Improvement of nonreciprocal unconventional photon blockade by two asymmetrical arranged atoms embedded in a cavity

We improve the nonreciprocal unconventional photon blockade (UCPB) in an asymmetrical single-mode cavity with two asymmetrical arranged two-level atoms (TLAs) where cavity and atom spatial symmetry breakings are involved in. In order to get direction-dependent UCPB in asymmetrical system, we deduce two restrictions of frequency and intensity through the steady solution of the cavity QED system analytically. The former restriction is exactly the same as that of a single-atom case, and the latter restriction combined with both spatial asymmetries. Controllable UCPB in this model shows an improving nonreciprocal UCPB with wider operating regime which is promoted by two asymmetrical arranged atoms. The most innovation of this work is that the contributions of two spatial symmetry breakings are figured out clearly and they play different roles in nonreciprocal UCPB. The cavity spatial symmetry breaking and weak nonlinearity are essential to quantum nonreciprocity, while the atoms spatial symmetry is not and it only can promote such nonreciprocal UCPB. Our findings show a prospective access to manipulate quantum nonreciprocity by a couple of atoms.

Abstract P2-13-35: Pyrotinib combined with fulvestrant in women with hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer: A single-arm phase II clinical trial

Background: HR+/HER2+ breast cancer is a unique molecular subtype of HER2+ breast cancer, which is characterized by mild biological behavior and is sensitive to endocrine therapy. Although the standard treatment for HR+/HER2+ metastatic breast cancer is chemotherapy combined with anti-HER2 therapy, this combination is not ideal for patients because of the heavy side effects of chemotherapy. Previous studies have shown that endocrine therapy combined with anti-HER2 therapy can also bring survival benefits to these patients. However, due to the limitations of previous treatment, the optimal combination mode of endocrine and anti-HER2 therapies has not been found. Pyrotinib is the most efficient pan-HER tyrosine kinase inhibitor (TKI) with irreversible blocking of HER2, while fulvestrant is the most potent estrogen receptor (ER) inhibitor. Previous cell experiments showed the cross-talk between ER and HER2 receptor pathways, indicating that the two signal pathways were important mechanisms of drug resistance for each other. Further research showed that ER inhibitor fulvestrant had synergistic effect with HER2 inhibitor pyrotinib. Therefore, we firstly explored the efficacy and safety of pyrotinib combined with fulvestrant in the treatment of HR+/HER2+ metastatic breast cancer.Methods: Eligible patients had histologically confirmed HR+/HER2+ metastatic breast cancer with no more than one line of prior treatment for metastatic disease. Those with central nervous system metastases or any prior HER2 TKI were excluded. Patients were treated with oral pyrotinib 400 mg once daily plus intramuscular injection of fulvestrant 500 mg on days 1, 15, and 29, and once every 28 days thereafter. The primary endpoint was progression-free survival (PFS), as assessed by the data and safety monitoring committee. Secondary endpoints included objective response rate, disease control rate (DCR), overall survival and safety. We also explored the efficacy of subgroups defined by different gene signatures, which were identified using comprehensive genomic variation profiling (FoundationOne CDx). This study is registered with ClinicalTrials.gov, NCT04034589.Results: From July 9, 2019 to June 20, 2021, 34 patients were enrolled; 19 (55.8%) patients had visceral metastases. Of 14 patients with measurable disease according to RECIST 1.1, seven (50%) achieved objective response. The DCR was 84.6%. Nine of the 34 included patients discontinued treatment because of disease progression, and PFS was immature. Twelve patients had available data of comprehensive genomic variation profiling, and the results showed that six patients had PIK3CA mutation, ten had TP53 mutation, and 11 had ErbB2 overexpression. The most common treatment-related adverse events were diarrhea and fatigue. The incidence of grade 3 or greater diarrhea was 12.1% (4/33) in patients with available safety data. No patient discontinued treatment because of adverse events. Conclusions: The combination of pyrotinib and fulvestrant was convenient and effective with manageable toxicity, which may offer a chemotherapy-free alternative treatment option for patients with HR+/HER2+ metastatic breast cancer.

Citation Format: Ying Wang, Jianli Zhao, Zhongyu Yuan, Guorong Zou, Haiyan Li, Linxiaoxiao Ding, Yaping Yang, Jie Chai, Donggeng Liu, Herui Yao. Pyrotinib combined with fulvestrant in women with hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer: A single-arm phase II clinical trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-13-35.

Case Report: A Novel Homozygous Mutation in MYF5 Due to Paternal Uniparental Isodisomy of Chromosome 12 in a Case of External Ophthalmoplegia With Rib and Vertebral Anomalies

External ophthalmoplegia with rib and vertebral anomalies (EORVA) is characterized by congenital nonprogressive external ophthalmoplegia, ptosis, scoliosis, torticollis, vertebral, and rib anomalies, caused by homozygous mutations in the myogenic factor 5 gene (MYF5) located on chromosome 12q21.31. Uniparental disomy (UPD) is a rare inheritance of a pair of chromosomes originating from only one parent. This study describes a case of an 8-year-old boy with ptosis, scoliosis, and dysmorphic hypoplastic ribs with fusion anomalies. Trio-based exome sequencing (trio-ES) identified a novel homozygous mutation c.191delC (p.Ala64Valfs*33) in MYF5 in the proband, with the father being heterozygous and the mother wild-type, as verified by Sanger sequencing. UPD identified from trio-ES variant call format data suggested the possibility of paternal UPD of chromosome 12 (UPD12pat) in the proband, further confirmed to be a complete isodisomy type of UPD by genome-wide single nucleotide polymorphism array. MYF5 was significantly downregulated by 69.14% (**p < 0.01) in HeLa cells transfected with mutant MYF5 containing c.191delC compared to those transfected with the wild-type MYF5, resulting in a truncated protein with a size of ∼20 kDa. In conclusion, this study identified a novel homozygous mutation in MYF5, broadening the genetic spectrum of EORVA and further deepening the understanding of this rare disease.

G protein-coupled receptor 17 restricts rabies virus replication via BAK-mediated apoptosis

Rabies, caused by rabies virus (RABV), is an ancient zoonotic disease that significantly affects human and animal health throughout the world. RABV causes acute encephalitis in mammals with a high fatality rate in developing countries. G protein-coupled receptor 17 (GPR17) is a vital gene in the central nervous system (CNS) that plays important roles in demyelinating diseases and ischemia brain. However, it is still unclear whether GPR17 participates in the regulation of RABV infection. Here, we found that upregulation or activation of GPR17 can reduce the virus titer; conversely, the inactivation or silence of GPR17 led to increased RABV replication in N2a cells. The recombinant RABV expressing GPR17 (rRABV-GPR17) showed reduced replication capacity compared to the parent virus rRABV. Moreover, overexpression of GPR17 can attenuate RABV pathogenicity in mice. Further study demonstrated that GPR17 suppressed RABV replication via BAK-mediated apoptosis. Our findings uncover an unappreciated role of GPR17 in suppressing RABV infection, where GPR17 mediates cell apoptosis to limit RABV replication and may be an attractive candidate for new therapeutic interventions in the treatment of rabies.

Detection of low-level parental somatic mosaicism for clinically relevant SNVs and indels identified in a large exome sequencing dataset

BACKGROUND

Due to the limitations of the current routine diagnostic methods, low-level somatic mosaicism with variant allele fraction (VAF) < 10% is often undetected in clinical settings. To date, only a few studies have attempted to analyze tissue distribution of low-level parental mosaicism in a large clinical exome sequencing (ES) cohort.

METHODS

Using a customized bioinformatics pipeline, we analyzed apparent de novo single-nucleotide variants or indels identified in the affected probands in ES trio data at Baylor Genetics clinical laboratories. Clinically relevant variants with VAFs between 30 and 70% in probands and lower than 10% in one parent were studied. DNA samples extracted from saliva, buccal cells, redrawn peripheral blood, urine, hair follicles, and nail, representing all three germ layers, were tested using PCR amplicon next-generation sequencing (amplicon NGS) and droplet digital PCR (ddPCR).

RESULTS

In a cohort of 592 clinical ES trios, we found 61 trios, each with one parent suspected of low-level mosaicism. In 21 parents, the variants were validated using amplicon NGS and seven of them by ddPCR in peripheral blood DNA samples. The parental VAFs in blood samples varied between 0.08 and 9%. The distribution of VAFs in additional tissues ranged from 0.03% in hair follicles to 9% in re-drawn peripheral blood.

CONCLUSIONS

Our study illustrates the importance of analyzing ES data using sensitive computational and molecular methods for low-level parental somatic mosaicism for clinically relevant variants previously diagnosed in routine clinical diagnostics as apparent de novo.

