisol were negatively related to obesity defined by different indices in Chinese rural populations. In addition, cortisol could be as a biomarker for prediction of obesity in males.

Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement

OBJECTIVES

Individual-level social needs have been shown to substantially impact emergency department (ED) care transitions of older adults. The Geriatric Emergency care Applied Research (GEAR) Network aimed to identify care transition interventions, particularly addressing social needs, and prioritize future research questions.

METHODS

GEAR engaged 49 interdisciplinary stakeholders, derived clinical questions, and conducted searches of electronic databases to identify ED discharge care transition interventions in older adult populations. Informed by the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) framework, data extraction and synthesis of included studies included the degree that intervention components addressed social needs and their association with patient outcomes. GEAR convened a consensus conference to identify topics of highest priority for future care transitions research.

RESULTS

Our search identified 248 unique articles addressing care transition interventions in older adult populations. Of these, 17 individual care transition intervention studies were included in the current literature synthesis. Overall, common care transition interventions included coordination efforts, comprehensive geriatric assessments, discharge planning, and telephone or in-person follow-up. Fourteen of the 17 care transition intervention studies in older adults specifically addressed at least one social need within the PRAPARE framework, most commonly related to access to food, medicine, or health care. No care transition intervention addressing social needs in older adult populations consistently reduced subsequent health care utilization or other patient-centered outcomes. GEAR stakeholders identified that determining optimal outcome measures for ED-home transition interventions was the highest priority area for future care transitions research.

CONCLUSIONS

ED care transition intervention studies in older adults frequently address at least one social need component and exhibit variation in the degree of success on a wide array of health care utilization outcomes.

lnc94638 is a testis-specific long non-coding RNA involved in spermatozoa formation in Zeugodacus cucurbitae (Coquillett)

Long non-coding RNAs (lncRNAs) generally display tissue-specific distributions, and testis-specific lncRNAs form the highest proportion of lncRNAs in many species. Here, we presented a detailed analysis of testis-specific lncRNAs in the melon fly, Zeugodacus cucurbitae, a highly destructive insect pest of cucurbitaceous and other related crops. Most testis-specific lncRNAs were found to be long intergenic non-coding RNAs (lincRNA). The size distribution of these lncRNAs ranged between 600 and 1000 nucleotides. Testis-specific lncRNAs that harboured one isoform number and two exons were the most abundant. Compared to other male tissues, the testis had more highly expressed lncRNAs. The quantitative real-time polymerase chain reaction results of 10 randomly selected testis-specific lncRNAs showed expression patterns consistent with RNA-seq data. Further analysis of the most highly expressed testis-specific lncRNA, lnc94638, was undertaken. Fluorescent in situ hybridization assays localized lnc94638 to the apical region of the testis that contains mature spermatozoa. RNA interference-mediated knockdown of lnc94638 expression reduced spermatozoa numbers and impaired the fertility of Z. cucurbitae male. This study provides a catalogue of testis-specific lncRNAs, shows that the testis-specific lnc94638 is involved in spermatogenesis and has the potential to be used for treating male sterility.

Influencing factors of carbonyl compounds and other VOCs in commercial airliner cabins: On-board investigation of 56 flights

