P1569The Impact of Multidisciplinary Cardio-Oncology Program on the Cardiovascular Outcomes in Breast Cancer Patients

Background

Chemo- and target therapies may induce myocardial dysfunction and lead to poor prognoses. Early detection of minor myocardial dysfunction is important for the prevention of subsequent cardiotoxicity. Cardio-oncology is a multidisciplinary field focusing on managing and preventing cardiovascular complications in cancer patients. However, whether Cardio-oncology program truly makes difference in cardiovascular outcomes remains unknown. Herein, we are sharing our experiences in our Medical Center.

Methods

Since 2014 till 2017, we recruited 154 patients with newly diagnosed breast cancer preparing for Epirubicin therapy. Echocardiography, biomarkers, six minute walking distance and cardiovascular adverse events including new onset of hypertension, stroke, myocardial infarction (MI) and mortality were recorded at baseline, three months, six months and one year. Any functional decline was reported to oncologists for the consideration of changing regimens. Otherwise, cardiologists would be consulted for cardiovascular educations and therapies. The echocardiographic and clinical records of 450 breast patients receiving Epirubicin therapy during 2010 to 2013 were also collected as comparison.

Results

Compared with the ratio of 20% patients receiving echocardiography prior to 2014, the ratio increased to 100% since Cardio-Oncology program started. Also, the drop of left ventricular ejection fraction (LVEF) from 25% attenuated to 5%. Before Cardio-Oncology Program, there were 1.7% of new onset hypertension, 0.8% of MI, 0.8% of stroke and 16.8% of mortality. Conversely, after the program, there were only 0.6% of new onset hypertension while no other cardiovascular complications were reported. Furthermore, compared with previous reports of the effectiveness of Cardio-Oncology Program, our result also displayed a superior impact on the cardiovascular outcomes.

Conclusions

Collectively, through a comprehensive monitoring and an early intervention of myocardial dysfunction post chemotherapies, Cardio-Oncology Program truly decreased the cardiovascular complications in breast cancer patients.

Acknowledgement/Funding

Chi-Mei Medical Center

Isolation and Structure Elucidation of Secondary Metabolites From an Endophytic Fungus Annulohypoxylon ilanense

Fractionation of the EtOAc-soluble fraction of the liquid fermentation of an endophytic fungus Annulohypoxylon ilanense associated with the wood of medicinal plant Cinnamomum species resulted in the isolation of 1 new α-pyrone, ilanpyrone (1), along with 3 previously identified compounds, 2 to 4. Their structures were elucidated by means of spectroscopic and mass-spectrometric analyses, especially 1D and 2D nuclear magnetic resonance (NMR) spectroscopy as well as high-resolution electrospray ionization mass spectrometry. The isolated compounds were tested for their cytotoxicity against MCF-7, NCI-H460, and SF-268 cell lines using the MTT assay. Among them, compounds 1 and 4 were found to have moderate-to-weak cytotoxic effects against these 3 cell lines in vitro.

Avocado (Persea americana) fruit extract (2R,4R)-1,2,4-trihydroxyheptadec-16-yne inhibits dengue virus replication via upregulation of NF-κB-dependent induction of antiviral interferon responses

Dengue virus (DENV) caused millions of infections around the world annually. Co-infection with different serotypes of DENV is associated with dengue hemorrhagic shock syndrome, leading to an estimate of 50% death rate. No approved therapies are currently available for the treatment of DENV infection. Hence, novel anti-DENV agents are urgently needed for medical therapy. Here we demonstrated that a natural product (2 R,4 R)-1,2,4-trihydroxyheptadec-16-yne (THHY), extracted from avocado (Persea americana) fruit, can inhibit DENV-2 replication in a concentration-dependent manner and efficiently suppresses replication of all DENV serotypes (1–4). We further reveal that the NF-κB-mediated interferon antiviral response contributes to the inhibitory effect of THHY on DENV replication. Using a DENV-infected ICR suckling mouse model, we found that THHY treatment caused an increased survival rate among mice infected with DENV. Collectively, these findings support THHY as a potential agent to control DENV infection.

