Improving diagnosis and outcome prediction of gastric cancer via multimodal learning using whole slide pathological images and gene expression

For the diagnosis and outcome prediction of gastric cancer (GC), machine learning methods based on whole slide pathological images (WSIs) have shown promising performance and reduced the cost of manual analysis. Nevertheless, accurate prediction of GC outcome may rely on multiple modalities with complementary information, particularly gene expression data. Thus, there is a need to develop multimodal learning methods to enhance prediction performance. In this paper, we collect a dataset from Ruijin Hospital and propose a multimodal learning method for GC diagnosis and outcome prediction, called GaCaMML, which is featured by a cross-modal attention mechanism and Per-Slide training scheme. Additionally, we perform feature attribution analysis via integrated gradient (IG) to identify important input features. The proposed method improves prediction accuracy over the single-modal learning method on three tasks, i.e., survival prediction (by 4.9% on C-index), pathological stage classification (by 11.6% on accuracy), and lymph node classification (by 12.0% on accuracy). Especially, the Per-Slide strategy addresses the issue of a high WSI-to-patient ratio and leads to much better results compared with the Per-Person training scheme. For the interpretable analysis, we find that although WSIs dominate the prediction for most samples, there is still a substantial portion of samples whose prediction highly relies on gene expression information. This study demonstrates the great potential of multimodal learning in GC-related prediction tasks and investigates the contribution of WSIs and gene expression, respectively, which not only shows how the model makes a decision but also provides insights into the association between macroscopic pathological phenotypes and microscopic molecular features.

Low-Symmetry 2D t-InTe for Polarization-Sensitive UV-Vis-NIR Photodetection

Polarization-sensitive photodetection grounded on low-symmetry 2D materials has immense potential in improving detection accuracy, realizing intelligent detection, and enabling multidimensional visual perception, which has promising application prospects in bio-identification, optical communications, near-infrared imaging, radar, military, and security. However, the majority of the reported polarized photodetection are limited by UV-vis response range and low anisotropic photoresponsivity factor, limiting the achievement of high-performance anisotropic photodetection. Herein, 2D t-InTe crystal is introduced into anisotropic systems and developed to realize broadband-response and high-anisotropy-ratio polarized photodetection. Stemming from its narrow band gap and intrinsic low-symmetry lattice characteristic, 2D t-InTe-based photodetector exhibits a UV-vis-NIR broadband photoresponse and significant photoresponsivity anisotropy behavior, with an exceptional in-plane anisotropic factor of 1.81@808 nm laser, surpassing the performance of most reported 2D counterparts. This work expounds the anisotropic structure-activity relationship of 2D t-InTe crystal, and identifies 2D t-InTe as a prospective candidate for high-performance polarization-sensitive optoelectronics, laying the foundation for future multifunctional device applications.

Highly reversible extrinsic electrocaloric effects over a wide temperature range in epitaxially strained SrTiO3 films

Electrocaloric effects have been experimentally studied in ferroelectrics and incipient ferroelectrics, but not incipient ferroelectrics driven ferroelectric using strain. Here we use optimally oriented interdigitated surface electrodes to investigate extrinsic electrocaloric effects in low-loss epitaxial SrTiO3 films near the broad second-order 243 K ferroelectric phase transition created by biaxial in-plane coherent tensile strain from DyScO3 substrates. Our extrinsic electrocaloric effects are an order of magnitude larger than the corresponding effects in bulk SrTiO3 over a wide range of temperatures including room temperature, and unlike electrocaloric effects associated with first-order transitions they are highly reversible in unipolar applied fields. Additionally, the canonical Landau description for strained SrTiO3 films works well if we set the low-temperature zero-field polarization along one of the in-plane pseudocubic <100> directions. In future, similar strain engineering could be exploited for other films, multilayers and bulk samples to increase the range of electrocaloric materials for energy efficient cooling.

