Spatial proteo-transcriptomic profiling reveals the molecular landscape of borderline ovarian tumors and their invasive progression

Serous borderline tumors (SBT) are epithelial neoplastic lesions of the ovaries that commonly have a good prognosis. In 10-15% of cases, however, SBT will recur as low-grade serous cancer (LGSC), which is deeply invasive and responds poorly to current standard chemotherapy1,2,3. While genetic alterations suggest a common origin, the transition from SBT to LGSC remains poorly understood4. Here, we integrate spatial proteomics5 with spatial transcriptomics to elucidate the evolution from SBT to LGSC and its corresponding metastasis at the molecular level in both the stroma and the tumor. We show that the transition of SBT to LGSC occurs in the epithelial compartment through an intermediary stage with micropapillary features (SBT-MP), which involves a gradual increase in MAPK signaling. A distinct subset of proteins and transcripts was associated with the transition to invasive tumor growth, including the neuronal splicing factor NOVA2, which was limited to expression in LGSC and its corresponding metastasis. An integrative pathway analysis exposed aberrant molecular signaling of tumor cells supported by alterations in angiogenesis and inflammation in the tumor microenvironment. Integration of spatial transcriptomics and proteomics followed by knockdown of the most altered genes or pharmaceutical inhibition of the most relevant targets confirmed their functional significance in regulating key features of invasiveness. Combining cell-type resolved spatial proteomics and transcriptomics allowed us to elucidate the sequence of tumorigenesis from SBT to LGSC. The approach presented here is a blueprint to systematically elucidate mechanisms of tumorigenesis and find novel treatment strategies.

Abstract 6782: Spatial transcriptomics of serous tubal intraepithelial carcinoma and its putative precursor lesions

Background: Increasing evidence over the past two decades has implicated serous tubal intraepithelial carcinoma (STIC) of the fallopian tube (FT) epithelium as the putative precursor lesion for high-grade serous ovarian cancer (HGSC). Additional atypical lesions of the FT known as p53 signature lesions and serous tubal intraepithelial lesions (STIL) have been proposed as early precursors in the carcinogenic sequence based on morphology, histochemical and genetic studies. Little however is known about the molecular events that drive FT epithelial cells to transform into HGSC. Methods: To elucidate the molecular changes that underlie the progression from p53 signature to STIL to STIC, we performed spatial transcriptomics on formalin-fixed paraffin embedded (FFPE) tissue sections using the Nanostring GeoMx Whole Transcriptome Atlas panel (18,000 protein-encoding gene panel). Our study cohort consisted of 16 representative cases (3 p53 signature cases, 3 STIL cases, 3 STIC lesions, and 7 STIC cases with matched HGSC). Results: We characterized gene expression to a depth of over 9400 genes in these rare precursor cell populations. Our analysis demonstrated that by gene expression profiles, p53 signatures and STIL lesions bear close resemblance to normal FT secretory cells compared to FT ciliated cells or even STIC and invasive HGSC. We identify for the first time, several pathways altered in expression between normal fallopian tube epithelium and early p53 signature lesions including those related to signaling pathways (Trop-2), Wnt pathway (LGR5), identifying new pathways observed in the progression from normal FT cells to precursor intraepithelial lesion. Our data show that STIC lesions bear significant similarities to invasive HGSC by gene expression, especially compared to the earlier precursor lesions (p53 signature and STIL). We observed several alterations in cell-adhesion(EGR1) and signaling pathways, transcription factors (Trop-2) and metabolism that mark the transition from STIC to HGSC, representing possible mechanisms by which these intraepithelial lesions transform into disseminated invasive disease. Conclusion: Our data profile HGSC precursor lesions in high-depth with characterization of over 9400 genes providing new insight into the molecular alterations that characterize these intraepithelial lesions. Our future direction is to pair transcriptomics data with our established spatial proteomics platform (Deep Visual Proteomics) to measure matched spatial protein expression in our cohort.

Citation Format: Rahul Krishnan, Lisa Schweizer, Agnes Bilecz, Aasa Shimizu, Rachelle Mendoza, Diane Yamada, Ricardo Lastra, Matthias Mann, Ernst Lengyel. Spatial transcriptomics of serous tubal intraepithelial carcinoma and its putative precursor lesions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6782.

