Construction of multi-scale feature fusion segmentation model of MRI knee images based on dual attention mechanism weighted aggregation

BACKGROUND

Early diagnosis of knee osteoarthritis is an important area of research in the field of clinical medicine. Due to the complexity in the MRI imaging sequences and the diverse structure of cartilage, there are many challenges in the segmentation of knee bone and cartilage. Relevant studies have conducted semantic fusion processing through splicing or summing forms, which results in reduced resolution and the accumulation of redundant information.

OBJECTIVE

This study was envisaged to construct an MRI image segmentation model to improve the diagnostic efficiency and accuracy of different grade knee osteoarthritis by adopting the Dual Attention and Multi-scale Feature Fusion Segmentation network (DA-MFFSnet).

METHODS

The feature information of different scales was fused through the Multi-scale Attention Downsample module to extract more accurate feature information, and the Global Attention Upsample module weighted lower-level feature information to reduce the loss of key information.

RESULTS

The collected MRI knee images were screened and labeled, and the study results showed that the segmentation effect of DA-MFFSNet model was closer to that of the manually labeled images. The mean intersection over union, the dice similarity coefficient and the volumetric overlap error was 92.74%, 91.08% and 7.44%, respectively, and the accuracy of the differential diagnosis of knee osteoarthritis was 84.42%.

CONCLUSIONS

The model exhibited better stability and classification effect. Our results indicated that the Dual Attention and Multi-scale Feature Fusion Segmentation model can improve the segmentation effect of MRI knee images in mild and medium knee osteoarthritis, thereby offering an important clinical value and improving the accuracy of the clinical diagnosis.

Potential low toxic alternative for Na-Cl cotransporter inhibition: A diuretic effect and mechanism study of Pyrrosia petiolosa

BACKGROUND

Hydrochlorothiazide, a diuretic commonly used for the treatment of hypertension, is often associated with serious metabolic side effects. Pyrrosia petiolosa (Christ) Ching is a traditional Chinese medicine that possesses diuretic properties, without any obvious side effects.

AIM

To evaluate the diuretic effect of P. petiolosa (Christ) Ching and to elucidate its underlying mechanism of action.

METHODS

Extracts obtained from different polar components of P. petiolosa (Christ) Ching were analyzed for toxicity in a Kunming mouse model. The diuretic effects of the extracts were compared to that of hydrochlorothiazide in rats. In addition, compound isolation procedures, cell assays of Na-Cl cotransporter inhibition and rat diuretic test of monomeric compounds were conducted to identify the active ingredients in the extract. Subsequently, homology modeling and molecular docking were performed to explain the reason behind the diuretic activity observed. Finally, LC-MS analysis was used to elucidate the underlying mechanism of action of P. petiolosa (Christ) Ching.

RESULTS

No toxicity was observed in mice administered P. petiolosa (Christ) Ching extracts. The ethyl acetate fraction showed the most significant diuretic effect. Similar results were obtained during the analysis for Na+ content in rat urine. Further separation of P. petiolosa (Christ) Ching components led to the isolation of methyl chlorogenate, 2',3'-dihydroxy propyl pentadecanoate, and β-carotene. Results from cell assays showed that the Na-Cl cotransporter inhibitory activity of methyl chlorogenate was greater than that of hydrochlorothiazide. This result was again confirmed by the diuresis tests of monomeric compounds in rats. The molecular simulations explain the stronger interactions between the methyl chlorogenate and Na-Cl cotransporter. Of the compounds determined using LC-MS analysis, 185 were identified to be mostly organic acids.

CONCLUSIONS

P. petiolosa possesses significant diuretic activities without any obvious toxicity, with least two possible mechanisms of action. Further study on this herb is warranted.

A simple and convenient model combining multiparametric MRI and clinical features to predict tumour-infiltrating lymphocytes in breast cancer

AIM

To develop a simple and convenient method based on multiparametric magnetic resonance imaging (MRI) and clinical features to non-invasively predict tumour-infiltrating lymphocytes (TILs) in breast cancer (BC) and to explore the relationship between TIL levels and disease-free survival (DFS).

MATERIALS AND METHODS

A total of 172 BC patients were enrolled between November 2017 and June 2021 in this retrospective study. The patients were divided into high (≥10%) and low (<10%) TIL groups. Clinicopathological data were collected. MRI features were reviewed by two radiologists. Predictors associated with TILs were determined by using multivariable logistic regression analyses. Kaplan-Meier survival curves based on TIL levels were used to estimate DFS.

RESULTS

A total of 102 patients with low TILs and 70 patients with high TILs were included in the study. Tumour size (odds ratio [OR], 1.040; 95% confidence interval [CI]: 1.006, 1.075; p=0.020), apparent diffusion coefficient (ADC; OR, 1.003; 95% CI: 1.001, 1.005; p=0.015), clinical axillary lymph node status (CALNS; OR, 3.222; 95% CI: 1.372,7.568; p=0.007), and enhancement pattern (OR, 0.284; 95% CI: 0.143, 0.563; p<0.001) were independently associated with TIL levels. These features were used in the ALSE model (where A is ADC, L is CALNS, S is size, and E is enhancement pattern). High TILs were associated with better DFS (p=0.016).

CONCLUSION

The ALSE model derived from multiparametric MRI and clinical features could non-invasively predict TIL levels in BC, and high TILs were associated with longer DFS, especially in human epidermal growth factor receptor 2 (HER2)-positive BC and triple-negative BC (TNBC).

Triple-negative breast cancer: predictive model of early recurrence based on MRI features

AIM

To develop an integrated model based on preoperative magnetic resonance imaging (MRI) features for predicting early recurrence in patients with triple-negative breast cancer (TNBC).

MATERIALS AND METHODS

Women with TNBC who underwent breast MRI and surgery between 2009 and 2019 were evaluated retrospectively. Two breast radiologists reviewed MRI images independently based on the Breast Imaging Reporting and Data System Lexicon (BI-RADS), and classified the breast oedema scores on T2-weighted imaging (WI) as no oedema, peritumoural oedema, prepectoral oedema, or subcutaneous oedema. The relationship between disease-free survival (DFS) and MRI features was analysed by Cox regression, and a nomogram model was generated based on the results.

RESULTS

150 patients with TNBC were included and divided into a training cohort (n=78) and validation cohort (n=72). MRI features including subcutaneous oedema and rim enhancement showed a tendency to worsen DFS in univariate analysis. Multivariate analysis showed that subcutaneous oedema (p=0.049, HR [95% confidence interval {CI} = 8.24 [1.01-67.52]) and rim enhancement (p=0.016, HR [95% CI] = 4.38 [1.32-14.54]) were independent predictors for DFS. In the nomogram, the areas under the curves (AUCs) of the training cohort was 0.808, and that of the validation cohort was 0.875.

CONCLUSION

The presence of subcutaneous oedema or rim enhancement on preoperative breast MRI was shown to be a good predictor of poor survival outcomes in patients with TNBC.

[Low-frequency fluctuation amplitude changes in resting-state brain functional magnetic resonance imaging and its correlation with clinical hearing levels in patients with unilateral hearing impairment]

Objective: To investigate low-frequency fluctuation amplitude changes in resting-state brain fMRI and its correlation with clinical hearing levels in patients with clinical hearing level in patients with unilateral hearing impairment. Methods: Forty-five patients with unilateral hearing impairment[12 males and 33 females, aged 36-67 (46.0±9.7) years], and 31 controls with normal hearing[9 males and 22 females, aged 36-67 (46.0±10.1) years], were retrospectively included. All subjects underwent blood oxygen level-dependent (BOLD) resting-state functional magnetic resonance imaging and high-resolution T1-weighted imaging. The patients were divided into the left-sided hearing impaired group(24 cases), and the right-sided hearing impaired group(21 cases). After data being preprocessed, differences in low frequency amplitude (ALFF) metrics between the evaluated patients and controls were calculated and analyzed, and the statistics were corrected for Gaussian random field (GFR). Results: Overall comparative analysis of patients with hearing impairment showed that one-way ANOVA among the three groups showed abnormal ALFF values only in the right anterior cuneiform lobe (GRF adjusted P=0.002). The ALFF value of the hearing impaired group was higher than that of the control group in one cluster (peak coordinates: X=9, Y=-72, Z=48, T=5.82), involving the left occipital gyrus, right anterior cuneiform lobe, left superior cuneiform lobe, left superior parietal gyrus, and left angular gyrus (GRF adjusted P=0.031). The ALFF value of the hearing impaired group was lower than that of the control group in three clusters (peak coordinates: X=57, Y=-48, Z=-24; T=-4.99; X=45, Y=-66, Z=0, T=-4.06; X=42, Y=-12, Z=36, T=-4.03), involving the right inferior temporal gyrus, the right middle temporal gyrus, and the right precentral gyrus (GRF adjusted P=0.009). Compared with the control group, the ALFF value of the left hearing impairment group was significantly higher than that of the control group in one cluster (peak coordinates: X=-12, Y=-75, Z=45, T=5.78), involving the left anterior cuneiform lobe, right anterior cuneiform lobe, left middle occipital gyrus, left superior parietal gyrus, left superior occipital gyrus, left cuneiform lobe, and right cuneiform lobe (P=0.023 after GRF correction). Compared with the control group, the right hearing impairment group had a significantly higher ALFF value in one cluster (peak coordinates: X=9, Y=-46, Z=22, T=6.06), involving the left middle occipital gyrus, right anterior cuneiform lobe, left cuneiform lobe, right cuneiform lobe, left superior occipital gyrus, and right superior occipital gyrus (GRF adjusted P=0.022); The brain area with reduced ALFF values is located in the right inferior temporal gyrus (GRF adjusted P=0.029). Spearman's two-tailed correlation analysis between ALFF values and pure tone average in the abnormal brain regions showed that ALFF values in the abnormal brain regions correlated to some extent with the pure tone average (PTA) only in the left-sided hearing impaired group(PTA=2 000 Hz, r=0.318,P=0.033;PTA=4 000 Hz,r=0.386,P=0.009). Conclusion: The abnormal neural activity within the brain are different in patients with left-sided and right-sided hearing impairment, and the severity of hearing impairment is related to the difference in functional integration of brain regions.