Volatile organic compounds (VOCs) as a non-negligible aircraft cabin air quality (CAQ) factor influence the health and comfort of passengers and crew members. On-board measurements of carbonyls (short-chain (C₁ -C₆ )) and other volatile organic compounds (VOCs, long-chain (C₆ -C₁₆ )) with a total of 350 samples were conducted in 56 commercial airliner cabins covering 8 aircraft models in this study. The mean concentration for each individual carbonyl compound was between 0.3 and 8.3 μg/m³ (except for acrolein & acetone, average = 20.7 μg/m³ ) similar to the mean concentrations of other highly detected VOCs (long-chain (C₆ -C₁₆ ), 97% of which ranged in 0-10 μg/m³ ) in aircraft cabins. Formaldehyde concentrations in flights were significantly lower than in residential buildings, where construction materials are known formaldehyde sources. Acetone is a VOC emitted by humans, and its concentration in flights was similar to that in other high-occupant density transportation vehicles. The variation of VOC concentrations in different flight phases of long-haul flights was the same as that of CO₂ concentration except for the meal phase, which indicates the importance of cabin ventilation in diluting the gaseous contaminants, while the sustained and slow growth of the VOC concentrations during the cruising phase in short-haul flights indicated that the ventilation could not adequately dilute the emission of VOCs. For the different categories of VOCs, the mean concentration during the cruising phase of benzene series, aldehydes, alkanes, other VOCs (detection rate > 50%), and carbonyls in long-haul flights was 44.2 µg/m³ , 17.9 µg/m³ , 18.6 µg/m³ , 31.5 µg/m³ , and 20.4 µg/m³  lower than those in short-haul flights, respectively. Carbonyls and d-limonene showed a significant correlation with meal service (p < 0.05). Unlike the newly decorated rooms or new vehicles, the inner materials were not the major emission sources in aircraft cabins. Practical Implications. The on-board measurements of 56 flights enrich the VOC database of cabin environment, especially for carbonyls. The literature review of carbonyls in the past 20 years contributes to the understanding the current status of cabin air quality (CAQ). The analysis of VOC concentration variation for different flight phases, flight duration, and aircraft age lays a foundation for exploring effective control methods, including ventilation and purification for cabin VOC pollution. The enriched VOC data is helpful to explore the key VOCs of aircraft cabin environment and to evaluate the acute/chronic health exposure risk of pollutants for passengers and crew members.

Associations of maternal hypertensive disorders during pregnancy with offspring risks of ischemic heart disease and stroke: a Nordic cohort study

Background

A substantial body of evidence suggests that children exposed to maternal hypertensive disorders during pregnancy (HDP) have increased risks of preterm birth, fetal growth restriction and several cardiovascular risk factors (e.g., hypertension, obesity, diabetes) later in life. However, the direct evidence on the link between maternal HDP and the risk of severe cardiovascular diseases such as ischemic heart disease (IHD) and stroke in the offspring is very limited.

Objective

To investigate the associations between maternal HDP and the risk of IHD and stroke in the offspring.

Methods

We conducted a population-based cohort study by linking several national registers in Sweden and Finland. Live singleton births from the Swedish Medical Birth Register (1973–2014) and the Finnish Medical Birth Register (1987- 2014) were followed for IHD and stroke until 2014 by the national patient and cause of death registers. We performed Cox regression models to examine the association between maternal HDP and its subtypes, i.e., pre-existing chronic hypertension, gestational hypertension, and preeclampsia, and the risk of IHD, and stroke in the offspring while adjusting for relevant maternal and pregnancy-related confounders. We conducted sibling analyses to control for unmeasured shared familial (genetic and/or environmental) risk factors.

Results

Among the 5,807,122 singletons included in the study, 218,322 (3.76%) children were born to mothers with HDP. During the up to 41 years of follow-up, 2,340 (0.04%) offspring were diagnosed with IHD and 5,360 (0.09%) were diagnosed with stroke. Offspring exposed to maternal HDP had an increased risk of IHD (adjusted hazard ratio (aHR), 1.29; 95% confidence interval (CI), 1.01–1.63), and stroke (aHR,1.33; 95% CI, 1.14–1.56). Significantly increased rates of stroke were also observed in children exposed to the subtypes of maternal HDP: pre-existing chronic hypertension (aHR, 1.64; 95% CI, 1.03–2.60), gestational hypertension (HR, 1.38; 95% CI, 1.08–1.77), and preeclampsia (HR, 1.26; 95% CI, 1.02–1.55). The associations between maternal HDP and offspring's IHD and stroke were independent of preterm birth and small for gestational age at birth. Maternal HDP remained associated with stroke in the offspring (aHR, 1.94; 95% CI, 1.16–3.22), but not with IHD (aHR, 0.89; 95% CI, 0.47–1.67) in the sibling analyses.