Tomographic and centroid reconstructions of plasma emission on C-2W via enhanced 300-channel bolometry system

The C-2W experimental device at TAE Technologies utilizes neutral beam injection and edge biasing to sustain long-lived, stable field reversed configuration (FRC) plasma. An ongoing effort is under way to optimize the electrode biasing system, which provides boundary control to stabilize the FRC. To this end, tomography offers a powerful and non-invasive technique as tomographic reconstruction of the FRC emission profile provides an important assessment of global stability. Recently, a new signal acquisition system was implemented on a bolometer array dedicated to tomography on C-2W, significantly enhancing the signal-to-noise of the collected data. The array consists of 300 simultaneously digitized photodiode channels that respond to a broad range of wavelengths, from soft x-ray to near-infrared, as well as energetic particles, yielding 180 unique lines of sight that intersect a toroidal plane of the FRC near the mid-plane. Utilizing the collected photo-signals from a set of plasma discharges in which the electrode biasing was intentionally terminated mid-shot, time-resolved reconstruction of the plasma emissivity is achieved via pixel-based 1D and 2D tomographic algorithms, revealing sharply annular profiles with a clear magnetohydrodynamic (MHD) mode structure. In addition, reconstruction of the plasma center-of-emission trajectories via a centroid algorithm applied to the same set of discharges demonstrates a cyclical plasma wobble. Crucially, both the tomography reconstruction and centroid reconstruction indicate an n = 1 toroidal mode that reverses from the electron diamagnetic direction to the ion diamagnetic direction and grows in amplitude after bias termination, qualitatively consistent with the expected stabilizing effect of electrodes.

Using patient biomarker time series to determine mortality risk in hospitalised COVID-19 patients: A comparative analysis across two New York hospitals

A large range of prognostic models for determining the risk of COVID-19 patient mortality exist, but these typically restrict the set of biomarkers considered to measurements available at patient admission. Additionally, many of these models are trained and tested on patient cohorts from a single hospital, raising questions about the generalisability of results. We used a Bayesian Markov model to analyse time series data of biomarker measurements taken throughout the duration of a COVID-19 patient’s hospitalisation for n = 1540 patients from two hospitals in New York: State University of New York (SUNY) Downstate Health Sciences University and Maimonides Medical Center. Our main focus was to quantify the mortality risk associated with both static (e.g. demographic and patient history variables) and dynamic factors (e.g. changes in biomarkers) throughout hospitalisation, by so doing, to explain the observed patterns of mortality. By using our model to make predictions across the hospitals, we assessed how predictive factors generalised between the two cohorts. The individual dynamics of the measurements and their associated mortality risk were remarkably consistent across the hospitals. The model accuracy in predicting patient outcome (death or discharge) was 72.3% (predicting SUNY; posterior median accuracy) and 71.3% (predicting Maimonides) respectively. Model sensitivity was higher for detecting patients who would go on to be discharged (78.7%) versus those who died (61.8%). Our results indicate the utility of including dynamic clinical measurements when assessing patient mortality risk but also highlight the difficulty of identifying high risk patients.

Colchicine in patients with acute myocardial infarction: an updated meta-analysis of randomized controlled trials

Background

Improvement in cardiovascular outcomes and treatment with anti-inflammatory agents have been the subject of many research. Colchicine inhibits tubulin polymerization and is used in treating pericarditis. Recent studies have shown its benefit when used for coronary events. The objective of this meta-analysis is to reexamine the role of colchicine in reducing cardiovascular events in acute coronary syndromes in light of more recent trials.

Methods

A systematic search for randomized controlled trials which involves use of colchicine and acute coronary syndrome was done using PubMed, Google Scholar, MEDLINE and Clinicaltrials.gov. Studies done in the last decade and those involving human subjects were included in the study.

Results

Seven RCT's (n: 11,282) were included in this meta-analysis comparing colchicine vs. placebo. Dose ranged from 0.5mg/day to 1mg/day. Among patients being treated for ACS, colchicine was associated with a significant reduction in composite cardiovascular outcomes (RR 0.69, 95% CI 0.60 – 0.79, P<0.ehab724.12731), unstable angina (RR 0.67, 95% CI 0.55 – 0.82, P<0.0001), and myocardial infarction (RR 0.75, 95% CI 0.62 – 0.92, P<0.005,). Gastrointestinal events were evident in the colchicine group with no statistical difference between the two (RR 1.28, 95% CI 0.98 – 1.67, P 0.07).

Conclusion

Use of colchicine reduces composite cardiovascular outcomes, recurrence of unstable angina and MI among patient who had ACS. There was no statistically significant difference between colchicine and placebo in terms of gastrointestinal events. It is possible that colchicine be part of the standard treatment in patients with acute coronary syndrome.

