Arterial stiffness in acute COVID-19 and potential associations with clinical outcome

BACKGROUND

Coronavirus disease 2019 (COVID-19) interferes with the vascular endothelium. It is not known whether COVID-19 additionally affects arterial stiffness.

METHODS

This case-control study compared brachial-ankle pulse wave (baPWV) and carotid-femoral pulse wave velocities (cfPWV) of acutely ill patients with and without COVID-19.

RESULTS

Twenty-two COVID-19 patients (50% females, 77 [67-84] years) were compared with 22 age- and sex-matched controls. In COVID-19 patients, baPWV (19.9 [18.4-21.0] vs. 16.0 [14.2-20.4], P = 0.02) and cfPWV (14.3 [13.4-16.0] vs. 11.0 [9.5-14.6], P = 0.01) were higher than in the controls. In multiple regression analysis, COVID-19 was independently associated with higher cfPWV (β = 3.164, P = 0.004) and baPWV (β = 3.532, P = 0.003). PWV values were higher in nonsurvivors. In survivors, PWV correlated with length of hospital stay.

CONCLUSION

COVID-19 appears to be related to an enhanced PWV reflecting an increase in arterial stiffness. Higher PWV might be related to an increased length of hospital stay and mortality.

A comparison of upper limb function in subjects with multiple sclerosis and healthy controls using an inertial measurement unit

Upper limbs (UL) dysfunction is frequent in people with Multiple Sclerosis (PwMS). Several objective measures of UL function are proposed; however, their use is mostly confined to assess subjects with mild-to-moderate disability and requires fine motor skills, often impaired in high disability level subjects. Thus, a tool to score UL function in the advanced disease stage is lacking. The aim of the study is to analyse and compare UL unilateral and bilateral movements of healthy control (HC) and PwMS, at different disability levels, using an instrumented version (Inertial Measurement Unit, IMU) of the 15-seconds finger-to-nose test (FNT). Each movement cycle was segmented in going/adjusting/returning phases. The inter-hand interval (IHI) allowed assessing bilateral coordination (i.e. synchrony) in each phase. The larger IHI, the more severe the bilateral coordination impairment is. After stratifying PwMS for disability level (PwMS_LOW, Expanded Disability Status Scale, EDSS≤5.5 and PwMS_HIGH, EDSS≥6), the ANOVA on IHI showed significant differences between PwMS and HC (p<0.001) in all phases. However, only the going phase IHI showed significantly higher asynchrony in PwMS_HIGH than PwMS_LOW and HC (p<0.001) and no differences between PwMS_LOW and HC. The going phase IHI seems to be a clinical marker specific for high disability level PwMS. These findings suggest inertial sensors during FNT could be an easy-to-use method for a more detailed quantitative characterization of UL function in PwMS also in subjects with EDSS greater than 6.

Real-life drug persistence in patients with rheumatic diseases treated with CT-P13: a prospective observational cohort study (PERSIST)

Objective

The aim was to report results from PERSIST, a real-life, observational, prospective cohort study of CT-P13, an infliximab (IFX) biosimilar, for treatment of patients with RA, AS or PsA who were biologic naïve or switched from an IFX reference product (IFX-RP; Remicade).

Methods

Adult patients were recruited during usual care at 38 sites in Europe and Canada and enrolled by their physicians after meeting eligibility criteria according to the country-approved label for CT-P13. Primary outcomes were to determine drug utilization and treatment persistence and to assess safety. Patients were followed for up to 2 years. Data were analysed and reported descriptively.

Results

Of 351 patients enrolled, 334 were included in the analysis (RA, 40.4%; AS, 34.7%; PsA, 24.9%). The safety analysis set comprised all 328 patients treated with CT-P13. The majority (58.2%) of patients received CT-P13 monotherapy, most (72.6%) by dosing every 6 or 8 weeks. The mean treatment persistence was 449.2 days; 62.3% of patients completed 2 years of treatment. In all, 214 treatment-emergent adverse events (TEAEs) were reported in 38.4% of patients. Most TEAEs were of mild or moderate intensity; 13 were severe. The most commonly reported TEAEs were drug ineffective (9.5%) and infusion-related reactions (5.2%). The most frequently reported infection-related TEAEs were upper respiratory tract infections (3.0%), nasopharyngitis (2.1%) and bronchitis (1.5%). No patients experienced tuberculosis.