Green Tea Catechins Attenuate Human Primary Pterygium Cell Survival and Migration Via Modulation of ERK p42/p44 and p38 Pathways

Pterygium belongs to an ocular surface disease with triangular-shaped hyperplastic growth, characterized by conjunctivalization, inflammation, and connective tissue remodeling. We previously demonstrated neoplastic-like properties of pterygium cells. Green tea catechin, (-)-epigallocatechin gallate (EGCG), has been shown to possess antitumorigenic properties; herein, we aimed to determine the effects of green tea catechins on human primary pterygium cell survival and migration and compared to that on patients' conjunctival cells. Both human primary pterygium and conjunctival cells expressed EGCG receptor, the 67 kDa laminin receptor. Seven-day treatment of green tea extract (Theaphenon E; 16.25 μg/mL) and EGCG (25 μM) attenuated pterygium cell proliferation by 16.78% (p < 0.001) and 24.09% (p < 0.001) respectively, without significantly influencing conjunctival cells. Moreover, green tea extract (16.25 μg/mL) and EGCG (25 μM) treatments also hindered pterygium cell migration by 35.22% (p < 0.001) and 25.20% (p = 0.019), respectively, but not conjunctival cells. Yet, green tea extract and EGCG treatments did not significantly induce pterygium cell apoptosis. Furthermore, green tea extract and EGCG treatments significantly increased the phosphorylation of p38 protein but reduced the phosphorylation of p42/p44 protein in pterygium cells. In summary, this study revealed that green tea extract and EGCG attenuated human primary pterygium cell survival and migration in vitro without damaging conjunctival cells, suggesting a novel potential therapeutic approach for primary pterygium treatment.

Lacticaseibacillus casei LH23 Suppressed HPV Gene Expression and Inhibited Cervical Cancer Cells

Microbiota of lower female reproductive tract is special in its microorganism composition with Lactobacillus as the predominant bacteria. A few of Lactobacillus species have been identified to benefit the inhibition of inflammatory and malignant diseases. Lacticaseibacillus casei LH23 is a strain isolated from traditional fermented food and had been demonstrate to ameliorate DSS-induced colitis in mice. In the present study, effects of Lacticaseibacillus casei LH23 on cervical cancer cells were investigated. Supernatants of lysates and heat-inactivated Lacticaseibacillus casei LH23 were found to inhibit the expression of human papillomavirus genes E6/E7 which is the main causative factor of cervical cancer. With MTT, EdU staining, and TUNEL staining assays, Lacticaseibacillus casei LH23 was shown to suppress the proliferation and induced the apoptosis of cervical cancer cells. Additionally, with wound-healing and Western-blot assays, Lacticaseibacillus casei LH23 was shown to slowdown the migration of cervical cancer cells and altered the expression of metastasis-related genes. These results demonstrated the anti-cervical cancer potential of Lacticaseibacillus casei LH23.

Contribution of uniparental disomy in a clinical trio exome cohort of 2675 patients

Background

Uniparental disomy (UPD) is the inheritance of two homologous chromosomes from the same parent. UPD may result in clinical phenotypes when occurring on chromosomes with specific imprinting pattern, when leading to homozygosity of a deleterious recessive allele inherited from one carrier parent, or when associated with a mosaic aneuploidy. Due to the importance of UPD in genetic disease etiology, UPD analysis has started to be implemented in the context of exome sequencing (ES) or genome sequencing.

Methods

We developed an in‐house algorithm TRIPS (Trio Parentage/UPD Studies) to identify UPD events in trio ES cases. This method identifies regions with uniparental inheritance by utilizing the trio genotyping data obtained from the concurrent SNP array to delineate the parental origin of the SNPs in the proband.

Results

We identified 16 UPD events from 2675 ES trios. Among those, four events led to imprinting disorders, seven unmasked a pathogenic/likely pathogenic variant in a recessive disease gene, and two were consistent with a mosaic genome wide paternal UPD pattern. Twelve of these UPD events directly contributed to the molecular diagnosis of the patients.

Conclusion

Our study demonstrated the contribution of UPD to the molecular diagnosis in one clinical ES cohort, thus UPD analysis should be incorporated into routine clinical ES interpretation.

Interaction of two quantum dots mediated by edge modes of coupled-cavity arrays

Topological photonics is a hot topic in recent years. We combine it with the quantum optics and explore the dynamics of two quantum dots (QDs) separated by the finite coupled-cavity arrays (CCAs). The finite CCAs possessing the alternating hopping strengths will lead to the existence of the topological protected edge modes, also called zero energy modes, when the boundaries leave the weak hopping at two ends. Due to the two edge modes, i.e., symmetric and antisymmetric, with nearly degenerate frequencies, the dynamics of two QDs coupled to the cavities at both ends exhibit complicated behaviors. When the CCAs are composed of a large number of cavities, there are two kinds of phenomena: if the coupling between QDs and cavity is weak, two edge modes will cancel each other out and isolate two QDs deeply; if the coupling between QDs and cavities is large compared with hopping strength, the edge mode disappears and two QDs can be connected through extend modes. Importantly, when the CCAs are formed by a small number of cavities, energy can be transferred to each other between two QDs through the edge modes. Such energy transfer is topologically protected, and the period is long and easily controlled. We also investigate the effects of topologically protected quantum entangled states on such system and find that the quantum entanglement can be well kept or generated for appropriate choices of system parameters and initial states. The investigations enrich the manifestation of topological physics and are helpful to apply the topological protection to quantum computation and quantum communication.

Magnetic resonance imaging radiomics signatures for predicting endocrine resistance in hormone receptor-positive non-metastatic breast cancer

Background

One-third of patients with hormone receptor (HR)-positive breast cancers fail to respond to hormone therapy, and some patients even progress within two years of adjuvant endocrine therapy (ET) toward primary endocrine resistance. However, there is no effective way to predict endocrine resistance.

Objective

To build a model that incorporates the radiomic signature of pretreatment magnetic resonance imaging (MRI) with clinical information to predict endocrine resistance.

Methods

Clinical data of non-metastatic breast cancer patients diagnosed between May 1, 2015 and December 31, 2018 and preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were retrospectively collected from three hospitals in China. The significant clinicopathological characteristics and radiomic signatures were included in multivariable logistic regression to establish a combined model to predict endocrine resistance in the training set, and validate the internal and external validation set.

Results

A total of 744 female non-metastatic breast cancer patients from three hospitals in China were included. In the training cohort, the AUC of the Radiomic-Clinical combined model to predict endocrine resistance was 0.975, which was higher than clinical model (0.849), IHC4 model (0.682) and similar as radiomic model (0.941). Also, the AUC of the combined model in the internal (0.921) and external validation cohort (0.955) were higher than clinical model and IHC4 model. The sensitivity of combined model was higher than radiomic alone, and got the best thresholding of the AUC.

Conclusion

This study developed and validated a pretreatment multiparametric MRI-based radiomic-clinical combined model and showed good performance in predicting endocrine resistance.

•

This study first established a model to predict endocrine resistance in non-metastatic breast cancer based on radiomic.

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This model was a combined model that contain multiparametric MRI radiomics features and clinical features.

•

The AUC of the combined model to predict endocrine resistance was 0.975 , with great potential in clinical applications.

[Two kinds of lateral retinacular release for lateral patellar compression syndrome:a retrospective comparative study]

Objective: To compare the clinical effects of arthroscopic lateral retinacular proximal release and "L" type release for lateral patellar compression syndrome. Methods: Sixty four lateral patellar compression syndrome (LPCS) patients were recruited who had arthroscopic surgery during September 2004 to January 2019 at Department of Sports Medicine,Peking University Third Hospital by the same group of doctors and a retrospective comparative study was conducted accordingly. Among them,24 cases underwent the traditional proximal release of lateral patellar retinaculum (traditional group),including 7 males and 17 females with an age of (42.9±14.6)years(range:23 to 72 years); 40 cases were treated with novel lateral retinacular release of "L" type release revised based on the previous experiences (novel group), consisting of 12 males and 28 females with an age of (54.9±13.1) years (range:28 to 76 years).All the patients participated surveys for the visual analogue scale (VAS),Lysholm score and International Knee Documentation Committee (IKDC) knee function subjective evaluation before and after the operation. The comparison of scores within groups was performed by Wilcoxon test,and comparison between groups was performed by Mann-Whitney U test and Chi-square test. Multivariate analysis was used to evaluate the related factors affecting each score. Results: The follow-up durations of traditional group and novel group were (12.6±1.0) years (range:11.7 to 15.3 years) and (2.2±1.0)years(range:1.0 to 4.4 years) respectively. At the last follow-up,VAS(0(1.0)to 6.0(2.0),Z=-5.471,P<0.01),Lysholm score(98.0(10.0)to 48.0(40.0),Z=-5.511,P<0.01),and IKDC score(82.8(11.2)to 37.4(18.5),Z=-5.444,P<0.01) in novel group were statistically significantly improved,and the postoperative excellent rate of Lysholm score was 97.5% in general. There was no significant difference in the changes of the three scores (P>0.05) between the traditional group and the novel group. However,20.8% (5/24)patients in the traditional group reported significant weakness of the knee extension after surgery,while no such complain was received in the novel group (P<0.01).The results of univariate analysis showed that surgical method was a related factor affecting the changes of VAS before and after surgery (P<0.05).The results of multivariate analysis showed that whether or not with osteoarthritis and operation type were independent factors affecting the changes of Lysholm and IKDC scores (P<0.05). Conclusions: The long-term effect of arthroscopic lateral retinacular release for the treatment of LPCS is satisfactory. Compared with the traditional proximal release surgery,the "L" type release can effectively avoid the complication of significant weakness of the knee extension significantly.