Funding Acknowledgement

Type of funding sources: None. Myocardial infarction forest plot

Efficient solar removal of acetaminophen contaminant from water using flexible graphene composites functionalized with Ni@TiO2:W nanoparticles

This work presents the morphological, structural and photocatalytic properties of flexible graphene composites decorated with Ni@TiO₂:W nanoparticles (TiNiW NPs) with an average size of 27 ± 2 nm. The TiNiW NPs were immobilized on the surface of a flexible graphene composite using a PVA-based slurry-paste (FG/TiNiW composite). The SEM study showed that the TiNiW NPs remained exposed on the surface of the FG/TiNiW composite, which benefited its photocatalytic activity. The photocatalytic performance for the degradation of acetaminophen (ACT) was evaluated using both the TiNiW powders and the FG/TiNiW composite, obtaining maximum degradation efficiencies of 100 and 86%, respectively, after 3 h under natural solar irradiation. The degradation of ACT was caused mainly by the reactive oxygen species such as OH radicals and h⁺, which was confirmed by scavenger experiments. Photoluminescence, XPS and absorbance experiments revealed that oxygen vacancy defects were created by i) doping the TiNiW NPs with W and by ii) introducing graphene into the composites. These defects enhanced the absorbance of light in the range of 400-800 nm, which in turn, promoted the photocatalytic degradation of ACT. Moreover, the reuse experiments confirmed that both the TiNiW NPs and FG/TiNiW composite were very stable for the degradation of ACT, since degradation efficiencies >82% were obtained after 4 reuse cycles for both photocatalysts. The experimental findings of this work demonstrate that the flexible TiO₂/graphene composites are a feasible option for the removal of pharmaceutical contaminants from water using natural solar irradiation.

HLA B53 is associated with a poor outcome in black COVID-19 patients

A disproportionate incidence of death has occurred in African Americans (Blacks) in the United States due to COVID-19. The reason for this disparity is likely to be multi-factorial and may involve genetic predisposition. The association of human leukocyte antigens (HLA) with severe COVID-19 was examined in a hospitalized population (89% Black, n = 36) and compared to HLA typed non-hospitalized individuals (20% Black, n = 40) who had recovered from mild disease. For additional comparison, HLA typing data was available from kidney transplant recipients and deceased donors. Hospitalized patients were followed for 45 days after admission to our medical center with death as the primary end-point. One HLA allele, B53, appeared to be more prevalent in the hospitalized COVID-19 patients (percent of positive subjects, 30.5) compared to national data in US Black populations (percent of positive subjects, 24.5). The percent B53 positive in non-hospitalized COVID-19 patients was 2.6, significantly less than the percent positive in the hospitalized COVID-19 patients (p = 0.001, Fisher’s exact test) and less than the 8 percent positive listed in national data bases for US Caucasian populations. Significantly greater deaths (73 percent) were observed in HLA B53 positive hospitalized COVID-19 patients compared to hospitalized COVID-19 patients who were B53 negative (40 percent). Multi-variate analysis indicated that HLA B53 positive Black hospitalized COVID-19 patients were at a 7.4 fold greater risk of death than Black COVID-19 patients who were B53 negative. Consideration for accelerated vaccination and treatment should be given to HLA B53 positive Black COVID19 patients.

Ephrin-A1 and the sheddase ADAM12 are upregulated in COVID-19

More than 3.5 million people have died globally from COVID-19, yet an effective therapy is not available. It is, therefore, important to understand the signaling pathways that mediate disease progression in order to identify new molecular targets for therapeutic development. Here, we report that the blood serum levels of ephrin-A1 and the sheddase ADAM12 were significantly elevated in COVID-19 patients treated at SUNY Downstate Hospital of Brooklyn, New York. Both ephrin-A1 and ADAM12 are known to be involved in inflammation and regulate endothelial cell permeability, thus providing a gateway to lung injury. The clinical outcome correlated with the ephrin-A1 and ADAM12 serum levels during the first week of hospitalization. In contrast, the serum levels of TNFα were elevated in only a small subset of the patients, and these same patients also had highly elevated levels of the sheddase ADAM17. These data indicate that ephrin-A1-mediated inflammatory signaling may contribute to COVID-19 disease progression more so than TNFα-mediated inflammatory signaling. They also support the notion that, in COVID-19 inflammation, ADAM12 sheds ephrin-A1, while ADAM17 sheds TNFα. Furthermore, the results suggest that elevated serum levels and activity of cytokines, such as TNFα, and other secreted inflammatory molecules, such as ephrin-A1, are not simply due to overexpression, but also to upregulation of sheddases that release them into the blood circulation. Our results identify ephrin-A1, ADAM12, and other molecules in the ephrin-A1 signaling pathway as potential pharmacological targets for treating COVID-19 inflammation.