Conclusion

Drug utilization and treatment persistence with CT-P13 were consistent with historical reports of IFX-RP in this patient population. Safety findings did not identify new concerns for CT-P13 in the treatment of patients with RA, AS or PsA.

Trial registration

ClinicalTrials.gov: NCT02605642.

Fostering Engagement With Health and Housing Innovation: Development of Participant Personas in a Social Housing Cohort

BACKGROUND

Personas, based on customer or population data, are widely used to inform design decisions in the commercial sector. The variety of methods available means that personas can be produced from projects of different types and scale.

OBJECTIVE

This study aims to experiment with the use of personas that bring together data from a survey, household air measurements and electricity usage sensors, and an interview within a research and innovation project, with the aim of supporting eHealth and eWell-being product, process, and service development through broadening the engagement with and understanding of the data about the local community.

METHODS

The project participants were social housing residents (adults only) living in central Cornwall, a rural unitary authority in the United Kingdom. A total of 329 households were recruited between September 2017 and November 2018, with 235 (71.4%) providing complete baseline survey data on demographics, socioeconomic position, household composition, home environment, technology ownership, pet ownership, smoking, social cohesion, volunteering, caring, mental well-being, physical and mental health-related quality of life, and activity. K-prototype cluster analysis was used to identify 8 clusters among the baseline survey responses. The sensor and interview data were subsequently analyzed by cluster and the insights from all 3 data sources were brought together to produce the personas, known as the Smartline Archetypes.

RESULTS

The Smartline Archetypes proved to be an engaging way of presenting data, accessible to a broader group of stakeholders than those who accessed the raw anonymized data, thereby providing a vehicle for greater research engagement, innovation, and impact.

CONCLUSIONS

Through the adoption of a tool widely used in practice, research projects could generate greater policy and practical impact, while also becoming more transparent and open to the public.

The pro-thrombotic transcriptomic signature of reticulated platelets in patients with chronic coronary syndrome

Introduction

Reticulated or immature platelets (RPs) are hyper-reactive young platelets that are larger and contain significantly more RNA compared to mature platelets (MPs). High levels of RPs in peripheral blood are predictors of an insufficient response to dual antiplatelet therapy and of adverse cardiovascular events in cardiovascular patients. Recently, we reported for the first time an enrichment of prothrombotic transcripts in RPs transcriptome of healthy donors. However, the biology of RPs in patients with coronary artery disease has not been investigated yet.

Purpose

We aimed to compare for the first time the transcriptomic profiles of RPs and MPs in patients with chronic coronary syndrome (CCS).

Methods

RPs and MPs from peripheral blood of CCS patients were isolated using fluorescent activated cell sorting (FACS) based on their RNA-content. After sorting, RNA was extracted and quality, concentration and integrity were assessed with the Tapestation 4200 platform (Agilent). Total-RNA libraries were prepared, multiplexed and sequenced on a NextSeq 500 Illumina platform obtaining 80 to 100 million paired-end reads per sample. RNA-sequencing analysis was performed with R and DESeq2.

Results

Total-RNA-sequencing detected 538 genes differentially expressed (300 downregulated, 238 upregulated) in RPs compared to MPs in CCS patients (Figure 1A). In particular, transcripts for the collagen receptor GP6 (FC 1.89, p=4.7x10–23), thrombin receptor PAR4 (F2RL3, FC 1.97, p=3.5x10–11), the ATP receptor P2RX1 (FC 1.94, p=3.1x10–15) and the ADP receptor P2RY1 (FC 1.82, p=3.15x10–10) were significantly enriched in RPs, whereas RNA regulators as the RISC-component TNRC6A (FC 0.5, p=7.98x10–13) and the splicing factor LUC7L3 (log2FC 0.55, p=1.76x10–11) were downregulated in RPs. Gene ontology analysis revealed an enrichment of relevant biological categories in RPs including “platelet activation” (fold enrichment = 10.5, p=1.8x10–8) and “blood coagulation” (fold enrichment = 4.4, p=2.4x10–3). Splicing analysis detected several differential splicing events. Of note, we detected an alternative splicing on GP6 transcript present only in RPs and absent in MPs (p=0.03, Figure 1B) At last, backsplicing analysis detected an enrichment of circular-RNAs in MPs.