Group membership moderates the process of making trust judgments based on facial cues

Trust is a foundation of interpersonal communication. Faces have a significant impact on trust judgments, and separate research demonstrates that group membership also influences trust judgments. However, it remains unclear whether and how group membership moderates the effect of face trustworthiness on trust judgments and investment decisions. In the present research, two experiments were conducted to explore the moderating effect of group membership (i.e., in-group vs. out-group) on perceptions of facial trustworthiness and trust judgments. Results showed that participants invested significantly more money on trials with trustworthy faces than trials with untrustworthy faces. Additionally, there was a significant interaction between group membership and facial trustworthiness; the investment difference between trustworthy faces and untrustworthy faces was greater for trials with in-group member faces than out-group member faces. These findings indicate that top-down and bottom-up cues jointly influence behavioral decisions.

Murine Ifit3 restricts the replication of Rabies virus both in vitro and in vivo

Rabies virus (RABV) infection can initiate the host immune defence response and induce an antiviral state characterized by the expression of interferon (IFN)-stimulated genes (ISGs), among which the family of genes of IFN-induced protein with tetratricopeptide repeats (Ifits) are prominent representatives. Herein, we demonstrated that the mRNA and protein levels of Ifit1, Ifit2 and Ifit3 were highly increased in cultured cells and mouse brains after RABV infection. Recombinant RABV expressing Ifit3, designated rRABV-Ifit3, displayed a lower pathogenicity than the parent RABV in C57BL/6 mice after intramuscular administration, and Ifit3-deficient mice exhibited higher susceptibility to RABV infection and higher mortality during RABV infection. Moreover, compared with their individual expressions, co-expression of Ifit2 and Ifit3 could more effectively inhibit RABV replication in vitro. These results indicate that murine Ifit3 plays an essential role in restricting the replication and reducing the pathogenicity of RABV. Ifit3 acts synergistically with Ifit2 to inhibit RABV replication, providing further insight into the function and complexity of the Ifit family.

PPP3CA truncating variants clustered in the regulatory domain cause early-onset refractory epilepsy

PPP3CA encodes the catalytic subunit of calcineurin, a calcium-calmodulin-regulated serine-threonine phosphatase. Loss-of-function (LoF) variants in the catalytic domain have been associated with epilepsy, while gain-of-function (GoF) variants in the auto-inhibitory domain cause multiple congenital abnormalities. We herein report five new patients with de novo PPP3CA variants. Interestingly, the two frameshift variants in this study and the six truncating variants reported previously are all located within a 26-amino acid region in the regulatory domain (RD). Patients with a truncating variant had more severe earlier onset seizures compared to patients with a LoF missense variant, while autism spectrum disorder was a more frequent feature in the latter. Expression studies of a truncating variant showed apparent RNA expression from the mutant allele, but no detectable mutant protein. Our data suggest that PPP3CA truncating variants clustered in the RD, causing more severe early-onset refractory epilepsy and representing a type of variants distinct from LoF or GoF missense variants.

Neoadjuvant everolimus plus letrozole versus fluorouracil, epirubicin and cyclophosphamide for ER-positive, HER2-negative breast cancer: a randomized pilot trial

Background

Here we evaluated the feasibility, efficacy, tolerability, and treatment-mediated immune modulation of neoadjuvant everolimus plus letrozole versus chemotherapy in treating postmenopausal patients with ER-positive, HER2-negative breast cancer.

Methods

Postmenopausal women with ER-positive, HER2-negative breast cancer who had a primary tumor > 2 cm or positive axillary lymph node(s) proofed by biopsy were randomly (1,1) enrolled to receive neoadjuvant everolimus plus letrozole for 18 weeks or fluorouracil, epirubicin plus cyclophosphamide (FEC) for 6 cycles before surgery. Primary outcome was feasibility of the trial. Secondary outcome included ultrasound response rate, pathological complete response rate, breast-conserving surgery rate, toxicities, treatment-mediated immune modulation and biomarkers.

Results

Forty patients were randomized. Completion rate was 90.0% in the neoadjuvant endocrine therapy (NET) arm but 70.0% in the neoadjuvant chemotherapy (NAC) arm. The ultrasound response rate was 65.0% in NET arm and 40.0% in FEC arm, respectively. In terms of the adverse events, clearly favored NET arm. Everolimus plus letrozole increased the ratio of peripheral Tregs to CD4⁺ T cells and tumor PD-L1 expression, and decreased Ki67 index and tumor-infiltrating Tregs, and patients with a greater increase of tumor-specific CTLs showed more sensitive to NET.

Conclusion

This pilot trial showed that neoadjuvant everolimus plus letrozole might achieve a favorable ultrasound response rate with low toxicities in treating postmenopausal ER-positive, HER2-negative breast cancer patients. Everolimus plus letrozole might have positive antitumoral immunity effects. Further large randomized controlled trials are needed to confirm our findings.

Trail registration

A Trial of Neoadjuvant Everolimus Plus Letrozole Versus FEC in Women With ER-positive, HER2-negative Breast Cancer, registered on 07/04/2016 and first posted on 18/04/2016, NCT02742051.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-021-08612-y.

Phase-Changing in Graphite Assisted by Interface Charge Injection

Among many phase-changing materials, graphite is probably the most studied and interesting: the rhombohedral (3R) and hexagonal (2H) phases exhibit dramatically different electronic properties. However, up to now the only way to promote 3R to 2H phase transition is through exposure to elevated temperatures (above 1000 °C); thus, it is not feasible for modern technology. In this work, we demonstrate that 3R to 2H phase transition can be promoted by changing the charged state of 3D graphite, which promotes the repulsion between the layers and significantly reduces the energy barrier between the 3R and 2H phases. In particular, we show that charge transfer from lithium nitride (α-Li₃N) to graphite can lower the transition temperature down to 350 °C. The proposed interlayer slipping model potentially offers the control over topological states at the interfaces between different phases, making this system even more attractive for future electronic applications.

A new nomogram for predicting the malignant diagnosis of Breast Imaging Reporting and Data System (BI-RADS) ultrasonography category 4A lesions in women with dense breast tissue in the diagnostic setting

Background

Biopsy has been recommended for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions. However, the malignancy rate of category 4A lesions is very low (2-10%). Therefore, most biopsies of category 4A lesions are benign, and the results will generally cause additional health care costs and patient anxiety.

Methods

A prediction model was developed based on an analysis of 418 BI-RADS ultrasonography (US) category 4A patients at Sun Yat-sen Memorial Hospital. Univariate and multivariate logistic regression analyses were applied to identify significant variables for inclusion in the final nomogram. The predictive accuracy and discriminative ability were evaluated using the concordance index (C-index) and calibration curves. An independent cohort of 97 patients from the Second Affiliated Hospital of Guangzhou Medical University was used for external validation.

Results

The independent risk factors from the multivariate analysis for the training cohort were family history of breast cancer (OR =4.588, P=0.004), US features [margin (OR =2.916, P=0.019), shape (irregular vs. oval, OR =2.474, P=0.044; round vs. oval, OR =1.935, P=0.276), parallel orientation vs. not parallel (OR =2.204, P=0.040)], low suspicious lymph nodes (OR =7.664, P=0.019), and suspicious calcifications on mammography (MG) (OR =6.736, P=0.001). The C-index was good in the training [0.813, 95% confidence interval (95% CI), 0.733 to 0.893] and validation cohorts (0.765, 95% CI, 0.584 to 0.946). The calibration curves showed optimal agreement between the nomogram prediction and actual observations for the probability of malignancy. Also, the cutoff score was set to 100 for discriminating high and low risk. The model performed well in discerning different risk groups.

Conclusions

We developed a well-discriminated and calibrated nomogram to predict the malignancy of BI-RADS US category 4A lesions in dense breast tissue, which may help clinicians identify patients at lower or higher risk.