Chlorocholine perchlorate is an organic ferroelectric with two-step ladder-like dielectric, second harmonic generation effects, and ferroelectricity

The simple organic salt chlorocholine perchlorate [ClCH2CH2N(CH3)3 ·ClO4] (CCP) is found to be a molecular ferroelectric with a high theoretical spontaneous polarization (Ps) value up to 17.09 μC cm-2. CCP could undergo two successive order-disorder phase transition at 332 and 365 K with space group changing from Cc to Cmc21 and then P63/mmc, accompanying with unusual two-step ladder-like dielectric, SHG signal with obvious "on/off" contrasts. This finding provides a new instance of further exploring successive thermal-stimuli multi-responsive switching materials applied as switches and sensors.

Construction of U-Net++ pulmonary nodule intelligent analysis model based on feature weighted aggregation

BACKGROUND

Lung cancer is a malignant tumor originating from the bronchial mucosa or glands of the lung. Early lung cancer patients often have no obvious symptoms, but early detection and treatment have an important clinical significance for prognostic effect. Computed tomography (CT) is one of the important means in the diagnosis of lung cancer. In order to better solve the problem of diagnosis efficiency, and reduce the rate of misdiagnosis and missed diagnosis, computer aided diagnosis are employed in the accurate localization and segmentation of pulmonary nodules through imaging diagnostics, image processing technology, and other clinical means.

OBJECTIVE

This present study was envisaged to establish an intelligent segmentation model of pulmonary nodules to improve the accuracy of early screening for lung cancer patients.

METHODS

Compared with the traditional segmentation model of fully convolutional neural network, the U-Net++ algorithm based on feature-weighted integration (WI-U-Net++) effectively utilized the feature weight information, adopted the adaptive weighted method for weighted integration, and performed an intelligent segmentation of the anatomical structure and image details, which was applied in the auxiliary diagnosis of pulmonary nodules in CT images. Standard chest X-ray phantom was selected as CT scanning objects, and 30 spherical and irregular simulated nodules were built into them, respectively. CT images were collected by setting different tube voltage and noise index, and randomly included into the training set, validation set and test set at a ratio of 8:1:1.

RESULTS

The experimental results showed that the segmentation accuracy of WI-U-Net++ algorithm for spheroid nodules and irregular nodules was 98.75% and 83.47%, respectively, which was better than that of U-Net and U-Net++ algorithm. In the auxiliary diagnosis, the recall rate of the WI-U-Net++ algorithm for spheroid nodules and irregular nodules was 93.47% and 84.52%, respectively. The accuracy of the benign or malignant identification was 80.27%, and the AUC was 0.9342.

CONCLUSION

U-Net++ algorithm based on feature-weighted integration could improve the segmentation effect of pulmonary nodules. Especially in the case of irregular nodules with malignant signs, the accuracy of clinical diagnosis was significantly improved, and the level of differential diagnosis between benign and malignant was improved.

A computational model for the transit of a cancer cell through a constricted microchannel

We propose a three-dimensional computational model to simulate the transient deformation of suspended cancer cells flowing through a constricted microchannel. We model the cell as a liquid droplet enclosed by a viscoelastic membrane, and its nucleus as a smaller stiffer capsule. The cell deformation and its interaction with the suspending fluid are solved through a well-tested immersed boundary lattice Boltzmann method. To identify a minimal mechanical model that can quantitatively predict the transient cell deformation in a constricted channel, we conduct extensive parametric studies of the effects of the rheology of the cell membrane, cytoplasm and nucleus and compare the results with a recent experiment conducted on human leukaemia cells. We find that excellent agreement with the experiment can be achieved by employing a viscoelastic cell membrane model with the membrane viscosity depending on its mode of deformation (shear versus elongation). The cell nucleus limits the overall deformation of the whole cell, and its effect increases with the nucleus size. The present computational model may be used to guide the design of microfluidic devices to sort cancer cells, or to inversely infer cell mechanical properties from their flow-induced deformation.

Tightly intercalated Ti3C2Tx/MoO3-x/PEDOT:PSS free-standing films with high volumetric/gravimetric performance for flexible solid-state supercapacitors

Ti₃C₂T_x-MXenes have extremely promising applications in electrochemistry, but the development of Ti₃C₂T_x is limited due to severe self-stacking problem. Here, we introduced oxygen vacancy-enriched molybdenum trioxide (MoO_3-x) with pseudocapacitive properties as the intercalator of Ti₃C₂T_x and PEDOT with high electronic conductivity as the co-intercalator and conductive binder of Ti₃C₂T_x to synthesize Ti₃C₂T_x/MoO_3-x/PEDOT:PSS (TMP) free-standing films by vacuum-assisted filtration and H₂SO₄ soaking. The tightly intercalated free-standing film structure can effectively improve the self-stacking phenomenon of Ti₃C₂T_x, expose more active sites and facilitate electron/ion transport, thus making TMP show excellent electrochemical performance. The volumetric and gravimetric capacitance of optimized TMP-2 can reach 1898.5 F cm^-3 and 523.0 F g^-1 at 1 A g^-1 with a rate performance of 90.5% at the current density from 1 A g^-1 to 20 A g^-1, which is significantly better than those of MXene-based composites reported in the literature. The directly-assembled TMP-2//TMP-2 flexible solid-state supercapacitor displays high energy/power output performances (25.1 W h L^-1 at 6383.1 W L^-1, 6.9 W h kg^-1 at 1758.4 W kg^-1) and there is no obvious change after 100 cycles at a bending angle of 180°. As a result, the tightly intercalated TMP-2 free-standing film with high volumetric/gravimetric capacitances is a promising material for flexible energy storage devices.

Application of intelligent X-ray image analysis in risk assessment of osteoporotic fracture of femoral neck in the elderly

The paper focuses on establishing a risk assessment model of femoral neck osteoporotic fracture (FNOF) in the elderly population and improving the screening efficiency and accuracy of such diseases in specific populations. In literature research, the main risk factors of femoral neck osteoporosis (FNOP) in the elderly were studied and analyzed; the femur region of interest (ROI) and the hard bone edge segmentation model were selected from the X-ray digital image by using the image depth learning method. On this basis, the femoral trabecular score and femoral neck strength (FNS) in the set region were selected as the main evaluation elements, and the quantitative analysis method was established; an X-ray image processing method was applied to the feasibility study of FNOP and compared with dual-energy X-ray absorptiometry measurements of bone mineral density; Finally, the main risk factors of FNOP were selected and the prediction model of FNOP in the elderly population was established based on medical image processing, machine learning model construction and other methods. Some FNOP health records were selected as test samples for comparative analysis with traditional manual evaluation methods. The paper shows the risk assessment model of FNOF in the elderly population, which is feasible in testing. Among them, the artificial neural network model had a better accuracy (95.83%) and recall rate (100.00%), and the support vector machine prediction model had high specificity (62.50%). With the help of a machine learning method to establish the risk assessment model of FNOF for the elderly, one can provide decision support for the fracture risk assessment of the elderly and remind the clinic to give targeted interventions for the above high-risk groups in order to reduce the fracture risk.

Activatable molecular rotor based on bithiophene quinolinium toward viscosity detection in liquids

The development of non-invasive and effective viscosity inspection methods during the liquid deterioration process is urgently needed since viscosity is one of the most important physical parameters of liquids. Methods featuring rapid detection, high sensitivity, cheap equipment, and fast result output are greatly desired. In this study, a viscosity-sensitive molecular rotor (BTPEQ) with a large Stokes shift (187 nm), and long emission wavelength (648 nm) has been developed. The rotor is comprised of a bithiophene donor and quinolinium acceptor, and displays a typical twisted intramolecular-charge transfer (TICT) feature, with good photostability, selectivity, and universality in various commercial liquids. With the aid of BTPEQ, the thickening effects of liquid thickeners can be determined. More importantly, BTPEQ was explored to visualize the viscosity variations in liquids at different metamorphic stages, and it was found that the viscosity level in microenvironments is highly dependent on the liquid food metamorphic period. It is worth noting that this approach can facilitate the continued perfection of fluorescent analytical methods for food quality and safety inspection.