Conclusions

This study represents the first deep transcriptomic profiling of RPs and MPs in patients with CCS and reports for the first time a differential enrichment of transcripts involved in platelet activation. Moreover, we could detect for the first time alternative splicing events in RPs and an enrichment of circular-RNAs in MPs. The clear upregulation of prothrombotic signaling in RPs (schematic overview Figure 1C) could explain, at least in part, their hyper-activity and their correlation with cardiovascular events in different pathological settings at it may offer a new therapeutic niche in patients with CCS.

Figure 1

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): German society of cardiology (DGK)

Transcatheter heart valve interventions: where are we? Where are we going?

Transcatheter heart valve interventions have transformed the outcomes of patients with valvular heart disease (VHD) who are unfavourable candidates for surgery. Technological advances have allowed extension of these interventions to younger or lower risk patients and those with other forms of VHD and may in the future permit earlier treatment of VHD in less symptomatic patients or those with moderate disease. The balance of risks and benefits is likely to differ between lower and higher risk patients, and more evidence is needed to evaluate the net benefit of transcatheter technology in these groups. As academic researchers, clinicians, industry, and patient stakeholders collaborate to research these broader indications for transcatheter valve interventions, it is essential to address (i) device durability and deliverability, (ii) specific anatomical needs (e.g. bicuspid aortic valves, aortic regurgitation, mitral and tricuspid valve disease), (iii) operator training, and (iv) the reinforced importance of the multidisciplinary Heart Team.

Box and block test, hand grip strength and nine-hole peg test: correlations between three upper limb objective measures in multiple sclerosis

BACKGROUND AND PURPOSE

Limited data are available in the literature for upper limb impairment in multiple sclerosis (MS). This study aimed to report the distribution of values of hand grip strength (HGS), of the box and block test (BBT) and of the nine-hole peg test (9HPT) correlated with demographic and clinical data in subjects with MS.

METHODS

This study involved five Italian neurological centres. The inclusion criteria were age ≥ 18, MS diagnosis, stable disease phase, right-hand dominance. All subjects underwent HGS, BBT and 9-HPT evaluation.

RESULTS

In all, 202 subjects with MS were enrolled: 137 females; mean age 48.4 years; mean Expanded Disability Status Scale (EDSS) 4.17; mean disease duration 14.12 years; disease course 129 relapsing-remitting, 21 primary progressive and 52 secondary progressive MS subjects; mean right HGS 25.3 kg, left 23.2 kg; mean right BBT 45.7 blocks, left 44.9 blocks; mean right 9-HPT 30.7 s, left 33.4 s. All results were statistically significantly different compared to healthy controls. HGS, BBT and 9-HPT were associated with age, EDSS and disease duration, whilst disease course correlated with BBT and 9-HPT. The BBT and 9-HPT scores significantly differed according to level of disability (EDSS ≤3.0, 3.5-5.5, ≥6.0).

CONCLUSION

Hand grip strength and BBT value distribution in a large MS population is reported. Correlations between HGS, BBT and 9-HPT were generally low.

Intermuscular coupling and postural control in unilateral transfemoral amputees - a pilot study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020;2020:3815-3818. [PMID: 33018832 DOI: 10.1109/embc44109.2020.9176850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