A Dynamic Bayesian Model for Identifying High-Mortality Risk in Hospitalized COVID-19 Patients

As Coronavirus Disease 2019 (COVID-19) hospitalization rates remain high, there is an urgent need to identify prognostic factors to improve patient outcomes. Existing prognostic models mostly consider the impact of biomarkers at presentation on the risk of a single patient outcome at a single follow up time. We collected data for 553 Polymerase Chain Reaction (PCR)-positive COVID-19 patients admitted to hospital whose eventual outcomes were known. The data collected for the patients included demographics, comorbidities and laboratory values taken at admission and throughout the course of hospitalization. We trained multivariate Markov prognostic models to identify high-risk patients at admission along with a dynamic measure of risk incorporating time-dependent changes in patients' laboratory values. From the set of factors available upon admission, the Markov model determined that age >80 years, history of coronary artery disease and chronic obstructive pulmonary disease increased mortality risk. The lab values upon admission most associated with mortality included neutrophil percentage, red blood cells (RBC), red cell distribution width (RDW), protein levels, platelets count, albumin levels and mean corpuscular hemoglobin concentration (MCHC). Incorporating dynamic changes in lab values throughout hospitalization lead to dramatic gains in the predictive accuracy of the model and indicated a catalogue of variables for determining high-risk patients including eosinophil percentage, white blood cells (WBC), platelets, pCO2, RDW, large unstained cells (LUC) count, alkaline phosphatase and albumin. Our prognostic model highlights the nuance of determining risk for COVID-19 patients and indicates that, rather than a single variable, a range of factors (at different points in hospitalization) are needed for effective risk stratification.

Correlation of Automated Chemiluminescent Method with Enzyme-Linked Immunosorbent Assay (ELISA) Antibody Titers in Convalescent COVID-19 Plasma Samples: Development of Rapid, Cost-Effective Semi-Quantitative Diagnostic Methods

Background

We investigated the utility of an automated chemiluminescent SARS-CoV-2 IgG antibody assay platform in quantifying the amount of binding antibodies present in donated convalescent plasma.

Methods

A total of 179 convalescent plasma units were analyzed for the presence of SARS-CoV-2 IgG antibodies using the Beckman-Coulter chemiluminescent immunoassay (CLIA) platform. The equipment-derived numerical values (S/Co ratio) were recorded. Aliquots from the same units were subjected to enzyme-linked immunosorbent assay (ELISA) that detects IgG antibodies against the receptor-binding domain (RBD) of the SARS-CoV-2 S1 protein. The relationship between ELISA titers and CLIA S/Co values was analyzed using linear regression and receiver operating characteristics (ROC) curve.

Results

Twenty-one samples (11.7%) had S/Co values of less than 1.0 and were deemed negative for antibodies and convalescent plasma had S/Co values between >1.0 and 5.0 (70/179, 39.1%). Fifteen units (8.4%) had negative ELISA titer. The majority of the units (95/179. 53.1%) had titers ≥1:1024. The sensitivities of ELISA to CLIA were comparable (90.5% vs 88.3%, respectively; p=0.18). There was positive linear correlation between CLIA S/Co values and ELISA IgG titer (Rho = 0.75; Spearman’s rank = 0.82, p-value = <0.0001). The agreement between the two methods was fair, with a κ index of 0.2741. Using the ROC analysis, we identified a CLIA S/Co cutoff value of 8.2, which gives a sensitivity of 90% and a specificity of 82% in predicting a titer dilution of ≥1:1024.

Conclusion

The utility of automated antibody detection systems can be extended from simply a screening method to a semi-quantitative and quantitative functional antibody analysis. CLIA S/Co values can be used to reliably estimate the ELISA antibody titer. Incorporation of chemiluminescent-based methods can provide rapid, cost-effective means of identifying anti-SARS-CoV-2 antibody titers in donated plasma for use in the treatment of COVID-19 infection.

A Rare Case of Congenital Factor X Mild Deficiency Presenting as Life-Threatening Hemorrhagic Shock in a Neonate

Introduction

Congenital factor X deficiency is one of rarest bleeding disorders, occurring in 1 out of 1 million births. Its rarity limits its consideration in newborns presenting with hemodynamic instability. It is autosomal recessive and seen frequently in the consanguineous population. Patients with factor X deficiency are classified into three groups, based on factor X activity level: severe (<1%), moderate (1%-4%), and mild (6%-10%). Severe deficiency presents with bleeding diathesis early in life.

Methods

A 3-day-old male newborn, delivered at term via spontaneous vaginal delivery, presented in a well-baby clinic for a routine bilirubin check. Family history was negative for bleeding disorder or consanguinity. Nurse noted persistent blood oozing at heel stick site and oral, nasal, and umbilical stump bleeding. The patient immediately developed respiratory distress and shock. Sepsis, vitamin K deficiency, and congenital metabolic syndrome were considered. Liver function, WBC count, and other chemistry were normal, and cultures were negative. Hemoglobin was low and platelet count was elevated. PT (30.3 seconds) and aPTT (53.3 seconds) were both prolonged. Mixing patient’s sample with normal plasma corrected PT (13.1 seconds) and aPTT (25.7 seconds), indicating a factor deficiency.