Heterozygous variants in SPTBN1 cause intellectual disability and autism

Spectrins are common components of cytoskeletons, binding to cytoskeletal elements and the plasma membrane, allowing proper localization of essential membrane proteins, signal transduction, and cellular scaffolding. Spectrins are assembled from α and β subunits, encoded by SPTA1 and SPTAN1 (α) and SPTB, SPTBN1, SPTBN2, SPTBN4, and SPTBN5 (β). Pathogenic variants in various spectrin genes are associated with erythroid cell disorders (SPTA1, SPTB) and neurologic disorders (SPTAN1, SPTBN2, and SPTBN4), but no phenotypes have been definitively associated with variants in SPTBN1 or SPTBN5. Through exome sequencing and case matching, we identified seven unrelated individuals with heterozygous SPTBN1 variants: two with de novo missense variants and five with predicted loss-of-function variants (found to be de novo in two, while one was inherited from a mother with a history of learning disabilities). Common features include global developmental delays, intellectual disability, and behavioral disturbances. Autistic features (4/6) and epilepsy (2/7) or abnormal electroencephalogram without overt seizures (1/7) were present in a subset. Identification of loss-of-function variants suggests a haploinsufficiency mechanism, but additional functional studies are required to fully elucidate disease pathogenesis. Our findings support the essential roles of SPTBN1 in human neurodevelopment and expand the knowledge of human spectrinopathy disorders.

Ischemia Injury induces mPTP opening by reducing Sirt3

Mitochondrial permeability transition pore (mPTP) opening is critical to mitochondrial apoptosis during ischemic injury. Sirtuin 3 (Sirt3) is a mitochondrial deacetylase known to play a major role in stress resistance and cell death. Our previous studies have shown that Sirt3 activates superoxide dismutase 2 and forkhead box O3a to reduce cellular reactive oxygen species. However, it is unclear the interaction between Sirt3 and mPTP and the roles they play in ischemic stroke. We used the middle cerebral artery occlusion (MCAO) model, a mouse model of stroke, to examine Sirt3 and mPTP-related protein levels. We then applied lentivirus packaged Sirt3 overexpression in HT22 cells, a mouse hippocampal neuronal cell line, to investigate the underlying mechanism. We found Sirt3 protein level was decreased in the penumbra area in MCAO mice, along with an increase in mPTP related proteins, namely voltage-dependent anion channel 1 (VDAC1) and adenine nucleotide translocator 1 (ANT1). Sirt3 overexpression suppressed the increase in VDAC1, ANT1 and cleaved caspase 3 that were induced by the serum and glucose deprivation (SGD) condition. Our studies suggest that ischemic injury induced mPTP opening and apoptosis by reducing Sirt3. It helps to identify new therapeutic targets for ischemic stroke.

Chiral interaction of an atom in a sandwiched waveguide

The chiral interaction between light and matter is mainly caused by the spin-momentum locking and makes the chiral quantum optics enter a vigorous development stage. Here, we explore the condition of the perfect chiral interaction between an atom possessing circular dipole and the surface plasmon polariton (SPP) mode. The realization of the perfect chiral interaction must satisfy the following two conditions at the same time. First, the SPP mode should possess the transverse circular polarization; and second, the atom decays mainly into the SPP mode, while the decay through other channel can be ignored. In this paper, we adopt a simple but effective structure to satisfy both of requirements, which is the sandwiched waveguide made of metal. We found that the transverse circular polarization of SPP mode might be achieved within the structure possessing multiple interfaces instead of the interface separating two semi-infinite materials. In our model, the decay rate into SPP mode overwhelms that through traveling wave, which provides higher quantum efficiency. What's more, we found that only the symmetric TM-polarized SPP mode might get the transverse circular polarization. For the sandwiched structure containing metal, the existence of two SPP modes weakens the overall chiral interaction. However, the structure containing left-handed materials (LHMs), which can only support one symmetric TM-polarized SPP mode, can get the nearly perfect chiral interaction. We measure the chiral interaction through the decay rate, radiation field distribution and the unidirectional rate through the energy flux. Our work provides a reference for exploring the perfect chiral interaction in more complex structures and has potential and wide applicability to other optical processes.

Pituitary Adenylate Cyclase-Activating Polypeptide Protects Against Cognitive Impairment Caused by Chronic Cerebral Hypoperfusion

BACKGROUND

Pituitary adenylate cyclase-activating polypeptide (PACAP) has beneficial effects in learning and memory. However, the mechanism by which PACAP improves cognitive impairment of vascular dementia (VaD) is not clear.

METHODS

We established a VaD model by bilateral common carotid stenosis (BCAS) to investigate the molecular mechanism of cognitive impairment. Protein levels of PACAP, Sirtuin 3 (Sirt3), brain-derived neurotrophic factor (BDNF), and postsynaptic density 95 (PSD-95) were assessed by Western blot. In vitro, oxygen glucose deprivation (OGD) was used to simulate the ischemia/hypoxia state. HT22 cells were transfected with Sirt3 knockdown and overexpression to study the relationship between PACAP, Sirt3, and BDNF. In vivo, PACAP was administered intranasally to assess its protective effects on BCAS.

RESULTS

The study showed that the levels of PACAP, Sirt3, BDNF, and PSD-95 were decreased in the BCAS model of VaD. PACAP increased the protein levels of Sirt3, BDNF, PSD-95, Bcl-2, and Bax under OGD condition in vitro. Sirt3 regulated BDNF and synaptic plasticity. Intranasal PACAP increased the protein levels of PAC1, Sirt3, BDNF, and PSD-95 in vivo.

CONCLUSIONS

This study provides evidence that PACAP regulates synaptic plasticity and plays an antiapoptotic role through Sirt3.

Familial Autonomic Ganglionopathy Caused by Rare CHRNA3 Genetic Variants

OBJECTIVE

To determine the molecular basis of a new monogenetic recessive disorder that results in familial autonomic ganglionopathy with diffuse autonomic failure.

METHODS

Two adult siblings from one family (I-4 and I-5) and another participant from a second family (II-3) presented with severe neurogenic orthostatic hypotension (nOH), small nonreactive pupils, and constipation. All 3 affected members had low norepinephrine levels and diffuse panautonomic failure.

RESULTS

Whole exome sequencing of DNA from I-4 and I-5 showed compound heterozygosity for c.907_908delCT (p.L303Dfs*115)/c.688 G>A (p.D230N) pathologic variants in the acetylcholine receptor, neuronal nicotinic, α3 subunit gene (CHRNA3). II-3 from the second family was homozygous for the same frameshift (fs) variant (p.L303Dfs*115//p.L303Dfs*115). CHRNA3 encodes a critical subunit of the nicotinic acetylcholine receptors (nAChRs) responsible for fast synaptic transmission in the autonomic ganglia. The fs variant is clearly pathogenic and the p.D230N variant is predicted to be damaging (SIFT)/probably damaging (PolyPhen2). The p.D230N variant lies on the interface between CHRNA3 and other nAChR subunits based on structural modeling and is predicted to destabilize the nAChR pentameric complex.

CONCLUSIONS

We report a novel genetic disease that affected 3 individuals from 2 unrelated families who presented with severe nOH, miosis, and constipation. These patients had rare pathologic variants in the CHRNA3 gene that cosegregate with and are predicted to be the likely cause of their diffuse panautonomic failure.

Specimen number based diagnostic yields of suspicious axillary lymph nodes in core biopsy in breast cancer: clinical implications from a prospective exploratory study

Background

Ultrasound (US)-guided core needle biopsy (CNB) is widely applied in the pathological diagnosis of suspicious axillary lymph nodes (ALNs) in breast cancer. However, the number of specimens removed during biopsy is currently based on the preference of the individual radiologist. This study aims to analyze the specimen number based diagnostic yields of US guided CNB of suspicious ALNs in breast cancer.

Methods

Core biopsy specimens of suspicious lymph nodes were prospectively obtained from breast cancer patients treated at our hospital between November, 2018, and July, 2019. Four specimens were obtained from each patient and labeled 1-4 in the order they were removed. Each specimen underwent pathological evaluation to determine whether metastasis had occurred. The diagnostic yields of the specimens were calculated and differences in diagnostic accuracy according to the number of specimens were evaluated by McNemar's test.

Results

A total of 167 patients were enrolled, and 139 (83.2%) cases were identified as metastasis by CNB. The diagnostic yields were: 74.2% (specimen 1), 87.8% (specimens 1-2), 91.2% (specimens 1-3), and 94.6% (specimens 1-4). The increases in diagnostic yield from specimen 1 to 1-2 and from specimens 1-2 to 1-4 were significant; however, no significant differences were detected between specimens 1-3 and the first two, or between specimens 1-4 and the first three in this sample size. The lower diagnostic abilities for the first two specimens were associated with shorter long- and short-axis lengths of lymph nodes on US.

Conclusions

Although the second specimen contributed significant diagnostic yield of suspicious axillary lymph nodes in core biopsy in breast cancer, a minimum number cannot be determined by this study. Additional specimens may improve diagnostic yield particularly in patients with small nodes.