Improving image quality of triple-low-protocol renal artery CT angiography with deep-learning image reconstruction: a comparative study with standard-dose single-energy and dual-energy CT with adaptive statistical iterative reconstruction

AIM

To investigate the improvement in image quality of triple-low-protocol (low radiation, low contrast medium dose, low injection speed) renal artery computed tomography (CT) angiography (RACTA) using deep-learning image reconstruction (DLIR), in comparison with standard-dose single- and dual-energy CT (DECT) using adaptive statistical iterative reconstruction-Veo (ASIR-V) algorithm.

MATERIALS AND METHODS

Ninety patients for RACTA were divided into different groups: standard-dose single-energy CT (S group) using ASIR-V at 60% strength (60%ASIR-V), DECT (DE group) with 60%ASIR-V including virtual monochromatic images at 40 keV (DE40 group) and 70 keV (DE70 group), and the triple-low protocol single-energy CT (L group) with DLIR at high level (DLIR-H). The effective dose (ED), contrast medium dose, injection speed, standard deviation (SD), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of abdominal aorta (AA), and left/right renal artery (LRA, RRA), and subjective scores were compared among the different groups.

RESULTS

The L group significantly reduced ED by 37.6% and 31.2%, contrast medium dose by 33.9% and 30.5%, and injection speed by 30% and 30%, respectively, compared to the S and DE groups. The L group had the lowest SD values for all arteries compared to the other groups (p<0.001). The SNR of RRA and LRA in the L group, and the CNR of all arteries in the DE40 group had highest value compared to others (p<0.05). The L group had the best comprehensive score with good consistency (p<0.05).

CONCLUSIONS

The triple-low protocol RACTA with DLIR-H significantly reduces the ED, contrast medium doses, and injection speed, while providing good comprehensive image quality.

The genetic landscape of histologically transformed marginal zone lymphomas

BACKGROUND

Marginal zone lymphomas (MZLs) comprise a diverse group of indolent lymphoproliferative disorders; however, some patients develop histologic transformation (HT) with rapid progression to aggressive lymphoma.

METHODS

Forty-three MZLs with HT (HT-MZLs), 535 MZLs, and 174 de novo diffuse large B-cell lymphomas (DLBCLs) without rearrangements of MYC, BCL2, and BCL6 were collected. Among these, 22 HT-MZLs, 39 MZLs, and 174 DLBCLs were subjected to 148-gene targeted exome sequencing. The clinicopathologic features of patients who had HT-MZL and their genetic alterations were compared with those of patients who had MZLs and DLBCLs.

RESULTS

All 43 HT-MZLs corresponded to DLBCLs. No HT-MZLs harbored BCL2 and MYC and/or BCL6 rearrangements. Bone marrow involvement and higher levels of lactate dehydrogenase were significantly more common in HT-MZLs than in MZLs. Furthermore, upregulated BCL6, MUM1, C-MYC, and Ki-67 expression was observed more frequently in HT-MZLs than in MZLs. TBL1XR1 was the most frequently altered gene (63.6%) in HT-MZLs, followed by CCND3 (31.8%), CARD11, ID3, and TP53 (22.7%). A trend toward worse progression-free survival in patients with TBL1XR1 mutations was observed. Compared with MZLs and non-germinal center B-cell (GCB) type DLBCLs, significantly higher frequencies of TBL1XR1 and ID3 mutations were identified in HT-MZLs. PIM1 mutations frequently occurred in DLBCLs and were significantly associated with TBL1XR1 mutations but were mutated less in HT-MZLs that had TBL1XR1 mutations.

CONCLUSIONS

The current findings reveal the clinicopathologic and genetic features of HT-MZLs, suggesting that these tumors might constitute a group distinct from MZL and de novo non-GCB type DLBCL. TBL1XR1 mutations may be considered a predictor of HT in MZL.

Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

High prevalence of ceftriaxone-resistant and XDR Neisseria gonorrhoeae in several cities of Cambodia, 2022-23: WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP)

Objectives

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a global public health concern. Ceftriaxone is the last effective and recommended option for empirical gonorrhoea therapy worldwide, but several ceftriaxone-resistant cases linked to Asia have been reported internationally. During January 2022-June 2023, the WHO Enhanced Gonococcal Antimicrobial Surveillance Programme (EGASP) investigated N. gonorrhoeae AMR and epidemiological factors in patients from 10 clinical sentinel sites in Cambodia.