Results

Coagulation factor assays revealed normal levels of factors VII, VIII, IX, and II. Factor X activity (12.9%) was low. The patient’s condition improved after multiple pRBC and plasma transfusions. He was placed on a daily 25-mL/kg dose of fresh-frozen plasma, which maintained his PT at 17.6 to 19.1 seconds and aPTT at 34.1 to 48.0 seconds. Factor X level increased to 20% after plasma transfusion.

Conclusion

Congenital bleeding disorder should be considered for neonates presenting with bleeding and shock. Factor X deficiency is suspected when both PT and aPTT are prolonged and corrected with mixing studies. Although factor levels of 10% to 40% are considered adequate for hemostasis, our patient with 12% factor X activity presented with a life-threatening bleeding event.

Current Practices in Cross-Cultural Neuropsychology: A Survey of Providers' Use of Appropriate Normative Data and Views on a Web-based Approach to the Collection and Dissemination of Normative Data for Spanish-speaking Populations

Objective

As the U.S. Spanish-speaking population grows, neuropsychologists provide assessment services to an increasingly diverse group of individuals. In response to the need for a centralized resource, NeuroShare, a no-cost website that collects and organizes cross-cultural neuropsychological normative data was created. The purpose of this study was to gather information on the current practices of cross-cultural neuropsychology, the utility of NeuroShare, and potential improvements that could be made to the platform.

Participants and Method

An anonymous survey was distributed to neuropsychologists and trainees through national and regional professional listservs. Participants’ demographics, clinical experience, and current practices (e.g. use of language specific normative data, assessment of acculturation/bilingualism) when providing neuropsychological services to Spanish-speaking populations were collected. The survey examined feedback on the NeuroShare database.

Results

60 participants completed the survey, and they were primarily White/ Caucasian (62%), along with Hispanic/ Latino (36%), Black/African American (1%), and biracial/multiracial (1%). About 66% reported that they often search for Spanish language normative data depending on the patient’s demographics. 70% of respondents reported administering tests developed primarily for English-speaking populations, that are then adapted, when testing Spanish-speaking individuals. Some recommendations for improving Neuroshare included the incorporation of pediatric normative data and a normative data calculator tool.

Conclusions

This study highlights the needs and benefits of a comprehensive, easy to use system in collecting and organizing normative information for diverse populations. NeuroShare serves as a tool to facilitate the practice of cross-cultural neuropsychology, as well as a catalyst to improve neuropsychological services through the provision of improved access to appropriate normative measures for use with diverse populations.

Primary Epithelioid Angiosarcoma of the Breast: A Rare and Challenging Biopsy Diagnosis

BACKGROUND Primary angiosarcoma of the breast is a rare neoplasm, accounting for less than 0.04% of all breast cancers. Epithelioid angiosarcoma is even more unusual with only a handful of cases reported in literature. Differentiating this from other breast malignancy is a challenge. There have been conflicting reports regarding factors that affect prognosis. We present a case of primary epithelioid angiosarcoma of the breast, and also discuss the prognostic and differential diagnostic issues. CASE REPORT A 70-year old female presented with slowly enlarging fungating mass in the right breast with a necrotic center and serosanguineous discharge. Initial biopsy done at an outside institution reported the lesion as carcinosarcoma. Histologic sections showed cellular, infiltrative neoplasm with extensive necrosis and ectatic vascular proliferations lined by plump endothelial cells. Infiltrative cells were spindle-shaped with vacuolated cytoplasm and marked anisonucleosis in myxoid background. Mitotic activity was brisk. CAM5.2, AE1/AE3, and CD31 were positive. Proliferation index was high. Estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2)/neu were negative. CONCLUSIONS Primary epithelioid angiosarcoma of the breast can present as a diagnostic dilemma in needle biopsies. This malignancy may mimic carcinoma or benign endothelial lesions. This entity is important to be recognized because it carries poor prognostic risk and requires distinct treatment modalities different from the usual epithelial breast neoplasms.

Integrated diagnostic and data analysis system of the C-2W advanced beam-driven field-reversed configuration plasma experiment

The new C-2W experiment (also called Norman) at TAE Technologies, Inc. studies the evolution of field-reversed configuration (FRC) plasmas sustained by neutral beam injection. Data on the FRC plasma performance are provided by a comprehensive suite of diagnostics that includes over 700 magnetic sensors, four interferometer systems, multi-chord far-infrared polarimetry, two Thomson scattering systems, ten types of spectroscopic measurements, multiple fast imaging cameras with selectable atomic line filters, bolometry, reflectometry, neutral particle analyzers, and fusion product detectors. Most of these diagnostic systems are newly built using experience and data from the preceding C-2U experiment to guide the design process. A variety of commercial and custom acquisition electronics collect over 4000 raw signals from the C-2W diagnostics. These data are processed into physics results using a large-scale database of diagnostics metadata and analysis software, both built using open-source software tools.

