Androgen synthesis cell-specific CREBZF deficiency alters adrenal cortex steroid secretion and develops behavioral abnormalities in adult male mice

The global challenge of male infertility is escalating, notably due to the decreased testosterone (T) synthesis in testicular Leydig cells under stress, underscoring the critical need for a more profound understanding of its regulatory mechanisms. CREBZF, a novel basic region-leucine zipper transcription factor, regulates testosterone synthesis in mouse Leydig cells in vitro; however, further validation through in vivo experiments is essential. Our study utilized Cyp17a1-Cre to knock out CREBZF in androgen-synthesis cells and explored the physiological roles of CREBZF in fertility, steroid hormone synthesis, and behaviors in adult male mice. Conditional knockout (cKO) CREBZF did not affect fertility and serum testosterone level in male mice. Primary Leydig cells isolated from CREBZF-cKO mice showed impaired testosterone secretion and decreased mRNA levels of Star, Cyp17a1, and Hsd3b1. Loss of CREBZF resulted in thickening of the adrenal cortex, especially X-zone, with elevated serum corticosterone and dehydroepiandrosterone levels and decreased serum dehydroepiandrosterone sulfate levels. Immunohistochemical staining revealed increased expression of StAR, Cyp11a1, and 17β-Hsd3 in the adrenal cortex of CREBZF-cKO mice, while the expression of AR was significantly reduced. Along with the histological changes and abnormal steroid levels in the adrenal gland, CREBZF-cKO mice showed higher anxiety-like behavior and impaired memory in the elevated plus maze and Barnes maze, respectively. In summary, CREBZF is dispensable for fertility, and CREBZF deficiency in Leydig cells promotes adrenal function in adult male mice. These results shed light on the requirement of CREBZF for fertility, adrenal steroid synthesis, and stress response in adult male mice, and contribute to understanding the crosstalk between testes and adrenal glands.

Economic Evaluation of COVID-19 Immunization Strategies: A Systematic Review and Narrative Synthesis

OBJECTIVES

This study aimed to systematically assess global economic evaluation studies on COVID-19 vaccination, offer valuable insights for future economic evaluations, and assist policymakers in making evidence-based decisions regarding the implementation of COVID-19 vaccination.

METHODS

Searches were performed from January 2020 to September 2023 across seven English databases (PubMed, Web of Science, MEDLINE, EBSCO, KCL-Korean Journal Dataset, SciELO Citation Index, and Derwent Innovations Index) and three Chinese databases (Wanfang Data, China Science and Technology Journal, and CNKI). Rigorous inclusion and exclusion criteria were applied. Data were extracted from eligible studies using a standardized data collection form, with the reporting quality of these studies assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022).

RESULTS

Of the 40 studies included in the final review, the overall reporting quality was good, evidenced by a mean score of 22.6 (ranging from 10.5 to 28). Given the significant heterogeneity in fundamental aspects among the studies reviewed, a narrative synthesis was conducted. Most of these studies adopted a health system or societal perspective. They predominantly utilized a composite model, merging dynamic and static methods, within short to medium-term time horizons to simulate various vaccination strategies. The research strategies varied among studies, investigating different doses, dosages, brands, mechanisms, efficacies, vaccination coverage rates, deployment speeds, and priority target groups. Three pivotal parameters notably influenced the evaluation results: the vaccine's effectiveness, its cost, and the basic reproductive number (R0). Despite variations in model structures, baseline parameters, and assumptions utilized, all studies identified a general trend that COVID-19 vaccination is cost-effective compared to no vaccination or intervention.

CONCLUSIONS

The current review confirmed that COVID-19 vaccination is a cost-effective alternative in preventing and controlling COVID-19. In addition, it highlights the profound impact of variables such as dose size, target population, vaccine efficacy, speed of vaccination, and diversity of vaccine brands and mechanisms on cost effectiveness, and also proposes practical and effective strategies for improving COVID-19 vaccination campaigns from the perspective of economic evaluation.

Pre- versus Post-synaptic Forms of LTP in Two Branches of the Same Hippocampal Afferent

There has been considerable controversy about pre- versus postsynaptic expression of memory-related long-term potentiation (LTP), with corresponding disputes about underlying mechanisms. We report here an instance in male mice, in which both types of potentiation are expressed but in separate branches of the same hippocampal afferent. Induction of LTP in the dentate gyrus (DG) branch of the lateral perforant path (LPP) reduces paired-pulse facilitation, is blocked by antagonism of cannabinoid receptor type 1, and is not affected by suppression of postsynaptic actin polymerization. These observations are consistent with presynaptic expression. The opposite pattern of results was obtained in the LPP branch that innervates the distal dendrites of CA3: LTP did not reduce paired-pulse facilitation, was unaffected by the cannabinoid receptor blocker, and required postsynaptic actin filament assembly. Differences in the two LPP termination sites were also noted for frequency facilitation of synaptic responses, an effect that was reproduced in a two-step simulation by small adjustments to vesicle release dynamics. These results indicate that different types of glutamatergic neurons impose different forms of filtering and synaptic plasticity on their afferents. They also suggest that inputs are routed to, and encoded by, different sites within the hippocampus depending upon the pattern of activity arriving over the parent axon.

LncRNA STAT3-AS regulates endometrial receptivity via the STAT3 signaling pathway

Endometrial receptivity is critical for the successful establishment of pregnancy in ruminants. Interferon tau (IFNT) plays a key role in promoting embryo attachment by activating the Janus kinase/signal transducer and activator of transcription pathway, which induces the expression of a series of interferon-stimulated genes (ISGs). In our previous study, sequencing analysis of goat endometrial epithelial cells (gEECs) treated with 20 ng/mL IFNT revealed a differentially expressed long non-coding RNA located on the STAT3 antisense chain, which we designated STAT3-AS. The aim of this study was to investigate the role and mechanism of STAT3-AS in establishing endometrial receptivity in goats. The results showed that STAT3-AS was expressed in both the nucleus and cytoplasm of gEECs, and its expression increased significantly in the uterus on day 15 of pregnancy. STAT3-AS expression was upregulated in gEECs treated with IFNT alone or in combination with progesterone and estradiol. Knockdown of STAT3-AS using specific short interfering RNA significantly inhibited the expression of classical ISGs such as interferon-stimulated gene 15 and 2',5'-oligodenylate synthetase 2, as well as uterine endometrial receptivity-related genes including homeobox gene A11, integrin beta 3, and vascular endothelial growth factor. Moreover, gEEC proliferation and the STAT3 pathway were suppressed in the absence of STAT3-AS. However, pretreatment with the STAT3 activator RO8191 restored the effect of silencing STAT3-AS on endometrial receptivity. Overall, these results suggest that STAT3-AS is an important regulator of endometrial receptivity in goats and that it regulates endometrial receptivity through the STAT3 pathway.

Diagnostic performance of SPECT in lumbar spondylolysis: a systematic review and meta-analysis

AIM

To evaluate the diagnostic value and clinical applicability of single-photon-emission computed tomography (SPECT) for lumbar spondylolysis using meta-analysis.

MATERIALS AND METHODS

Stata 12.0, was used to test the heterogeneity, and the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and other effect sizes were collected to generate the summary receiver operating characteristic (SROC) curve for comprehensive evaluation. Meta-regression analysis was used to explore the source of heterogeneity, and subgroup analysis was performed. Funnel plots, Fagan's line diagrams, and likelihood ratio dot plots were drawn to evaluate publication bias and clinical applicability.

RESULTS

Eight studies involving 785 patients were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, odds ratio, and area under the SROC curve of SPECT for the diagnosis of lumbar spondylolysis were 0.85 (95% confidence interval [CI]: 0.70 0.93), 0.92 (95% CI: 0.60 0.99), 11.01 (95% CI: 1.61 75.18), 0.17 (95% CI: 0.08 0.35), 0.92 (95% CI: 0.90 0.94). Meta-regression analysis showed that the sources of heterogeneity were region and age. Subgroup analysis showed that the specificity of the child and adolescent subgroup was significantly higher than that of the middle-aged and elderly subgroups. Deek's funnel plots showed no significant publication bias. The pooled effect of the likelihood ratio dot plot for diagnosis is in the upper-right quadrant.

CONCLUSION

As a diagnostic tool for spondylolysis, SPECT has a high degree of specificity, moderate sensitivity, and relatively high diagnostic effectiveness. It can be used as an auxiliary sign in the diagnosis and treatment of lumbar spondylolysis.