Methods

Urethral swabs from males with urethral discharge were cultured. ETEST determined the MIC of five antimicrobials, and EGASP MIC alert values and EUCAST breakpoints were used. EGASP demographic, behavioural and clinical variables were collected using a standardized questionnaire.

Results

From 437 male patients, 306 had positive N. gonorrhoeae cultures, AMR testing and complete epidemiological data. Resistance to ceftriaxone, cefixime, azithromycin and ciprofloxacin was 15.4%, 43.1%, 14.4% and 97.1%, respectively. Nineteen (6.2%) isolates were resistant to all four antimicrobials and, accordingly, categorized as XDR N. gonorrhoeae. These XDR isolates were collected from 7 of the 10 sentinel sites. No EGASP MIC alert values for gentamicin were reported. The nationally recommended cefixime 400 mg plus azithromycin 1 g (65.4%) or ceftriaxone 1 g plus azithromycin 1 g (34.6%) was used for treatment.

Conclusions

A high prevalence of ceftriaxone-resistant, MDR and XDR N. gonorrhoeae in several cities of Cambodia were found during 2022-23 in WHO EGASP. This necessitates expanded N. gonorrhoeae AMR surveillance, revision of the nationally recommended gonorrhoea treatment, mandatory test of cure, enhanced sexual contact notification, and ultimately novel antimicrobials for the treatment of gonorrhoea.

Cascaded plastic optical fiber based SPR sensor for simultaneous measurement of refractive index and temperature

A cascaded side-polish plastic optical fiber (POF) and FONTEX optical fiber based surface plasmon resonance (SPR) sensor is proposed for simultaneous measurement of refractive index (RI) and temperature. The side-polish POF and FONTEX optical fiber are connected by using the UV glue in a Teflon plastic tube. The SPR phenomenon can be excited at both of the side-polish region and the FONTEX fiber cladding. The polydimethylsiloxane (PDMS) is coated on the side-polish POF to get a temperature sensing channel. Due to the low RI sensitivity of the FONTEX optical fiber, the cascaded fiber sensor can obtain a broader RI measurement range with a low crosstalk. An RI sensitivity of 700 nm/RIU in the RI measurement range of 1.335-1.39 and a temperature sensitivity of -1.02 nm/°C measured in deionized water with a range of 20-60 °C are obtained. In addition, the cascaded POF based SPR sensor has potential application prospects in the field of biochemical sensing.

Discriminative Regression With Adaptive Graph Diffusion

In this article, we propose a new linear regression (LR)-based multiclass classification method, called discriminative regression with adaptive graph diffusion (DRAGD). Different from existing graph embedding-based LR methods, DRAGD introduces a new graph learning and embedding term, which explores the high-order structure information between four tuples, rather than conventional sample pairs to learn an intrinsic graph. Moreover, DRAGD provides a new way to simultaneously capture the local geometric structure and representation structure of data in one term. To enhance the discriminability of the transformation matrix, a retargeted learning approach is introduced. As a result of combining the above-mentioned techniques, DRAGD can flexibly explore more unsupervised information underlying the data and the label information to obtain the most discriminative transformation matrix for multiclass classification tasks. Experimental results on six well-known real-world databases and a synthetic database demonstrate that DRAGD is superior to the state-of-the-art LR methods.

[Effect of information-knowledge-attitude-practice theory-based health education on clonorchiasis control among community residents and primary school students in Zhongshan City]

OBJECTIVE

To evaluate the effect of information-knowledge-attitude-practice (IKAP) theory-based health education interventions on clonorchiasis control among community residents and primary school students in Torch High-tech Development Zone of Zhongshan City, so as to provide insights into formulation of clonorchiasis control strategies among different types of populations.

