Radiomic Phenotypes Distinguish Atypical Teratoid/Rhabdoid Tumors from Medulloblastoma

BACKGROUND AND PURPOSE

Atypical teratoid/rhabdoid tumors and medulloblastomas have similar imaging and histologic features but distinctly different outcomes. We hypothesized that they could be distinguished by MR imaging-based radiomic phenotypes.

MATERIALS AND METHODS

We retrospectively assembled T2-weighted and gadolinium-enhanced T1-weighted images of 48 posterior fossa atypical teratoid/rhabdoid tumors and 96 match-paired medulloblastomas from 7 institutions. Using a holdout test set, we measured the performance of 6 candidate classifier models using 6 imaging features derived by sparse regression of 900 T2WI and 900 T1WI Imaging Biomarker Standardization Initiative-based radiomics features.

RESULTS

From the originally extracted 1800 total Imaging Biomarker Standardization Initiative-based features, sparse regression consistently reduced the feature set to 1 from T1WI and 5 from T2WI. Among classifier models, logistic regression performed with the highest AUC of 0.86, with sensitivity, specificity, accuracy, and F1 scores of 0.80, 0.82, 0.81, and 0.85, respectively. The top 3 important Imaging Biomarker Standardization Initiative features, by decreasing order of relative contribution, included voxel intensity at the 90th percentile, inverse difference moment normalized, and kurtosis-all from T2WI.

CONCLUSIONS

Six quantitative signatures of image intensity, texture, and morphology distinguish atypical teratoid/rhabdoid tumors from medulloblastomas with high prediction performance across different machine learning strategies. Use of this technique for preoperative diagnosis of atypical teratoid/rhabdoid tumors could significantly inform therapeutic strategies and patient care discussions.

Adherence to antihypertensive medications for secondary prevention of cardiovascular disease events: a dose-response meta-analysis

OBJECTIVES

The aim of the study was to explore the association between adherence to antihypertensive medications (AHMs) and the risk of recurrence of cardiovascular disease (CVD) events in patients with a history of CVD events from cohort studies.

STUDY DESIGN

This is a dose-response meta-analysis.

METHODS

PubMed and Embase databases were searched up to March 4, 2021, to identify English-language reports of cohort studies that assessed the association of AHM adherence with risk of recurrence of CVD events. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated by using a fixed- or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear association.

RESULTS

We included nine cohort studies (54,349 patients) in the present meta-analysis. The pooled RR of CVD events was 0.66 (95% CI, 0.54-0.78) for the highest versus lowest AHM adherence category. We did not find any evidence of non-linearity association between AHM adherence and risk of CVD events (P_{non-linearity} = 0.534); for patients with a history of CVD events, the risk of CVD events was reduced by 9% for each 20% increase in AHM adherence (RR, 0.91; 95% CI, 0.85-0.97). The results of sensitivity analysis and subgroup analysis were virtually unchanged.

CONCLUSIONS

The high level of adherence to AHM is an effective strategy for preventing recurrence of CVD events. Patients with a history of CVD events should adhere to AHM.

Bone marrow-derived mesenchymal stem cells inhibit CD8+ T cell immune responses via PD-1/PD-L1 pathway in multiple myeloma