A head-to-head comparison of the measurement properties of EQ-5D-3L and EQ-5D-5L in Chinese family caregivers of cancer patients

BACKGROUND

Although both EQ-5D-3L(3L) and EQ-5D-5L(5L) have demonstrated good measurement properties in several patient populations, there is currently limited evidence comparing the measurement properties of 3L and 5L in family caregivers (FCs) of cancer patients.

PURPOSE

This study aimed to compare the measurement properties of 3L and 5L in a sample of family caregivers of cancer patients.

METHODS

A consecutive sample of FCs of cancer patients recruited from three tertiary hospitals were invited to complete the two versions of the EQ-5D in two rounds of interviews. We compared i) the ceiling effect using the McNemar's test, ii) test-retest reliability using intraclass correlation coefficient (ICC) and Cohen's Kappa, iii) convergent validity using Spearman's rank correlation coefficient, iv) known-group validity using F-statistic, v) and discriminant capacity using ordinal logistic regression.

RESULTS

A total of 416 FCs completed the baseline questionnaire and 120 caregivers completed the follow-up questionnaire. Ceiling effects were smaller in 5L (12.5%) than in 3L (20.7%). The convergent validity (r = 0.344-0.771), known-groups validity (Fratio5L/3L = 2.06-4.09), discriminant capacity (ES = 0.341-0.396), and test-retest reliability (ICC = 0.725) of the 5L were slightly better than those of the 3L in China.

CONCLUSION

The current study found both 3L and 5L to be suitable for use by FCs of cancer patients. However, 5L showed superior measurement properties compared to 3L and therefore could be the preferred instrument when EQ-5D data of cancer patients FCs is required.

Preventing post-contrast acute kidney injury and hypersensitivity reactions: UK national audit

AIM

To audit UK radiology departmental protocols related to the prevention of Iodine-based contrast media (ICM) adverse drug reactions (ADRs) and to assess their compliance with the Royal College of Radiologists (RCR) endorsed Royal Australian and New Zealand College of Radiologists' 2018 Iodinated Contrast Guidelines.

MATERIALS AND METHODS

Questionnaires were sent to all UK acute National Health Service (NHS) providers treating adult patients with an audit lead registered with the RCR (162 providers encompassing 211 hospital radiology departments). The questionnaire included three main sections: renal function screening, renal protection regimens, and hypersensitivity reactions prevention and follow-up. Data collection was conducted between April and July 2022.

RESULTS

Sixty-one per cent (129/211) of departments responded, representing 67% of eligible providers. An independent imaging services provider supplied one additional set of data (n=130 overall). Of the responding departments, for post-contrast acute kidney injury (PC-AKI), 41% and 56% had the recommended risk assessment for inpatients and outpatients, respectively. Renal function testing was often over-utilised, and their results were applied improperly. Sixty-eight per cent of departments used the advised threshold for considering renal protection. For hypersensitivity reactions, 9% of departments had the correct risk assessment. Thirty-six per cent of departments had the correct risk mitigation protocol for identified high-risk patients. The documentation and follow-up for hypersensitivity reactions were similarly inadequate.

CONCLUSION

Local protocols on preventing ICM ADRs were largely non-compliant with RCR guidelines. Departments need to update their protocols in line with current evidence to avoid iatrogenic morbidity or unnecessary tests and over-precaution.

Novel Functional Radiomics for Prediction of Cardiac PET Avidity in Lung Cancer Radiotherapy

PURPOSE/OBJECTIVE(S)

Traditional methods of evaluating cardiotoxicity focus solely on radiation doses to the heart and do not incorporate functional imaging information. Functional imaging has great potential to improve the ability to provide early prediction for cardiotoxicity for lung cancer patients undergoing radiotherapy. FDG-based PET/CT imaging is routinely obtained as part of standard staging work up for lung cancer patients. Although FDG PET/CT scans are typically used to evaluate the tumor, imaging guidelines note that FDG PET/CT scans are an FDA-approved method to image for cardiac inflammation, and studies have noted that the PET cardiac signal can be predictive of clinical outcomes. The purpose of this work was to develop a radiomics model to predict clinical cardiac assessment of standard of care FDG PET/CT scans.

MATERIALS/METHODS

The study included 100 consecutive lung cancer patients treated with radiotherapy who underwent standard pre-treatment FDG-PET/CT staging scans. A clinician reviewed the PET/CT scans per clinical cardiac assessment guidelines and classified the cardiac uptake as: 0 = uniform diffuse, 1 = absent, 2 = heterogeneous, with event rates of 20%, 44%, and 35%, respectively. The heart was delineated and 200 novel functional radiomics features were selected to classify cardiac FDG uptake patterns. We divided the data into an 80% training set and a 20% test set to train and evaluate the classification models. Feature reduction was carried out using the Wilcoxon test (with Bonferroni adjusted p<0.05), hierarchical clustering, and Recursive Feature Elimination. Two automatic machine learning (AutoML) frameworks were used to determine classification models: a Random Forest Classifier (Tree-based Pipeline Optimization Tool, TPOT) and Linear Discriminant Analysis (AutoSklearn). 10-fold cross validation was carried out for training and the accuracy of the ability of the models to predict for clinical cardiac assessment is reported.

RESULTS

Fifty-one independent radiomics features were reduced to 3 clinically pertinent features (PET 2D Skewness, PET Grey Level Co-occurrence Matrix Correlation, and PET Median) using feature reduction techniques. The model selected by TPOT showed 89.8% predictive accuracy in the cross validation of the training set and 85% predictive accuracy on the test set. The model selected by AutoSklearn showed 89.7% predictive accuracy in the cross validation of the training set and 80% predictive accuracy on the test set.

CONCLUSION

The novelty of this work is that it is the first study to develop and evaluate functional cardiac radiomic features from standard of care FDG PET/CT scans with the data showing good predictive accuracy with clinical imaging evaluation. If validated, the current work provides automated methods to provide functional cardiac information using standard of care imaging that can be used as an imaging biomarker for early clinical toxicity prediction for lung cancer patients.

Improvement of soil acidification and ammonium nitrogen content in tea plantations by long-term use of organic fertilizer

Soil acidification is common in some Chinese tea plantations, which seriously affected growth of tea trees. Hence, it is essential to explore soil remediation in acidified tea plantations for sustainable development of the tea industry. We sought to determine how different fertilizers affect acidified soil and their N transformation in tea plantations. Different fertilizers were used on acidified tea plantation soils for 4 years (2017-2021), and changes in soil pH, indices related to soil N transformation and tea yield were analysed to construct interaction networks of these indices and find which had the largest influence on fertilization. Long-term use of sheep manure reduced soil acidification, increased soil pH, enhanced the number and intensity of N-fixing and ammonifying bacteria, urease, protease, asparaginase and N-acetamide glucose ribosidase activity and nifH gene expression. This treatment reduced the number and intensity of soil nitrifying and denitrifying bacteria, nitrate reductase and nitrite reductase activity, while the expression of amoA-AOA, nirK, nirS, narG and nosZ in turn increased ammonium N content of the soil, reduced nitrate N content, and enhanced tea yield. Topsis index weight analysis showed that ammonium N content in the soil had the largest impact among fertilization effects. Long-term use of sheep manure was beneficial in restoring the balance of the micro-ecosystem in acidified soil. This study provides an important practical basis for soil remediation and fertilizer management in acidified tea plantation soils.