Conclusion

Children to mothers with HDP have increased rates of IHD and stroke from childhood to young adulthood. While the link between maternal HDP and IHD in the offspring seemed to be attributed to confounding by familial factors, the relation between maternal HDP and stroke persisted even when considering such confounding. Persons born to mothers with HDP may benefit from early screening and prevention efforts to reduce the risk of IHD and stroke later in life.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung Foundation

Death of a child and the risk of heart failure: a population-based cohort study from Denmark and Sweden

Background

Increasing evidence suggests that the death of a child is associated with increased risks of ischemic heart diseases and atrial fibrillation and the association is in part attributable to stress-related mechanisms. However, knowledge regarding the risk of heart failure (HF) after the death of a child is very limited.

Purpose

To study the association between the death of a child and the parents' risk of HF.

Methods

We conducted a population-based cohort study involving parents of live-born children recorded in the Danish and Swedish Medical Birth Registers during 1973–2016 and 1973–2014, respectively (n=6,717,531). We retrieved information on child death, HF diagnosis and parents' sociodemographic characteristics from several nationwide registries. We performed Poisson regression models to estimate incidence rate ratio (IRR) and 95% confidence intervals (CI) for HF.

Results

A total of 129,829 (1.9%) parents lost at least one child during the follow-up. Bereaved parents had a 35% higher risk of HF than non-bereaved parents [IRR (95% CI): 1.35 (1.29–1.41)]. The association was present not only if the child died due to cardiovascular or other natural causes [IRR (95% CI): 1.48 (1.25–1.75) and 1.35 (1.27–1.44), respectively], but also in case of unnatural deaths [IRR (95% CI): 1.32 (1.24–1.42)]. There was a trend toward a U-shaped association according to the deceased child's age at loss and the risk of HF. Bereaved parents who lost their only child or had three or more remaining live children at the time of loss had higher HF risk than those with one or two live children at the time of loss. We found no clear evidence for a difference in the association of interest over time.

Conclusions

The death of a child was associated with an increased risk of HF. The finding that not only cardiovascular and other natural deaths, but also unnatural deaths were associated with HF suggests that stress-related mechanisms may contribute to the development of HF.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Swedish Council for Working Life and Social Research and Karolinska Institutet's Research Foundation

The diagnostic indicators of gestational diabetes mellitus from second trimester to birth: a systematic review

BACKGROUND

Gestational diabetes mellitus (GDM) is glucose intolerance first recognised during pregnancy. Both modalities and thresholds of the GDM diagnostic test, the Oral Glucose Tolerance Test (OGTT), have varied widely over time and among countries. Additionally, OGTT limitations include inconsistency, poor patient tolerability, and questionable diagnostic reliability. Many biological parameters have been reported to be modified by GDM and could potentially be used as diagnostic indicators. This study aimed to 1) systematically explore biomarkers reported in the literature as differentiating GDM from healthy pregnancies 2) screen those indicators assessed against OGTT to propose OGTT alternatives.

MAIN BODY

A systematic review of GDM diagnostic indicators was performed according to PRISMA guidelines (PROSPERO registration CRD42020145499). Inclusion criteria were full-text, comprehensible English-language articles published January 2009-January 2021, where a biomarker (from blood, ultrasound, amniotic fluid, placenta) was compared between GDM and normal glucose tolerance (NGT) women from the second trimester onward to immediately postpartum. GDM diagnostic method had to be clearly specified, and the number of patients per study higher than 30 in total or 15 per group. Results were synthesised by biomarkers.

RESULTS

Of 13,133 studies identified in initial screening, 174 studies (135,801 participants) were included. One hundred and twenty-nine studies described blood analytes, one amniotic fluid analytes, 27 ultrasound features, 17 post-natal features. Among the biomarkers evaluated in exploratory studies, Adiponectin, AFABP, Betatrophin, CRP, Cystatin-C, Delta-Neutrophil Index, GGT, TNF-A were those demonstrating statistically and clinically significant differences in substantial cohorts of patients (> 500). Regarding biomarkers assessed versus OGTT (i.e. potential OGTT alternatives) most promising were Leptin > 48.5 ng/ml, Ficolin3/adiponectin ratio ≥ 1.06, Chemerin/FABP > 0.71, and Ultrasound Gestational Diabetes Score > 4. These all demonstrated sensitivity and specificity > 80% in adequate sample sizes (> / = 100).