High expression of the inhibitory receptor programmed cell death ligand 1 (PD-L1) on tumor cells and tumor stromal cells have been found to play a key role in tumor immune evasion in several human malignancies. However, the expression of PD-L1 on bone marrow mesenchymal stem cells (BMSCs) and whether the programmed cell death 1 (PD-1)/PD-L1 signal pathway is involved in the BMSCs versus T cell immune response in multiple myeloma (MM) remains poorly defined. In this study, we explored the expression of PD-L1 on BMSCs from newly diagnosed MM (NDMM) patients and the role of PD-1/PD-L1 pathway in BMSC-mediated regulation of CD8⁺ T cells. The data showed that the expression of PD-L1 on BMSCs in NDMM patients was significantly increased compared to that in normal controls (NC) (18·81 ± 1·61 versus 2·78± 0·70%; P < 0·001). Furthermore, the PD-1 expression on CD8⁺ T cells with NDMM patients was significantly higher than that in normal controls (43·22 ± 2·98 versus 20·71 ± 1·08%; P < 0·001). However, there was no significant difference in PD-1 expression of CD4⁺ T cells and natural killer (NK) cells between the NDMM and NC groups. Additionally, the co-culture assays revealed that BMSCs significantly suppressed CD8⁺ T cell function. However, the PD-L1 inhibitor effectively reversed BMSC-mediated suppression in CD8⁺ T cells. We also found that the combination of PD-L1 inhibitor and pomalidomide can further enhance the killing effect of CD8⁺ T cells on MM cells. In summary, our findings demonstrated that BMSCs in patients with MM may induce apoptosis of CD8⁺ T cells through the PD-1/PD-L1 axis and inhibit the release of perforin and granzyme B from CD8⁺ T cells to promote the immune escape of MM.

Computer-Aided Diagnostic System for Thyroid Nodules on Ultrasonography: Diagnostic Performance Based on the Thyroid Imaging Reporting and Data System Classification and Dichotomous Outcomes

BACKGROUND AND PURPOSE

Artificial intelligence-based computer-aided diagnostic systems have been introduced for thyroid cancer diagnosis. Our aim was to compare the diagnostic performance of a commercially available computer-aided diagnostic system and radiologist-based assessment for the detection of thyroid cancer based on the Thyroid Imaging Reporting and Data Systems (TIRADS) and dichotomous outcomes.

MATERIALS AND METHODS

In total, 372 consecutive patients with 454 thyroid nodules were enrolled. The computer-aided diagnostic system was set up to render a possible diagnosis in 2 formats, the Korean Society of Thyroid Radiology (K)-TIRADS and the American Thyroid Association (ATA)-TIRADS-classifications, and dichotomous outcomes (possibly benign or possibly malignant).

RESULTS

The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the computer-aided diagnostic system for thyroid cancer were, respectively, 97.6%, 21.6%, 42.0%, 93.9%, and 49.6% for K-TIRADS; 94.6%, 29.6%, 43.9%, 90.4%, and 53.5% for ATA-TIRADS; and 81.4%, 81.9%, 72.3%, 88.3%, and 81.7% for dichotomous outcomes. The sensitivities of the computer-aided diagnostic system did not differ significantly from those of the radiologist (all P > .05); the specificities and accuracies were significantly lower than those of the radiologist (all P < .001). Unnecessary fine-needle aspiration rates were lower for the dichotomous outcome characterizations, particularly for those performed by the radiologist. The interobserver agreement for the description of K-TIRADS and ATA-TIRADS classifications was fair-to-moderate, but the dichotomous outcomes were in substantial agreement.

CONCLUSIONS

The diagnostic performance of the computer-aided diagnostic system varies in terms of TIRADS classification and dichotomous outcomes and relative to radiologist-based assessments. Clinicians should know about the strengths and weaknesses associated with the diagnosis of thyroid cancer using computer-aided diagnostic systems.

Exogenous 6-benzyladenine application affects root morphology by altering hormone status and gene expression of developing lateral roots in Malus hupehensis