[Clinical presentation and prognosis in children over 10-year-old with primary nephrotic syndrome]

Objective: To summary the clinical presentation and prognosis of primary nephrotic syndrome (PNS) in teenagers. Methods: The clinical data, renal pathological types and prognosis of 118 children over 10-year-old with PNS treated in the Department of Nephrology of the Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2010 to December 2020 were retrospectively analyzed, with 408 children ≤10-year-old as control group synchronously. Chi-square test was used to compare the difference of clinical types, pathologic types, response to steroids and tubulointerstitial changes between the groups. The teenagers with steroid resistant nephrotic syndrome (SRNS) were divided into initial non-responder group and late non-responder group. Kaplan-Meier method was used to compare the difference of persistent proteinuria, and Fisher's exact test for the histological types. Results: There were 118 children >10-year-old, including 74 males and 44 females, with the onset age of 12.1 (10.8, 13.4) years; and 408 children ≤10-year-old with the onset age of 4.5 (3.2, 6.8) years. The proportion of SRNS was significantly higher in patients >10-year-old than those ≤10-year-old (24.6% (29/118) vs. 15.9% (65/408), χ²=4.66, P=0.031). There was no statistical difference in the pathological types between >10-year-old and ≤10-year-old (P>0.05), with minimal change disease the most common type (56.0% (14/25) vs. 60.5% (26/43)). The percentage of cases with renal tubulointerstitial lesions was significantly higher in children >10-year-old compared to those ≤10-year-old (60.0% (15/25) vs. 23.3% (10/43), χ²=9.18, P=0.002). There were 29 cases presented with SRNS in PNS over 10-year-old, including 19 initial non-responders and 10 late non-responders. Analyzed by Kaplan-Meier curve, it was shown that the percentage of persistent proteinuria after 6 months of immunosuppressive treatments was significantly higher in initial non-responders than those of the late non-responders ((22±10)% vs. 0, χ²=14.68, P<0.001); the percentage of minimal change disease was significantly higher in patients of late non-responders than those of the initial non-responders (5/6 vs. 3/13, P=0.041). Of the 63 >10-year-old with steroid-sensitive nephrotic syndrome followed up more than one year, 38 cases (60.3%) had relapse, and 14 cases (22.2%) were frequent relapse nephrotic syndrome and steroid dependent nephrotic syndrome. Among the 45 patients followed up over 18-year-old, 22 cases (48.9%) had recurrent proteinuria continued to adulthood, 3 cases of SRNS progressed to kidney insufficiency, and one of them developed into end stage kidney disease and was administrated with hemodialysis. Conclusions: Cases over 10-year-old with PNS tend to present with SRNS and renal tubulointerstitial lesions. They have a favorable prognosis, but are liable to relapse in adulthood.

Discriminating Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Using Latent Neuroimaging and Neuropsychological Profiles in Active-Duty Military Service Members

OBJECTIVE

Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD.

METHODS

Active-Duty US Service Members ( n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a neuropsychological battery and T1- and diffusion-weighted structural neuroimaging. Cortical, subcortical, ventricular, and WM volumes and whole brain fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated. Latent profile analyses were performed to determine how the GM and WM indicators, together with neuropsychological indicators, classified individuals.

RESULTS

For both GM and WM, respectively, a 4-profile model was the best fit. The GM model identified greater ventricular volumes in Service Members with cognitive symptoms, including those with a diagnosis of mTBI, either alone or with PTSD. The WM model identified reduced FA and elevated RD in those with psychological symptoms, including those with PTSD or mTBI and comorbid PTSD. However, contrary to expectation, a global neural signature unique to those with comorbid mTBI and PTSD was not identified.

CONCLUSIONS

The findings demonstrate that neuropsychological performance alone is more robust in differentiating Active-Duty Service Members with mTBI and PTSD, whereas global neuroimaging measures do not reliably differentiate between these groups.

[Prediction of potential suitable habitats of Haemphysalis concinna in Heilongjiang Province based on the maximum entropy model]

OBJECTIVE

To predict the potential suitable habitat of Haemaphysalis concinna in Heilongjiang Province under different climatic scenarios.

METHODS

The geographic locations of ticks in Heilongjiang Province from 1980 to 2022 were captured from literature review and field ticks monitoring data from Harbin Center for Disease Control and Prevention in Heilongjiang Province, and the tick distribution sites with spatial correlations were removed using the software ArcGIS 10.2. The environment data under historical climatic scenarios from 1970 to 2000 and the climatic shared socioeconomic pathways (SSP) 126 scenario model from 2021 to 2040 and from 2041 to 2060 were downloaded from the WorldClim website, and the elevation (1 km, 2010), population (1 km grid population dataset of China, 2010) and annual vegetation index (1 km, 2010) data were downloaded from the Resource and Environmental Science and Data Center, Institute of Geographical Sciences and Natural Resources, Chinese Academy of Sciences. The contribution of environmental factors to H. concinna distribution was evaluated and environmental variables were screened using the software MaxEnt 3.4.1 and R package 4.1.0, and the areas of suitable habitats of H. concinna and changes in center of gravity were analyzed using the maximum entropy model in Heilongjiang Province under different climatic scenarios. In addition, the accuracy of the maximum entropy model for prediction of H. concinna distribution was assessed using the area under curve (AUC) of the receiver operating characteristic curve.

RESULTS

A total of 79 H. concinna distribution sites and 24 environmental variables were collected, and 70 H. concinna distribution sites and 9 environmental factors that contributed to distribution of the potential suitable habitats of H. concinna in Heilongjiang Province were screened. The three most significant contributing factors included precipitation seasonality, annual precipitation, and mean temperature of the driest quarter, with cumulative contributions of 60.7%. The total area of suitable habitats of H. concinna was 29.05 × 10⁴ km² in Heilongjiang Province under historical climatic scenarios, with the center of gravity of suitable habitats located at (47.31° N, 129.16° E), while the total area of suitable habitats of H. concinna reduced by 0.97 × 10⁴ km² in Heilongjiang Province under the climatic SSP126 scenario from 2041 to 2060, with the center of gravity shifting to (47.70° N, 129.28° E).

CONCLUSIONS

The distribution of suitable habitats of H. concinna strongly correlates with temperature and humidity in Heilongjiang Province. The total area of potential suitable habitats of H. concinna may appear a tendency towards a decline with climatic changes in Heilongjiang Province, and high-, medium- and low-suitable habitats may shift.

USP18 promotes endometrial receptivity via the JAK/STAT1 and the ISGylation pathway

Interferon-tau (IFNT), a pregnancy recognition signal in ruminants, promotes the establishment of endometrial receptivity by inducing the expression of interferon-stimulated genes (ISGs) via the Janus kinase/signal transducer and activator of transcription (JAK/STATs) signaling pathway. However, the precise mechanisms remain largely unknown. Ubiquitin-specific protease 18 (USP18) acts specifically on the ISGylation modification system to exert deubiquitination and participates in the regulation of the type I IFN signaling pathway. The purpose of this study was to determine the role and mechanism of USP18 on endometrial receptivity in goat. USP18 was mainly localized in the uterine luminal and glandular epithelium, and its expression levels were significantly increased from days 5-18 of early pregnancy. Progesterone (P₄), estradiol (E₂), and IFNT significantly stimulated USP18 expression in goat endometrial epithelial cells (gEECs) cultured in vitro. Meanwhile, the markers of endometrial receptivity HOXA11, ITGB1, ITGB3, and ITGB5 were significantly upregulated after USP18 overexpression in gEECs. However, USP18 interference significantly inhibited the expression of HOXA10, ITGB1, ITGB3, and ITGB5 in gEECs. In addition, both the phosphorylation levels of STAT1 and the expression of ISGylation-modified proteins were significantly increased after USP18 silencing in gEECs. Furthermore, pretreatment with the STAT1 inhibitor Fludara markedly restored the effect of USP18 interference in gEECs. In summary, USP18 may play an important role in promoting goat endometrial receptivity by regulating the JAK/STAT1 pathway and ISGylation.

Exome-wide screening identifies novel rare risk variants for bone mineral density

Bone mineral density (BMD) is an independent risk factor of osteoporosis-related fractures. We performed gene-based burden tests to assess the association between rare variants and BMD, and identified several BMD candidate genes.

PURPOSE

BMD is highly heritable and a major predictor of osteoporotic fractures, but its genetic basis remains unclear. We aimed to identify rare risk variants contributing to BMD.

METHODS

Utilizing the newly released UK Biobank 200,643 exome dataset, we conducted a gene-based exome-wide association study in males and females, respectively. First, 100,639 males and 117,338 females with BMD values were included in the polygenic risk scores (PRS) analysis. Among individuals with lower 30% PRS, cases were individuals with top 10% BMD, and individuals with bottom 10% BMD were the controls. Considering the effects of vitamin D (VD), individuals with the highest 30% VD concentration were selected for VD-BMD analysis. After quality control, 741 males and 697 females were included in the BMD analysis, and 717 males and 708 females were included in the VD-BMD analysis. The variants were annotated by ANNOVAR software, then BMD and VD-BMD qualified variants were imported into the SKAT R-package to perform gene-based burden tests, respectively.

RESULTS

The gene-based burden test of the exonic variants identified genome-wide candidate associations in ANKRD18A (P = 1.60 × 10^-5, P_{Bonferroni adjust} = 2.11 × 10^-3), C22orf31 (P = 3.49 × 10^-4, P_{Bonferroni adjust} = 3.17 × 10^-2), and SPATC1L (P = 1.09 × 10^-5, P_{Bonferroni adjust} = 8.80 × 10^-3). For VD-BMD analysis, three genes were associated with BMD, such as NIPAL1 (P = 1.06 × 10^-3, P_{Bonferroni adjust} = 3.91 × 10^-2).