POS0558 A INFLAMMATORY FACTOR-BASED NOMOGRAM PREDICTS FIRST REMISSION TIME OF RHEUMATOID ARTHRITIS PATIENTS WITH BASELINE GALECTIN-9

Background

Rheumatoid arthritis (RA) is an autoimmune disease. The core treatment principle of RA is to achieve remission or low disease activity as soon as possible to ensure optimal outcomes. Predicting the first remission time according to the patient’s risk factors is very important for the choice of treatment scheme.

Objectives

We aimed to verify the prognostic value of inflammatory factors in RA and establish a nomogram based on Human Interleukin-6(IL-6), Galectin-9(Gal-9)and disease activity to predict the first remission time after conventional synthetic DMARDstreatment.

Methods

184 RA active patients(DAS28-ESR> 3.2, ACR 1987 criteria or EULAR 2010 criteria) were enrolled in the rheumatology department of Qilu Hospital of Shandong University from June 2014 to June 2020.129 patients were assigned to the development cohort and 55 patients were assigned to the validation cohort randomly. Baseline clinical data and plasma were collected. The expressions of Tumour Necrosis Factor α (TNF-α), Vascular Endothelial Growth Factor (VEGF), IL-6 and Gal-9 in plasma of RA patients were detected by ELISA. All patients were treated with csDMARDs and we recorded activity of each follow-up visit until 36 months. Lasso regression and Cox regression analysis were used to screen the 14 variables (including activity indices and cytokines) at baseline, and the prediction model was established to draw the nomogram.

Results

Patient age, CRP, IL-6, Gal-9, HAQ and DAS28-ESR were the significant prognostic factors in the lasso and Cox regression analyses, especially Gal-9. The multivariate analysis revealed that IL-6≤ 9.04 pg/ml(HR =0.54, 95% CI:0.31–0.95), Gal-9≤ 4490 pg/ml(HR =0.43, 95% CI:0.21–0.89) were independent protective factors (Table 1). Above-mentioned six factors were included in our model as predictors (Figure 1). The resulting model containing six factors had good discrimination ability in both the development cohort (C-index, 0.729) and the validation cohort (C-index, 0.710). Time-dependent ROC curve (Figure 2), calibration analysis (Figure 3) and decision curve analysis (DCA) show that the nomogram has significant discriminant power, stability and clinical practicability in predicting the first remission time.

Conclusion

We constructed and validated a nomogram with baseline activity indices and cytokines that can predict first remission time in RA patients after csDMARDs treatment. Using this simple-to-use model with plasma Gal-9 at baseline, the remission rate can be determined for an individual patient and could be useful for the early identification of high-risk patients.

References

[1]SUN J, SUI Y, WANG Y, et al. Galectin-9 expression correlates with therapeutic effect in rheumatoid arthritis [J]. Scientific reports, 2021, 11(1): 5562.

[2]ZHANG L, CHEN F, GENG S, et al. Methotrexate (MTX) Plus Hydroxychloroquine versus MTX Plus Leflunomide in Patients with MTX-Resistant Active Rheumatoid Arthritis: A 2-Year Cohort Study in Real World [J]. Journal of inflammation research, 2020, 13: 1141-50.

[3]FORNARO M, CACCIAPAGLIA F, LOPALCO G, et al. Predictors of long-term clinical remission in rheumatoid arthritis [J]. European journal of clinical investigation, 2021, 51(2): e13363.

Acknowledgements

Funded by ECCM Program of Clinical Research Center of Shandong University (No. 2021SDUCRCB010)

Disclosure of Interests

None declared.

POS0306 EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH ACTIVE ANKYLOSING SPONDYLITIS REFRACTORY TO BIOLOGIC THERAPY: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED PHASE 3 TRIAL

Background

Upadacitinib (UPA) was shown to be safe and effective through 2 years in patients (pts) with active ankylosing spondylitis (AS) naïve to biologic disease-modifying antirheumatic drugs (bDMARDs) in the pivotal phase 2/3 SELECT-AXIS 1 trial.1,2

Objectives

To assess the efficacy and safety of UPA in pts with active AS with an inadequate response (IR) to bDMARDs.

Methods

SELECT-AXIS 2 (NCT04169373) was conducted under a master protocol and includes two separate studies (one for AS bDMARD-IR and one for non-radiographic axial spondyloarthritis [nr-axSpA]). The AS bDMARD-IR study is a randomized, double-blind, placebo (PBO)-controlled, phase 3 trial that enrolled adults ≥18 years with AS who met modified New York criteria, had BASDAI and pt’s assessment of total back pain scores ≥4 (numeric rating scale 0–10) at study entry, and had an IR to one or two bDMARDs (TNF inhibitor or IL-17 inhibitor). Pts were randomized 1:1 to receive oral UPA 15 mg once daily (QD) or PBO during the 14-week (wk) double-blind treatment period. The primary endpoint was ASAS40 response at wk 14. Multiplicity-controlled secondary endpoints evaluated at wk 14 were improvements from baseline in disease activity (ASDAS [CRP], ASDAS ID [<1.3], ASDAS LDA [<2.1], BASDAI50, ASAS20, and ASAS PR), pain (total and nocturnal back pain), function (BASFI), objective measure of inflammation (SPARCC MRI score of the spine), spinal mobility (BASMI), enthesitis (MASES), and quality of life (ASQoL and ASAS HI). Non-responder imputation incorporating multiple imputation (NRI-MI) was used to handle intercurrent events and missing data for binary endpoints. Cochran-Mantel-Haenszel (CMH) test and mixed-effect model for repeated measures (MMRM) were used for analyzing binary and continuous endpoints, respectively. Treatment-emergent adverse events (TEAEs) assessed through wk 14 are reported for pts who had ≥1 dose of study drug.

Results

All 420 randomized pts with active AS received assigned treatment (UPA 15 mg, n=211; PBO, n=209); 409 (97%) received study drug through wk 14. Baseline demographic and disease characteristics were generally similar between treatment groups and reflective of an active AS bDMARD-IR population (74% male; mean age 42.4 years; mean disease duration 7.7 years; 83% HLA-B27 positive; mean BASDAI 6.8). Significantly more pts achieved the primary endpoint of ASAS40 response at wk 14 with UPA vs PBO (45% vs 18%; P<0.0001; Figure 1); UPA showed onset of effect in ASAS40 as early as wk 4 (nominal P≤0.05). All multiplicity-controlled secondary endpoints met statistical significance for UPA vs PBO at wk 14 across multiple clinical domains of AS (P<0.0001; Figure 1). The rate of TEAEs was similar between treatment groups through wk 14 (UPA, 41%; PBO, 37%). TEAEs led to discontinuation in 3 (1.4%) pts treated with PBO and none with UPA. Serious infections occurred with UPA (2.4%) but not with PBO and included 4 events of COVID-19 and 1 event of uveitis. Additional events of uveitis were reported in 3 (1.4%) pts treated with PBO. Inflammatory bowel disease (IBD) occurred in 1 (0.5%) pt on UPA and none on PBO. No malignancy, major adverse cardiovascular events, venous thromboembolic events, or death were reported with UPA; 1 event of malignancy was observed with PBO.

Conclusion

UPA 15 mg QD was significantly more effective than PBO over 14 wks of treatment in pts with active AS and IR to bDMARDs. No new safety risks were identified with UPA compared with its known safety profile.3,4 These findings are consistent with and complementary to those of SELECT-AXIS 1 (bDMARD-naïve AS population),1,2 and support the use of UPA in pts with active AS, including those who had a previous IR to bDMARD therapy.

References

[1]van der Heijde D, et al. Arthritis Rheumatol. 2021;73(suppl 10).

[2]van der Heijde D, et al. Lancet. 2019;394(10214):2108–2117.

[3]Cohen SB, et al. ARD. 2021;80:304–311.

[4]Burmester G, et al. Rheumatol Ther. 2021;1–19.

Acknowledgements

AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Julia Zolotarjova, MSc, MWC, of AbbVie.

Disclosure of Interests

Désirée van der Heijde Consultant of: AbbVie, Bayer, BMS, Cyxone, Eisai, Galapagos, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, and UCB, Employee of: Director of Imaging Rheumatology BV, Xenofon Baraliakos Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, and UCB, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, and Werfen, Grant/research support from: AbbVie, Novartis, Joachim Sieper Speakers bureau: AbbVie, Janssen, Merck, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Merck, and Pfizer, Atul Deodhar Consultant of: AbbVie, Amgen, Aurinia, BMS, Celgene, GSK, Janssen, Lilly, MoonLake, Novartis, Pfizer, and UCB., Grant/research support from: AbbVie, GSK, Lilly, Novartis, Pfizer, and UCB, Robert Inman Consultant of: AbbVie, Amgen, Janssen, Lilly, Novartis, Pfizer, and Sandoz, Grant/research support from: AbbVie, Amgen, and Janssen, Hideto Kameda Speakers bureau: AbbVie, Asahi-Kasei, BMS, Chugai, Eisai, Janssen, Lilly, Mitsubishi-Tanabe, Novartis, and Pfizer, Consultant of: AbbVie, Janssen, Lilly, Novartis, Sanofi, and UCB, Grant/research support from: AbbVie, Asahi-Kasei, Boehringer Ingelheim, Chugai, Eisai, and Mitsubishi-Tanabe, Xiaofeng Zeng: None declared, Yunxia Sui Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Xianwei Bu Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Aileen Pangan Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Peter Wung Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, In-Ho Song Shareholder of: May own AbbVie stock or options, Employee of: AbbVie

AB0407 EFFICACY AND SAFETY OF 144-WEEK TREATMENT WITH TACROLIMUS AS THE FIRST-LINE CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUG (csDMARD) FOR PATIENTS WITH ACTIVE REFRACTORY RHEUMATOID ARTHRITIS： A PROSPECTIVE, COHORT STUDY

Background

The T2T guideline in RA recommended the normal csDMARDs irresponsive patients (pts) switching to other treatment target. Tacrolimus (TAC), the inhibitor of T cell activation, is candidate for these pts, especially with extrarticular complications (EC).