Malus hupehensis is an extensively used apple rootstock in China. In the current study, M. hupehensis seedlings were treated with exogenous 2.2 µm 6-benzyladenine (6-BA) so as to investigate the mechanism by which 6-BA affects lateral root development. The results indicate that 6-BA treatment promotes elongation and thickening of both root and shoot in M. hupehensis, but reduces the number of lateral roots, as well as reducing the auxin level after 6-BA treatment. Moreover, MhAHK4, MhRR1 and MhRR2 were also significantly up-regulated in response to 6-BA treatment. Expression levels of auxin synthesis- and transport-related genes, such as MhYUCCA6, MhYUCCA10, MhPIN1 and MhPIN2, were down-regulated, which corresponds with lower auxin levels in the 6-BA-treated seedlings. A negative regulator of auxin, MhIAA3, was induced by 6-BA treatment, leading to reduced expression of MhARF7 and MhARF19 in 6-BA-treated seedlings. As a result, expression of MhWOX11, MhWOX5, MhLBD16 and MhLBD29 was blocked, which in turn inhibited lateral root initiation. In addition, a lower auxin level decreased expression of MhRR7 and MhRR15, which repressed expression of key transcription factors associated with root development, thus inhibiting lateral root development. In contrast, 6-BA treatment promoted secondary growth (thickening) of the root by inducing expression of MhCYCD3;1 and MhCYCD3;2. Collectively, the changes in hormone levels and gene expression resulted in a reduced number of lateral roots and thicker roots in 6-BA-treated plants.

Downregulation of lncRNA SNHG7 inhibits proliferation and invasion of nasopharyngeal carcinoma cells through repressing ROCK1

OBJECTIVE

Recent studies have revealed the important role of long noncoding RNAs (lncRNAs) in the progression of tumorigenesis. This study aimed to identify the biological function of lncRNA small nucleolar RNA host gene 7 (SNHG7) in the progression of nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS

LncRNA SNHG7 expressions in NPC cell lines and 50 paired NPC tissue samples were detected by Real-time quantitative polymerase chain reaction (RT-qPCR). Transwell assay, wound healing assay and proliferation assay were conducted to evaluate the in vitro function of SNHG7 in NPC cells. Xenograft model was established for determining the in vivo effect of SNHG7 on tumor formation and metastasis of NPC. The underlying mechanism of SNHG7 in mediating the progression of NPC was explored by RT-qPCR and Western blot.

RESULTS

SNHG7 expression was remarkably downregulated in NPC tissues compared with that in adjacent normal samples. Knockdown of SNHG7 attenuated proliferation, invasion and migration of NPC cells. Moreover, tumor size and the number of metastatic nodules were reduced in mice administrated with NPC cells transfected with sh-SNHG7. Knockdown of SNHG7 downregulated ROCK1 at mRNA and protein level. Besides, the expression of ROCK1 in tumor tissues was positively correlated to SNHG7 expression.

CONCLUSIONS

Knockdown of SNHG7 inhibits migration, invasion and proliferation of NPC cells through downregulating ROCK1, which may offer a new therapeutic intervention for NPC patients.

Deep Learning for Pediatric Posterior Fossa Tumor Detection and Classification: A Multi-Institutional Study

BACKGROUND AND PURPOSE

Posterior fossa tumors are the most common pediatric brain tumors. MR imaging is key to tumor detection, diagnosis, and therapy guidance. We sought to develop an MR imaging-based deep learning model for posterior fossa tumor detection and tumor pathology classification.

MATERIALS AND METHODS

The study cohort comprised 617 children (median age, 92 months; 56% males) from 5 pediatric institutions with posterior fossa tumors: diffuse midline glioma of the pons (n = 122), medulloblastoma (n = 272), pilocytic astrocytoma (n = 135), and ependymoma (n = 88). There were 199 controls. Tumor histology served as ground truth except for diffuse midline glioma of the pons, which was primarily diagnosed by MR imaging. A modified ResNeXt-50-32x4d architecture served as the backbone for a multitask classifier model, using T2-weighted MRIs as input to detect the presence of tumor and predict tumor class. Deep learning model performance was compared against that of 4 radiologists.

RESULTS

Model tumor detection accuracy exceeded an AUROC of 0.99 and was similar to that of 4 radiologists. Model tumor classification accuracy was 92% with an F₁ score of 0.80. The model was most accurate at predicting diffuse midline glioma of the pons, followed by pilocytic astrocytoma and medulloblastoma. Ependymoma prediction was the least accurate. Tumor type classification accuracy and F₁ score were higher than those of 2 of the 4 radiologists.

CONCLUSIONS

We present a multi-institutional deep learning model for pediatric posterior fossa tumor detection and classification with the potential to augment and improve the accuracy of radiologic diagnosis.