CONCLUSIONS

Our study suggested that rare variants contribute to BMD, providing new sights for broadening the genetic structure of BMD.

A randomised controlled trial of dexmedetomidine for delirium in adults undergoing heart valve surgery

Dexmedetomidine might reduce delirium after cardiac surgery. We allocated 326 participants to an infusion of dexmedetomidine at a rate of 0.6 μg kg^-1 for 10 min and then at 0.4 μg.kg^-1 .h^-1 until the end of surgery; 326 control participants received comparable volumes of saline. We detected delirium in 98/652 (15%) participants during the first seven postoperative days: 47/326 after dexmedetomidine vs. 51/326 after placebo, p = 0.62, adjusted relative risk (95%CI) 0.86 (0.56-1.33), p = 0.51. Postoperative renal impairment (Kidney Disease Improving Global Outcomes stages 1, 2 and 3) was detected in 46, 9 and 2 participants after dexmedetomidine and 25, 7 and 4 control participants, p = 0.040. Intra-operative dexmedetomidine infusion did not reduce the incidence of delirium after cardiac valve surgery but might impair renal function.

Invasive fungal infection is associated with antibiotic exposure in preterm infants: a multi-centre prospective case-control study

BACKGROUND

Previous antibiotic exposure is an important risk factor for invasive fungal infection (IFI). Antibiotic overexposure is common in lower-income countries; however, multi-centre studies concerning IFI in relation to antibiotic exposure are scarce.

AIM

This prospective, multi-centre matched case-control study explored the correlation of IFI and antibiotic exposure in very preterm infants or very-low-birthweight infants admitted to 23 tertiary hospitals in China between 2018 and 2021.

METHODS

Using a 1:2 matched design for gestational age, birth weight and early-onset sepsis (yes/no), the risk factors between infants diagnosed with IFI and infection-free controls were compared. The antibiotic use rate (AUR) was calculated using calendar days of antibiotic therapy in the 4 weeks preceding IFI onset divided by onset day of IFI.

FINDINGS

In total, 6368 infants were included in the study, of which 90 (1.4%) were diagnosed with IFI. Median AUR, length of antibiotic therapy (LOT) and days of antibiotic therapy (DOT) within the 4 weeks preceding IFI onset were 0.90, 18 days and 30 days, respectively. Multi-variate analysis showed that a 10% increase in AUR, each additional day of DOT and LOT, and each additional day of third-generation cephalosporins and carbapenems were notably associated with IFI.

CONCLUSION

Prolonged antibiotic therapy is common before the onset of IFI, and is an important risk factor, especially the use of third-generation cephalosporins and carbapenems. Antibiotic stewardship should be urgently developed and promoted for preterm infants in order to reduce IFI in lower-income countries such as China.

Hand2os1 Regulates the Secretion of Progesterone in Mice Corpus Luteum

The corpus luteum plays a key role in pregnancy maintenance and estrous cycle regulation by secreting progesterone. Hand2os1 is an lncRNA located upstream of Hand2, with which a bidirectional promoter is shared and is involved in the regulation of cardiac development and embryo implantation in mice. The aim of this study was to investigate the expression and regulation of Hand2os1 in the ovaries. Here, we used RNAscope to detect differential expression of Hand2os1 in the ovaries of cycling and pregnant mice. Hand2os1 was specifically detected in luteal cells during the proestrus and estrus phases, showing its highest expression in the corpus luteum at estrus. Additionally, Hand2os1 was strongly expressed in the corpus luteum on day 4 of pregnancy, but the positive signal progressively disappeared after day 8, was detected again on day 18, and gradually decreased after delivery. Hand2os1 significantly promoted the synthesis of progesterone and the expression of StAR and Cyp11a1. The decreased progesterone levels caused by Hand2os1 interference were rescued by the overexpression of StAR. Our findings suggest that Hand2os1 may regulate the secretion of progesterone in the mouse corpus luteum by affecting the key rate-limiting enzyme StAR, which may have an impact on the maintenance of pregnancy.

[Vasohibin-2 promotes proliferation and metastasis of cervical cancer cells by regulating epithelial-mesenchymal transition]

OBJECTIVE

To explore the role of vasohibin-2 (VASH2) in regulation of proliferation and metastasis of cervical cancer cells.

METHODS

We analyzed the differentially expressed genes between cervical cancer cells with flotillin-1 overexpression and knockdown by RNA-seq combined with analysis of public databases. The expression levels of VASH2 were examined in normal cervical epithelial cells (HcerEpic), cervical cancer cell lines (HeLa, C-33A, Ca ski, SiHa and MS751) and fresh cervical cancer tissues with different lymph node metastasis status. We further tested the effects of lentivirus-mediated overexpression and interference of VASH2 on proliferation, migration, invasion and lymphatic vessel formation of the cervical cancer cells and detected the expression levels of key epithelial-mesenchymal transition (EMT) markers and TGF-β mRNA.

RESULTS

RNA-seq and analysis of public databases showed that VASH2 expression was significantly upregulated in cervical cancer cells exogenously overexpressing flotillin-1 (P < 0.05) and downregulated in cells with flotillin-1 knockdown (P < 0.05), and was significantly higher in cervical cancer tissues with lymph node metastasis than in those without lymph node metastasis (P < 0.01). In cervical cancer cell lines Ca Ski, SiHa, and MS751 and cervical cancer tissue specimens with lymph node metastasis, VASH2 expression was also significantly upregulated as compared with HcerEpic cells and cervical cancer tissues without lymph node metastasis (P < 0.05). Exogenous overexpression of VASH2 significantly promoted proliferation, migration, invasion and lymphatic vessel formation of cervical cancer cells, whereas these abilities were significantly inhibited in cells with VASH2 knockdown (P < 0.05). The cervical cancer cells overexpressing VASH2 showed significant down- regulation of e-cadherin and up- regulation of N-cadherin, Vimentin and VEGF-C, while the reverse changes were detected in cells with VASH2 knockdown (P < 0.05). TGF-β mRNA expression was significantly up-regulated in cervical cancer cells overexpressing VASH2 and down-regulated in cells with VASH2 knockdown (P < 0.001).

CONCLUSION

Flotillin-1 may participate in TGF-β signaling pathway-mediated EMT through its down-stream target gene VASH2 to promote the proliferation, migration, invasion and lymphatic vessel formation of cervical cancer cells in vitro.

Rheumatoid arthritis and the risk of major cardiometabolic diseases: a Mendelian randomization study

OBJECTIVE

Rheumatoid arthritis (RA) is suggested to be implicated in the development of cardiometabolic diseases. We conducted a Mendelian randomization (MR) study to assess potential causality for associations of RA with the risk of cardiometabolic diseases, including type 2 diabetes (T2D), coronary artery disease (CAD), and ischaemic stroke.

METHOD

Seventy independent single-nucleotide polymorphisms (SNPs) associated with RA were identified as instrumental variables from a genome-wide association study (GWAS) of 58 284 European subjects. Summary-level data for the associations of the 70 genetic variants with T2D, CAD, and ischaemic stroke were taken from three GWASs with a total of 1 529 131 participants. Inverse-variance weighted (IVW) MR was used in the main analyses.

RESULTS

The main IVW MR analysis showed that genetically determined RA was associated with higher risks of T2D [odds ratio (OR): 1.04, 95% confidence interval (CI) 1.02-1.05; p < 0.001] and CAD (OR: 1.02, 95% CI 1.00-1.03; p = 0.012), but not ischaemic stroke (OR: 1.00, 95% CI 0.99-1.02; p = 0.961). Sensitivity analyses with multiple MR methods confirmed these associations. MR-Egger regression showed no evidence of pleiotropy in the association between genetically determined RA and the risk of T2D, CAD, and ischaemic stroke. Leave-one-out sensitivity analysis showed that the association between genetically determined RA and the risk of T2D, CAD, and ischaemic stroke was not driven by any individual SNP.

CONCLUSION

Genetically determined RA was associated with increased risks of T2D and CAD, suggesting that RA plays a crucial role in the pathogenesis of T2D and CAD.