Enhanced magnetic field probe array for improved excluded flux calculations on the C-2U advanced beam-driven field-reversed configuration plasma experiment

External flux conserving coils were installed onto the exterior of the C-2U [M. W. Binderbauer et al., Phys. Plasmas 22, 056110 (2015)] confinement vessel to increase the flux confinement time of the system. The 0.5 in. stainless steel vessel wall has a skin time of ∼5 ms. The addition of the external copper coils effectively increases this time to ∼7 ms. This led to better-confined/longer-lived field-reversed configuration (FRC) plasmas. The fringing fields generated by the external coils have the side effect of rendering external field measurements invalid. Such measurements were key to the previous method of excluded flux calculation [M. C. Thompson et al., Rev. Sci. Instrum. 83, 10D709 (2012)]. A new array of B-dot probes and Rogowski coils were installed to better determine the amount of flux leaked out of the system and ultimately provide a more robust measurement of plasma parameters related to pressure balance including the excluded flux radius. The B-dot probes are surface mountable chip inductors with inductance of 33 μH capable of measuring the DC magnetic field and transient field, due to resistive current decay in the wall/coils, when coupled with active integrators. The Rogowski coils measure the total change in current in each external coil (150 A/2 ms). Currents were also actively driven in the external coils. This renders the assumption of total flux conservation invalid which further complicates the analysis process. The ultimate solution to these issues and the record breaking resultant FRC lifetimes will be presented.

Far infrared laser polarimetry and far forward scattering diagnostics for the C-2 field reversed configuration plasmas

A two-chord far infrared (FIR) laser polarimeter for high speed sub-degree Faraday rotation measurements in the C-2 field reversed configuration experiment is described. It is based on high power proprietary FIR lasers with line width of about 330 Hz. The exceptionally low intrinsic instrument phase error is characterized with figures of merit. Significant toroidal magnetic field with rich dynamics is observed. Simultaneously obtained density fluctuation spectra by far forward scattering are presented.

Congenital malformations, chromosomal abnormalities and perinatal results in IVF/ICSI newborns resulting from very poor quality embryos: a case-control study

AIMS

To explore whether the transfer of very poor quality (VPQ) embryos is associated with an increase in congenital malformations or perinatal problems.

METHODS

In this retrospective case-control study, 74 children conceived by in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI) resulting exclusively from the transfer of VPQ embryos were compared with 1,507 children born after the transfer of top morphological quality (TQ) embryos over the same period of time in the same centers.

RESULTS

The prevalence of birth defects in children resulting from VPQ embryos was 1.35% (1/74), similar to the 1.72% (26/1,507) when only TQ embryos were transferred; the rate of chromosomal abnormalities detected was also similar (0.0 vs. 0.4%), as was perinatal mortality. After correcting for multiplicity (higher in the TQ group), the aforementioned parameters remained similar in the two groups.

CONCLUSION

Congenital malformations and perinatal complications do not seem to be more common in children born after transfer of VPQ embryos in IVF/ICSI cycles. Given our preliminary data, which need to be confirmed in much larger studies, when only VPQ embryos are available for transfer in IVF/ICSI cycles, we do not believe that they should be discarded with the intention of avoiding birth defects or perinatal complications.

Impact of defoliation intensities on plant biomass, nutrient uptake and arbuscular mycorrhizal symbiosis in Lotus tenuis growing in a saline-sodic soil

The impact of different defoliation intensities on the ability of Lotus tenuis plants to regrowth, mobilise nutrients and to associate with native AM fungi and Rhizobium in a saline-sodic soil was investigated. After 70 days, plants were subjected to 0, 25, 50, 75 and 100% defoliation and shoot regrowth was assessed at the end of subsequent 35 days. Compared to non-defoliated plants, low or moderate defoliation up to 75% did not affect shoot regrowth. However, 100% treatment affected shoot regrowth and the clipped plants were not able to compensate the growth attained by non-defoliated plants. Root growth was more affected by defoliation than shoot growth. P and N concentrations in shoots and roots increased with increasing defoliation while Na(+) concentration in shoots of non-defoliated and moderately defoliated plants was similar. Non-defoliated and moderately defoliated plants prevented increases of Na(+) concentration in shoots through both reducing Na(+) uptake and Na(+) transport to shoots by accumulating Na(+) in roots. At high defoliation, the salinity tolerance mechanism is altered and Na(+) concentration in shoots was higher than in roots. Reduction in the photosynthetic capacity induced by defoliation neither changed the root length colonised by AM fungi nor arbuscular colonisation but decreased the vesicular colonisation. Spore density did not change, but hyphal density and Rhizobium nodules increased with defoliation. The strategy of the AM symbiont consists in investing most of the C resources to preferentially retain arbuscular colonisation as well as inoculum density in the soil.