Chemical Constituents from the Fungus Antrodia cinnamomea

A new benzenoid, 4-methoxy-7-methylbenzo[ d][1,3]dioxol-5-ol (1) and three known secondary metabolites 2,3-dimethoxy-5-methyl[1,4]benzoquinone (2), 2-methoxy-6-methyl-1,4-benzoquinone (3) and 5-methyl-benzo[1,3]dioxole-4,7-diol (4) were isolated from the mycelia of A. cinnamomea BCRC 36799 by solid state fermentation with adlay. Their chemical structures were elucidated on the basis of HRESIMS, NMR spectroscopic data and comparison with reported values. All isolated compounds 1–4 were tested for their cytotoxicity against the six cancer cell lines using the MTT assay. Among them, compound 3 displayed significant cytotoxic effects toward all six tested cancer cell lines, with IC50 values ranging from 2.8–8.7 μM in vitro.

[Spatial analysis and prediction of severe fever with thrombocytopenia syndrome in Zhejiang province, 2011-2015]

Objective: To understand the distribution of the severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang province, and predict the incidence and the probability of SFTS outbreak. Methods: Based on the cases of SFTS from 2011-2015, software ArcGIS 10.0 was used to analyze the spatial distribution, Moran's I and Getis-Ord Gi were used to analyze the spatial autocorrelation. The incidence trend was explored by trend surface analysis, and the prediction was made by Kriging interpolation. Results: The incidence of SFTS increased and the distribution expanded in Zhejiang from 2011 to 2015, the seasonal and the demographic characteristics of SFTS were similar to the previous research; there were regional clustering of the cases (P<0.001); a downward trend was observed from northeast to southwest in terms of incidence of SFTS; the second-order disjunctive Kriging interpolation based on circular model and the indicator Kriging interpolation based on exponential model had higher prediction accuracy, the probabilities of outbreak in Anji, Daishan and Tiantai were high, the prediction deviation of inland was less than that of edge area. Conclusion: The prediction of SFTS by Kriging interpolation had high accuracy, the incidence of SFTS was higher and the distribution of SFTS was larger than the results of surveillance, the risk areas for epidemic were Anji, Daishan, Ninghai,Tiantai, Sanmen and Linhai.

Terahertz generation from laser-driven ultrafast current propagation along a wire target

Generation of intense coherent THz radiation by obliquely incidenting an intense laser pulse on a wire target is studied using particle-in-cell simulation. The laser-accelerated fast electrons are confined and guided along the surface of the wire, which then acts like a current-carrying line antenna and under appropriate conditions can emit electromagnetic radiation in the THz regime. For a driving laser intensity ∼3×10^{18}W/cm^{2} and pulse duration ∼10 fs, a transient current above 10 KA is produced on the wire surface. The emission-cone angle of the resulting ∼0.15 mJ (∼58 GV/m peak electric field) THz radiation is ∼30^{∘}. The conversion efficiency of laser-to-THz energy is ∼0.75%. A simple analytical model that well reproduces the simulated result is presented.

Antisite disorder driven spontaneous exchange bias effect in La(2-x)Sr(x) CoMnO₆ (0 ⩽ x ⩽ 1)

Doping at the rare-earth site by divalent alkaline-earth ions in perovskite lattice has witnessed a variety of magnetic and electronic orders with spatially correlated charge, spin and orbital degrees of freedom. Here, we report an antisite disorder driven spontaneous exchange bias effect as a result of hole carrier (Sr(2+)) doping in La(2-x)Sr(x)CoMnO6 (0  <  x  <  1) double perovskites. X-ray diffraction and Raman spectroscopy have evidenced an increase in disorder with the increase of Sr content up to x  =  0.5 and thereby a decrease from x  =  0.5 to 1. X-ray absorption spectroscopy has revealed that only Co is present in the mixed valence of Co(2+) and Co(3+) states with Sr doping to compensate the charge neutrality. Magnetotransport is strongly correlated with the increase of antisite disorder. The antisite disorder at the B-site interrupts the long-range ferromagnetic order by introducing various magnetic interactions and instigates reentrant glassy dynamics, phase separation and canted type antiferromagnetic behavior with the decrease of temperature. This leads to a novel magnetic microstructure with unidirectional anisotropy that causes a spontaneous exchange bias effect that can be tuned with the amount of antisite disorder.