New management unit for conservation of the Endangered green turtle Chelonia mydas at the Xisha (Paracel) Islands, South China Sea

The Qilianyu cluster of the Xisha (Paracel) Islands has one of the few remaining green turtle Chelonia mydas rookeries in the China region. Genetic samples were obtained from dead green turtle embryos and hatchlings salvaged from post-hatched nests at Middle Island (n = 3), North Island (n = 9) and South Sand (n = 1) of the Qilianyu cluster in 2017-2019. The ~800 bp mitochondrial DNA control region was sequenced from the samples, and 5 haplotypes were identified belonging to 2 documented clades (clades III and VIII), including 2 new haplotypes (CmP243.1 and CmP244.1) and 3 previously reported haplotypes (CmP18.1, CmP19.1, CmP20.1). These results were combined with previously published mtDNA data for the Qilianyu cluster and nearby (~93 km) Yongle Islands indicating a lack of differentiation based on truncated 384 bp control region sequences (exact test, p = 0.0997; FST = 0.015, p = 0.2760), to represent a single Xisha Islands rookery. The rookery at the Xisha Islands was significantly differentiated (p < 0.01) from all 19 management units (MUs) documented in the Indo-Pacific and Japan regions, supporting recognition of the Xisha Islands rookery as a new independent MU. The results will help inform national and international conservation action plans by China and the countries around the South China Sea to protect green turtles in the West Pacific Ocean.

Unique motif shared by HLA-B*59:01 and HLA-B*55:02 is associated with methazolamide-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Han Chinese

BACKGROUND

Methazolamide (MTZ) has been occasionally linked to the lethal Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are associated with HLA-B*59:01. However, some MTZ-induced SJS/TEN (MTZ-SJS/TEN) cases are negative for HLA-B*59:01, implying that other genetic factors besides HLA-B*59:01 are contributing to MTZ-SJS/TEN.

OBJECTIVES

To comprehensively identify HLA and non-HLA genetic susceptibility to MTZ-SJS/TEN in Han Chinese.

METHODS

Eighteen patients with MTZ-SJS/TEN, 806 subjects of the population control and 74 MTZ-tolerant individuals were enrolled in this study. Both exome-wide and HLA-based association studies were conducted. Molecular docking analysis was employed to simulate the interactions between MTZ and risk HLA proteins.

RESULTS

We found a strong signal in the major histocompatibility complex region on chromosome 6 with 22 SNPs reaching exome-wide significance. Compared with MTZ-tolerant controls, a significant association of HLA-B*59:01 with MTZ-SJS/TEN was validated (odds ratio [OR] = 146.00, 95% confidence interval [CI]: 16.12-1321.98; P = 6.19 × 10^-10 ). Moreover, 66.7% of MTZ-SJS/TEN patients negative for HLA-B*59:01 were carriers of HLA-B*55:02, while 2.7% of the tolerant individuals were observed with HLA-B*55:02 (OR = 71.00, 95% CI: 7.84-643.10; P = 1.43 × 10^-4 ). Within HLA-B protein, the E45-L116 motif could completely explain the association of HLA-B*59:01 and HLA-B*55:02 with MTZ-SJS/TEN (OR = 119.33, 95% CI: 29.19-1227.96; P = 4.36 × 10^-13 ). Molecular docking analysis indicated that MTZ binds more stably to the pocket of HLA-B*59:01 and HLA-B*55:02 than to that of non-risk alleles of HLA-B*40:01 and HLA-C*01:02.

CONCLUSIONS

This study confirmed the association of HLA-B*59:01 with MTZ-SJS/TEN and identified HLA-B*55:02 as a novel risk allele in Han Chinese with the largest sample size to date. Notably, the rs41562914(A)-rs12697944(A) haplotype, encoding E45-L116, is capable of serving as a powerful genetic predictor for MTZ-SJS/TEN with a sensitivity of 89% and specificity of 96%.

Experimental Verification of Dissipation-Time Uncertainty Relation

Dissipation is vital to any cyclic process in realistic systems. Recent research focus on nonequilibrium processes in stochastic systems has revealed a fundamental trade-off, called dissipation-time uncertainty relation, that entropy production rate associated with dissipation bounds the evolution pace of physical processes [Phys. Rev. Lett. 125, 120604 (2020)PRLTAO0031-900710.1103/PhysRevLett.125.120604]. Following the dissipative two-level model exemplified in the same Letter, we experimentally verify this fundamental trade-off in a single trapped ultracold ^{40}Ca^{+} ion using elaborately designed dissipative channels, along with a postprocessing method developed in the data analysis, to build the effective nonequilibrium stochastic evolutions for the energy transfer between two heat baths mediated by a qubit. Since the dissipation-time uncertainty relation imposes a constraint on the quantum speed regarding entropy flux, our observation provides the first experimental evidence confirming such a speed restriction from thermodynamics on quantum operations due to dissipation, which helps us further understand the role of thermodynamical characteristics played in quantum information processing.

A 2-year locomotive exploration and scientific investigation of the lunar farside by the Yutu-2 rover

The lunar nearside has been investigated by many uncrewed and crewed missions, but the farside of the Moon remains poorly known. Lunar farside exploration is challenging because maneuvering rovers with efficient locomotion in harsh extraterrestrial environment is necessary to explore geological characteristics of scientific interest. Chang'E-4 mission successfully targeted the Moon's farside and deployed a teleoperated rover (Yutu-2) to explore inside the Von Kármán crater, conveying rich information regarding regolith, craters, and rocks. Here, we report mobile exploration on the lunar farside with Yutu-2 over the initial 2 years. During its journey, Yutu-2 has experienced varying degrees of mild slip and skid, indicating that the terrain is relatively flat at large scales but scattered with local gentle slopes. Cloddy soil sticking on its wheels implies a greater cohesion of the lunar soil than encountered at other lunar landing sites. Further identification results indicate that the regolith resembles dry sand and sandy loam on Earth in bearing properties, demonstrating greater bearing strength than that identified during the Apollo missions. In sharp contrast to the sparsity of rocks along the traverse route, small fresh craters with unilateral moldable ejecta are abundant, and some of them contain high-reflectance materials at the bottom, suggestive of secondary impact events. These findings hint at notable differences in the surface geology between the lunar farside and nearside. Experience gained with Yutu-2 improves the understanding of the farside of the Moon, which, in return, may lead to locomotion with improved efficiency and larger range.

Long-term corneal recovery by simultaneous delivery of hPSC-derived corneal endothelial precursors and nicotinamide

Human pluripotent stem cells (hPSCs) hold great promise for the treatment of various human diseases. However, their therapeutic benefits and mechanisms for treating corneal endothelial dysfunction remain undefined. Here, we developed a therapeutic regimen consisting of the combination of hPSC-derived corneal endothelial precursors (CEPs) with nicotinamide (NAM) for effective treatment of corneal endothelial dysfunction. In rabbit and nonhuman primate models, intracameral injection of CEPs and NAM achieved long-term recovery of corneal clarity and thickness, similar with the therapeutic outcome of cultured human corneal endothelial cells (CECs). The transplanted human CEPs exhibited structural and functional integration with host resident CECs. However, the long-term recovery relied on the stimulation of endogenous endothelial regeneration in rabbits, but predominantly on the replacing function of transplanted cells during the 3-year follow-up in nonhuman primates, which resemble human corneal endothelium with limited regenerative capacity. Mechanistically, NAM ensured in vivo proper maturation of transplanted CEPs into functional CECs by preventing premature senescence and endothelial-mesenchymal transition within the TGF-β–enriched aqueous humor. Together, we provide compelling experimental evidence and mechanistic insights of simultaneous delivery of CEPs and NAM as a potential approach for treating corneal endothelial dysfunction.

Understanding the Complex Interactions between Coffee, Tea Intake and Neurologically Relevant Tissues Proteins in the Development of Anxiety and Depression

OBJECTIVES

Coffee and tea intake might be associated with psychiatry diseases. However, it is unclear whether the effect of coffee/tea on anxiety and depression depending on the different types of proteins.

DESIGN

This was a cross-sectional study.

SETTING

Our datasets were downloaded from online.

PARTICIPANTS

Phenotypic and genotypic data for coffee intake(N=376,196) and tea intake (N=376,078) were derived from UK Biobank. GWAS data of proteins (N=1,537) from neurologically relevant tissues (brain, cerebrospinal fluid (CSF) and plasma) were obtained from a recently published study.

MEASUREMENTS

Multivariate linear analysis was then used to evaluate the potential interaction effect between coffee/tea intake and proteins polygenetic risk score (PRS) on the risks of anxiety and depression controlling for age, sex, Townsend deprivation index (TDI), smoke, drinking and education level.