Magnetic diagnostic suite of the C-2 field-reversed configuration experiment confinement vessel

Magnetic measurements are a fundamental part of determining the size and shape of field-reversed configuration (FRC) plasmas in the C-2 device. The magnetic probe suite consists of 44 in-vessel and ex-vessel probes constructed using various technologies: ultra-high vacuum compatible mineral-insulated cable, nested triple axis coils hand-wound on ceramic bobbins, and commercial chip inductors mounted on printed circuit boards. Together, these probes measure the three-dimensional excluded flux profile of the FRC, which approximates the shape of the separatrix between the confined plasma volume and the scrape-off layer. High accuracy is achieved by using the extensive probe measurements to compensate for non-ideal effects such as flux leakage through the vacuum vessel and bulk motion of the FRC towards the wall. A subset of the probes is also used as a set of Mirnov arrays that provide sensitive detection of perturbations and oscillations of the FRC.

Internal magnetic field measurement on C-2 field-reversed configuration plasmas

A long-lived field-reversed configuration (FRC) plasma has been produced in the C-2 device by dynamically colliding and merging two oppositely directed, highly supersonic compact toroids (CTs). The reversed-field structure of the translated CTs and final merged-FRC state have been directly verified by probing the internal magnetic field structure using a multi-channel magnetic probe array near the midplane of the C-2 confinement chamber. Each of the two translated CTs exhibits significant toroidal fields (B(t)) with opposite helicity, and a relatively large B(t) remains inside the separatrix after merging.

Human chorionic gonadotropin (hCG) plasma levels at oocyte retrieval and IVF outcomes

PURPOSE

The aim of our study was to ascertain the influence of hCG levels at oocyte pick-up on IVF outcomes, and their relationship with clinical parameters.

METHODS

A prospective study was performed including 473 women undergoing IVF, aged under 40 years. Blood samples to analyze hCG levels were obtained at the time of follicular aspiration, 36 h after the administration of 250 μg of recombinant hCG.

RESULTS

Neither the numbers of oocytes obtained or fertilized, nor the pregnancy rate, were correlated with hCG levels. Moreover, hCG values were very similar in women who did and did not become pregnant (123.3 ± 48.7 and 117.5 ± 44.7 mUI/mL). Cases in which no oocytes were recovered after follicular aspiration had similar hCG levels to those in which more than 1 oocyte was obtained. On the other hand, hCG levels were negatively related to body mass index, weight, and age.

CONCLUSIONS

These data indicate that after the administration of 250 μg of recombinant hCG, hCG levels are not responsible for failure to recover oocytes. Specifically, there was no correlation between plasma hCG levels and the number of oocytes obtained or other markers of IVF outcome. There was, however, an inverse relationship with BMI, body weight and age.

Field reversed configuration confinement enhancement through edge biasing and neutral beam injection

Field reversed configurations (FRCs) with high confinement are obtained in the C-2 device by combining plasma gun edge biasing and neutral beam injection. The plasma gun creates an inward radial electric field that counters the usual FRC spin-up. The n = 2 rotational instability is stabilized without applying quadrupole magnetic fields. The FRCs are nearly axisymmetric, which enables fast ion confinement. The plasma gun also produces E × B shear in the FRC edge layer, which may explain the observed improved particle transport. The FRC confinement times are improved by factors 2 to 4, and the plasma lifetimes are extended from 1 to up to 4 ms.

Mid-follicular LH supplementation in women aged 35-39 years undergoing ICSI cycles: a randomized controlled study

This single-centre, randomized, parallel group, comparative study aimed to identify potential benefits of mid-follicular recombinant human LH (r-HLH) supplementation in women aged 35-39 years undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI). The main endpoint was the number of metaphase II oocytes retrieved. After pituitary suppression with a gonadotrophin-releasing hormone agonist, ovarian stimulation was initiated with recombinant human FSH (r-HFSH; 300-450 IU/day). On stimulation day 6, patients were randomized to receive r-HFSH alone or r-HFSH + r-HLH (r-HLH 150 IU/day) for the remainder of the stimulation period. Final follicular maturation was triggered with 250 μg of recombinant human chorionic gonadotrophin. After assessing oocyte nuclear maturity, oocyte were fertilized by ICSI and afterwards embryo quality was analyzed. Of the 131 women enrolled, 68 were allocated to r-HFSH alone and 63 to r-HFSH + r-HLH. No significant differences were observed in markers of either oocyte or embryo quality or quantity. However, higher rates of implantation and live birth per started cycle were observed with r-HLH supplementation than with r-HFSH alone. Although additional large studies are required to further investigate these findings, r-HLH supplementation for women aged 35-39 years undergoing ICSI is recommended as it may have a beneficial action on implantation.