The dynamics of the adjustment of center of pressure (CoP) has been utilized to understand motor control in human pathologies characterized by impairments in postural balance. The control mechanisms that maintain balance can be investigated via the analysis of muscle recruitment using electromyography (EMG) signals. In this work, we combined these two techniques to investigate balance control during upright standing in transfemoral unilateral amputees wearing a prosthesis. The dynamics of the CoP adjustments and EMG-EMG coherence between four muscles of the trunk and lower limb of 5 unilateral transfemoral amputees and 5 age-matched able-bodied participants were quantified during 30 s of quiet standing using the entropic half-life (EnHL) method. Two visual conditions, eyes open and eyes closed, were tested. Overall, the group of amputees presented lower EnHL values (higher dynamics) in their CoP adjustments than controls, especially in their intact limb. The EnHL values of the EMG-EMG coherence time series in the amputee group were lower than the control group for almost all muscle pairs under both visual conditions. Different correlations between the EnHL values of the CoP data and the EMG-EMG coherence data were observed in the amputee and control groups. These preliminary results suggest the onset of distinct neuromuscular adaptations following a unilateral amputation.Clinical Relevance - Understanding neuromuscular adaptation mechanisms after an amputation may serve to design better rehabilitation treatments and novel prosthetic devices with sensory feedback.

Efficacy of levetiracetam on upper limb movement in multiple sclerosis patients with cerebellar signs: a multicenter double-blind, placebo-controlled, crossover study

BACKGROUND AND PURPOSE

The literature provides contrasting results on the efficacy of levetiracetam (LEV) in multiple sclerosis (MS) patients with cerebellar signs. It was sought to evaluate the efficacy of LEV on upper limb movement in MS patients.

METHODS

In this multicenter double-blind placebo-controlled crossover study, MS patients with prevalently cerebellar signs were randomly allocated into two groups: LEV followed by placebo (group 1) or placebo followed by LEV (group 2). Clinical assessments were performed by a blinded physician at T0 (day 1), T1 (day 22), T2 (2-week wash-out period, day 35) and T3 (day 56). The primary outcome was dexterity in the arm with greater deficit, assessed by the nine-hole peg test (9HPT). Secondary clinical outcomes included responders on the 9HPT (∆9HPT >20%), tremor activity of the daily living questionnaire and self-defined upper limb impairment, through a numeric rating scale. Kinematic evaluation was performed using a digitizing tablet, providing data on normalized jerk, aiming error and centripetal acceleration.

RESULTS

Forty-eight subjects (45.2 ± 10.4 years) were randomly allocated into two groups (n = 24 each). 9HPT significantly improved in the LEV phase in both groups (P < 0.001). The LEV treatment phase led to a significant improvement (P < 0.01) of all clinical outcomes in group 1 and in dexterity in group 2. No significant changes were reported during both placebo phases in the two groups. Considering the kinematic analysis, only normalized jerk significantly improved after treatment with LEV (T0-T1) in group 1.

CONCLUSIONS

Levetiracetam treatment seems to be effective in improving upper limb dexterity in MS patients with cerebellar signs.

De Novo SOX6 Variants Cause a Neurodevelopmental Syndrome Associated with ADHD, Craniosynostosis, and Osteochondromas

SOX6 belongs to a family of 20 SRY-related HMG-box-containing (SOX) genes that encode transcription factors controlling cell fate and differentiation in many developmental and adult processes. For SOX6, these processes include, but are not limited to, neurogenesis and skeletogenesis. Variants in half of the SOX genes have been shown to cause severe developmental and adult syndromes, referred to as SOXopathies. We here provide evidence that SOX6 variants also cause a SOXopathy. Using clinical and genetic data, we identify 19 individuals harboring various types of SOX6 alterations and exhibiting developmental delay and/or intellectual disability; the individuals are from 17 unrelated families. Additional, inconstant features include attention-deficit/hyperactivity disorder (ADHD), autism, mild facial dysmorphism, craniosynostosis, and multiple osteochondromas. All variants are heterozygous. Fourteen are de novo, one is inherited from a mosaic father, and four offspring from two families have a paternally inherited variant. Intragenic microdeletions, balanced structural rearrangements, frameshifts, and nonsense variants are predicted to inactivate the SOX6 variant allele. Four missense variants occur in residues and protein regions highly conserved evolutionarily. These variants are not detected in the gnomAD control cohort, and the amino acid substitutions are predicted to be damaging. Two of these variants are located in the HMG domain and abolish SOX6 transcriptional activity in vitro. No clear genotype-phenotype correlations are found. Taken together, these findings concur that SOX6 haploinsufficiency leads to a neurodevelopmental SOXopathy that often includes ADHD and abnormal skeletal and other features.