Objectives

To observe the efficacy and safety of TAC-based csDMARDS regimen refractory RA (RRA) pts and the characteristics of TAC combined treatment.

Methods

This prospective cohort study (ClinicalTrials.gov Identifier NCT02837978) was conducted in China. According to baseline DAS28-ESR, RRA pts (ACR 1987 criteria [1]) were classified to severe (>5.1, S) or moderate (> 3.2,≦5.1, M) groups. The efficacy indicators and AE were recorded untill 144w.

The combined medicine with TAC was based on the past history of csDMARD prescription and EC, including TAC with/wo MTX (T+M or T group), Pred, HCQ.

Results

150 pts (52±14y) were involved, 15 finished 144w observation, 50 still following up and 85 lost.

As shown with GEE analysis, DAS28-ESR, CRP, HAQ were decreased significantly in all pts within 24ws, and maintained stable in later period (Figure 1). The REM or LDA, achieved ACR20, good or moderate EULAR response (G+M) proportion of 103 pts completed the 24w were 41.75%, 56.31%, 76.70%.

Figure 1.

Disease activity index of 150 RRA pts decreased in 144weeks

Similar to the Japanese study [2], DAS28-ESR, CRP and HAQ typically declined rapidly in S group, but still higher than M (Figure 2A-C). According to GBTM analysis, S group, longer disease course or higher HAQ had a higher ACR20 remission rate (Figure 2D).

Figure 2.

Disease activity index of 103 pts declined rapidly in 24weeks.

(A). DAS28-ESR; (B) CRP; (C). HAQ declined significantly in S (n=53) than M (n=50) during 24ws. (D).higher increased ACR20 remission group (90.6%), compared with low-stable (0%) in 24ws. *p< 0.05, compared to M; #p< 0.05, compared to baseline.

A total of 69 RA pts (46.0%) had 177 times (23.07%) AE, including 2 SAEs. Infection was the dominating AE (30%) due to asymptomatic positive urinary leucocyte and cold were classified, higher than (3.4%) Japanese study [3]. AEs were mainly happened in pts with higher TAC blood concentration 4.55(3-14.5) ng/ml, compared to No AE group 3.8(2.4-7.8) ng/ml, p=0.048, extremely in those abnormal glucose tolerance and hypertensive pts, p=0.002, 0.022.

The most common reasons of lost were drug ineffective (32.94%), economic reasons (29.1%). There was no difference in efficacy of TAC combined treatment. Combination MTX reduce AE, decrease the usage rate and dosage of Pred. Combination Pred increased AE.

Pts that achieved REM+LDA, G+M, had better TAC survival rate (Figure 3A-B). The combination of MTX, HCQ reduce lost rate (Figure 3C-D).

Figure 3.

TAC survival ratio were compared in different response and csDMARDs combination groups.

(A).The pts acquired remission (n= 31) or LDA (n= 18) had higher TAC survival rate than high (n=28) & moderate (n=73) group, * p < 0.05, compared to group High; # p < 0.05, compared to Moderate; & p < 0.05, compared to Low; (B). The pts G+M (n=95) had better TAC survival rate, compared with no response (N, n=55), ** p < 0.01; (C). Combine MTX reduced lost rate, ** p < 0.01, compared to T; (D). Combine MTX and HCQ reduced lost rate, * p < 0.05 compared to MTX-HCQ-; # p < 0.05 compared to MTX+HCQ-.

The Logistic regression showed baseline DAS28-ESR was an independent protective factor for poor response. Baseline DAS28-ESR and previous Perd use were independent protective factors for ACR20 remission.　

Conclusion

TAC-based combined therapies are effective and tolerable for RRA, especially to the higher disease activity pts. TAC blood concentration related to AE. The lower disease activity index and better respond, the higher TAC survival ratio. MTX is recommended as TAC combined treatment.

References

[1]Levin RW, et al. Scand J Rheumatol 1996, 25(5):277-281.

[2]Kanzaki T,et al., Rheumatology International,2013. 33(4):871-877.

[3]Takeuchi T, et al. Mod Rheumatology 2018,28(1): 48-57.

Acknowledgements

Acknowledgements: Funded by ECCM Program of Clinical Research Center of Shandong University (No. 2021SDUCRCB010)

Disclosure of Interests

None declared

A new organic–inorganic hybrid perovskite ferroelectric [ClCH2CH2N(CH3)3][PbBr3] and Its PVDF matrix-assisted highly-oriented flexible ferroelectric films

A hybrid perovskite with dielectric, SHG, and ferroelectric triple transitions was tailored into highly-oriented films using PVDF matrix-assisted in situ growth.

A Layered Hybrid Rare-Earth Double Perovskite with Two Continuous Reversible Phase Transitions Induced By Unusual Two Driving Gears of Fan-Like Rotation Movements

Organic-inorganic hybrid rare-earth double perovskite has been paid more and more attention owing to their intriguing chemical and physical properties. In this paper, we report a new layered 2D hybrid...

Visual detection of viscosity through activatable molecular rotor with aggregation-induced emission

Food safety has become one of the urgent affairs in the global public health studies, and irregular viscosity is closely associated with the food spoilage extent. In this study, one kind of activatable molecular rotor (TPA-PBZ) based on triphenylamine derivates has been synthesized via the Schiff base condensation reaction. This rotor is comprised by donor-accepter conjugated structure, with aggregation induced-emission feature and a large Stokes shift of 160 nm in water. The rotation of aromatic rings in TPA-PBZ is restricted in high-viscosity microenvironment, with the gradually increasing fluorescence emission signal at 568 nm. Significantly, this rotor TPA-PBZ has successfully been applied not only in the determination of thickening effects of food gum, but also in the detection of viscosity enhancement during the liquid food spoilage process. This molecular rotor can be utilized as an intelligent monitor platform for food quality and safety inspection in viscosity-related conditions.

Thermal Dynamics of Charge Density Wave Pinning in ZrTe_{3}

Impurity pinning has long been discussed to have a profound effect on the dynamics of an incommensurate charge density wave (CDW), which would otherwise slide through the lattice without resistance. Here, we visualize the impurity pinning evolution of the CDW in ZrTe_{3} using the variable temperature scanning tunneling microscopy. At low temperatures, we observe a quasi-1D incommensurate CDW modulation moderately correlated to the impurity positions, indicating a weak impurity pinning. As we raise the sample temperature, the CDW modulation gets progressively weakened and distorted, while the correlation with the impurities becomes stronger. Above the CDW transition temperature, short-range modulations persist with the phase almost all pinned by impurities. The evolution from weak to strong impurity pinning through the CDW transition can be understood as a result of losing phase rigidity.

AB0260 LONG-TERM EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS FROM CHINA, BRAZIL, AND SOUTH KOREA WITH RHEUMATOID ARTHRITIS AND AN INADEQUATE RESPONSE TO CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS: RESULTS AT 64 WEEKS

Background:

Upadacitinib (UPA), an oral Janus kinase inhibitor, in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), showed significant improvements in clinical and functional measures compared with placebo (PBO) up to 12 weeks (wks), in patients (pts) from China, Brazil, and South Korea with rheumatoid arthritis (RA) and prior inadequate response to csDMARDs (csDMARD-IR).1

Objectives:

To assess the efficacy and safety of UPA up to 64 wks (long-term extension; LTE) in csDMARD-IR pts with RA from China, Brazil, and South Korea.

Methods:

Pts were randomized to 12 wks of blinded treatment with UPA 15 mg once daily (QD) or PBO, in combination with csDMARDs. From Wk 12 onward, pts could continue to receive open-label UPA 15 mg QD. Efficacy endpoints were analyzed by original randomized treatment group sequences over 64 wks and included American College of Rheumatology (ACR) responses, and key remission and low disease activity measures. Non-responder imputation was used to handle missing data for binary endpoints. Treatment-emergent adverse events (TEAEs) per 100 patient-years (PY) were summarized for pts receiving ≥1 dose of UPA from baseline through to Wk 64.

Results:

Of 338 randomized pts who received ≥1 dose of study drug, 310 (91.7%) entered the LTE and 275 (81.4%) completed 64 wks of treatment. Among those initially randomized to UPA, the proportion of pts achieving 20%/50%/70% improvement in ACR criteria, and key remission and low disease activity measures increased over 64 wks of treatment (Figure 1). Improvements from baseline in the Health Assessment Questionnaire-Disability Index and pts’ assessment of pain were observed over 64 wks of UPA treatment (data not shown). By Wk 64, efficacy results for pts who switched from PBO to UPA at Wk 12 followed a similar trajectory to those originally randomized to UPA.