Downregulation of lncRNA SNHG7 inhibits proliferation and invasion of nasopharyngeal carcinoma cells through repressing ROCK1

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Downregulation of lncRNA SNHG7 inhibits proliferation and invasion of nasopharyngeal carcinoma cells through repressing ROCK1, by L. Wang, T. Xu, X. Cui, M. Han, L.-H. Zhou, Z.-X. Wei, Z.-J. Xu, Y. Jiang, published in Eur Rev Med Pharmacol Sci 2019; 23 (14): 6186-6193-DOI: 10.26355/eurrev_201907_18432-PMID: 31364118" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18432.

Improved fruit fly algorithm on structural optimization

To improve the efficiency of the structural optimization design in truss calculation, an improved fruit fly optimization algorithm was proposed for truss structure optimization. The fruit fly optimization algorithm was a novel swarm intelligence algorithm. In the standard fruit fly optimization algorithm, it is difficult to solve the high-dimensional nonlinear optimization problem and easy to fall into the local optimum. To overcome the shortcomings of the basic fruit fly optimization algorithm, the immune algorithm self–non-self antigen recognition mechanism and the immune system learn–memory–forgetting knowledge processing mechanism were employed. The improved algorithm was introduced to the structural optimization. Optimization results and comparison with other algorithms show that the stability of improved fruit fly optimization algorithm is apparently improved and the efficiency is obviously remarkable. This study provides a more effective solution to structural optimization problems.

Efficacy of Beef Crust from Dry-Aged Beef Loins as Novel Functional Ingredient

ObjectivesDry-aging is a traditional butchery process, but currently, it has been more practiced in a niche market as a value-adding process. As dry aging involves placing primal/sub-primal sections under a controlled refrigerated condition without packaging materials, the formation of the dried surface (crust) is inevitable due to moisture evaporation. A considerable portion of the crust is to be trimmed off as waste, which is one of the major drawbacks of dry aging. While the beef crust may still exert its functional/technological properties, no information is available regarding the efficacy of utilizing beef crust as a potential food ingredient. Thus, the objective of this study was to determine the physicochemical and functional properties of beef crust from dry-aged beef loins processed under various dry-aging conditions.Materials and MethodsPaired bone-in beef shell loins from 13 cull cow carcasses (C-maturity) were obtained at 5d postmortem, divided into 2 sections and assigned to four aging treatments: wet-aging (WA), dry-aging (DA), dry-aging in water-permeable bag (DWA) and dry-aging under UV-light (UDA; 5 J/s/12 h per day). Beef sections were aged for 28d at 2°C, 65% RH and 0.8 m/s air flow. After aging, the crusts were separated and beef samples from WA and initial (aged for 0 d, INI) were collected for comparison. In three independent batches, the crust samples were freeze-dried and powdered. Moisture contents of samples were measured before lyophilization. Emulsification capacity, salt-soluble protein solubility, emulsifying activity index, and surface hydrophobicity were determined. CIE* color attributes, lipid oxidation (TBARS), and protein oxidation (carbonyl and thiol contents) were measured. The PROC MIXED procedure of SAS was used to analyze the data. Significance level of least square means was set at the confidence level of 95%.ResultsBeef crusts from dry-aged loins had lower moisture contents compared with WA and INI (P < 0.05), while no difference between dry-aging methods was found (P > 0.05). The crust samples had lower L* and chroma values than WA and INI (P < 0.05). Emulsification capacity of DA, DWA, and UDA were lower than WA and INI (P < 0.05), with DA being the lowest (P < 0.05). In general, the crust had a significantly higher salt-soluble protein solubility compared to WA, while no difference between crusts and INI was found (P > 0.05). For emulsifying activity index, DA exhibited higher values than DWA, UDA and WA (P < 0.05), and was comparable to INI (P > 0.05). DA and INI had higher surface hydrophobicity values than the other samples, which could possibly explain the results of emulsifying activity index. A trend of higher TBARS values was found in all dry-aged crusts than WA and INI (P = 0.0688). The crust from dry aging had a higher carbonyl content compared to WA (P < 0.05), while thiol contents were not affected by the treatment (P = 0.1092).ConclusionThe results from the current study indicate that beef crusts exert its functional and technological properties, which could be superior or at least equivalent to wet-aged or unaged beef samples. This study provides novel insight into the potential feasibility and utilization of beef crust from dry-aged beef as a value-added product. Further studies determining the practical application of beef crust as a novel food ingredient (e.g., meat emulsion or beef patty) are in progress.