Upregulated-gene expression of pro-inflammatory cytokines, oxidative stress and apoptotic markers through inflammatory, oxidative and apoptosis mediated signaling pathways in Bovine Pneumonia

Pneumonia is the acute inflammation of lung tissue and is multi-factorial in etiology. Staphylococcus aureus (S. aureus) is a harmful pathogen present as a normal flora of skin and nares of dairy cattle. In bovine pneumonia, S. aureus triggers to activates Toll-Like Receptors (TLRs), that further elicits the activation of the inflammation via NF-κB pathway, oxidative stress and apoptotic pathways. In the current study, pathogen-associated gene expression of the pro-inflammatory cytokines, oxidative stress and apoptotic markers in the lung tissue of cattle was explored in bovine pneumonia. Fifty lung samples collected from abattoir located in Wuhan city, Hubei, China. Histopathologically, thickening of alveolar wall, accumulation of inflammatory cells and neutrophils in perivascular space, hyperemia, hemorrhages and edema were observed in infected lungs as compared to non-infected lung samples. Furthermore, molecular identification and characterization were carried by amplification of S. aureus-specific nuc gene (270 base pairs) from the infected and non-infected lung samples to identify the S. aureus. Moreover, qPCR results displayed that relative mRNA levels of TLR2, TLR4, pro-inflammatory gene (IL-1β, IL-6 and TNF-α) and apoptosis-associated genes (Bax, caspase-3 and caspase-9) were up-regulated except Bcl-2, which is antiapoptotic in nature, and oxidative stress related genes (Nrf2, NQO1, HO-1 and GCLC) which was down-regulated in infected pulmonary group. The relative protein expression of NF-κB, mitochondria-mediated apoptosis gene was up-regulated while Bcl-2 and Nrf2 pathway genes were downregulated in infected cattle lungs. Our findings revealed that genes expression levels of inflammatory mediators, oxidative stress and apoptosis were associated with host immunogenic regulatory mechanisms in the lung tissue during infection. Conclusively, the present study provides insights of active immune response via TLRs-mediated inflammatory, oxidative damage, and apoptotic paradox.

Value of Exome Sequencing in Diagnosis and Management of Recurrent Non-immune Hydrops Fetalis: A Retrospective Analysis

The purpose of the study was to use exome sequencing (ES) to study the contribution of single-gene disorders to recurrent non-immune hydrops fetalis (NIHF) and retrospectively evaluate the value of genetic diagnosis on prenatal management and pregnancy outcome. From January 2012 to October 2018, a cohort of 28 fetuses with recurrent NIHF was analyzed by trio ES. Fetuses with immune hydrops, non-genetic factors (including infection, etc.), karyotype, or CNV abnormalities were excluded. Variants were interpreted based on ACMG/AMP guidelines. Fetal therapy was performed on seven fetuses. Of the 28 fetuses, 10 (36%) were found to carry causal genetic variants (pathogenic or likely pathogenic) in eight genes (GBA, GUSB, GBE1, RAPSN, FOXC2, PIEZO1, LZTR1, and FOXP3). Five (18%) fetuses had variant(s) of uncertain significance (VUS). Of the 10 fetuses with definitive molecular diagnosis, five (50%) were diagnosed with inborn errors of metabolism. Among the seven fetuses who received fetal therapy, two had definitive molecular diagnosis and resulted in neonatal death. Among the remaining five fetuses with negative results, four had newborn survival and one had intrauterine fetal death. Trio ES could facilitate genetic diagnosis of recurrent NIHF and improve the prenatal management and pregnancy outcome.

Interferon-τ regulates the expression and function of bovine leukocyte antigen by downregulating bta-miR-204

IFN-τ is a pregnancy recognition factor that regulates embryo implantation in ruminants. IFN-τ has been suggested to be involved in the expression of microRNA (miRNA/miR) and bovine leukocyte antigen (BoLA), which is an analog of the human major histocompatibility complex class I. However, little is known about whether the miRNAs are involved in the expression of BoLA in ruminants. The present study firstly verified that bta-miR-204 was downregulated and that BoLA was upregulated in the uterine tissues of dairy cows during early pregnancy. Subsequently, luciferase reporter assays, reverse transcription-quantitative PCR and western blot analysis were used to validate BoLA as the target gene of bta-miR-204. Moreover, BoLA was markedly upregulated and bta-miR-204 was downregulated in bovine endometrial epithelial cells (bEECs) treated with IFN-τ. In addition, the results indicated that when the expression level of BoLA was increased by IFN-τ, the expression level of programmed death-ligand 1 (PD-L1) and programmed death-ligand 2 (PD-L2) was also increased. Furthermore, when BoLA was silenced in bEECs by small interfering RNA, the expression of PD-L1 and PD-L2 was not affected by IFN-τ. The expression level of PD-L1 and PD-L2 was also increased in the uterine tissues of pregnant dairy cattle. In conclusion, IFN-τ may function by suppressing the expression of bta-miR-204 to increase the expression of BoLA during the embryo implantation period in cattle. IFN-τ may induce PD-L1 and PD-L2 transcription by regulating BoLA, which may influence the T cell immune response, thereby regulating pregnant cattle immunization.

MED27 Variants Cause Developmental Delay, Dystonia, and Cerebellar Hypoplasia

The Mediator multiprotein complex functions as a regulator of RNA polymerase II-catalyzed gene transcription. In this study, exome sequencing detected biallelic putative disease-causing variants in MED27, encoding Mediator complex subunit 27, in 16 patients from 11 families with a novel neurodevelopmental syndrome. Patient phenotypes are highly homogeneous, including global developmental delay, intellectual disability, axial hypotonia with distal spasticity, dystonic movements, and cerebellar hypoplasia. Seizures and cataracts were noted in severely affected individuals. Identification of multiple patients with biallelic MED27 variants supports the critical role of MED27 in normal human neural development, particularly for the cerebellum. ANN NEUROL 2021;89:828-833.

Development of antisense RNA-mediated quantifiable inhibition for metabolic regulation

Trans-regulating elements such as noncoding RNAs are crucial in modifying cells, and has shown broad application in synthetic biology, metabolic engineering and RNA therapies. Although effective, titration of the regulatory levels of such elements is less explored. Encouraged by the need of fine-tuning cellular functions, we studied key parameters of the antisense RNA design including oligonucleotide length, targeting region and relative dosage to achieve differentiated inhibition. We determined a 30-nucleotide configuration that renders efficient and robust inhibition. We found that by targeting the core RBS region proportionally, quantifiable inhibition levels can be rationally obtained. A mathematic model was established accordingly with refined energy terms and successfully validated by depicting the inhibition levels for genomic targets. Additionally, we applied this fine-tuning approach for 4-hydroxycoumarin biosynthesis by simultaneous and quantifiable knockdown of multiple targets, resulting in a 3.58-fold increase in titer of the engineered strain comparing to that of the non-regulated. We believe the developed tool is broadly compatible and provides an extra layer of control in modifying living systems.

•

Achieved quantifiable asRNA inhibition by varying core RBS coverage.

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Developed and validated a mathematical model for quantifiable inhibition.

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Improved 4-hydroxycoumarin biosynthesis by 3.58 folds with multiplexed inhibition.

Aruta J, Ashraf M, Bakaitytė A, Bertolli C, Bërxulli D, Bi C, Block K, Boehnke M, Bongiorno R, Bosak J, Casini A, Chen Q, Chi P, Cubela Adoric V, Daalmans S, Dandy J, Lemus SD, Dhakal S, Dvorianchikov N, Egami S, Etchezahar E, Sofia Esteves C, Felix N, Froehlich L, Garcia-Sanchez E, Gavreliuc A, Gavreliuc D, Gomez Á, Guizzo F, Graf S, Greijdanus H, Grigoryan A, Grzymała-Moszczyńska J, Guerch K, Gustafsson Sendén M, Hale ML, Hämer H, Hirai M, Hoang Duc L, Hřebíčková M, Hutchings PB, Høj Jensen D, Jasinskaja-Lahti I, Karabati S, Kelmendi K, Kengyel G, Khachatryan N, Ghazzawi R, Kinahan M, Kirby TA, Kovács M, Kozlowski D, Krivoshchekov V, Kulich C, Kurosawa T, Thi Lac An N, Labarthe J, Latu I, Anne Lauri M, Mankowski E, Musbau Lawal A, Li J, Lindner J, Lindqvist A, Maitner AT, Makarova E, Makashvili A, Malayeri S, Malik S, Mancini T, Manzi C, Mari S, Martiny SE, Mayer CH, Mihić V, Milošević Đorđević J, Moreno-Bella E, Moscatelli S, Bryan Moynihan A, Muller D, Narhetali E, Neto F, Noels KA, Nyúl B, O’Connor EC, Ochoa DP, Ohno S, Olanrewaju Adebayo S, Osborne R, Giuseppina Pacilli M, Palacio J, Patnaik S, Pavlopoulos V, Pérez de León P, Piterová I, Barreiros Porto J, Puzio A, Pyrkosz-Pacyna J, Rentería Pérez E, Renström E, Rousseaux T, Ryan MK, Sainz M, Salvati M, Samekin A, Schindler S, Seydi M, Shepherd D, Sherbaji S, Schmader T, Simão C, Sobhie R, Souza LD, Sarter E, Sulejmanović D, Sullivan KE, Tatsumi M, Tavitian-Elmadjian L, Jain Thakur S, Thi Mong Chi Q, Torre B, Torres A, Torres CV, Türkoğlu B, Ungaretti J, Valshtein T, Van Laar C, van der Noll J, Vasiutynskyi V, Vauclair CM, Venäläinen S, Vohra N, Walentynowicz M, Ward C, Yang Y, Yzerbyt V, Zanello V, Ludmila Zapata-Calvente A, Žukauskienė R. Psychometric Properties and Correlates of Precarious Manhood Beliefs in 62 Nations