METHODS

Residents were randomly sampled from two communities and students from two primary schools using a random cluster sampling method in Torch High-tech Development Zone, Zhongshan City from 2019 to 2021, and health education pertaining to clonorchiasis control was performed based on the IKAP theory. The changes in the awareness of basic clonorchiasis control knowledge and belief, self-reported risk of Clonorchis sinensis infections and dietary behaviors were compared among community residents and primary school students before and after health education interventions.

RESULTS

The participants included 146 male and 151 female community residents and 158 male and 153 female primary school students, with no significant difference detected in gender distribution (χ2 = 0.16, P > 0.05). The mean awareness of basic clonorchiasis control knowledge increased by 44.71% and 43.28% among primary school students and community residents 6 months following health education, and there were significant differences in the awareness of each item of basic clonorchiasis control knowledge before and after health education (χ2 = 41.53 to 284.44, all P values < 0.05). The proportions of primary school students and community residents thinking very high and high risks of C. sinensis infections increased from 9.35% and 6.71% before health education to 22.15% and 37.75% after health education, but only the difference of the attitudes in community residents achieve statistical significance (χ2 = 92.18, P < 0.05). The frequency of separation of raw and cooked foods with chopping board and knife significantly increased among community residents and primary school students following health education (χ2 = 16.04 to 62.65, all P values < 0.05). The frequency of eating raw freshwater fish (χ2 = 32.85, P < 0.05), fish congee (χ2 = 7.02, P < 0.05) and fish fillet hot pot (χ2 = 4.88, P < 0.05) significantly reduced among primary school students following health education, while only the frequency and proportions of eating raw freshwater fish have significantly reduced in community residents (χ2 = 11.77, P < 0.05).

CONCLUSIONS

Health education interventions based on the IKAP theory are effective to increase the awareness of clonorchiasis control knowledge and improve dietary behaviors associated with C. sinensis infections among community residents and primary school students in Zhongshan City.

Recombinant inbred lines derived from wide crosses in Pisum

Genomic resources are becoming available for Pisum but to link these to phenotypic diversity requires well marked populations segregating for relevant traits. Here we describe two such resources. Two recombinant inbred populations, derived from wide crosses in Pisum are described. One high resolution mapping population involves cv Caméor, for which the first pea whole genome assembly was obtained, crossed to JI0281, a basally divergent P. sativum sativum landrace from Ethiopia. The other is an inter sub-specific cross between P. s. sativum and the independently domesticated P. s. abyssinicum. The corresponding genetic maps provide information on chromosome level sequence assemblies and identify structural differences between the genomes of these two Pisum subspecies. In order to visualise chromosomal translocations that distinguish the mapping parents, we created a simplified version of Threadmapper to optimise it for interactive 3-dimensional display of multiple linkage groups. The genetic mapping of traits affecting seed coat roughness and colour, plant height, axil ring pigmentation, leaflet number and leaflet indentation enabled the definition of their corresponding genomic regions. The consequence of structural rearrangement for trait analysis is illustrated by leaf serration. These analyses pave the way for identification of the underlying genes and illustrate the utility of these publicly available resources. Segregating inbred populations derived from wide crosses in Pisum, together with the associated marker data, are made publicly available for trait dissection. Genetic analysis of these populations is informative about chromosome scale assemblies, structural diversity in the pea genome and has been useful for the fine mapping of several discrete and quantitative traits.

Relay learning: a physically secure framework for clinical multi-site deep learning

Big data serves as the cornerstone for constructing real-world deep learning systems across various domains. In medicine and healthcare, a single clinical site lacks sufficient data, thus necessitating the involvement of multiple sites. Unfortunately, concerns regarding data security and privacy hinder the sharing and reuse of data across sites. Existing approaches to multi-site clinical learning heavily depend on the security of the network firewall and system implementation. To address this issue, we propose Relay Learning, a secure deep-learning framework that physically isolates clinical data from external intruders while still leveraging the benefits of multi-site big data. We demonstrate the efficacy of Relay Learning in three medical tasks of different diseases and anatomical structures, including structure segmentation of retina fundus, mediastinum tumors diagnosis, and brain midline localization. We evaluate Relay Learning by comparing its performance to alternative solutions through multi-site validation and external validation. Incorporating a total of 41,038 medical images from 21 medical hosts, including 7 external hosts, with non-uniform distributions, we observe significant performance improvements with Relay Learning across all three tasks. Specifically, it achieves an average performance increase of 44.4%, 24.2%, and 36.7% for retinal fundus segmentation, mediastinum tumor diagnosis, and brain midline localization, respectively. Remarkably, Relay Learning even outperforms central learning on external test sets. In the meanwhile, Relay Learning keeps data sovereignty locally without cross-site network connections. We anticipate that Relay Learning will revolutionize clinical multi-site collaboration and reshape the landscape of healthcare in the future.