The observed rate of serious infections was 8.1 events/100 PY. Herpes zoster events were mostly non-serious, involving only 1 or 2 dermatomes. Most cases of hepatic disorders were Grade 1 or 2 hepatic transaminase elevations. There was 1 case of venous thromboembolic event (VTE; concurrent pulmonary embolism and deep vein thrombosis [DVT] in a patient with a history of DVT) and 3 cases of malignancy. Adjudicated major adverse cardiovascular events (Table 1) occurred in 2 pts (1 with non-fatal myocardial infarction and 1 with non-fatal stroke) who had underlying risk factors for cardiovascular disease. There were no deaths, active tuberculosis, or renal dysfunction.

Conclusion:

UPA 15 mg was effective in treating the signs and symptoms of RA and in improving physical function over 64 wks with no new safety signals1 in csDMARD-IR pts with RA from China, Brazil, and South Korea.

References:

[1]Zeng A, et al. Ann Rheum Dis 2020;79(Suppl 1):1016 [abstract SAT0160]

Table 1.

TEAEs at Wk 64

Event (E/100 PY)UPA 15 mg(n=322; PY=334.5)Any AE421.5 (399.8–444.1) Serious AE19.1 (14.7–24.4) AE leading to discontinuation of study drug9.0 (6.1–12.8) Deathsa0AEs of special interest Serious infection8.1 (5.3–11.7) Opportunistic infection0.9 (0.2–2.6) Herpes zoster9.0 (6.1–12.8) Hepatic disorder42.2 (35.5–49.7) Gastrointestinal perforation (adjudicated)0.3 (0.0–1.7) Any malignancy (excluding NMSC)0.6 (0.1–2.2) NMSC0.3 (0.0–1.7) MACE (adjudicated)b0.6 (0.1–2.2) VTE (adjudicated)c0.3 (0.0–1.7) Anemia11.1 (7.8–15.2) Neutropenia11.7 (8.3–15.9) Lymphopenia7.8 (5.1–11.4) CPK elevation11.1 (7.8–15.2)

aIncluding non-treatment-emergent deaths. bDefined as cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. cIncluding DVT and pulmonary embolism.

AE, adverse event; CPK, creatine phosphokinase; E, events; MACE, major adverse cardiovascular event; NMSC, non-melanoma skin cancer

Acknowledgements:

AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Yanna Song, PhD, of AbbVie provided statistical support. Medical writing support was provided by Laura Chalmers, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.

Disclosure of Interests:

Xiaofeng Zeng: None declared, Dongbao Zhao: None declared, Sebastiao Radominski: None declared, MAURO KEISERMAN: None declared, Chang-Keun Lee: None declared, Naomi Martin Employee of: AbbVie employee and may own stock or options, Sebastian Meerwein Employee of: AbbVie employee and may own stock or options, Yunxia Sui Employee of: AbbVie employee and may own stock or options, Won Park: None declared

OP0144 EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH ACTIVE ANKYLOSING SPONDYLITIS: 1-YEAR RESULTS FROM A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY WITH OPEN-LABEL EXTENSION

Background:

Upadacitinib (UPA) was efficacious and well tolerated vs placebo (PBO) during the first 14 weeks (wks) of the phase 2/3 SELECT-AXIS 1 study in patients (pts) with active ankylosing spondylitis (AS) who had an inadequate response to NSAIDs.1

Objectives:

To report efficacy and safety of UPA through 1 year in the SELECT-AXIS 1 study.

Methods:

In SELECT-AXIS 1 (NCT03178487) pts were randomized 1:1 to UPA 15 mg once daily (QD) or PBO; at wk 14, pts continued in the 90-wk open-label extension and received UPA 15 mg QD; reported here are data up to wk 64. The study enrolled pts (≥18 y) with active AS (defined as BASDAI ≥4 and pt assessment of back pain ≥4 [numeric rating scale, 0–10] at screening and baseline [BL]) who had inadequate response to ≥2 NSAIDs or intolerance to or contraindication for NSAIDs and were biologic DMARD naive. Efficacy assessments included percentage of pts with Assessment of SpondyloArthritis international Society (ASAS) 20/40 response, ASAS partial remission, BASDAI50, AS Disease Activity Score (ASDAS) and change from BL in ASDAS and BASFI. Data are reported as observed and by using non-responder imputation (NRI). Treatment-emergent adverse events (TEAEs) were reported as events per 100 patient-years (PY) up to January 31, 2020.

Results:

Of 187 pts, 178 pts (each n=89 for UPA and PBO arms) completed wk 14 on study drug and entered the open-label extension; 160 pts completed wk 64. Efficacy was maintained or continued to improve throughout the study in the continuous UPA group: 85% (95% CI, 77%–93%) of pts achieved ASAS40 at wk 64 in the as-observed analysis and 72% (63%–81%) in the NRI analysis (Figure). Pts who switched from PBO to UPA at wk 14 showed similar speed of onset and magnitude of response vs pts initially randomized to UPA: 81% (95% CI, 72%–89%) in the as-observed analysis and 70% (61%–80%) in the NRI analysis achieved ASAS40 at wk 64 (Figure). Similar results were observed for other efficacy endpoints (Figure). Among all 182 pts receiving UPA, 618 AEs were reported. AEs leading to discontinuation and serious AEs were low (Table). No serious infections, active tuberculosis, venous thromboembolic events, gastrointestinal perforation, major adverse cardiovascular events, renal dysfunction, or deaths were reported.

Table 1.

TEAEs per 100 PYs

Events/(E/100 PY)UPA 15 mg QDN=182 (237.6 PY)Any AE618 (260.1)Serious AE14 (5.9)AE leading to discontinuation15 (6.3)Infections205 (86.3) Opportunistic infection*2 (0.8) Herpes zoster†5 (2.1)Creatine phosphokinase elevation‡28 (11.8)Hepatic disorder§24 (10.1)Neutropenia||7 (2.9)Anemia||3 (1.3)Lymphopenia||2 (0.8)Malignancy¶1 (0.4)Death0

AE, adverse event; PY, patient-year; QD, once daily; TEAE, treatment-emergent AE; UPA, upadacitinib.

*Two non-serious events of esophageal candidiasis in the same patient.

†Five events in 4 patients; all non-serious and limited to 1 dermatome.

‡All events were non-serious and none led to study drug discontinuation; majority were asymptomatic.

§Majority based on asymptomatic alanine aminotransferase/aspartate aminotransferase elevations; all were non-serious and none led to study drug discontinuation.

||All events were non-serious and none led to study drug discontinuation.

¶Squamous cell carcinoma of tongue in 61-year-old male former smoker; no reasonable possibility to be study drug related per investigator.

Conclusion:

UPA 15 mg QD showed sustained and consistent efficacy over 1 year. Pts who switched from placebo to UPA at wk 14 showed a similar efficacy response compared with pts who received continuous UPA. No new safety findings were observed compared with safety data from the UPA clinical development program in other indications.2

References:

[1]van der Heijde D, et al. Lancet. 2019;394(10214):2108-2117.

[2]Cohen, et al. Arthritis Rheumatol. 2019;71(suppl 10).

Acknowledgements:

AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship. Medical writing support was provided by M Hovenden and J Matsuura of ICON plc (North Wales, PA) and was funded by AbbVie.

Disclosure of Interests:

Atul Deodhar Speakers bureau: Novartis, Pfizer, Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer, UCB, Désirée van der Heijde Consultant of: AbbVie, BMS, Cyxone, Eisai, Galapagos, Gilead, GlaxoSmithKline, Lilly, Novartis, Pfizer, and UCB Pharma, Joachim Sieper Speakers bureau: AbbVie, Janssen, Lilly, Merck, and Novartis, Consultant of: AbbVie, Janssen, Lilly, Merck, and Novartis, Filip van den Bosch Speakers bureau: AbbVie, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB Pharma, Consultant of: AbbVie, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB Pharma, Walter P Maksymowych Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB Pharma, Grant/research support from: AbbVie, Novartis and Pfizer, Tae-Hwan Kim Speakers bureau: AbbVie, Celltrion, Kirin, Lilly, and Novartis, Mitsumasa Kishimoto Consultant of: AbbVie, Amgen-Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, BMS, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB Pharma, Andrew Ostor Consultant of: AbbVie, BMS, Roche, Janssen, Lilly, Novartis, Pfizer, UCB, Gilead, and Paradigm, Bernard Combe Speakers bureau: AbbVie, Lilly, Merck, Consultant of: AbbVie, Lilly, Gilead, Janssen, Novartis, Roche-Chugai, and Sanofi, Grant/research support from: AbbVie and Lilly, Yunxia Sui Shareholder of: AbbVie, Employee of: AbbVie, xin wang Shareholder of: AbbVie, Employee of: AbbVie, Alvina Chu Shareholder of: AbbVie, Employee of: AbbVie, In-Ho Song Shareholder of: AbbVie, Employee of: AbbVie

Synergistic effect of defects and porous structure in CoCCHH-CoSe heterogeneous-tube @PEDOT:PSS foam towards elastic supercapacitor with enhanced pseudocapacitances

It is still challenging to construct stable 3D energy storage materials at the nanoscale by precise pore structure control and reasonable surface modification. Herein, a novel interwoven porous Co(CO₃)_0.35Cl_0.20(OH)_1.10 (CoCCHH)-CoSe heterogeneous-tube @PEDOT:PSS 3D foam with abundant active sites is presented as supercapacitor electrodes. The electrochemical results indicated that the pore structure provides ample space for redox reaction, and increases the number of ion transport channels. Besides, rational surface modification brings about sufficient active sites for redox reaction. The stable, porous PEDOT:PSS foam with a 3D elastic frame exhibited excellent electrical conductivity. Thus, the CoCCHH-CoSe@PEDOT:PSS foam possessed excellent specific capacitance and energy density, due to the synergistic effect of the unique 3D structure and surface defects. The home-made supercapacitor with CoCCHH-CoSe@PEDOT:PSS foam as cathode materials showed high specific capacitance (440.6F g^-1 at 1 A g^-1) and excellent energy density (137.7 Wh kg^-1). This work provides a valuable strategy to develop potential materials for electrochemical energy storage.