CONCLUSIONS

Numerous biomarkers may differentiate GDM from normoglycaemic pregnancy. Given the limitations of the OGTT and the lack of a gold standard for GDM diagnosis, advanced phase studies are needed to triangulate the most promising biomarkers. Further studies are also recommended to assess the sensitivity and specificity of promising biomarkers not yet assessed against OGTT.

TRIAL REGISTRATION

PROSPERO registration number CRD42020145499.

Association of maternal gestational weight gain with intellectual developmental disorder in the offspring: a nationwide follow-up study in Sweden

OBJECTIVES

To investigate the association between maternal gestational weight gain (GWG) and offspring's intellectual developmental disorders (IDD); how this association is modified by maternal early-pregnancy BMI.

DESIGN

Population-based cohort study.

SETTING AND POPULATION

All liveborn singletons with information on maternal GWG in the Swedish Medical Register during 1992-2006 (n = 467 485).

METHODS

We used three GWG classifications, (1) Institute of Medicine (IOM) guidelines ('ideal' GWG: maternal underweight = 12.7-18.1 kg; normal = 11.3-15.9 kg; overweight = 6.8-11.3 kg; obesity = 5.0-9.1 kg), (2) LifeCycle project recommendation ('ideal' GWG: maternal underweight = 14.0-16.0 kg; normal = 10.0-18.0 kg; overweight = 2.0-16.0 kg; obesity class I = 2.0-6.0 kg; obesity class II ≤0.0-4.0 kg; obesity class III ≤0.0-6.0 kg) and (3) GWG centiles. Hazard ratio (HR) and 95% CI for offspring's IDD risk using Cox regression.

MAIN OUTCOME MEASURES

IDD was extracted from Swedish National Patient Register (code ICD-9:317-319/ICD-10:F70-F79).

RESULTS

Forty-one per cent of children were born to mothers with excessive GWG, 32.8% with ideal GWG and 26.2% with inadequate GWG according to IOM guidelines. Inadequate GWG was associated with 21% higher risk of offspring's IDD (95% CI 1.11-1.31) relative to ideal GWG. In contrast, when using the LifeCycle classification, children of mothers with inadequate GWG (HR 1.14, 95% CI 1.05-1.24) or excessive GWG (HR 1.09, 95% CI 1.01-1.17) had higher risks of IDD than those of mothers with ideal GWG. When using GWG centiles, extremely low GWG (<20th centile) and low GWG (20th-40th centile) were associated with elevated offspring's IDD risk. Further stratified analysis by maternal early-pregnancy body mass index (BMI) showed that overweight/obese mothers (BMI ≥25 kg/m² ) with extremely excessive GWG (>25 kg) was associated with an increased offspring's IDD.

CONCLUSION

Our findings suggest that inadequate maternal GWG may increase offspring's IDD risk, irrespective of maternal early-pregnancy BMI. Extremely excessive GWG (>25 kg) may increase offspring's IDD risk, but only among mothers with an early-pregnancy BMI ≥25 kg/m² .

TWEETABLE ABSTRACT

Inadequate maternal weight gain during pregnancy may increase the risk of offspring's intellectual disability, regardless of maternal BMI.

A Systematic Review and Meta-Analysis of Statins in Animal Models of Intracerebral Hemorrhage

BACKGROUND

Intracerebral hemorrhage (ICH) is a severe form of stroke with limited treatment options. Statins have shown promise as a therapy for ICH in animal and human studies. We systematically reviewed and assessed the quality of preclinical studies exploring statin-use after ICH to guide clinical trial decision-making and design.

METHODS

We identified preclinical trials assessing the efficacy of statins in ICH via a systematic review of the literature according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In total, 16 studies were identified that described statin use in an animal model of ICH and assessed histological outcomes, behavioral scores, or both. Design characteristics were analyzed using Stroke Therapy Academic Industry Roundtable (STAIR) criteria modified for ICH. Meta-analysis was performed using a random effects model.

RESULTS

Behavioral outcomes were assessed in 12 of the studies with 100% (n = 12) reporting that statins significantly improved ICH recovery. Histologic hematoma volume and brain water content outcomes were analyzed in 10 of the studies, with 50% (n = 5) reporting significant improvement. The ratio of means between experimental and control cases for modified Neurological Severity Score was 0.63 (95% confidence interval 0.49-0.82). The ratio of means between experimental and control cases for hemorrhagic volume was 0.85 (95% confidence interval 0.70-1.03). There was heterogeneity between studies (P < 0.0001) but no evidence of publication bias (P = 0.89, P = 0.59, respectively).