A Traditional Chinese Patent Medicine ZQMT for Neovascular Age- Related Macular Degeneration: A Multicenter Randomized Clinical Trial

BACKGROUND

Anti-VEGF agent ranibizumab has been extensively used as a standard treatment for wet AMD. We investigated whether traditional Chinese medicine could serve as a complementary therapy for this disease.

METHODS

144 patients with neovascular age-related macular degeneration received either intravitreal ranibizumab treatment as needed plus placebo or intravitreal ranibizumab treatment as needed plus an FDA approved traditional Chinese patent medicine named ZQMT. Both groups received treatment for 24 weeks. The primary outcome was the mean change of visual acuity at week 24 as compared to the baseline.

RESULTS

We found that intravitreal ranibizumab treatment plus ZQMT was non-inferior to the treatment with intravitreal ranibizumab alone in improving visual acuity scores at week 24 with patients in both groups who gained substantial numbers of letters. In addition, we found that ZQMT treatment resulted in significant improvements in reducing retinal hemorrhage, fluid, and lesion size. Importantly, administration of ZQMT reduced the number of needed ranibizumab injections (P<0.0001, analysis of variance) in wet AMD patients leading to a significant reduction of drug cost.

CONCLUSION

The combinatory therapy of ranibizumab and traditional Chinese patent medicine ZQMT had equivalent effects on visual acuity improvement and safety profiles as the ranibizumab treatment alone. Ranibizumab injections coupled with ZQMT offer therapeutic advantages in terms of reduction of retinal lesions and ease the financial burden of patients undergoing treatment by reducing the frequency of necessary ranibizumab injections.

OS6.2 Loss of CYP46A1 directs altered cholesterol homeostasis and opens therapeutic opportunities for glioblastoma

BACKGROUND

Dysregulated cholesterol metabolism is a hallmark of many cancers, including glioblastoma (GBM), but its role in disease progression is not well understood. Here, we identified cholesterol 24-hydroxylase (CYP46A1), a brain-specific enzyme responsible for elimination of cholesterol through conversion of cholesterol to 24(S)-hydroxycholesterol (24OHC), as one of the most dramatically dysregulated cholesterol metabolism genes in GBM.

MATERIAL AND METHODS

Molecular and clinical data was obtained from publicly genomic databases. Immunohistochemistry was applied to assess protein levels of CYP46A1 in primary GBM samples. Lentiviral constructs expressing CYP46A1 were transduced into LN229, LN18 and primary GBM GSCs for functional assays carried out in vitro and in vivo in an orthotopic xenograft model. RNA-seq was performed to identify downstream targets of 24OHC.

RESULTS

CYP46A1 was significantly decreased in GBM samples compared to normal brain tissue. Reduced CYP46A1 expression was associated with increasing tumour grade and poor prognosis in GBM patients. Ectopic expression of CYP46A1 suppressed cell proliferation and in vivo tumour growth by increasing 24OHC levels. Treatment of GBM cells with 24OHC suppressed tumour growth through regulation of LXR and SREBP signalling. Efavirenz (EFV), an activator of CYP46A1 with BBB penetration, inhibited GBM growth in vivo.

CONCLUSION

Our findings demonstrate that CYP46A1 is a critical regulator of cellular cholesterol in GBM and that the CYP46A1/24OHC axis is a potential therapeutic target.