P819 Outflow graft twist occlusion in the heartmate 3 left ventricular assist system in 7 cases: analysis of potential mechanisms using computed tomography

Background

Twist of the outflow graft (OG) of the HeartMate 3 left ventricular (LV) assist device (HM3) with subsequent occlusion is a rare, but life-threatening complication.

Purpose

We evaluated if potential implantation technique dependent mechanisms of OG twist can be predicted by multislice computed tomography (MSCT).

Methods

We retrospectively analyzed clinical, echocardiographic and MSCT data of 7 patients with angiographically proven and surgically corrected OG twist and of 11 consecutive patients without any type of pump obstruction. MSCT parameters were: position of inflow cannula related to anatomical LV apex (1), angulation of axis of inflow cannula related to LV axis (2), orientation of outflow channel of the pump housing related to LV axis (3), OG course (4). Echocardiographic parameters were LV end-diastolic diameter (LVEDD) and aortic valve opening.

Results

Mean time from implantation to twist was 563 ± 161 days. Preoperative LVEDD (64.6 ± 9.8 mm vs. 67.4 ± 10.2 mm, p = 0.563) was similar. LVEDD reduction after implantation (20% vs. 28%) and prevalence of aortic valve opening was higher in the twist group (71% vs. 45%). The MSCT measurements showed a high degree of heterogeneity in both groups: (1) differed from superior to infero-lateral; (2) varied from cranial to caudal, lateral and medial; (3) varied from antero-septal to inferior. (4) showed an incidence of non-obstructive kinking of 29% and 36%, respectively.

Conclusion

Marked heterogeneity of the measured MSCT parameters was observed in both groups. No specific pattern or geometric relation could be attributed to the OG twist phenomenon.

3049Equally high detection rates of atrial fibrillation in patients after a TIA and stroke by systematic ECG monitoring with an implanted device: SPIDER-AF study

Introduction

The risk of neurovascular and cardiovascular morbidity is substantially increased by undetected atrial fibrillation (AF). Therefore, early detection of AF is crucial to initiate appropriate therapy in persons at risk and may improve outcome. An implantable loop recorder (ILR) can monitor the heart rhythm for up to three years, modern devices provide dedicated algorithms to detect AF.

Hypothesis

We aimed to investigate the AF detection rate by the use of an ILR in patients after a recent cerebrovascular event (TIA n=137 or stroke n=363) presenting in sinus rhythm and no history of AF in the ambulatory setting by office based cardiologists.

Purpose

Observational study in patients with no prior diagnosis of AF, who had (presumably thromboembolic) transient ischemic attack (TIA) or stroke within 12 months and were implanted an ILR in the last 6 months. Follow-up visits every 3 months for 1 year overall.

Results

In 34 outpatient cardiology centers in Germany, a total of 500 patients were documented (mean age 63.1±12.7 years, 35.4% >70 years; 60.8% males). The qualifying event - diagnosed by neurologists - was a TIA in 137 (27.4%) and a stroke in 363 (72.6%) with typical thromboembolic pattern in NMR imaging (29.2% TIA/45.2% stroke, p<0.001), in CT imaging (7.3% TIA/7.7% stroke, n.s.), in both (6.6% TIA/19.6% stroke, p<0.001).

During follow-up, AF was newly detected by the device in TIA patients in 29.9% and in stroke patients in 25.6% (n.s.). The mean screening period until detection of AF with the Reveal LinQ device was 170±134 days in TIA, 145±128 in stroke respectively (n.s.). 95.7% had paroxysmal and 4.3% persistent AF in stroke, TIA patients had 100% paroxysmal AF (n.s.), median duration was 5.0 min in TIA and 5.2 min in stroke, respectively (n.s.). Most AF patients were asymptomatic (68.3% TIA/ 83.9% stroke, p<0.03).