Multidimensional tunable graphene chiral metasurface based on coherent control

The deep application of chiral metasurfaces requires higher flexibility. Herein, we propose a multidimensional tunable chiral graphene metasurface, which uses coherent control to obtain more than 0.8 circular conversion dichroism (CCD) at 2.4 THz as a transmission structure. Its operating frequency can be changed in the 1.3-2.4 THz range, while the amplitude has almost perfect modulation depth in the range of 0-0.8. The mechanism of differential absorption was analyzed through numerical simulation. The device designed is easy to obtain reverse CCD, which is used for unit layout and proves its advantages in near-field imaging. Our work has broadened the path for the development of chiral metasurfaces towards higher degrees of freedom.

Analysis of Institutional DIBH Coaching Program for Surface Guided-DIBH Patients

PURPOSE/OBJECTIVE(S)

Our institute has implemented a surface guided-DIBH (SG-DIBH) coaching program which involves consultation, pre-treatment (CT-sim) and treatment. We would like to analyze the effectiveness of the program.

MATERIALS/METHODS

A total of 72 left breast cancer patients between 1st Apr 2022 to 9th Dec 2022 were registered for radiation treatment. During consultation, oncologist selected suitable patients based on the following criteria: a) age of 18-70; b) left breast cancer, right breast cancer with internal mammary nodes irradiation or dextrocardia; c) no lung/cardiac disease history & d) volunteer for SG-DIBH technique. The eligible patients were then trained by the coaching therapist using a teaching video and practiced at home. During CT simulation, patients were assessed according to the DIBH evaluation form. The evaluation components included patient's compliancy and understanding, the differences of lateral skin marking (free breathing, FB vs DIBH), duration of breath hold and reproducibility. Patients who passed the evaluation were scanned under both FB and DIBH for SG-DIBH treatment. IMRT-FFF 6 to 7 fields were planned. During SG-DIBH treatment, first 3 fractions and weekly CBCT were taken. Patients were encouraged to continue DIBH practice at home throughout whole course of the treatment and they were given 3 identical survey forms (5 questions) at the beginning, middle and end of treatment. The measure for the success of this coaching program would be number of breath-holds, duration of treatment time, treatment accuracy (CBCT matching) and survey results.

RESULTS

There were 48 patients who were eligible for DIBH coaching program, however, only 24 patients had passed the coaching evaluation and 20 patients were treated with SG-DIBH technique successfully. The mean of number of breath-hold and treatment time was 7 times and 7.9 minutes. Total of 123 CBCT images were studied. The setup errors were (0.242±0.180) cm, (0.152±0.137) cm, (0.202±0.165) cm, (0.684±0.640) degrees, (0.816±0.767) degrees, (0.912±0.707) degrees in lateral, longitudinal, vertical, pitch, roll and yaw directions. According to the survey analysis, the number of times to practice at home decreased as the treatment went by. An improvement was seen in patients' self-evaluation in mastering DIBH technique with proper coaching program (from 60% to 90%). Patients' anxiety in performing DIBH were alleviated greatly towards the end of the treatment (from 47% to 15%). 100% of the patients were willing to go for DIBH treatment if given a second chance and additional suggestions claimed that professional clinical teams and coaching program were important for their DIBH treatment journey.