Assessment of nematode community structure as a bioindicator in river monitoring

Nematode communities from river water and sediments were assessed for the abundance, feeding types, maturity indices and nematode channel ratio (NCR). The sampling sites studied included different levels of pollution and contamination from agricultural, industrial and sewage sources. The nematode abundance found in the sediment samples was more than that in the water samples. The lowest nematode abundance in sediment samples and the lowest NCR in water samples were both found at the industrial pollution site. Water samples showed positive correlation between the NCR and river pollution index (RPI). Mean maturity indices in sediment samples were inversely correlated with RPI. The pollutant source determined the relationship between NCR and pollution level, while maturity index always showed negative correlation with pollutant level regardless of the pollutant sources. The nematode abundance and its community structure were both reliable bioindicators for monitoring long-term river pollution in both qualitative and quantitative aspects.

Atomic structure of the Ag/Ge(111)-(sq.rt.(3) x sq.rt.(3)) surface: From scanning tunneling microscopy observation to theoretical study

The atomic structure of the Ag/Ge(111)-(sq.rt.(3) x sq.rt.(3))R30 degrees surface is studied by scanning tunneling microscopy (STM) and the density functional theory (DFT) calculations. Our STM images have shown a structure which is different from the widely accepted honeycomb-chained-triangle (HCT) model before. The structure is similar to the inequivalent triangle (IET) model found for the Ag/Si(111)-(sq.rt.(3) x sq.rt(3))R30 degrees surface. This model proposed two types of silver triangles with different sizes in the unit cell, corresponding to the bright spots and the dark spots in the STM image. A distinguishable hexagonal pattern of the IET structure was well disclosed in the temperature range from 100 to 473 K in our STM studies for Ag/Ge(111)-(sq.rt.(3) x sq.rt.(3))R30 degrees. Furthermore, the result of the DFT calculations showed that the IET structure is 0.20 eV energetically more stable than the HCT model. Besides, the Ge triangles, which were not disclosed in earlier STM research, are found in this study.

Self-organizing GeV, nanocoulomb, collimated proton beam from laser foil interaction at 7 x 10;{21} W/cm;{2}

We report on a self-organizing, quasistable regime of laser proton acceleration, producing 1 GeV nanocoulomb proton bunches from laser foil interaction at an intensity of 7 x 10;{21} W/cm;{2}. The results are obtained from 2D particle-in-cell simulations, using a circular polarized laser pulse with Gaussian transverse profile, normally incident on a planar, 500 nm thick hydrogen foil. While foil plasma driven in the wings of the driving pulse is dispersed, a stable central clump with 1-2lambda diameter is forming on the axis. The stabilization is related to laser light having passed the transparent parts of the foil in the wing region and enfolding the central clump that is still opaque. Varying laser parameters, it is shown that the results are stable within certain margins and can be obtained both for protons and heavier ions such as He;{2+}.

Single-cycle strong terahertz pulse generation from a vacuum-plasma interface driven by intense laser pulses

Single-cycle strong terahertz pulses can be generated by irradiating ultrashort intense laser pulses onto a tenuous plasma slab. At the plasma surface, laser ponderomotive force accelerates electrons and induces net currents, which radiate terahertz pulses. Our theoretical model suggests that if tau_{L}>2pi/omega_{p}, with tau_{L} as the laser-pulse duration and omega_{p} as the plasma frequency, the emission frequency is around tau_{L};{-1}. On the other hand, the emission frequency is around omega_{p}/2pi if tau_{L}<2pi/omega_{p}. Our numerical simulations support the theoretical model, showing that such a terahertz source is capable of providing megawatt power, field strengths of MV/cm, and broad frequency tunability.

A scanning tunneling microscopy study of distyrylbenzene on Ag/Ge(111)-(sqr rt of 3 x sqr rt of 3)R30 degrees

The adsorption and self-organized monolayers of trans,trans-distyrylbenzene (tt-DSB) and cis,cis-distyrylbenzene (cc-DSB) on Ag/Ge(111)-(sqr rt of 3 x sqr rt of 3)R30 degrees (Ag/Ge(111)-sqr rt of 3) were studied by low-temperature scanning tunneling microscopy (STM) in ultrahigh vacuum. tt-DSB and cc-DSB overlayers were prepared by vapor deposition at a substrate temperature of 200 K and imaged after the samples were cooled to 100 K. High-resolution images allow identification of the internal structure of individual tt-DSB molecules with three phenyl rings and their molecular arrangements on the Ag/Ge(111)-sqr rt of 3 surface. It is found that the intermolecular distance between two terminal phenyl rings in tt-DSB is about twice the lattice constant of Ag/Ge(111)-sqr rt of 3. Such a lattice match makes Ag/Ge(111)-sqr rt of 3 an ideal substrate for tt-DSB self-organization and the formation of a (3 x 1) overlayer unit cell. The structural model and the molecule registry corresponding to STM images for the adlayers of tt-DSB on Ag/Ge(111)-sqr rt of 3 are proposed and discussed. For cc-DSB adsorption on Ag/Ge(111)-sqr rt of 3, uniform molecular overlayers with two discernible molecular images corresponding to two major types of cc-DSB conformers were observed. The coexistence of multiple conformers and the mismatch of molecular dimension of cc-DSB with the substrate unit cell length limit the growth of large cc-DSB domains.