Expression and localization of cannabinoid receptors in human immature oocytes and unfertilized metaphase-II oocytes

Endocannabinoid anandamide and cannabinoid receptors have been described in some organs of the female reproductive system, but little is known about the expression of these receptors in human oocytes. The aim of the study was to describe the expression of cannabinoid receptors in human oocytes and to investigate their differential distribution at various stages of meiotic resumption in human oocytes. A total of 750 human oocytes from 214 patients were analysed by Western blot, immunocytochemistry and PCR. For this study, oocytes that were not suitable for intracytoplasmic sperm injection (ICSI) (germinal-vesicle and metaphase-I stages), as well as metaphase-II oocytes that had not developed into an embryo after ICSI were used. Western blot analysis revealed the presence of CB1 and CB2 receptor proteins in human oocytes. CB1 and CB2 receptor immunostaining patterns changed during the various stages of meiotic resumption. Localization of CB1 receptor was peripheral at germinal-vesicle stage, homogeneous over the entire oocyte at metaphase I and peripheral at mature metaphase II. CB2 receptor localization was peripheral at germinal-vesicle and metaphase-I stages but homogeneous over the entire cell at metaphase II. This finding suggests a possible role for endocannabinoids, acting via receptors, in the maturation of female gametes and fertilization. The number of couples with sterility problems attending fertility programmes is rising but treatment is not always successful. Important problems associated with failure to conceive remain unresolved because many physiological aspects of human reproduction are still unknown. Endocannabinoids are endogenous chemical compounds that mimic the action of the main psychoactive component of marijuana, delta-9-tetrahydrocannabinol. An endogenous cannabinoid named anandamide has been found in human follicular fluid. Thus, in order to develop knowledge in this field, in the present study we have described the presence of the cannabinoid receptors CB1 and CB2 (the proteins required to mediate the action of the cannabinoids) in the early stages of meiotic resumption of oocytes (the stages before ovulation) and we could postulate that the endocannabinoids could act in the regulation of maturation of oocytes. Our study, together with other studies, indicates that the endocannabinoid system may play a role in human reproduction.

Two-chord interferometry using 3.39 μm He-Ne laser on a flux-coil-generated FRC

A two-chord λ(IR)∼3.39 μm He-Ne laser interferometer system was developed for a flux-coil-generated field-reversed configuration to estimate the electron density and the total temperature of the field-reversed configuration (FRC) plasma. This two-chord heterodyne interferometer system consists of a single ∼2 mW infrared He-Ne laser, a visible (λ(vis)∼632.8 nm) He-Ne laser for the alignment, a 40 MHz acousto-optic modulator, photodetectors, and quadrature phase detectors. Initial measurement was performed and the measured average electron densities were 2-10×10(19) m(-3) at two different radial positions in the midplane. A time shift in density was observed as the FRC expands radially. The time evolution of the line-averaged density agrees with the density estimated from the in situ internal magnetic probes, based on a rigid-rotor profile model.

Dynamic formation of a hot field reversed configuration with improved confinement by supersonic merging of two colliding high-β compact toroids

A hot stable field-reversed configuration (FRC) has been produced in the C-2 experiment by colliding and merging two high-β plasmoids preformed by the dynamic version of field-reversed θ-pinch technology. The merging process exhibits the highest poloidal flux amplification obtained in a magnetic confinement system (over tenfold increase). Most of the kinetic energy is converted into thermal energy with total temperature (T{i}+T{e}) exceeding 0.5 keV. The final FRC state exhibits a record FRC lifetime with flux confinement approaching classical values. These findings should have significant implications for fusion research and the physics of magnetic reconnection.

Mid-follicular LH supplementation in women aged 35-39 years undergoing ICSI cycles: a randomized controlled study

This single-centre, randomized, parallel group, comparative study aimed to identify potential benefits of mid-follicular recombinant human LH (r-HLH) supplementation in women aged 35-39 years undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI). The main endpoint was the number of metaphase II oocytes retrieved. After pituitary suppression with a gonadotrophin-releasing hormone agonist, ovarian stimulation was initiated with recombinant human FSH (r-HFSH; 300-450 IU/day). On stimulation day 6, patients were randomized to receive r-HFSH alone or r-HFSH + r-HLH (r-HLH 150 IU/day) for the remainder of the stimulation period. Final follicular maturation was triggered with 250 mug of recombinant human chorionic gonadotrophin. After assessing oocyte nuclear maturity, oocyte were fertilized by ICSI and afterwards embryo quality was analyzed. Of the 131 women enrolled, 68 were allocated to r-HFSH alone and 63 to r-HFSH + r-HLH. No significant differences were observed in markers of either oocyte or embryo quality or quantity. However, higher rates of implantation and live birth per started cycle were observed with r-HLH supplementation than with r-HFSH alone. Although additional large studies are required to further investigate these findings, r-HLH supplementation for women aged 35-39 years undergoing ICSI is recommended as it may have a beneficial action on implantation.