CONCLUSION

A comprehensive DIBH coaching program can effectively identify SG-DIBH patient's suitability. Patient compliancy, treatment accuracy and treatment experience can be enhanced with good coaching program. The involvement of clinical team from consultation to pre-treatment and treatment stage is essential for a successful SG-DIBH treatment.

Semi-embedded slot waveguide electro-optic modulator

Electro-optic modulators are essential devices on silicon photonic chips in modern optical communication networks. This paper presents a compact, low-loss electro-optic modulator. The modulation efficiency is greatly improved by embedding the lower half of the slot waveguide into the buried oxide layer and inserting graphene at the junction. The interaction of graphene with an optical field in a waveguide is studied using the finite element method. The functions of phase modulation and absorption modulation are realized by changing the gate voltage to change the chemical potential of graphene. The semi-embedded slot waveguide optical modulator has a length of 50 µm. After simulation verification, it can be used as an electro-absorption modulator and can achieve a modulation depth of 26.38 dB and an insertion loss of 0.60 dB. When used as an electro-refractive modulator, it can be realized with a linear change of phase from zero to π; the total insertion loss is only 0.59 dB. The modulator has a modulation bandwidth of 79.6 GHz, and the energy consumption as electro-absorption and electro-refraction modulation are 0.51 and 1.92 pj/bit, respectively. Compared with common electro-optic modulators, the electro-optic modulator designed in this paper has a higher modulation effect and also takes into account the advantages of low insertion loss and low energy consumption. This research is helpful for the design of higher-performance optical communication network devices.

SPP excitation and coupling mechanism based on micro/nano fibers

A hot trend in the development of optoelectronic devices is how to use the principle of surface plasmon resonance to enhance the performance of integrated photonics devices and achieve miniaturization. This paper proposes an accompanying waveguide coupling structure of micro/nano fibers, which consists of two parallel-placed micro/nano fibers (MNFs) coated with a silver film in the waist region and infused with a refractive index matching oil. In the overlapping region, there exists a segment of surface plasmon polaritons (SPPs) coupling area. The excitation and coupling characteristics of SPPs are studied through numerical simulation. Optimal coupling enhancement configuration is obtained by studying variables such as spacing distance, coupling length, and metal film thickness. A comparison is made with the SPP intensity of a single MNF, showing a 220% increase in electric field intensity, demonstrating its excellent coupling effect. By using this coupling structure, exploration of SPPs excitation and coupling mechanisms is enhanced, and structures resembling interferometric devices can be designed, providing new insights for high-performance miniaturized devices.

Bright light treatment counteracts stress-induced sleep alterations in mice, via a visual circuit related to the rostromedial tegmental nucleus

Light in the environment greatly impacts a variety of brain functions, including sleep. Clinical evidence suggests that bright light treatment has a beneficial effect on stress-related diseases. Although stress can alter sleep patterns, the effect of bright light treatment on stress-induced sleep alterations and the underlying mechanism are poorly understood. Here, we show that bright light treatment reduces the increase in nonrapid eye movement (NREM) sleep induced by chronic stress through a di-synaptic visual circuit consisting of the thalamic ventral lateral geniculate nucleus and intergeniculate leaflet (vLGN/IGL), lateral habenula (LHb), and rostromedial tegmental nucleus (RMTg). Specifically, chronic stress causes a marked increase in NREM sleep duration and a complementary decrease in wakefulness time in mice. Specific activation of RMTg-projecting LHb neurons or activation of RMTg neurons receiving direct LHb inputs mimics the effects of chronic stress on sleep patterns, while inhibition of RMTg-projecting LHb neurons or RMTg neurons receiving direct LHb inputs reduces the NREM sleep-promoting effects of chronic stress. Importantly, we demonstrate that bright light treatment reduces the NREM sleep-promoting effects of chronic stress through the vLGN/IGL-LHb-RMTg pathway. Together, our results provide a circuit mechanism underlying the effects of bright light treatment on sleep alterations induced by chronic stress.