RESULTS

34 coffee intake-proteins interactions and 15 tea intake-proteins interactions were observed in anxiety individuals, such as coffee intake-c-Jun interaction (β=0.0169, P=4.131×10-3), coffee intake-Fas interaction (β=-0.0190, P=8.132×10-4), tea intake-sL-Selectin interaction (β=0.0112, P=5.412×10-3) and tea intake-IL-1F6 (β=0.0083, P=4.471×10-2). 25 coffee intake-proteins and 14 tea intake-proteins interactions were observed in depression individuals, including coffee intake- IL-1 sRI (β=0.0171, P=4.888×10-3) and coffee intake-NXPH1 interaction (β=0.0156, P=9.819×10-3), tea intake-COLEC12 interaction (β=0.0127, P=3.280×10-3), and tea intake-Layilin interaction (β=0.0117, P=7.926×10-3).

CONCLUSIONS

Our results suggested the important role of multiple proteins in neurologically relevant tissues in the associations between coffee/tea intake and psychiatry diseases, providing entry points to explore the mechanisms underlying anxiety and depression.

Extracellular vesicles derived from bone marrow mesenchymal stem cells alleviate neuroinflammation after diabetic intracerebral hemorrhage via the miR-183-5p/PDCD4/NLRP3 pathway

OBJECTIVES

Intracerebral hemorrhage (ICH) induced by diabetes results in further brain injury and nerve cell death. Bone marrow mesenchymal stem cell (BMSC) transplantation contributes to attenuating neurological deficits after ICH. This study investigated the mechanism of extracellular vesicles (EVs) derived from BMSCs in reducing neuroinflammation after diabetic ICH.

METHODS

BMSC-EVs were isolated and identified. The rat model of db/db-ICH was established and the model rats were administered with EVs. miR-183-5p expression in brain tissues of db/db-ICH rats was detected. The brain injury of db/db-ICH rats was evaluated by measuring neurobehavioral score, brain water content and inflammatory factors. BV2 cells were cultured in vitro to establish high-glucose (HG)-Hemin-BV2 cell model. The levels of reactive oxygen species (ROS) and inflammatory factors in BV2 cells were measured, and BV2 cell viability and apoptosis were assessed. The targeting relationship between miR-183-5p and PDCD4 was predicted and verified. The activation of PDCD4/NLRP3 pathway in rat brain tissues and BV2 cells was detected.

RESULTS

miR-183-5p expression was reduced in db/db-ICH rats brain tissues. BMSC-EVs ameliorated cranial nerve function, decreased brain water content and repressed inflammatory response by carrying miR-183-5p. BMSC-EVs mitigated HG-Hemin-BV2 cell injury, reduced ROS level and suppressed inflammatory response. miR-183-5p targeted PDCD4. PDCD4 promoted BV2 cell inflammation by activating the NLRP3 pathway. BMSC-EVs inhibited HG-Hemin-BV2 cell inflammation through the miR-183-5p/PDCD4/NLRP3 pathway, and inhibition of miR-183-5p reversed the protective effect of EVs.

CONCLUSION

BMSC-EVs carried miR-183-5p into db/db-ICH rat brain tissues and repressed the NLRP3 pathway by targeting PDCD4, thus alleviating neuroinflammation after diabetic ICH.

Predicting haemodynamic significance of coronary stenosis with radiomics-based pericoronary adipose tissue characteristics

AIM

To investigate the diagnostic performance of the radiomics features of pericoronary adipose tissue (PCAT) in determining haemodynamically significant coronary artery stenosis as evaluated by fractional flow reserve (FFR).

MATERIALS AND METHODS

A total of 92 patients with clinically suspected coronary artery disease who underwent coronary computed tomography (CT) angiography (CCTA), invasive coronary angiography (ICA), and FFR examination within 1 month were included retrospectively, and 121 lesions were randomly assigned to the training and testing set. Based on manual segmentation of PCAT, 1,116 radiomics features were computed. After radiomics robustness assessment and feature selection, radiomics models were established using the different machine-learning algorithms. The area under the receiver operating characteristic (ROC) curve (AUC) and net reclassification index (NRI) were analysed to compare the discrimination and reclassification abilities of radiomics models.

RESULTS

Two radiomics features were selected after exclusions, and both were significantly higher in coronary arteries with FFR ≤0.8 than those with FFR >0.8. ROC analysis showed that the combination of CCTA and decision tree radiomics model achieved significantly higher diagnostic performance (AUC: 0.812) than CCTA alone (AUC: 0.599, p=0.015). Furthermore, the NRI of the combined model was 0.820 and 0.775 in the training and testing sets, respectively, suggesting the radiomics features of PCAT had were effective in classifying the haemodynamic significance of coronary stenosis.

CONCLUSIONS

Adding PCAT radiomics features to CCTA enabled identification of haemodynamically significant coronary artery stenosis.

Biphasic Sarcomatoid Sweat Gland Carcinoma With Ductal Epithelial And Spindled Myoepithelial Cell Components (Malignant Mixed Tumor Of Skin)

Introduction/Objective

Sweat gland carcinomas are a group of malignant skin adnexal tumors that are difficult to diagnose due to their rarity, wide morphologic variation, and limited literature on diagnosis and classification. These tumors may appear bland and morphologically resemble benign skin adnexal tumors, or may appear poorly differentiated and mimic metastatic carcinoma especially from a breast primary. Biphasic sweat gland carcinomas are an even rarer entity, with only few cases reported in literature, and have been described to consist of a well- differentiated ductal epithelial component and a poorly differentiated, sarcomatoid, spindle cell component.

Methods/Case Report

Our case report describes a 53 year old female referred to our institution for diagnosis of an excised skin lesion of the right upper arm, which had been slowly growing for 8 years. The histology revealed a biphasic malignant neoplasm involving the dermis and subcutis. The tumor consisted of an epithelial cell component with glandular and squamoid morphology and positive for CK5/6, CK7, and CAM5.2, and a spindled myoepithelial cell component with sarcomatoid morphology and positive for S100, vimentin, and p63. Stains for CK20, ER, PR, PAX8, CEA, and TTF1 were negative. The histological and clinical findings favored a primary skin adnexal tumor, rather than a metastatic lesion.

The patient underwent wide local excision of the lesion given that margins of the original excision were indeterminate. The histology of this re-excision demonstrated the same biphasic tumor with ductal epithelial and sarcomatoid myoepithelial cell components positive for the same stains. Although margins were negative in this re-excision, 3-4 months later, the patient developed dyspnea with multiple new pulmonary and hilar masses discovered on imaging, and new-onset headache with a frontal lobe mass discovered on brain imaging. These masses were biopsied/resected, and revealed to be metastases of the original cutaneous tumor positive for the same markers.

Results (if a Case Study enter NA)

NA

Conclusion

This case report describes a rare, diagnostically challenging case of a biphasic sweat gland carcinoma with ductal epithelial and sarcomatoid myoepithelial cell components, which demonstrated aggressive behavior with distant metastasis. These tumors are a clinicopathological quandary given their rarity and the paucity of literature on their characterization.

A mechanical, electrical dual autonomous self-healing multifunctional composite hydrogel

The versatile properties make hydrogels a potential multipurpose material that finds wide applications. However, the preparation of multipurpose hydrogels is very challenging. Here, we report a method based on free radical reaction and composite mechanisms to prepare mechanical and electrical self-healing multifunctional hydrogels. In this study, the introduction of imidazolium salt ionic liquids and glycerol in the hydrogel system endows the gels with good antibacterial, conductive, and adhesive properties and excellent antifreeze properties. The testing results show that the as-prepared hydrogel has stable mechanical and electrical properties even under the extremely cold condition of -50°C after self-healing. Moreover, the active esters formed in the dynamic radical reaction have better reducibility, thus further investing the as-prepared hydrogel with high antioxidant activity. The application results show that these comprehensive properties make such hydrogel system very useful in wound repair and wearable strain sensors.

P–313 Endometrial receptivity analysis for personalized embryo transfer in patients with recurrent implantation failure: a retrospective analysis of a Chinese cohort

Study question

To quantify the effectiveness of endometrial receptivity analysis (ERA)-guided personalized embryo transfer (pET) in Chinese women.

Summary answer

ERA-guided pET may remarkably improve pregnancy and implantation rates among Chinese women with Recurrent implantation failure (RIF).

What is known already

RIF is a major cause of infertility, and endometrial receptivity is widely accepted to impact implantation failure. Precision prediction of the WOI, the time when the endometrium is most receptive to the implantation of the embryo, is, therefore, of great significance to improve implantation prospects. Previous studies have shown the effectiveness of ERA for the prediction of the WOI, and how pET, timed by ERA, improves implantation and pregnancy rates; however, the efficacy of ERA-guided pET remains unknown for Chinese women.