Potential of Bradyrhizobia inoculation to promote peanut growth and beneficial Rhizobacteria abundance

AIMS

To investigate the effects of three symbiotic Bradyrhizobium strains on peanut growth and on rhizobacterial communities in flowering and harvest stages in an organic farm, also to evaluate the role of plant development in influencing peanut rhizobacterial microbiota and correlations among the inoculants, rhizobacterial communities and plant growth.

METHODS AND RESULTS

Peanut seeds were inoculated with three individual Bradyrhizobium strains, plant growth performance was measured in two developmental stages and rhizobacterial communities were analysed by Illumina sequencing of rpoB gene amplicons from peanut rhizosphere. The three bradyrhizobial inoculants significantly increased the nodule numbers and aboveground fresh weight of peanut plants regardless of the different growth stages, and the pod yields were increased to some extent and significantly positively correlated with Bradyrhizobium abundances in rhizosphere. Principal coordinate analysis indicated that the rhizobacterial communities were strongly influenced by the inoculation and peanut developmental stages. The bradyrhizobia inoculation increased relative abundances of potentially beneficial bacteria in peanut rhizosphere, and also altered rhizobacterial co-occurrence association networks and important network hub taxa. Similarly, plant development also significantly influenced the structure, composition and co-occurrence association networks of rhizobacterial communities.

CONCLUSIONS

Bradyrhizobial inoculants increased peanut growth and yields, they and plant development affected the assembly of peanut rhizobacterial communities.

SIGNIFICANCE AND IMPACT OF THE STUDY

Rhizobial inoculants improved the host plant performance that might also be associated with the dynamic changes in rhizobacterial community except enhancing the biological nitrogen fixation and helps to profoundly understand the mechanism how rhizobia inoculants improve plant growth and yields.

Spinel LiMn2O4 nanoparticles fabricated by the flexible soft template/Pichini method as cathode materials for aqueous lithium-ion capacitors with high energy and power density

Spinel LiMn2O4 (LMO) with a three-dimensional structure has become one of the cathode materials that has gained the most interest due to its safety, low price and abundant resources. However, the lithium ion transmission is limited by large particle size and particle agglomeration of LMO. Thus, reducing the particle size and agglomeration of LMO can effectively improve its lithium ion transmission. Here, we synthesized a LMO cathode material with a nanoscale crystal size using the flexible expanded graphite (EG) soft template and Pichini method. EG-controlled particle size and particle agglomeration of LMO is conducive to charge transfer and diffusion of lithium ions between LMO and the electrolyte, meanwhile, there are more redox sites on the nanosized LMO particles, which makes the redox reaction of LMO more thorough during the charge and discharge process, resulting in high capacitance performance. In order to obtain the considerably required lithium-ion capacitors (LICs) with high energy density and power density, we assembled aqueous LMO//activated carbon (AC) LICs with 5 M LiNO3 as the aqueous electrolytes, which are environmentally friendly, safe, low cost and have higher electrical conductivity than organic electrolytes. The optimal LIC has an energy density of 32.63 W h kg-1 at a power density of 500 W kg-1 and an energy density of 8.06 W h kg-1 at a power density of 10 000 W kg-1, which is higher than most of the LMO-based LICs in previous reports. After 2000 cycles, the specific capacitance retention rate was 75.9% at a current density of 3 A g-1. Therefore, our aqueous LMO//AC LICs synthesized by the soft template/Pichini method have wide prospects and are suitable for low-cost, high-safety and high-power applications.

A reinforced concrete structure rGO/CNTs/Fe2O3/PEDOT:PSS paper electrode with excellent wettability and flexibility for supercapacitors

A paper electrode with a reinforced concrete structure using reduced rGO nanosheets, PEDOT:PSS, CNTs and Fe₂O₃ nanoparticles was formed by a facile and simple vacuum drying method. The assembled symmetrical supercapacitor exhibits excellent electrochemical performance.

PANI/MoO3−x shell–core composites with enhanced rate and cycling performance for flexible solid-state supercapacitors and electrochromic applications

PANI/MoO_3−x shell–core composites show enhanced electrochemical and electrochromic performance as a bi-functional electrode material for flexible solid-state supercapacitors, attributed to a synergistic effect from PANI nanorods and MoO_3−x nanobelts.

SAT0160 EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS FROM CHINA, BRAZIL, AND SOUTH KOREA WITH RHEUMATOID ARTHRITIS WHO HAVE HAD INADEQUATE RESPONSE TO CONVENTIONAL SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS

Background:

Upadacitinib (UPA), an oral, selective JAK-1 inhibitor was effective in global ph 3 trials in rheumatoid arthritis (RA) patients with inadequate response (IR)/intolerance to csDMARDs and bDMARDs.

Objectives:

This Phase 3, randomized, double-blind, placebo (PBO)-controlled study assessed the efficacy and safety of UPA in combination with csDMARDs in csDMARD-IR patients with RA from China, Brazil, and South Korea.

Methods:

Patients were randomized 1:1 to receive UPA 15 mg once daily (QD) or PBO in combination with csDMARDs. The primary endpoint was ACR20 response at Week 12, using non-responder imputation.

Results:

338 patients were randomized, and 310 (91.7%) completed Week 12. At Week 12, statistically significantly more patients receiving UPA vs PBO achieved the primary endpoint of ACR20 (71.6% vs 31.4%, p<0.001). UPA also demonstrated statistically significant improvements in all ranked secondary endpoints vs PBO at Week 12 (Table 1), including mean change in DAS28(CRP), HAQ-DI, and SF-36 PCS, and patients achieving DAS28(CRP) ≤3.2, DAS28(CRP) <2.6, and CDAI ≤10. Greater responses were also seen with UPA vs PBO for other key secondary endpoints including ACR50 and ACR70. Onset of UPA action was rapid with more patients on UPA achieving ACR20 by Week 1 (25.4% vs 5.9%, p<0.001). The frequency of AEs (61.5% vs 49.1%) and serious AEs (7.1% vs 3.0%) was higher with UPA vs PBO. The frequency of AEs of special interest was generally similar between UPA and PBO, with the exception of herpes zoster (1.8% vs 0.6%), hepatic disorders (9.5% vs 7.1%), neutropenia (3.0% vs 0%), and elevated creatine phosphokinase (1.8% vs 0.6%), which were higher with UPA. One case of breast cancer (on Day 1 of study) and one VTE (pulmonary embolism and deep vein thrombosis in a patient with history of deep vein thrombosis) were reported with UPA treatment.

Table 1.

Efficacy endpoints at Week 12

EndpointaUPA 15 mg QD (n=169)PBO(n=169)Primary endpointACR20, %71.6***31.4Secondary endpointsΔ DAS28(CRP)-2.56***-0.95Δ HAQ-DI-0.62***-0.18Δ SF-36 PCS8.93c***3.36dDAS28(CRP) ≤3.2, %46.2***13.6DAS28(CRP) <2.6, %29.6***5.3CDAI ≤10, %35.5***11.2ACR50, %b40.8***8.3ACR70, %b21.3***3.6ACR20 at Week 1, %b25.4***5.9

***p<0.001 vs PBO

aNRI for binary endpoints; ANCOVA with multiple imputation for DAS28(CRP) and HAQ-DI; mixed model repeated measures for other continuous endpoints

bUnranked secondary endpoint.cn=143.dn=149

Conclusion:

Efficacy of UPA was demonstrated in this csDMARD-IR population from China, Brazil, and South Korea. The safety of UPA was comparable with the global Phase 3 program.