Current Knowledge and Attitudes About Organ Donation and Transplantation Among Chinese University Students

Current attitudes toward organ donation among university students in mainland China and the differences in attitudes between Chinese students in mainland China versus overseas are unknown. To address these issues, we conducted a cross-sectional survey using questionnaires among 922 Chinese undergraduates from mainland China and overseas regions of the world. Data were analyzed by descriptive statistics, Student t tests, chi-square tests, and a logistic regression analysis. We found that blood donors showed significantly better awareness of heart, liver, lung, skin, and tendon donation among commonly transplanted organs/tissues. As to the willingness for cadaveric organ donation, 61.3% of respondents consented, 8.5% objected, and 30.3% answered "not sure." The percentage holding an organ donor card was 15.7% among students from Hong Kong; 3.0%, mainland China; 2.8%, Macau; 2.6%, Taiwan, and 4.0%, other regions of the world. In a logistic regression analysis, female students (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.35 to 3.72) and blood donors (OR, 1.91; 95% CI, 1.10 to 3.32) did, but age and study specialty (medical vs nonmedical) did not show significantly more positive attitudes toward cadaveric organ donation. Compared with students from mainland China, overseas Chinese students from various regions did not show significantly different attitudes toward cadaveric organ donation. In summary, blood donors among university students have a greater knowledge of transplantation and a more positive attitude toward organ donation. Since university students are an important source of blood donors in China, they will be a potential pool of organ donors in the future.

ADA polymorphisms and asthma: a study in the Chinese Han population

We have studied a sample of 120 asthmatic patients and 116 healthy control subjects from the Chinese Han population. Three polymorphic sites: ADA(1), ADA(2), and ADA(6), within the ADA gene have been examined. The proportion of carriers of *2 allele at locus ADA(1) is drastically reduced in asthmatics as compared to controls. There is an epistatic interaction of ADA(2) on the ADA(1) site characterized by a suppressive effect by the *2 allele of ADA(2) on the protective effect exerted by the *2 allele of ADA(1) site on susceptibility to asthma. Our data suggest the presence of some DNA sequences influencing the susceptibility to asthma are located in the area between ADA(1) and ADA(2) sites.

Correlations of androgen deficiency with clinical symptoms in Taiwanese males

The purpose of this study was to elucidate correlations between different biochemical measurements of androgen deficiency and clinical symptoms in male residents of Taiwan. An investigation of the serum biochemical markers for androgen deficiency in 650 males, including total testosterone, calculated free testosterone, and bioavailable testosterone, was conducted. Measurements of clinical symptoms were obtained using a questionnaire of the androgen deficiency in the aging male (ADAM) by St Louis University (SLQ). Correlations among the biochemical markers, correlations of the biochemical markers and age, and relationships between the biochemical markers and the SLQ were evaluated. The sensitivity and specificity of the SLQ were determined. Bioavailable and calculated free testosterone correlated better with age than did total testosterone. Eighty percent of the men had a positive SLQ, and 20% had a negative SLQ. The percentage of positive SLQ results increased with age. No statistically significant difference was noted between the biochemical markers of bioavailable and calculated free testosterone levels and the SLQ status except for men aged over 70 years. The SLQ in this study showed an acceptable sensitivity of about 80%, but the specificity was poor (about 20%). In conclusion, bioavailable testosterone and calculated free testosterone were more-closely correlated with age and may be better biochemical markers for androgen deficiency. SLQ might not be a suitable single measurement for androgen deficiency and should be used together with biochemical markers.