Study design, size, duration

Patients in Chengdu Xi’nan Gynecology Hospital (Chengdu, China) who were undergoing frozen embryo transfer (FET) at the blastocyst stage on day five or day six during the period from November 2019 through September 2020 were recruited for this study. A total of 145 eligible patients were included in the study and assigned to the ERA group (n = 67) or the control group (n = 78). Clinical pregnancy outcomes were compared between the two groups.

Participants/materials, setting, methods

Endometrial specimens were collected the from ERA group. Total RNA was extracted from endometrial specimens, the transcriptomic sequencing data were processed using RNA-Seq and the endometrial receptivity status was assessed by the ERA predictor. The endometrium was classified as receptive or non-receptive according to the ERA assessment, and pET was done at the time determined by ERA in the ERA group. Subjects in the control group did not receive ERA and underwent blastocyst transfer normally.

Main results and the role of chance

The demographic and clinical characteristics were comparable between the ERA and control groups (P &gt; 0.05). The ERA test identified 10.45% of samples as receptive and 89.55% of samples as non-receptive in the ERA group, with 70.15% of samples presenting a pre-receptive profile. We observed higher cumulative pregnancy (74.63% vs. 64.10%) and cumulative implantation rate (47.32% vs. 21.68%) rates, and a lower biochemical pregnancy rate (18.00% vs. 34.00%) in the ERA group when compared to the control group (P &lt; 0.05). Additionally, we found higher pregnancy (67.16% vs. 39.74%) and implantation (46.54% vs. 16.94%) rates as well as a lower biochemical pregnancy rate (17.78% vs. 45.16%) after the first ERA test in the ERA group when compared to the control group (P &lt; 0.01).

Limitations, reasons for caution

First, this is a retrospective analysis, which is relatively more biased than prospective clinical trials. Second, the study sample is considerably small. Third, only 10.45% of the subjects were identified as presenting a receptive profile, which limits the comparisons of clinical outcomes between patients with receptive and non-receptive endometria.

Wider implications of the findings: This study demonstrates that the ERA test helps to determine the optimal timing for embryo transfer, improve pregnancy and implantation rates in patients with RIF, and guides the clinical application of the ERA test.

Trial registration number

approval No. 2020–018

P–371 Clinical value assessment between endometrial receptivity array and immune profiling in patients with implantation failure

Study question

To evaluate whether the pregnancy outcomes could be improved in implantation failure patients by endometrial receptivity array, endometrial immune profiling, or a combination of both.

Summary answer

There was no statistical difference between different endometrial receptivity evaluation and treatment in improving the clinical pregnancy rate.

What is known already

Both endometrial receptivity array and endometrial immune profiling were promised to improve the endometrial receptivity and subsequent clinical pregnancy. However, less is known about the efficiency between each other and whether the combination could further enhance their clinical value.

Study design, size, duration

Between November 2019 and September 2020, 143 women with a history of at least two or more consecutive implantation failure in IVF/ICSI treatment in Chengdu Xinan Gynecology Hospital were included. They were divided into three groups: ‘ERA + Immune Profiling’ (n = 70), ‘Immune Profiling’ (n = 41), and ‘ERA’ (n = 32).

Participants/materials, setting, methods

Inclusion criteria were age ≤ 38, with normal uterus and uterine cavity. All patients were suggested to evaluate endometrial receptivity by ERA test (Igenomix, Valencia, Spain) and endometrial immune profiling based on immunohistochemistry simultaneously, who would be free to choose each or both evaluation approaches. Personal Embryo Transfer and/or personal medical care were adopted according to evaluation results. Clinical pregnancy was confirmed by gestational sacs observed under ultrasonography.

Main results and the role of chance

The overall prevalence of displaced window of implantation (WOI) is 84.3%, and nearly 74.8% (83/111) patients were diagnosed as endometrial immune dysregulation. Clinical Pregnancy rate and embryonic implantation rate decreased in the ‘Immune Test’ groups, but without a statistical difference (P = 0.311, and 0.158, respectively). Multivariable logistic regression analysis showed that different endometrial receptivity evaluation and treatment was not associated the clinical pregnancy rate, suggesting the performance of different endometrial receptivity evaluation and treatment is similar in improving the clinical pregnancy rate. Neither the immune profiling (CD56, P = 0.591; FOXP3, P = 0.195; CD68, P = 0.820; CD163, P = 0.926; CD1a, P = 0.561; CD57, P = 0.221; CD8, P = 0.427; CD138 CE, P = 0.372) nor histologic endometrial dating defined by Noyes criteria (P = 0.374) were associated with ERA phases.

Limitations, reasons for caution

Although the selection of evaluation approaches was based on patients’ willingness, the variances of baseline characteristics and immune profiling existed in different groups. The immunological treatment efficacy based on immune profiling was not evaluated before embryo transfer.

Wider implications of the findings: To our knowledge, this is the first study comparing the pregnancy outcomes after two typical endometrial receptivity evaluation approaches. The findings highlight the unsubstitutability for each assessment, indicating that both asynchronous and pathological WOI contribute to implantation failure.

Trial registration number

X2019004

[Clinical characteristics of anti-CV2 antibody-associated neurological diseases]

This study reviewed the clinical data of patients who were hospitalized in the Department of Neurology of Henan Provincial People's Hospital from January 2017 to October 2020. A total of 46 patients with positive serum anti-CV2 antibody were included. The average age of the patients was (54±15) years old, with a male to female ratio of 1.88∶1. Twenty-six patients were diagnosed with paraneoplastic neurological syndrome (PNS). The most malignant tumors were thymoma, small cell lung cancer, and prostate cancer. The most common PNS included myasthenia gravis, subacute cerebellar degeneration, and subacute/chronic sensorimotor neuropathies. Twenty non-PNS patients exhibited subacute/old cerebral infarction, Parkinson's disease, Alzheimer's disease, and so on. Among them, brain magnetic resonance imaging (MRI) of 10 cases showed different degrees of white matter demyelination, some of which were accompanied by brain atrophy. The current study found that the positive predictive value of anti-CV2 antibody for the diagnosis of PNS was 56.5%, which was relatively weak. As an accompanying antibody, it may be a coincidence, and it may also be related to the involvement of family members in the pathological process of the diseases.

Progesterone-induced RNA Hand2os1 regulates decidualization in mice uteri

Decidualization is a critical process for successful embryo implantation and subsequent placenta formation. The characterization and physiological function of lncRNA during decidualization remain largely unknown. In the present study, we conducted RNA-sequencing analysis to compare gene expression between decidua of days 6 and 8, and normal pregnant endometrium (day 4). A total of 2332 high-confidence putative lncRNA transcripts were expressed. Functional clustering analysis of cis and trans lncRNA targets showed that differentially expressed lncRNAs may regulate multiple gene ontology terms and pathways that have important functions in decidualization. Subsequent analyses using qRT-PCR validated that eight of all lncRNAs were differentially regulated in mice uteri during decidualization, both in vivo and in vitro. Furthermore, we showed that differentially expressed lncRNA of Hand2os1 was specifically detected in stromal cells on days 2 to 5 of pregnancy and was strongly upregulated in decidual cells on days 6-8 of pregnancy. Similarly, Hand2os1 expression was also strongly expressed in decidualized cells following artificial decidualization, both in vivo and in vitro. In uterine stromal cells, P4 was able to significantly upregulate the expression of Hand2os1, but upregulation was impeded by RU486, whereas E2 appeared to have no regulating effect on Hand2os1 expression. Concurrently, Hand2os1 significantly promoted the decidual process in vitro and dramatically increased decidualization markers Prl8a2 and Prl3c1. Our results provide a valuable catalog for better understanding of the functional roles of lncRNAs in pregnant mouse uteri, as it relates to decidualization.