Precarious manhood beliefs portray manhood, relative to womanhood, as a social status that is hard to earn, easy to lose, and proven via public action. Here, we present cross-cultural data on a brief measure of precarious manhood beliefs (the Precarious Manhood Beliefs scale [PMB]) that covaries meaningfully with other cross-culturally validated gender ideologies and with country-level indices of gender equality and human development. Using data from university samples in 62 countries across 13 world regions ( N = 33,417), we demonstrate: (1) the psychometric isomorphism of the PMB (i.e., its comparability in meaning and statistical properties across the individual and country levels); (2) the PMB’s distinctness from, and associations with, ambivalent sexism and ambivalence toward men; and (3) associations of the PMB with nation-level gender equality and human development. Findings are discussed in terms of their statistical and theoretical implications for understanding widely-held beliefs about the precariousness of the male gender role.

Molecular characterization of the viral structural protein genes in the first outbreak of dengue virus type 2 in Hunan Province, inland China in 2018

Background

An unexpected dengue outbreak occurred in Hunan Province in 2018. This was the first dengue outbreak in this area of inland China, and 172 cases were reported.

Methods

To verify the causative agent of this outbreak and characterise the viral genes, the genes encoding the structural proteins C/prM/E of viruses isolated from local residents were sequenced followed by mutation and phylogenetic analysis. Recombination, selection pressure, potential secondary structure and three-dimensional structure analyses were also performed.

Results

Phylogenetic analysis revealed that all epidemic strains were of the cosmopolitan DENV-2 genotype and were most closely related to the Zhejiang strain (MH010629, 2017) and then the Malaysia strain (KJ806803, 2013). Compared with the sequence of DENV-2SS, 151 base substitutions were found in the sequences of 89 isolates; these substitutions resulted in 20 non-synonymous mutations, of which 17 mutations existed in all samples (two in the capsid protein, six in the prM/M proteins, and nine in the envelope proteins). Moreover, amino acid substitutions at the 602nd (E322:Q → H) and 670th (E390: N → S) amino acids may have enhanced the virulence of the epidemic strains. One new DNA binding site and five new protein binding sites were observed. Two polynucleotide binding sites and seven protein binding sites were lost in the epidemic strains compared with DENV-2SS. Meanwhile, five changes were found in helical regions. Minor changes were observed in helical transmembrane and disordered regions. The 429th amino acid of the E protein switched from a histamine (positively charged) to an asparagine (neutral) in all 89 isolated strains. No recombination events or positive selection pressure sites were observed. To our knowledge, this study is the first to analyse the genetic characteristics of epidemic strains in the first dengue outbreak in Hunan Province in inland China.

Conclusions

The causative agent is likely to come from Zhejiang Province, a neighbouring province where dengue fever broke out in 2017. This study may help clarify the intrinsic geographical relatedness of DENV-2 and contribute to further research on pathogenicity and vaccine development.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-05823-3.

The Ratio of the Transverse to Longitudinal Diameter of the Glenoid Projection Is of Good Predictive Value for Defining the Reliability of Critical Shoulder Angle in Nonstandard Anteroposterior Radiographs

PURPOSE

To investigate (1) whether measurement of the critical shoulder angle (CSA) is still reliable in some nonstandard anteroposterior radiographs; and (2) whether the ratio of the transverse to longitudinal diameter of the glenoid projection (RTL) could be used to determine the reliability of the CSA in nonstandard anteroposterior radiographs.

METHODS

The authors analyzed radiology records from 2017 to 2019 for patients with computed tomography (CT) scans of the shoulder. According to the Suter-Henninger classification system, each CT scan underwent 3-dimensional (3D) reconstructions to obtain 8 digitally reconstructed radiographs (DRRs), including 1 type A1 film and 7 type D1 films with different rotation angles. CSA and RTL were measured on all films, and 2 blinded reviewers evaluated DRRs. The relationship between RTL and CSA was determined by Pearson correlation test. The threshold value was determined by receiver operating characteristic (ROC) analyses using RTL as predictors and defined reliable CSA as criterion in the logistic regression. Intra- and inter-rater reliability were assessed by the intraclass correlation coefficient (ICC). Discriminative capacity was calculated with ROC analyses and area under the curve (AUC). An optimal measurement cutoff with resultant sensitivity and specificity was calculated.

RESULTS

A total of 86 patients were included, mean age 40.70 ± 18.25 years, 19 of whom had rotator cuff tears (RCTs) and 67 without RCTs. Spearman's correlation test revealed that the deviation of CSA was positively correlated with RTL, correlation coefficient 0.544 (P < .001) in all patients and 0.686 (P < .001) only in patients with RCTs. ROC analysis of all patients showed that the AUC of the RTL was 0.90, and the optimal cutoff point was 0.25 (sensitivity 88%, specificity 87%). ROC analysis only of patients with RCTs showed that the AUC of the RTL was 0.95, and the optimal cutoff point was 0.22 (sensitivity 95%, specificity 92%).

CONCLUSION

The ratio of the transverse to longitudinal diameter of the glenoid projection (RTL) is of good predictive value in defining the reliability of the CSA in malposition films. Based on the results, the CSA can be considered reliable if its RTL is <0.25.

LEVEL OF EVIDENCE

III, retrospective cohort study investigating a diagnostic test.

Phenotypic expansion of the BPTF-related neurodevelopmental disorder with dysmorphic facies and distal limb anomalies

Neurodevelopmental disorder with dysmorphic facies and distal limb anomalies (NEDDFL), defined primarily by developmental delay/intellectual disability, speech delay, postnatal microcephaly, and dysmorphic features, is a syndrome resulting from heterozygous variants in the dosage‐sensitive bromodomain PHD finger chromatin remodeler transcription factor BPTF gene. To date, only 11 individuals with NEDDFL due to de novo BPTF variants have been described. To expand the NEDDFL phenotypic spectrum, we describe the clinical features in 25 novel individuals with 20 distinct, clinically relevant variants in BPTF, including four individuals with inherited changes in BPTF. In addition to the previously described features, individuals in this cohort exhibited mild brain abnormalities, seizures, scoliosis, and a variety of ophthalmologic complications. These results further support the broad and multi‐faceted complications due to haploinsufficiency of BPTF.

Ultrasound-Guided Vacuum-assisted Biopsy Versus Surgical Resection in Patients With Breast Desmoid Tumor

BACKGROUND

Recent studies suggest that desmoid tumors can be managed more conservatively rather than undergoing wide surgical resection (SR). Ultrasound-guided vacuum-assisted biopsy (UGVAB) is a minimally invasive technique. This retrospective study aimed to compare the outcome in patients with breast desmoid tumor (BDT) who received UGVAB alone versus SR.

MATERIALS AND METHODS

The pathology database was searched for patients diagnosed with BDT ≤ 3 cm from 2007 to 2019. All patients underwent breast ultrasound examination and were then performed UGVAB alone or local SR. The Kaplan-Meier method with a log-rank test was used as a univariate analysis to compare the relapse-free survival (RFS) rates between UGVAB and SR groups. Cox regression analysis was used for multivariate analysis.

RESULTS

A total of 39 patients were included. The median follow-up was 41 mo (range, 5-110 mo). The incidence of tumor recurrence was 23.1% (9/39). The 3-y cumulative RFS was 83.1% and 95.8% in the UGVAB and SR group, respectively, which was not significantly different between the two groups (P = 0.131, log-rank test). Multivariate analysis also revealed that treatment strategy (UGVAB versus SR) was not associated with an increased risk of relapse events (P = 0.274).

CONCLUSIONS

Small desmoid tumors (≤3 cm) after UGVAB alone did not have a significantly compromised RFS compared with those who underwent SR. UGVAB may be an alternative and relatively conservative method for the diagnosis and local control of BDT with a smaller size. A prospective, randomized study with large sample size is needed to confirm this observation.