Nested micro-ring refractive index sensor based on a subwavelength grating waveguide and the Vernier effect

In this paper, a nested micro-ring refractive index sensor based on a subwavelength grating waveguide and the Vernier effect is proposed. In this scheme, the nested micro-ring structure is combined with a subwavelength grating structure to enhance the contact area between the optical field and the analyte, and the wavelength offset is doubled through the Vernier effect. The proposed sensor can effectively increase sensing sensitivity, taking into account the improvement of the free spectral range. This structure enables the device to reach a sensitivity of 8030 nm/RIU near 1550 nm wavelength in a deionized water environment, with a detection limit of 5.659×10-5 RIU and free spectral range of 41.956 nm. The device suggested in this study has a greater reduced footprint than the conventional micro-ring resonant sensor, measuring just 35µm×25µm. Due to its high integration, high sensitivity, and large free spectral range compared to conventional micro-ring resonant sensors, such structures are of great value in biosensing and environmental monitoring.

Avelumab or talazoparib in combination with binimetinib in metastatic pancreatic ductal adenocarcinoma: dose-finding results from phase Ib of the JAVELIN PARP MEKi trial

BACKGROUND

Combinations of avelumab [anti-programmed death-ligand 1 (anti-PD-L1)] or talazoparib [poly(adenosine diphosphate ribose) polymerase (PARP) inhibitor] with binimetinib (MEK inhibitor) were expected to result in additive or synergistic antitumor activity relative to each drug administered alone. Here, we report phase Ib results from JAVELIN PARP MEKi, which investigated avelumab or talazoparib combined with binimetinib in metastatic pancreatic ductal adenocarcinoma (mPDAC).

PATIENTS AND METHODS

Patients with mPDAC that had progressed with prior treatment received avelumab 800 mg every 2 weeks plus binimetinib 45 mg or 30 mg two times daily (continuous), or talazoparib 0.75 mg daily plus binimetinib 45 mg or 30 mg two times daily (7 days on/7 days off). The primary endpoint was dose-limiting toxicity (DLT).

RESULTS

A total of 22 patients received avelumab plus binimetinib 45 mg (n = 12) or 30 mg (n = 10). Among DLT-evaluable patients, DLT occurred in five of 11 patients (45.5%) at the 45-mg dose, necessitating de-escalation to 30 mg; DLT occurred in three of 10 patients (30.0%) at the 30-mg dose. Among patients treated at the 45-mg dose, one (8.3%) had a best overall response of partial response. Thirteen patients received talazoparib plus binimetinib 45 mg (n = 6) or 30 mg (n = 7). Among DLT-evaluable patients, DLT occurred in two of five patients (40.0%) at the 45-mg dose, necessitating de-escalation to 30 mg; DLT occurred in two of six patients (33.3%) at the 30-mg dose. No objective responses were observed.

CONCLUSIONS

Combinations of avelumab or talazoparib plus binimetinib resulted in higher-than-expected DLT rates. However, most DLTs were single occurrences, and the overall safety profiles were generally consistent with those reported for the single agents.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.govNCT03637491; https://clinicaltrials.gov/ct2/show/NCT03637491.

Schwann cells regulate tumor cells and cancer-associated fibroblasts in the pancreatic ductal adenocarcinoma microenvironment

Neuropathy is a feature more frequently observed in pancreatic ductal adenocarcinoma (PDAC) than other tumors. Schwann cells, the most prevalent cell type in peripheral nerves, migrate toward tumor cells and associate with poor prognosis in PDAC. To unveil the effects of Schwann cells on the neuro-stroma niche, here we perform single-cell RNA-sequencing and microarray-based spatial transcriptome analysis of PDAC tissues. Results suggest that Schwann cells may drive tumor cells and cancer-associated fibroblasts (CAFs) to more malignant subtypes: basal-like and inflammatory CAFs (iCAFs), respectively. Moreover, in vitro and in vivo assays demonstrate that Schwann cells enhance the proliferation and migration of PDAC cells via Midkine signaling and promote the switch of CAFs to iCAFs via interleukin-1α. Culture of tumor cells and CAFs with Schwann cells conditioned medium accelerates PDAC progression. Thus, we reveal that Schwann cells induce malignant subtypes of tumor cells and CAFs in the PDAC milieu.