The high-speed Hydra-Plus-One system for automated high-throughput protein crystallography

An automated high-throughput dispenser has been developed for the setup of protein crystallization trials by vapor diffusion or Microbatch methods. The Hydra-Plus-One is composed of a Hydra-PP system equipped with a motorized XYZ-platform, 96 precision glass syringes and a single-channel microsolenoid dispenser, which transfers 100 nl-50 micro l of protein solution with an accuracy of > 90% at a speed of 60s per 96 wells. Up to 300 micro l of premixed cocktails can be aspirated with the 96-syringe-assembly and dispensed into reservoir and droplet wells within 60s. The Hydra-Plus-One combines high precision, reliability and speed in a cost-effective high-throughput system ideally suited for protein crystallization

Comparing whole body 18F-2-deoxyglucose positron emission tomography and technetium-99m methylene diphosphate bone scan to detect bone metastases in patients with renal cell carcinomas - a preliminary report

PURPOSE

Conventional technetium-99m methylene diphosphate whole body bone scan (bone scan) has a high sensitivity but a poor specificity to detect bone metastases. However, positron emission tomography with 18F-2-deoxyglucose (FDG-PET) can offer superior spatial resolution and improved specificity. We have attempted to evaluate the usefulness of FDG-PET for detecting bone metastases in renal cell carcinomas (RCC) and to compare FDG-PET results with bone scan findings.

METHODS

Eighteen patients were selected for this study with biopsy-proven RCC. They were suspected of having bone metastases and were undergoing bone scan and FDG-PET to detect bone metastases. The final diagnoses of bone metastases were established by operative, histopathological findings or clinical follow-up longer than 1 year by additional radiographs or following FDG-PET/bone scan findings showing progressive and extensive widespread bone lesions.

RESULTS

A total of 52 bone lesions including 40 metastatic and 12 benign bone lesions found on either FDG-PET or bone scan were evaluated. FDG-PET could accurately diagnose all 40 metastatic and 12 benign bone lesions. Bone scan could accurately diagnose only 31 metastatic bone lesions. Diagnostic sensitivity and accuracy of FDG-PET were 100% and 100%, respectively,and bone scan were 77.5% and 59.6%, respectively.

CONCLUSIONS

Our data suggest that FDG-PET has a higher sensitivity and a better accuracy than that of bone scan to detect bone metastases in patients with RCC.

Approaching healthy body mass index norms for children and adolescents from health-related physical fitness

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.

High-throughput array production using precision glass syringes

The advantages of using 1, 96, or 384 precision glass syringes in automated high-throughput microdispensers in creating highly uniform and reproducible DNA, protein, and organic compound array filters and slides are described. Using the Hydra Microdispenser and Tango Liquid Handling system, 0.1-5 ng (in 50-300 nL) PCR-amplified, human cancer-related genes and housekeeping genes were spotted onto nylon membranes and coated slides. Protein solutions of 50 microg/mL to 1 mg/mL were spotted onto coated slides or onto MaxiSorp 96-well plates. Up to 6144 spots/membrane and up to 1000 spots/slide were printed. The size of the spots created by glass syringes was uniform and reproducible (precision variation of less than 5%) from spot to spot and membrane to membrane. Using a Tango 384 system, a total of ten 6144-spot filters can be produced in approximately 25 min, translating into a spotting speed of 2.5 min/membrane.

Method for the determination of dialkyl phosphates in urine by strong anion exchange disk extraction and in-vial derivatization

A method for the determination of four dialkylphosphate metabolites in urine by strong anion exchange disk (SAX) was investigated. Calcium hydroxide was added to a 1-mL urine sample to reduce interference. The aliquot was passed through the SAX disk to accumulate dialkylphosphate metabolites on the disk. The retained dialkylphosphate metabolites were derivatized with methyl iodide in acetonitrile online, and the resulting methyl esters of dialkylphosphate metabolites were directly analyzed by capillary column gas chromatography with flame photometric detection. The recoveries of these dialkylphosphate metabolites were found to be stable. When the intact sample was diluted with deionized water at a 1:1 ratio, the recoveries were both increased and stabilized. The urine samples collected from eight fruit farmers showed that levels of dialkylphosphate metabolites in urine were significantly different before and after pesticide application, indicating the method established in this study is applicable for real sample analysis. Compared with previous studies, this method not only can greatly simplify sample preparation, but it can also significantly reduce the consumption of toxic solvents in sample preparation.