Differences in Explicit Stereotype Activation among Social Groups Based on the Stereotype Content Model: Behavioral and Electrophysiological Evidence in Chinese Sample

The stereotype content model (SCM; Fiske, Cuddy, Glick and Xu, 2002) identifies four basic categories of stereotyped social groups: high warmth-high competence (HW-HC), high warmth-low competence (HW-LC), low warmth-high competence (LW-HC), and low warmth-low competence (LW-LC). However, many of these groups have not been directly examined in stereotype activation research. The purpose of the present research was to extend stereotype activation research to groups that more fully represent those identified under the SCM. Employing explicit sequential priming task, participants responded to prime-target stimulus pairs that were either congruent or incongruent with stereotypes of social groups from all four SCM quadrants in two studies in the current investigation. Study 1 was to determine the behavioral pattern of explicit stereotype activation among four quadrants (the sample included 60 Chinese undergraduate students, 51%-female). Study 2 further employed event-related brain potentials (ERPs) technique to track the time course and electrophysiological underpinnings of explicit stereotype activation (the sample included 22 right-handed Chinese undergraduate students, 76%-female). In Study 1, participants responded more quickly and accurately on stereotype congruent trials than incongruent trials for all social groups except LW-LC groups. This reverse priming effect on LW-LC social groups in RTs was also replicated in Study 2. ERPs findings further showed that incongruent targets elicited larger N400 amplitudes than congruent targets for all four SCM quadrants. Moreover, congruent targets elicited larger P2 than incongruent targets, but only found for the LW-LC social groups. In addition, congruent targets elicited larger amplitudes of late positive component than incongruent targets for the low warmth (LW-LC and LW-HC) groups. Together, these results highlight the unique processing that LW-LC groups receive throughout the cognitive stream, ultimately manifesting in distinctive behavioral responses. Unconscious activation of egalitarian goals, disgust, and distrust accounts are discussed.

The Effect of Low and High Vacuum Drainage on the Postoperative Drainage of Breast Cancer: Insights from a Prospective, Non-Inferiority, Randomized Clinical Trial

Background

Vacuum drains have been extensively applied to prevent seroma formation after breast surgery. However, the usage of negative suction drainage is mainly determined by surgeon’s experience and preferences. The aim of this study is to prospectively compare the drain effect after breast surgery between the low and high vacuum drains.

Methods

This prospectively randomized trial (from January 2018 to June 2019) involved 188 patients who were subjected to modified radical mastectomy (group A, n=128) or immediate breast reconstruction with implants (group B, n=60). In each group, patients were randomized to receive high vacuum drain (pressure=–98 kPa) or low vacuum drain (pressure=–12 kPa) after surgery. Days of drain permanence, which means the duration of drainage, was the primary endpoint.

Results

According to the comparison of days of drain permanence, the effect of a low vacuum drain is not inferior to a high vacuum drain in group A (pectoral drain, P<0.001; axillary drain, P<0.001) or group B (submuscular drain, P=0.002). The complications frequently occurred on patients with high vacuum drain (11.7%), such as seroma formation. The expense of low vacuum drain was significantly lower than high vacuum drain in both groups (P<0.01).

Conclusion

The drain effect of the low vacuum drain is not inferior to a high vacuum drain in both group A and group B. The low vacuum drain was effective, relatively cheap, and did not increase the incidence of complications; it is therefore more recommended after breast surgery.

In situ manipulation of van der Waals heterostructures for twistronics

In van der Waals heterostructures, electronic bands of two-dimensional (2D) materials, their nontrivial topology, and electron-electron interactions can be markedly changed by a moiré pattern induced by twist angles between different layers. This process is referred to as twistronics, where the tuning of twist angle can be realized through mechanical manipulation of 2D materials. Here, we demonstrate an experimental technique that can achieve in situ dynamical rotation and manipulation of 2D materials in van der Waals heterostructures. Using this technique, we fabricated heterostructures where graphene is perfectly aligned with both top and bottom encapsulating layers of hexagonal boron nitride. Our technique enables twisted 2D material systems in one single stack with dynamically tunable optical, mechanical, and electronic properties.

Development and Validation of a Preoperative Magnetic Resonance Imaging Radiomics-Based Signature to Predict Axillary Lymph Node Metastasis and Disease-Free Survival in Patients With Early-Stage Breast Cancer

IMPORTANCE

Axillary lymph node metastasis (ALNM) status, typically estimated using an invasive procedure with a high false-negative rate, strongly affects the prognosis of recurrence in breast cancer. However, preoperative noninvasive tools to accurately predict ALNM status and disease-free survival (DFS) are lacking.

OBJECTIVE

To develop and validate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) radiomic signatures for preoperative identification of ALNM and to assess individual DFS in patients with early-stage breast cancer.

DESIGN, SETTING, AND PARTICIPANTS

This retrospective prognostic study included patients with histologically confirmed early-stage breast cancer diagnosed at 4 hospitals in China from July 3, 2007, to September 21, 2019, randomly divided (7:3) into development and vaidation cohorts. All patients underwent preoperative MRI scans, were treated with surgery and sentinel lymph node biopsy or ALN dissection, and were pathologically examined to determine the ALNM status. Data analysis was conducted from February 15, 2019, to March 20, 2020.

EXPOSURE

Clinical and DCE-MRI radiomic signatures.

MAIN OUTCOMES AND MEASURES

The primary end points were ALNM and DFS.

RESULTS

This study included 1214 women (median [IQR] age, 47 [42-55] years), split into development (849 [69.9%]) and validation (365 [30.1%]) cohorts. The radiomic signature identified ALNM in the development and validation cohorts with areas under the curve (AUCs) of 0.88 and 0.85, respectively, and the clinical-radiomic nomogram accurately predicted ALNM in the development and validation cohorts (AUC, 0.92 and 0.90, respectively) based on a least absolute shrinkage and selection operator (LASSO)-logistic regression model. The radiomic signature predicted 3-year DFS in the development and validation cohorts (AUC, 0.81 and 0.73, respectively), and the clinical-radiomic nomogram could discriminate high-risk from low-risk patients in the development cohort (hazard ratio [HR], 0.04; 95% CI, 0.01-0.11; P < .001) and the validation cohort (HR, 0.04; 95% CI, 0.004-0.32; P < .001) based on a random forest-Cox regression model. The clinical-radiomic nomogram was associated with 3-year DFS in the development and validation cohorts (AUC, 0.89 and 0.90, respectively). The decision curve analysis demonstrated that the clinical-radiomic nomogram displayed better clinical predictive usefulness than the clinical or radiomic signature alone.

CONCLUSIONS AND RELEVANCE

This study described the application of MRI-based machine learning in patients with breast cancer, presenting novel individualized clinical decision nomograms that could be used to predict ALNM status and DFS. The clinical-radiomic nomograms were useful in clinical decision-making associated with personalized selection of surgical interventions and therapeutic regimens for patients with early-stage breast cancer.

[Effects of mobile health intervention on early knee function after anterior cruciate ligament reconstruction: a prospective randomized controlled study]

Objective: To investigate the early clinical effects of home-based mobile health intervention on knee joint function after anterior cruciate ligament (ACL) reconstruction. Methods: This was a prospective randomized controlled trial. Patients undergoing arthroscopic ACL reconstruction alone at the Institute of Sports Medicine, Peking University Third Hospital from April 2019 to December 2019 were elected in the trial. Patients were divided into the intervention group and the control group according to random number method. The control group only received the guidance of the traditional paper rehabilitation schedule, while the intervention group also received personalized guidance of electronic rehabilitation prescription and follow-up notice delivered by a WeChat Mini Program Rehabilitation Cloud Platform in addition to the traditional guidance. Joint range of motion (ROM), visual analogue scale (VAS) and thigh circumference difference were assessed before and after the operation. Independent sample t test or Mann-Whitney U test was used for comparison of data between groups, and chi-square test was used for comparison of enumeration data. Results: One hundred and twenty five patients were enrolled in the trial, including 99 males and 26 females, with an average age of 29.0 years (range:18 to 45 years) and an average body mass index of 24.8 kg/m(2) (range:15.8 to 36.6 kg/m(2)). At 6 weeks, follow-up was available in 106 cases the target-reach rate of ROM in control group was 42.6%(23/54), which was 67.3%(35/52) in the intervention group, the difference was statistically significant (χ(2)=6.53, P=0.01); VAS of the intervention group was 2.5(2.0), lower than that of the control group 3.0(2.0)(M(Q(R))), the difference was statistically significant (Z=-2.06,P=0.04); And the thigh circumference difference of the intervention group was 2.0(2.0)cm lower than that of the control group 3.0(1.8)cm, the difference was statistically significant (Z=-3.00, P<0.01). Conclusion: Mobile health intervention can improve the early postoperative rehabilitation effect after ACL construction and the ROM of the knee joint, and reduce the bent-knee pain along with the thigh circumference difference.