CONCLUSIONS

Behavioral outcomes in ICH were found to consistently improve with administration of statins in preclinical studies suggesting that statin therapy may be suitable for randomized clinical trials in humans. In addition, the STAIR criteria can be modified to effectively evaluate preclinical studies in ICH.

Delirium Prevention, Detection, and Treatment in Emergency Medicine Settings: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement

BACKGROUND

Older adult delirium is often unrecognized in the emergency department (ED), yet the most compelling research questions to overcome knowledge-to-practice deficits remain undefined. The Geriatric Emergency care Applied Research (GEAR) Network was organized to identify and prioritize delirium clinical questions.

METHODS

GEAR identified and engaged 49 transdisciplinary stakeholders including emergency physicians, geriatricians, nurses, social workers, pharmacists, and patient advocates. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews, clinical questions were derived, medical librarian electronic searches were conducted, and applicable research evidence was synthesized for ED delirium detection, prevention, and management. The scoping review served as the foundation for a consensus conference to identify the highest priority research foci.

RESULTS

In the scoping review, 27 delirium detection "instruments" were described in 48 ED studies and used variable criterion standards with the result of delirium prevalence ranging from 6% to 38%. Clinician gestalt was the most common "instrument" evaluated with sensitivity ranging from 0% to 81% and specificity from 65% to 100%. For delirium management, 15 relevant studies were identified, including one randomized controlled trial. Some intervention studies targeted clinicians via education and others used clinical pathways. Three medications were evaluated to reduce or prevent ED delirium. No intervention consistently prevented or treated delirium. After reviewing the scoping review results, the GEAR stakeholders identified ED delirium prevention interventions not reliant on additional nurse or physician effort as the highest priority research.

CONCLUSIONS

Transdisciplinary stakeholders prioritize ED delirium prevention studies that are not reliant on health care worker tasks instead of alternative research directions such as defining etiologic delirium phenotypes to target prevention or intervention strategies.

Coordination of primary metabolism and virulence factors expression mediates the virulence of Vibrio parahaemolyticus towards cultured shrimp (Penaeus vannamei)

AIMS

Acute hepatopancreatic necrosis disease (AHPND) caused by Vibrio parahaemolyticus has emerged as a severe bacterial disease of cultured shrimp. To identify the key virulence factors, two AHPND-causing V. parahaemolyticus (Vp_AHPND ) strains (123 and 137) and two non-Vp_AHPND strains (HZ56 and ATCC 17082) were selected.

METHODS AND RESULTS

Challenge tests showed that the four strains exhibited different virulence towards shrimp with cumulative mortalities at 48 h postinfection (hpi) ranging from 10 to 92%. The expression of pirAB^VP in strain 123 and 137 was not significantly different. Genomic analysis revealed that the two Vp_AHPND strains contain a plasmid with the PirAB^VP toxins (pirAB^VP ) flanked by the insertion sequence (ISVal1) that has been identified in various locations of chromosomes in Vp_AHPND strains. The two Vp_AHPND strains possessed almost identical virulence factors, while ISVal1 disrupted three genes related to flagellar motility in strain 137. Phenotype assay showed that strain 123 possessed the highest growth rate and swimming motility, followed by strain 137, suggesting that the disruption of essential genes mediated by ISVal1 significantly affected the virulence level. Transcriptome analysis of two Vp_AHPND strains (123 and 137) further suggested that virulence genes related to the capsule, flagella and primary metabolism were highly expressed in strain 123.

CONCLUSIONS

Here for the first time, it is demonstrated that the virulence of Vp_AHPND is not only determined by the expression of pirAB^VP , but also is mediated by ISVal1 which affects the genes involved in flagellar motility and primary metabolism.

SIGNIFICANCE AND IMPACT OF THE STUDY

The genomic and transcriptomic analysis of Vp_AHPND strains provides valuable information on the virulence factors affecting the pathogenicity of Vp_AHPND.