Ufmylation regulates granulosa cell apoptosis via ER stress but not oxidative stress during goat follicular atresia

Follicular atresia is primarily caused by granulosa cell (GC) apoptosis, although the mechanisms are largely unknown. Ufmylation is a recently identified ubiquitin-like post-translational modifier that plays an important role in cell proliferation and apoptosis. The purpose of this study was to investigate the effects of Ufmylation on GC apoptosis during goat follicular atresia. Ubiquitin-fold modifier 1 (UFM1) and its target DDRGK domain containing 1 (DDRGK1) proteins were identified in granulosa cells (GCs) isolated from all stages of preantral follicles and from healthy (HF), early atretic (EF) and progressed atretic (PF) antral follicles. The expression levels were higher in GCs derived from antral atretic follicles than healthy follicles. Although the viability of GCs was not affected after overexpression of UFM1, siRNA-mediated UFM1 silencing significantly inhibited GC proliferation and induced apoptosis. Notably, components of the ufmylation pathway were significantly upregulated in GCs induced by the ER stress agent tunicamycin (Tm) and thapsigargin (Tg), but not affected by oxidative stress inducer H₂O₂. Furthermore, UFM1 silencing markedly increased the apoptosis of GCs upon Tg treatment by stimulating the ER stress-related gene expression. Our results provide evidence that UFM1 and its target DDRGK1 are expressed in the goat GCs during follicular development and atresia, and ufmylation may play an important role in the prevention of ER stress but not oxidative stress-induced GCs apoptosis.

Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality

BACKGROUND

Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics.

METHODS

Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised.

RESULTS

One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity.

CONCLUSIONS

The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected.

REGISTRATION

This review was registered on PROSPERO as CRD42020177714 .

Genomic scan revealed KIT gene underlying white/gray plumage color in Chinese domestic geese

Goose is an important type of domesticated poultry. The wild geese that are regarded as the ancestors of modern domestic geese present gray plumage. Domesticated, geese have both white and gray feathers. To elucidate the genetic mechanisms underlying the formation of white and gray plumage in geese, we resequenced the whole genome of 18 geese from six populations including white and gray goose breeds. The average sequencing depth per individual was 9.81× and the average genome coverage was 96.8%. A total of 346 genes were detected in the top 1% of F_ST scores of gray- and white-feathered geese, and a significant F_ST site was located in the intron region within the KIT gene, the 18 bp deletion in KIT having the strongest potential association with white feathers. It has been reported that a number of genes are associated with plumage colors in birds. However, no studies have identified the relationship between KIT and plumage color in birds at present, although the white coat can be attributed to mutations in KIT in some mammals. Our study showed that that KIT is a plausible candidate gene for white/gray plumage color in Chinese domestic geese.

Effects of subacute ruminal acidosis on colon epithelial morphological structure, permeability, and expression of key tight junction proteins in dairy goats

The hindgut epithelial barrier plays an important role in maintaining absorption and immune homeostasis in ruminants. However, little information is available on changes in colon epithelial barrier structure and function following grain-induced subacute ruminal acidosis (SARA). The objective of this study was to investigate the effects of grain-induced SARA on colon epithelial morphological structure, permeability, and gene expression involved in epithelial barrier function. Twelve mid-lactating (136 ± 2 d in milk; milk yield = 1.68 ± 0.15 kg/d) Saanen dairy goats with 62.13 ± 4.76 kg of body weight were randomly divided into either the control (CON) treatment (n = 6) or SARA treatment (n = 6). The CON goats were fed a basal diet with a nonfiber carbohydrates to neutral detergent fiber ratio of 1.15 for 60 d. The SARA goats were fed 4 diets with increasing nonfiber carbohydrates to neutral detergent fiber ratio at 1.15, 1.49, 2.12, and 2.66 to induce SARA, with each diet (referred to as period) being fed for 15 d, including 12 d for adaptation and 3 d for sampling. Continuous ruminal pH recordings were used to diagnose the severity of SARA. Additionally, colonic tissues were collected to evaluate the epithelial morphological structure, permeability, and expression of tight junction proteins using transmission electron microscopy, Ussing chamber, quantitative real-time PCR, and Western blotting. Profound disruption in the colonic epithelium was mainly manifested as the electron density of tight junctions decreased, intercellular space widened, and mitochondria swelled in SARA goats. Colon epithelial short-circuit current, tissue conductance, and the mucosal-to-serosal flux of fluorescein isothiocyanate-dextran 4 kDa were increased and potential difference was decreased in SARA goats compared with CON goats. Subacute ruminal acidosis increased mRNA and protein expression levels of CLDN1 and OCLN in the colonic epithelium. Overall, the data of the present study demonstrate that SARA can impair the barrier function of the colonic epithelium at both structural and functional levels, which is associated with severe epithelial structural damage and increased permeability and changes in the expression of tight junction proteins.

Neural peptide promotes the angiogenesis and osteogenesis around oral implants

Generally, impaired bones heal by bone repair and bone regeneration. These two processes are necessary during the healing period of dental implant. Vasculature plays a crucial role in bone healing because bones are highly vascularized tissue. Osteogenesis and angiogenesis are highly coupled processes and can be regulated by Hippo-YAP signaling pathway. Recent studies have demonstrated Hippo-YAP pathway may be regulated by alpha calcitonin gene-related peptide. However, the regulatory effects of αCGRP-YAP pathway on angiogenesis and osteogenesis during bone healing around implants remain unclear. Four groups of mice were established: KO Group: αCGRP ^-/- mice; KO + αCGRP group: αCGRP ^-/- mice with αCGRP overexpressing lentiviral transfection; KO + YAP group: αCGRP ^-/- mice with YAP overexpressing lentiviral transfection; WT group: wildtype mice. After 14 or 28 days, animals were sacrificed and tested. Results showed αCGRP deficiency hampered osteogenesis and angiogenesis. In addition, the impaired bone healing can be rescued by overexpressing αCGRP and YAP in αCGRP ^-/- mice. In-vivo results indicate αCGRP-YAP pathway promotes angiogenesis and osteogenesis in bone healing, especially at the early stage. Taken together, present study demonstrated αCGRP up-regulate the expression of YAP, and down-stream genes to promote the osteogenesis and angiogenesis around the implants.

Maintenance treatment in advanced HER2-negative gastric cancer

Survival for patients with advanced gastric cancer (GC) remains poor. Systemic chemotherapy which has reached a plateau stays the standard first-line (1L) treatment for advanced human epidermal growth-factor receptor 2 (HER2)-negative GC. To maximize the benefit of 1L treatment, the concept of maintenance treatment is constantly being explored. In advanced HER2-negative GC, current clinical guidelines do not recommend a standard maintenance therapy strategy. In addition to the monotherapy maintenance with fluorouracil after 4-6 cycles of 1L chemotherapy, some agents that are active against novel targets have been evaluated in clinical trials for maintenance treatment. Whereas most of these trials do not reach their primary endpoints, they open new horizons for the 1L treatment of advanced HER2-negative GC. Therefore, we reviewed the clinical trials in the field of maintenance treatment in advanced HER2-negative GC and discussed some of the problems in clinical trials.

[Study on the factors affecting the degradation of niclosamide in the soil]

OBJECTIVE

To investigate the factors affecting the degradation of niclosamide in the soil, so as to provide the evidence for the assessment of the environmental safety in the field snail control with niclosamide.

METHODS

A high performance liquid chromatography was established for the determination of niclosamide in the field. Then, the degradation of niclosamide was investigated in soils with different moistures (10%, 30%, 50%, 70% and 90%), temperatures [(15 ± 1), (25 ± 1), (35 ± 1) °C], initial concentrations (1, 5, 10 mg/kg) and in sterilized and non-sterilized soils. In addition, the degradation of niclosamide was fitted with the first-order kinetics equation, and the degradation half-life was calculated.

RESULTS

The niclosamide residues gradually decreased over time in soils with different moistures, and a higher rate of degradation was seen in soils with a higher moisture. The degradation half-life of niclosamide reduced from 4.258 d in the soil with a 10% moisture to 2.412 d in the soil with a 90% moisture. The niclosamide residues gradually decreased over time in soils with different temperatures, and a higher rate of degradation was seen in soils with a higher temperature. The degradation half-life of niclosamide reduced from 4.398 d in the soil with a temperature of (15 ± 1) °C to 2.828 d in the soil with a temperature of (35 ± 1) °C. The degradation half-lives of niclosamide were 3.212, 3.333 d and 3.448 d in soils containing niclosamide at initial concentrations of 1, 5 mg/kg and 10 mg/kg, and > 30 d and 3.273 d in sterilized and non-sterilized soils. Multiple linear regression analysis revealed that soil microorganisms (P = 0.010), moisture (P = 0.000) and temperature (P = 0.002) affected the half-life of niclosamide degradation.

CONCLUSIONS

The degradation of niclosamide in soils fits the first-order kinetics equation, and presence of microorganisms, a high temperature and high moisture may accelerate the degradation of niclosamide in the soil.