[A consensus recommendation for the interpretation and reporting of exome sequencing in prenatal genetic diagnosis]

With the rapid development and adaptation of high-throughput sequencing in clinical settings, application of exome sequencing (ES) has been gradually expanded from pediatric to prenatal diagnosis in recent years. There is an urgent need to establish criteria for clinical grade ES in order to facilitate such a complex testing. The standardization of pre- and post-test consultation, quality control for sample processing process and validation of bioinformatics data analysis, and more importantly data interpretation and reporting, as well as appropriate reporting scope, is of great importance for health care stakeholders. To achieve this, a committee composed of a wide range of healthcare professionals has proposed an ES standard for prenatal diagnosis. This has provided expert opinion on the genetic counseling and reporting standards of prenatal ES for the purpose of applying ES technology in prenatal setting.

No pulsed radio emission during a bursting phase of a Galactic magnetar

Fast radio bursts (FRBs) are millisecond-duration radio transients of unknown physical origin observed at extragalactic distances^1-3. It has long been speculated that magnetars are the engine powering repeating bursts from FRB sources^4-13, but no convincing evidence has been collected so far¹⁴. Recently, the Galactic magnetar SRG 1935+2154 entered an active phase by emitting intense soft γ-ray bursts¹⁵. One FRB-like event with two peaks (FRB 200428) and a luminosity slightly lower than the faintest extragalactic FRBs was detected from the source, in association with a soft γ-ray/hard-X-ray flare^18-21. Here we report an eight-hour targeted radio observational campaign comprising four sessions and assisted by multi-wavelength (optical and hard-X-ray) data. During the third session, 29 soft-γ-ray repeater (SGR) bursts were detected in γ-ray energies. Throughout the observing period, we detected no single dispersed pulsed emission coincident with the arrivals of SGR bursts, but unfortunately we were not observing when the FRB was detected. The non-detection places a fluence upper limit that is eight orders of magnitude lower than the fluence of FRB 200428. Our results suggest that FRB-SGR burst associations are rare. FRBs may be highly relativistic and geometrically beamed, or FRB-like events associated with SGR bursts may have narrow spectra and characteristic frequencies outside the observed band. It is also possible that the physical conditions required to achieve coherent radiation in SGR bursts are difficult to satisfy, and that only under extreme conditions could an FRB be associated with an SGR burst.

Development and validation of a nomogram in survival prediction among advanced breast cancer patients

Background

The overall survival (OS) among patients with advanced breast cancer (ABC) varies greatly. Although molecular subtype is known as the most important factor in OS differentiation, significant differences in OS among patients with the same molecular subtype still occur, leading to the need for a more accurate prognostic prediction model. This study aimed to develop a prediction model (nomogram) based on current diagnosis and treatment to predict the OS of newly diagnosed ABC patients in China.

Methods

From the institution’s database, we collected data of 368 ABC patients from Sun Yat-sen Memorial Hospital (national hospital) as a training set to establish a nomogram with prognostic risk factors that calculated the predicted probability of survival. Nomograms were independently validated with 278 patients with ABC from two other institutions using the concordance index (C-index), calibration plots and risk group stratifications.

Results

The initial primary tumor stage, molecular subtype, disease-free survival (DFS), presence of brain metastasis, and the tumor burden of metastasis disease (local recurrence, oligo-metastatic disease, or multiple-metastatic disease) were included in the prognostic nomogram. The nomogram had a C-index of 0.77 and 0.71 in the training and the validation sets, respectively. The nomogram was able to stratify patients into different risk groups, respectively (HR 6.81, 95% CI: 4.69 to 9.89, P<0.001). In the lower risk score group (risk score <11), there was no significant difference between the OS with chemotherapy and hormone therapy (HR 0.81, 95% CI: 0.44 to 1.47, P=0.48).

Conclusions

We have constructed a novel prediction nomogram that can guide the physicians to select personalized treatment options. Furthermore, our study is the first to add oligo-metastatic disease and primary endocrine/trastuzumab resistance into the prognostic models.

Association of 24-Hour Intraocular Pressure Fluctuation With Corneal Hysteresis and Axial Length in Untreated Chinese Primary Open-Angle Glaucoma Patients

PURPOSE

The purpose of this study was to evaluate the association of 24-hour intraocular pressure (IOP) fluctuation with corneal biomechanics and ocular biometric parameters in Chinese patients with primary open angle glaucoma (POAG) before initial treatment.

METHODS

Forty-nine Chinese patients with POAG (98 eyes) were recruited in this study before start of any POAG treatment. The 24-hour IOP was measured with a 2-hour interval by a noncontact tonometer. Corneal biomechanical properties and biometric parameters were measured once during 8 AM to 6 PM before 24-hour IOP measurement.

RESULTS

The 24-hour IOP fluctuation was defined as the differences between the peak and trough IOP measurement and was significantly associated with axial length (AL) in the multivariate analysis. The POAG subjects with AL ≤ 26 mm had significantly larger 24-hour IOP fluctuation but lower corneal hysteresis, compared to those with AL > 26 mm. In addition, subgroup analysis showed that high tension glaucoma subjects had larger 24-hour IOP fluctuation and higher corneal resistance factor than patients with normal tension glaucoma.

CONCLUSIONS

This study revealed the association of 24-hour IOP fluctuation with office hour corneal biomechanical properties and AL in patients with POAG. Their contributions to IOP fluctuation should be considered in the risk analysis of glaucoma development and progression.

TRANSLATIONAL RELEVANCE

Ocular biometric parameters are related with 24-hour IOP fluctuation in patients with POAG, which is potentially helpful in explaining different progression patterns in different types of patients.

Directional dipole radiations and long-range quantum entanglement mediated by hyperbolic metasurfaces

In the vicinity of two-dimensional structures, the excitation of deep subwavelength polaritonic modes can be realized owing to the presence of free-carrier motion. Here we consider the launching of surface plasmonics in hyperbolic metasurfaces and theoretically demonstrate that the radiation energy of quantum emitter channels along specific directions was determined by the conductivity tensor of the surface. While the propagating length of the suface plasmon field supported by isotropic surfaces is normally limited on the scale of subwavelength to several vacuum wavelengths, it may be largely amplified when hyperbolic metasurfaces have been applied. Based on these exciting properties, prominent super- and subradiant behaviors between two distant quantum emitters are observed by engineering the anisotropy of the metasurfaces. Further investigations show that the directional collective interactions supported by the metasurfaces enable the generation of quantum entanglement over macroscopic dipole separations, with large values of concurrence, and allow remarkable revivals from sudden death. Our proposal can easily be extended to systems that include multiple quantum emitters interacting through hyperbolic metasurfaces and thus may have potential applications in on-chip science that aims at quantum information processing and quantum networks.

The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST

BACKGROUND

To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA).

METHODS

One hundred eleven newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose-response relation between follow-up time and corneal biomechanics.

RESULTS

The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β = -0.0015, P = 0.016), the first applanation velocity (AV1, β = -0.0004, P = 0.00058) decreased and the first applanation time (AT1, β = 0.0089, P < 0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P = 0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P = 0.00002) in NTG than in HTG after adjusting for confounding factors.

CONCLUSIONS

Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.

Generation and propagation of hyperbolic secant solitons, Peregrine solitons, and breathers in a coherently prepared atomic system

We study the generation and propagation of hyperbolic secant solitons, Peregrine solitons, and various breathers in a coherently prepared three-level atomic system, where two lower states are coherently prepared prior to the injection of a strong pump field and a weak probe field. We show that a flat dispersion without gain and loss along with a large Kerr nonlinearity can be achieved in a broad range of probe field frequency. Moreover, optical hyperbolic secant solitons can be easily achieved in such a broad range at a very low light intensity and propagate stably. Due to the enhanced Kerr nonlinearity, we also show that it is possible to generate optical rogue waves and breathers with very weak light stimulus, which is three orders of magnitude smaller than that used in nonlinear fibers. Because the gain/absorption is negligible and the quantum noise of the probe field can be significantly suppressed, our work may pave the way for realizing solitons, rogue waves, and breathers at the quantum level.

All-optical negative differential transporter of Bose-Einstein condensates in cavity

We present a new and interesting physical phenomenon of optical negative differential transmission (ONDT, whose output intensity decreases with the increasing of input field intensity for an arbitrary optical system) in present BEC-cavity coupling system which pumped by a strong light and probed by a weak light. Theoretical results show that the transmission of the probe can be suppressed or promoted greatly by the pump due to optical nonlinearity and the Stokes/anti-Stokes scattering. To our most interest, two kinds of ONDT respectively induced by the nonlinear incoherent light-controlling and the nonlinear coherent interference have been uncovered, which have promising prospect in producing hyper-stable light source since it provides an unusual negative feedback.