The mean CHA2DS2Vasc score in patients with AF was 4.0 and 4.1 in those with TIA and stroke (n.s.), for patients in sinus rhythm 3.7 and 3.9, respectively (n.s.). Arterial hypertension was present in 71.5% with TIA/76.0% with stroke (n.s.), diabetes mellitus in 15.3% with TIA/25.1% with stroke (p<0.05), coronary artery disease in 12.4% with TIA/14.6% with stroke (n.s.), vascular disease in 3.6% with TIA/5.0% with stroke (n.s.).

Conclusions

In patients in sinus rhythm and no history of AF after a TIA or stroke, during 1-year follow-up AF could be newly detected in a quarter of patients by means of systematic continuous screening with an implantable ECG device. As AF diagnosis usually leads to immediate secondary prevention with long-term anticoagulation, such screening is useful not only in stroke but also in TIA patients and may substantially reduce the risk of recurrent stroke and cardiovascular morbidity.

Acknowledgement/Funding

SPIDER-AF registry was performed by BNK Service GmbH, Munich (Germany) and supported by Bayer Vital GmbH and Medtronic GmbH in equal parts

P04.07 Correlation of 18F-fluorethyl-L-tyrosine (18F-FET) uptake in positron emission tomography (PET) and MRI growth rate in low-grade glioma

BACKGROUND

Low-grade gliomas (LGGs, WHO grade II) are a heterogeneous group of tumors of the central nervous system with diverse behavior in histopathology, genetics and growth patterns. Therefore, different therapeutic strategies are discussed ranging from watchful waiting to radical resection and adjuvant radio-/chemotherapy. For a better evaluation of tumor progression or malignant transformation, the O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) uptake in PET or the tumor growth rate assessed on MRI are used depending on the neurooncological center. Here, we correlated both methods.

MATERIAL AND METHODS

Inclusion criteria for this retrospective study were (1) newly diagnosed and neuropathologically confirmed low-grade glioma; (2) at least two MRIs at initial diagnosis and follow-up for calculation of the tumor growth rate (using IDS7 by Sectra AB, Sweden, 2018); (3) and an additional preoperative 18F-FET PET scan.

RESULTS

From 2008 to 2018, 34 patients were identified (mean age 39.7 years; 68% diffuse astrocytoma). The mean tumor growth rate on MRI was 0.091 cm3/d. The average mean 18F-FET uptake was 1.42; the average maximum 18F-FET uptake was 2.18. The Pearson correlation coefficient between the tumor growth rate and the mean and maximum 18F-FET uptake was r=0.19, and r=0.10. In the group of diffuse astrocytomas, the mean growth rate in tumors with a mean 18F-FET uptake of >1.5 was significantly higher than the mean growth rate of those with a mean 18F-FET uptake of ≤1.5 (p<0.1).

CONCLUSION

Data suggest that astrocytic LGGs with increased 18F-FET uptake may show a more aggressive behaviour, with a potentially higher risk for an earlier tumor progression or malignant transformation. For further elucidation of a correlation between the tumor growth rate and the 18F-FET uptake, larger prospective studies are needed. In the future, the combination of both methods in the management of low-grade gliomas could help to detect tumor progression as well as tumor malignization more precisely.

Prebiotics as excipients for enhancement of stability and functionality of Bifidobacterium longum ssp. infantis with potential application as symbiotics in food and pharmaceuticals

Objective: Formulations containing probiotics are promoted due to health benefits. During lyophilization and subsequent storage in the gastrointestinal tract, bacteria are exposed to stress conditions that can lead to impairment and loss of viability. Methods: The suitability of various excipients for enhancing the stability and functionality of Bifidobacterium longum subsp. infantis during storage as freeze-dried powder and through exposure to acid and bile was investigated. Cells were lyophilized in the presence of sucrose, trehalose, lactose, cellobiose and fructooligosaccharide (FOS) and stored at 4 °C or 25 °C. The effect of diverse protectants on the persistence after exposure to acid and bile environment was examined through determination of the colony forming units, the β-glucosidase and β-galactosidase activity and the membrane integrity changes. Results: Cells freeze-dried in the presence of cryoprotectants had comparable survivability during storage at 4 °C whereas the survival rate at 25 °C of cells protected by cellobiose and FOS was higher than for those protected with sucrose and trehalose. Furthermore, the respective excipients used as cryoprotectants enhanced the stability of cells exposed to simulated gastric and small intestinal medium. Stabilization may be achieved through different mechanism of action such as protecting the membrane integrity and as metabolizable substrates. Overall, prebiotic and thus metabolizable protectants including cellobiose and FOS were superior to other protectants used. Conclusion: In symbiotic formulas with B. infantis, these sugars might serve as prebiotics and stabilizers of this probiotic strain during lyophilization, storage and in gastrointestinal conditions simultaneously, potentially increasing its health-promoting effects.