P11.57 A 3D brain organoid coculture system delineates the invasive cell components in glioblastoma

BACKGROUND

Glioblastoma (GBM) cell infiltration into the surrounding normal brain tissue where the blood brain barrier is intact, represents a major problem for clinical management and therapy. There is a vital need to understand the molecular mechanism that drives tumor cell invasion into the surrounding brain. We have previously developed a 3D coculture model where mature brain organoids are confronted with patient-derived glioblastoma stem-like cells (GSCs). In such a coculture system, single cell invasion into the normal brain tissue can be studied in detail. Here, we first describe in detail, by RNA-seq and proteomics, the differentiation of various neural cell lineages into mature brain organoids as well as their cellular organization. By real-time confocal microscopy and imaging analyses we also determine the speed of tumor cell invasion into the brain. Finally, we used this coculture system to delineate in detail the cellular heterogeneity within the invasive compartment and their gene expression.

MATERIAL AND METHODS

Immunohistochemistry and immunofluorescence were used to determine the expression and distribution of mature neurons, astrocytes, oligodendrocytes, and microglia within the brain organoids. Proteomics and RNA-seq were used to determine brain development ex-vivo. To assess the clonal composition of the GBM-invasive compartment, we used cellular (RGB) barcoding technology. By advanced imaging, we tracked in real time the invasion of barcoded cells into the brain organoids. Finally, we isolated invasive cells and non-invasive cells from our coculture system and used single cell sequencing to analyze their gene expression profiles and molecular phenotypes.

RESULTS

Immunohistochemistry and immunofluorescence showed that brain organoids, after 21 days of differentiation, display a highly cellular and structural organization. RNA-seq and proteomics, performed at different time points of organoid differentiation, revealed that the brain organoids develop into mature brain structures after 21 days as verified by a comparative analysis to normal rat brain development in vivo. Imaging analyses showed that multiple clones within the GBMs have the capacity to invade into the brain tissue with an average speed of ~ 20 μm/h. RNA-sec analysis of the invasive compartment revealed a strong up-regulation of genes and pathways associated with anaerobic respiration (glycolysis).

CONCLUSION

We describe a highly standardized brain organoid coculture system that can be used to delineate GBM invasion ex-vivo. We demonstrate that this platform can be used to unravel the mechanisms that drive GBM invasion into the normal brain.

[The correlation studies between ambulatory blood pressure and OSA in non-hypertensive patients]

Objective:To discuss the changes and rules of nighttime blood pressure in obstructive sleep apnea(OSA) patients without hypertension.Method:Eighty-nine non-hypertensive patients whose office blood pressure was lower than 130/85 mmHg and diagnose with OSA by PSG in sleep monitoring room were choose as the research group.Forty non-hypertensive and polyp of vocal cord or vocal nodules patients whose office blood pressure was lower than 130/85 mmHg and diagnose with non-OSA by PSG were choose as matched group.All the patients were in treatment in our hospital from December 2017 to June 2018. All the patients got PSG,and the same time got the ambulatory blood pressure monitoring based on pulse transit time all night.Compared the mean value of systolic blood pressure,the mean value of diastolic blood pressure.Higher than 12 mmHg blood pressure rise index,the mean rise in blood pressure. The highest increase in blood pressure, maximum systolic pressure between the study group and the marched group all night.Result:The difference of all the test index between the study group and the marched group was significant(P<0.05).In OSA patients.The difference of all the test index between the severe OSA group and the mild OSA group or the moderate OSA group was significant(P<0.05).In severe OSA group.The difference between the fluctuation of blood pressure caused by respiratory events and spontaneous blood pressure fluctuation was significant(P=0.004).The difference of the mean value of diastolic blood pressure(P=0.032) blood pressure rise index(P=0.037) the mean rise in blood pressure(P=0.045) between age 55 or older patients and under 55years old patients.Conclusion:Ambulatory blood pressure monitoring synchronizatied in PSG contribute to the early diagnosis and prevention of hypertension in OSA patients.