Disclosure of Interests: :

Xiaofeng Zeng Consultant of: MSD Pharmaceuticals, Dongbao Zhao: None declared, Sebastiao Radominski: None declared, MAURO KEISERMAN Speakers bureau: Pfizer, Abbott, Actelion, AstraZeneca, Amgen, Roche, Bristol Myers Squibb, and Janssen and has received clinical trial honoraria from Pfizer, Amgen, AstraZeneca, Anthera Pharmaceuticals, Bristol-Myers Squibb, Biogen Idec Inc, Celltrion Inc., Eli Lilly, Human Genome Sciences, Novartis, Roche, Sanofi, UCB Inc., Chang-Keun Lee: None declared, Sebastian Meerwein Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Jeffrey Enejosa Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Yunxia Sui Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Mohamed-Eslam Mohamed Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Won Park: None declared

Organic-inorganic Hybrid ([BrCH2 CH2 N(CH3 )3 ]+ 2 [CdBr4 ]2- ) with Unusual Ferroelectric and Switchable Dielectric Bifunctional Properties over Different Temperature Range

Both ferroelectric and switchable dielectric behaviors are of great academic value and practical significance, but they usually exist alone. If combine the two properties into one compound, it will be more valuable in practical application. In this paper, quasi-spherical (2-bromoethyl) trimethylammonium cation was used to match with [CdBr₄ ]^2- anion, and a new organic-inorganic hybrid compound ([BrCH₂ CH₂ N(CH₃ )₃ ]⁺ ₂ [CdBr₄ ]^2- , BETABCdBr) was obtained and carefully characterized. The results indicate that this compound undergoes two continuous reversible phase transition around 342 K and 390 K. It could respectively exhibit ferroelectric and switchable dielectric properties over different temperature range. This work may provide a new clue to explore new types of bifunctional phase transition smart materials to meet various application requirements.

Large-Area Exfoliated Lead-Free Perovskite-Derivative Single-Crystalline Membrane for Flexible Low-Defect Photodetectors

Wide applications of personal consumer electronics have tended to cause a huge demand for smart and portable electronics, featuring mechanical flexibility, lightweight, and environmental friendliness. However, most of the recently reported flexible photodetectors based on microcrystalline and amorphous components commonly suffer from severe drawbacks, including plenty of grains, boundaries, and surface defects. Here, we present a new lead-free chiral perovskite-derivative light absorber of (aminoguanidinium)₃Bi₂I₉ (AG₃Bi₂I₉), which displays a narrow direct band gap of about 1.89 eV. High-quality bulk single crystals were successfully grown with dimensions up to 24 × 12 × 5 mm³. Emphatically, as-grown bulk single crystals are easy to be exfoliated for large-area ultrathin wafers with an exfoliated area up to 0.6 cm², showing promise for low-defect flexible optoelectronic applications. The remarkable surface smoothness and crystalline quality of single-crystalline thin layers were further confirmed by TEM, HRTEM, AFM, single-crystalline X-ray diffraction, and space-charge limited current (SCLC) measurements. As expected, the planar photodetectors based on flexible exfoliated wafers are first fabricated and exhibit notable photoelectric performance. This work represents an important step forward as it offers an effective strategy for the fabrication of high-quality large-area flexible exfoliated wafer devices.

Two 1D homochiral heterometallic chains: crystal structures, spectra, ferroelectricity and ferromagnetic properties

Two new homo chiral Cu–Ln (Ln = Gd and Ho) compounds bearing a chiral Schiff base ligand (1R,3S)-N′,N′′-bis[3-methoxysalicylidene]-1,3-diamino-1,2,2-trimethylcyclopentane (H₂L) have been synthesized and characterized by elemental analysis, IR spectroscopic and single-crystal X-ray diffraction techniques. The compounds were found to exhibit 1D zig-zag skeletons with double μ-1,5 bridging dicyanamide anions. Circular dichroism (CD) spectra have been used to verify their chiroptical activities. Magnetic studies suggest that 1 and 2 hold the same magnetic behavior with the dinuclear compounds presenting ferromagnetic interaction. Furthermore, both compounds show ferroelectricity with the remnant polarization (P_r) value of 0.23 and 0.18 μC cm⁻² at room temperature, respectively.

Two homochiral 1D heterometallic chains are potential multifunctional molecules coexisting optical activity, ferromagnetic and ferroelectric properties.

Dexamethasone alleviates allergic asthma immature rat through Toll like receptor 4

OBJECTIVE

The allergic asthma model induced by ovalbumin (OVA) was established in the immature rat. Dexamethasone (DXM) was adopted for intervention to analyze the treatment effect and to explore the relationship with toll-like receptor 4 (TLR4).

MATERIALS AND METHODS

Immature SD rat was treated by OVA to construct allergic asthma model and intervened by DXM. The rats were randomly divided into model group, experimental group, and control group. The changes in lung tissue were observed by light microscope. The EOS infiltration and reactivity of airway wall were compared. The expressions of TLR2 and TLR4 protein and mRNA in the lung tissue were tested by Western blot and RT-PCR.

RESULTS

The lung tissue in the model group was infiltrated by a lot of inflammatory cells, and mucous membrane edema was observed, compared with that in the control group. There were only a few inflammatory cells in the interstitial tissue and pulmonary alveoli in the experimental group compared with that in the model group. EOS count of airway wall and airway reactivity decreased in the experimental group. The levels of TLR2 and TLR4 were significantly elevated in the third week compared with the first week (p<0.05).

CONCLUSIONS

The treatment of DXM can alleviate the pathological changes of the lung tissue in SD immature rat with allergic asthma, reduce EOS infiltration in the airway wall, decrease airway reactivity, and elevate expressions of TLR2 and TLR4.

Abstract P4-08-17: Expression score (Escore) for the prediction of likelihood of recurrence of DCIS

Background: Ductal carcinoma in situ (DCIS) accounts for at least 20% of breast cancers. Factors associated with recurrence of DCIS or progression to invasive carcinoma are not well delineated. The goals of the current study were to profile the epithelial cells using the GE Cell DIVE™ immuno-fluorescent based analyses. This was coupled with semi-automated algorithms to characterize the inter-relationships between cell populations and likelihood of recurrence.

Patients and Methods: A TMA-based (total 8 TMAs) cohort of cases of DCIS with and without recurrence was obtained from Oxford University. Recurrence in this cohort was defined as ipsilateral DCIS, ipsilateral invasive, contralateral invasive and metastatic. Analysis for 31 epithelial markers (HER4, CK56, ABCG2, PTEN, S6, CKAE1, PR, ER, NaKATPase, CK19, ALDH1, CK PCK26, cMET, CD44v6, HER2, CDCP1, p53, CK15, COX2, VEGFR2, ABCb1, HTF9C, CD10, MRP4, CEACAM5, EGFR, p21, MRP5, SLC7A5, Ki67, DAPI) was performed on a single FFPE TMA section containing cases of DCIS. Briefly, FFPE sections from TMAs containing DCIS were sequentially (cyclically) stained for the markers. Each cycle entailed staining with 2-3 markers followed by imaging, dye inactivation, and re-staining. DAPI was used for nuclear demarcation and for registration of the images, while S6, pan-cadherin, Na+K+ATPase and pan-cytokeratin were used for epithelial segmentation. K-means clustering followed regression analysis was performed to identify inter-relationships between markers and association with likelihood of recurrence. Log-rank analysis was performed and the relapse-free survival data depicted using Kaplan Meier plots. Escore was developed by logistic regression model, classification model on recurrence

Results: Filtering of the expression analysis by the quality, specificity, compartment localization and fields entirely composed of DCIS, in addition to availability of clinical data resulted final analysis of 31 markers in 67 cases. Correlation analyses were performed on each of the markers to identify markers that were significantly correlated in univariate analysis. K-means cluster analysis was performed using a set of 4 markers (ER, HER2, SLC7A5 and cMET) to identify 6 clusters. High cMET (cluster 1; low HER2 and SLC7A5) and High ER (low cMET, HER2, SLC7A5; Cluster 5) were associated with low risk of recurrence (p values 0.014 and &lt;0.0001). In contrast, Cluster 2 (High HER2, high SLC7A5, low ER) and Cluster 3 (High HER2, low ER, SLC7A5and cMET) were associated with increased risk of recurrence (P values 0.038 and 0.076). A regression analysis based algorithm was developed using these markers to calculate a numerical score which could predict likelihood of recurrence. As depicted in the KM plots, the HR for recurrence increases significantly (P-value 2.4E-05; p=0.02 with LOOCV) with increase in expression score (Escore).

Conclusions: We describe the development of an Escore using expression 4 markers to predict likelihood of recurrence. Additional ongoing studies will seek to validate the utility of the Escore in predicting likelihood of recurrence of DCIS and development of invasive carcinomas and comparison with other scoring systems.

Citation Format: Badve SS, Cho S, Gokmen-Polar Y, Zavodszky M, Sui Y, Chadwick C, Tan PH, Gerdes M, Harris AL, Ginty F. Expression score (Escore) for the prediction of likelihood of recurrence of DCIS [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-17.

Effect of pressure on the self-hole-doped superconductor RbGd2Fe4As4O2

RbGd₂Fe₄As₄O₂ is a newly discovered self-hole-doped stoichiometric superconductor, which has a hybrid structure with separated double FeAs layers and exhibits a high superconducting transition temperature T _c  =  35 K. Here, we report the effect of pressure (P) on its T _c and normal-state transport properties by measuring the temperature dependence of resistivity ρ(T) under various pressures up to 14 GPa with a cubic anvil cell apparatus. We found that the T _c is suppressed monotonically to ca. 12.5 K upon increasing pressure to 14 GPa with a slope change of T _c(P) at around 4 GPa. In addition, the low-temperature normal-state ρ(T), which is proportional to T ⁿ , also evolves gradually from a non-Fermi-liquid with n  =  1 at ambient pressure to a Fermi liquid with n  =  2 at P  ⩾  4 GPa. Accompanying with the non-Fermi-liquid to Fermi-liquid crossover, the quadratic temperature coefficient of resistivity, which reflects the effective mass of charge carriers, also experiences a significant reduction as commonly observed in the vicinity of a magnetic quantum critical point (QCP). Our results indicate that the stoichiometric RbGd₂Fe₄As₄O₂ at ambient pressure might be located near a QCP such that the enhanced critical spin fluctuations lead to high-T _c superconductivity. The application of pressure should broaden the electronic bandwidth and weaken the spin fluctuations, and then restore a Fermi-liquid ground state with lower T _c.