Terahertz broadband tunable chiral metamirror based on VO2-metal hybrid structure

Aiming at the problems of narrow working bandwidth, low efficiency, and complex structure of existing terahertz chiral absorption, we propose a chiral metamirror composed of C-shaped metal split ring and L-shaped vanadium dioxide (VO₂). This chiral metamirror is composed of three layers of structure, a gold substrate at the bottom, the first polyethylene cyclic olefin copolymer (Topas) dielectric layer and VO₂-metal hybrid structure as the top. Our theoretical results led us to show that this chiral metamirror has a circular dichroism (CD) value greater than 0.9 at 5.70 to 8.55 THz and has a maximum value of 0.942 at f = 7.18 THz. In addition, by adjusting the conductivity of VO₂, the CD value can be continuously adjustable from 0 to 0.942, which means that the proposed chiral metamirror supports the free switching of the CD response between the on and off states, and the CD modulation depth exceeds 0.99 in the range of 3 to 10 THz. Moreover, we discuss the influence of structural parameters and the change of incident angle on the performance of the metamirror. Finally, we believe that the proposed chiral metamirror has important reference value in the terahertz range for constructing chiral light detectors, CD metamirrors, switchable chiral absorbers and spin-related systems. This work will provide a new idea for improving the terahertz chiral metamirror operating bandwidth and promote the development of terahertz broadband tunable chiral optical devices.

Ultra-compact on-chip meta-waveguide phase modulator based on split ring magnetic resonance

With the development of photonic integration technology, meta-waveguides have become a new research hotspot. They have broken through the theoretical diffraction limit by virtue of the strong electromagnetic manipulation ability of the metasurface and the strong electromagnetic field limitation and guidance ability of the waveguide. However, the reported meta-waveguides lack research on dynamic modulation. Therefore, we analyze the modulation effect of the metasurface on the optical field in the waveguide and design an ultra-compact on-chip meta-waveguide phase modulator using split ring magnetic resonance. It has a very short modulation length of only 3.65 µm, wide modulation bandwidth of 116.8 GHz, and low energy consumption of 263.49 fJ/bit. By optimizing the structure, the energy consumption can be further reduced to 90.69 fJ/bit. Meta-waveguides provide a promising method for the design of integrated photonic devices.

Altered cytokeratin 5 expression in breast lobular myoepithelial cells

AIMS

Cytokeratin 5 (CK5) is a surrogate maker of progenitor cells and early glandular and myoepithelial cells (MECs) in the breast, and CK5 expression in breast MECs varies from ducts to lobules, and from normal to diseased tissue. However, the mechanisms underlying immunophenotypic alterations of CK5 expression in MECs remain unclear.

METHODS

CK5 expression in MECs of 20 normal breast samples, 58 ductal carcinoma in situ (DCIS; including 21 DCIS with extensive lobular involvement), 11 atypical ductal hyperplasia (ADH), 18 non-invasive lobular neoplasia consisting of 11 atypical lobular hyperplasia (ALH) and 7 lobular carcinoma in situ (LCIS), 20 cystic lobules and 10 usual ductal hyperplasia (UDH) involving lobules were observed to evaluate the effects of contact with benign hyperplastic or cancerous luminal cells and pressure of dilated glands on CK5 expression.

RESULTS

CK5 expression in normal ductal MECs was exclusively positive, whereas most normal lobular MECs were negative. In DCIS, cancerous ducts were primarily surrounded by CK5-positive MECs (91.0%), as were lobular acini involved by DCIS (89.2%), while the remaining normal acini maintained CK5-negative. CK5-positive MECs were found in 57.5% of acini in ALH and were more prevalent in LCIS (70.7%). CK5 expression was occasionally positive in both cystic lobules (16.7%) and lobules involved by UDH (14.3%), while an increase of CK5-positive MECs was found in ADH (38.2%).

CONCLUSIONS

These results suggest that CK5 expression in lobular MECs may be altered by contact with cancerous luminal cells rather than benign hyperplastic luminal cells or pressure from dilated glands.