Investigation on core-fucosylated prostate-specific antigen as a refined biomarker for differentiation of benign prostate hyperplasia and prostate cancer of different aggressiveness

Prostate cancer represents a major cause of cancer death in men worldwide. Novel non-invasive methods are still required for differentiation of non-aggressive from aggressive tumors. Recently, changes in prostate-specific antigen glycosylation pattern, such as core-fucosylation, have been described in prostate cancer. The objective of this study was to evaluate whether the core-fucosylation determinant of serum prostate-specific antigen may serve as refined marker for differentiation between benign prostate hyperplasia and prostate cancer or identification of aggressive prostate cancer. A previously developed liquid chromatography-mass spectrometry/mass spectrometry-based strategy was used for multiplex analysis of core-fucosylated prostate-specific antigen (fuc-PSA) and total prostate-specific antigen levels in sera from 50 benign prostate hyperplasia and 100 prostate cancer patients of different aggressiveness (Gleason scores, 5-10) covering the critical gray area (2-10 ng/mL). For identification of aggressive prostate cancer, the ratio of fuc-PSA to total prostate-specific antigen (%-fuc-PSA) yielded a 5%-8% increase in the area under the curve (0.60) compared to the currently used total prostate-specific antigen (area under the curve = 0.52) and %-free prostate-specific antigen (area under the curve = 0.55) tests. However, our data showed that aggressive prostate cancer (Gleason score > 6) and non-aggressive prostate cancer (Gleason score ≤ 6) could not significantly (p-value = 0.08) be differentiated by usage of %-fuc-PSA. In addition, both non-standardized fuc-PSA and standardized %-fuc-PSA had no diagnostic value for differentiation of benign prostate hyperplasia from prostate cancer. The %-fuc-PSA serum levels could not improve the differentiation of non-aggressive and aggressive prostate cancer compared to conventional diagnostic prostate cancer markers. Still, it is unclear whether these limitations come from the biomarker, the used patient cohort, or the imprecision of the applied method itself. Therefore, %-fuc-PSA should be further investigated, especially by more precise methods whether it could be clinically used in prostate cancer diagnosis.

Impact of catchment land use on fish community composition in the headwater areas of Elbe, Danube and Main

Intensification of catchment land-use and the corresponding habitat degradation pose a threat to freshwater biodiversity and ecosystem health, yet few studies comprehensively quantified the effects of specific land-use variables on fish communities for different catchments within the same climatic region. Herein, we investigated the influence of catchment land use on fish community composition in the headwater areas of the European main river systems Elbe, Danube and Main/Rhine. The analyses comprising 289 streams and rivers in Bavaria, southern Germany, revealed that the influence of urbanization (e.g. ground sealing), potamalisation (impoundment of water courses), and erosion-prone, agricultural land-use types (e.g. root crop, maize) were significantly related to the fish community composition. In addition, multiple stressors were effective indicators and their importance differed between survey-area scales, geographical regions, and stream sizes. The findings suggest that terrestrial effects of land-use and urbanization need to be more strongly considered in the conservation of endangered stream fishes, ideally including combined measures of erosion control, restoration of environmental flows and mitigation of structural degradation.