Pressure-induced enhancement of thermoelectric power factor in pristine and hole-doped SnSe crystals

We evaluate the influence of pressure on the thermoelectric power factors PF ≡ S²σ of pristine and Na-doped SnSe crystals by measuring their electrical conductivity σ(T) and Seebeck coefficient S(T) up to ∼22 kbar with a self-clamped piston-cylinder cell. For both cases, σ(T) is enhanced while S(T) reduced with increasing pressure as expected, but their imbalanced variations lead to a monotonic enhancement of PF under pressure. For pristine SnSe, σ(290 K) increases by ∼4 times from ∼10.1 to 38 S cm⁻¹, while S(290 K) decreases by only ∼12% from 474 to 415 μV K⁻¹, leading to about three-fold enhancement of PF from 2.24 to 6.61 μW cm⁻¹ K⁻², which is very close to the optimal value of SnSe above the structural transition at ∼800 K at ambient pressure. In comparison, the PF of Na-doped SnSe at 290 K is enhanced moderately by ∼30% up to 20 kbar. In contrast, the PF of isostructural black phosphorus with a simple band structure was found to decrease under pressure. The comparison with black phosphorus indicates that the multi-valley valence band structure of SnSe is beneficial for the enhancement of PF by retaining a large Seebeck coefficient under pressure. Our results also provide experimental confirmation on the previous theoretical prediction that high pressure can be used to optimize the thermoelectric efficiency of SnSe.

The thermoelectric power factor of SnSe is enhanced by three times under a hydrostatic pressure of 22.5 kbar.

Abstract P1-06-02: Impact of heterogeneity of DCIS on immune cell infiltrations

Background: Ductal carcinoma in situ (DCIS) accounts for at least 20% of breast cancers. Factors associated with recurrence of DCIS or progression to invasive carcinoma are not well delineated. The goals of the current study were to profile the epithelial and immune cells using the MultiOmyx hyperplexed immuno-fluorescent based analyses. This was coupled with semi-automated algorithms to characterize the inter-relationships between cell populations within individual DCIS lesions.

Patients and Methods: Analysis for 15 antibody markers (EGFR, Her2, Her4, S6, pMTOR, PCAD, CD44v6, NaKATPase, SLC7A5, CD4, CD8, CD20, CD68, and CD10) was performed on a single FFPE section containing 10-20 distinct ducts from 13 cases of DCIS. Briefly, approximately 40 fields of view (FOV) from digitized sections containing DCIS or normal tissue were sequentially (cyclically) stained for the 15 markers. Each cycle entailed staining with 2-3 markers followed by imaging, dye inactivation, and re-staining. DAPI was used for nuclear demarcation and for registration of the images, while S6, pan-cadherin, Na+K+ATPase and pan-cytokeratin were used for epithelial segmentation. K-means clustering was used to determine patterns of co-expression of markers at the single cell, duct, and patient levels. These clusters were then correlated with immune marker expression by tumor infiltrating lymphocytes (TILs) by marker type (CD4, CD8, and CD20) and tumor compartment (stromal versus intraepithelial).

Results: Analysis of the epithelial component in each of 13 cases of DCIS (n= 415 ducts) revealed 8 distinct expression patterns (clusters) using a panel of 7 markers (EGFR, Her2, Her4, pmTOR, CD44v6, SLC7A5, and CD10). The frequency and distribution of clusters, annotated at the single cell level, showed that 4 DCIS's were dominated (&gt;80%) by a single cell phenotype represented by cluster groups 3 and 7 (high Her2), cluster 6 (High Her4 and SLC7A5 and low Her2), or cluster 4 (non-descript). In 5 pts, the pattern was more heterogeneous consisting of mixture of cell populations with 50-70% of the cells belonging to cluster 1 (moderate to high levels for all markers except EGFR and CD10). The remaining pts had a strong representation of cluster 4 and 5 (CD44v6 and phospho-mTOR) cells. The distribution of both intra-epithelial and stromal TILs in DCIS cases were either consisted of a mixed B-cell (CD20+) and T-cell response (n=4), or one dominated by T-cells. Cluster 2 (High EGFR and CD10) was associated with a largely T-cell response (rs = 0.83, P value = 0.0004), while Cluster 7 (strong HER2) was associated with a B-cell response (rs = 0.68, P value = is 0.009).

Conclusions: Analysis 15 markers and use of K-means clustering algorithm, shows prominent inter-tumoral (but not intra-tumoral) heterogeneity in DCIS. Furthermore, epithelial cell specific clusters (high HER2 or EGFR) were associated with distinct B or T cell infiltration by TILs. Additional ongoing studies will determine the clinical significance of the clusters with respect to recurrence of DCIS and development of invasive carcinomas.

Citation Format: Badve S, Gökmen-Polar Y, Harris AL, Sui Y, Sevinsky C, Santamaria-Pang A, Ginty F, Tan PH, Gerdes MJ. Impact of heterogeneity of DCIS on immune cell infiltrations [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-06-02.

Differentiation of Low- and High-Grade Gliomas Using High b-Value Diffusion Imaging with a Non-Gaussian Diffusion Model

BACKGROUND AND PURPOSE

Imaging-based tumor grading is highly desirable but faces challenges in sensitivity, specificity, and diagnostic accuracy. A recently proposed diffusion imaging method by using a fractional order calculus model offers a set of new parameters to probe not only the diffusion process itself but also intravoxel tissue structures, providing new opportunities for noninvasive tumor grading. This study aimed to demonstrate the feasibility of using the fractional order calculus model to differentiate low- from high-grade gliomas in adult patients and illustrate its improved performance over a conventional diffusion imaging method using ADC (or D).

MATERIALS AND METHODS

Fifty-four adult patients (18-70 years of age) with histology-proved gliomas were enrolled and divided into low-grade (n = 24) and high-grade (n = 30) groups. Multi-b-value diffusion MR imaging was performed with 17 b-values (0-4000 s/mm(2)) and was analyzed by using a fractional order calculus model. Mean values and SDs of 3 fractional order calculus parameters (D, β, and μ) were calculated from the normal contralateral thalamus (as a control) and the tumors, respectively. On the basis of these values, the low- and high-grade glioma groups were compared by using a Mann-Whitney U test. Receiver operating characteristic analysis was performed to assess the performance of individual parameters and the combination of multiple parameters for low- versus high-grade differentiation.

RESULTS

Each of the 3 fractional order calculus parameters exhibited a statistically higher value (P ≤ .011) in the low-grade than in the high-grade gliomas, whereas there was no difference in the normal contralateral thalamus (P ≥ .706). The receiver operating characteristic analysis showed that β (area under the curve = 0.853) produced a higher area under the curve than D (0.781) or μ (0.703) and offered a sensitivity of 87.5%, specificity of 76.7%, and diagnostic accuracy of 82.1%.

CONCLUSIONS

The study demonstrated the feasibility of using a non-Gaussian fractional order calculus diffusion model to differentiate low- and high-grade gliomas. While all 3 fractional order calculus parameters showed statistically significant differences between the 2 groups, β exhibited a better performance than the other 2 parameters, including ADC (or D).

Posttraumatic stress disorder and posttraumatic growth coexistence and the risk factors in Wenchuan earthquake survivors

Various studies have assessed the negative and/or positive changes in the aftermath of traumatic events. Yet few of these have addressed the factors associated with the coexistence of both negative and positive changes after a devastating earthquake. The aim of this study is to assess the relationship between the negative and positive changes and elucidate the risk factors of such changes one year after Wenchuan earthquake. A total of 2080 survivors from 19 counties participated in a self-report questionnaire survey which included the posttraumatic stress disorder (PTSD) Check list-Civilian, the posttraumatic growth PTG Inventory (PTGI). The prevalence of PTSD and moderate PTG was found to be 40.1% (95% CI [37.9% 42.3%]) and 51.1% (95% CI [48.9% 53.3%]). The PTSD and moderate PTG coexistence was 19.6% (95% CI [17.8% 21.4%]). PTSD symptom severity was significantly positively associated with the PTG score. Middle aged groups (31-40 and 41-50 years old, OR=2.323, 95% CI [1.059, 5.095] and OR=2.410, 95% CI [1.090, 5.329] respectively), those with lower income levels (OR=8.019, 95% CI [2.421, 26.558]), those living in temporary house (OR=1.946, 95% CI [1.280, 2.956]), and those who had had less social support (OR=1.109, 95% CI [1.076, 1.143]) had a significantly higher possibility for the presence of PTSD and moderate PTG coexistence. The results indicated the widespread positive changes in earthquake survivors. Better income levels and living conditions and higher social support were suggested to promote PTG in those with PTSD.