rBAN: retro-biosynthetic analysis of nonribosomal peptides

Proteinogenic and non-proteinogenic amino acids, fatty acids or glycans are some of the main building blocks of nonribsosomal peptides (NRPs) and as such may give insight into the origin, biosynthesis and bioactivities of their constitutive peptides. Hence, the structural representation of NRPs using monomers provides a biologically interesting skeleton of these secondary metabolites. Databases dedicated to NRPs such as Norine, already integrate monomer-based annotations in order to facilitate the development of structural analysis tools. In this paper, we present rBAN (retro-biosynthetic analysis of nonribosomal peptides), a new computational tool designed to predict the monomeric graph of NRPs from their atomic structure in SMILES format. This prediction is achieved through the "in silico" fragmentation of a chemical structure and matching the resulting fragments against the monomers of Norine for identification. Structures containing monomers not yet recorded in Norine, are processed in a "discovery mode" that uses the RESTful service from PubChem to search the unidentified substructures and suggest new monomers. rBAN was integrated in a pipeline for the curation of Norine data in which it was used to check the correspondence between the monomeric graphs annotated in Norine and SMILES-predicted graphs. The process concluded with the validation of the 97.26% of the records in Norine, a two-fold extension of its SMILES data and the introduction of 11 new monomers suggested in the discovery mode. The accuracy, robustness and high-performance of rBAN were demonstrated in benchmarking it against other tools with the same functionality: Smiles2Monomers and GRAPE.

Long-Term Functionality of Transversal Intraneural Electrodes Is Improved By Dexamethasone Treatment

Neuroprostheses aimed to restore lost functions after a limb amputation are based on the interaction with the nervous system by means of neural interfaces. Among the different designs, intraneural electrodes implanted in peripheral nerves represent a good strategy to stimulate nerve fibers to send sensory feedback and to record nerve signals to control the prosthetic limb. However, intraneural electrodes, as any device implanted in the body, induce a foreign body reaction (FBR) that results in the tissue encapsulation of the device. The FBR causes a progressive decline of the electrode functionality over time due to the physical separation between the electrode active sites and the axons to interface. Modulation of the inflammatory response has arisen as a good strategy to reduce the FBR and maintain electrode functionality. In this study transversal intraneural multi-channel electrodes (TIMEs) were implanted in the rat sciatic nerve and tested for 3 months to evaluate stimulation and recording capabilities under chronic administration of dexamethasone. Dexamethasone treatment significantly reduced the threshold for evoking muscle responses during the follow-up compared to saline-treated animals, without affecting the selectivity of stimulation. However, dexamethasone treatment did not improve the signal-to-noise ratio of the recorded neural signals. Dexamethasone treatment allowed to maintain more working active sites along time than saline treatment. Thus, systemic administration of dexamethasone appears as a useful treatment in chronically implanted animals with neural electrodes as it increases the number of functioning contacts of the implanted TIME and reduces the intensity needed to stimulate the nerve.

Long-term speech and swallowing function after primary resection and sentinel node biopsy for early oral squamous cell carcinoma

OBJECTIVES

Analysis of long-term speech and swallowing function and subjective quality of life (QOL) after primary resection and sentinel node biopsy (SNB) in patients with early stage (cT1/T2) oral squamous cell carcinomas (OSCC).

MATERIAL AND METHODS

Eighty-one consecutive patients treated primarily by transoral resection without flap reconstruction and SNB for a cT1/T2 OSCC were included. Completion neck dissection (CND) was indicated in case of occult disease in the sentinel nodes. Adjuvant radiation (aRT) was administered according to the ultimate lymph node status. All patients showed no evidence of disease at time of analysis. Speech and swallowing function were assessed using standardized clinical examinations (11-item, articulation test) and validated questionnaires on subjective QOL (MDADI, FIGS). Median follow-up was 60 months (range 13-159 months) after initial treatment.

RESULTS

In all assessments for speech and swallowing, the entire study cohort achieved very high scores, with mean values located in the highest 10% of the scales. Neither tumor size nor site, age, pN-category, CND, and aRT had significant impact on functional outcomes and subjective QOL with the exception of lower scores in the global and physical scores of MDADI after CND or aRT, and articulation in the population over 60 years of age.

CONCLUSION

Transoral resection without reconstruction and SNB for early OSCC achieves excellent outcome with regard to speech, swallowing and subjective QOL.