Homogeneous Spatial Distribution of Deuterium Chemisorbed on Free-Standing Graphene

Atomic deuterium (D) adsorption on free-standing nanoporous graphene obtained by ultra-high vacuum D2 molecular cracking reveals a homogeneous distribution all over the nanoporous graphene sample, as deduced by ultra-high vacuum Raman spectroscopy combined with core-level photoemission spectroscopy. Raman microscopy unveils the presence of bonding distortion, from the signal associated to the planar sp2 configuration of graphene toward the sp3 tetrahedral structure of graphane. The establishment of D–C sp3 hybrid bonds is also clearly determined by high-resolution X-ray photoelectron spectroscopy and spatially correlated to the Auger spectroscopy signal. This work shows that the low-energy molecular cracking of D2 in an ultra-high vacuum is an efficient strategy for obtaining high-quality semiconducting graphane with homogeneous uptake of deuterium atoms, as confirmed by this combined optical and electronic spectro-microscopy study wholly carried out in ultra-high vacuum conditions.

AB0157 EFFICACY AND SAFETY OF FILGOTINIB IN ACTIVE RHEUMATOID ARTHRITIS PATIENTS WITH INADEQUATE RESPONSE TO METHOTREXATE: COMPARATIVE STUDY WITH FILGOTINIB AND TOCILIZUMAB EXAMINED BY CLINICAL INDEX AS WELL AS MUSCULOSKELETAL ULTRASOUND ASSESSMENT (TRANSFORM STUDY): STUDY PROTOCOL

Background

The administration of Janus kinase (JAK) inhibitors as well as biological disease-modifying anti-rheumatic drugs has dramatically improved even the clinical outcomes in rheumatoid arthritis (RA) patients with inadequate response to methotrexate (MTX). The dysregulation of JAK- signal transducer and activator of transcription (STAT) pathways via overproduction of cytokines, such as interleukin-6 (IL-6) is involved in the pathogenesis of RA (1). Filgotinib, a preferential JAK1 inhibitor, is effective in suppressing disease activity and preventing the progression of joint destruction due to inhibition of the JAK-STAT pathway. IL-6 inhibitors such as tocilizumab also inhibit the JAK-STAT pathways due to inhibition of IL-6 signaling. Thus, it should be desirable to investigate whether the effectiveness of filgotinib monotherapy is non-inferior to those of tocilizumab monotherapy in RA patients with inadequate response to MTX. In addition, it is important to accurately evaluate disease activity at the joint level by using musculoskeletal ultrasound (MSUS) and clinical disease activity indices, including subjective parameters (2).

Objectives

This study’s principal objective is to evaluate the effects of filgotinib monotherapy is non-inferior to those of tocilizumab monotherapy in RA patients with inadequate response to MTX. In addition, we will evaluate changes in patients’ parameters, including clinical disease activity indices, MSUS scores, serum biomarkers, patient-reported outcome (PRO), and modified total Sharp score (mTSS) after the administration of filgotinib or tocilizumab. Herein, we describe the study protocol for this study.

Methods

This study is an interventional, multicenter, randomized, open-label, parallel-group and non-inferiority clinical trial with a 52-week follow-up. In total, 400 RA patients with at least moderate disease activity during treatment with MTX will be included. Patients will be randomized in a 1:1 ratio to administration of filgotinib 200mg/day monotherapy or subcutaneous tocilizumab 162mg/biweekly monotherapy switched from MTX (Figure 1). We will evaluate disease activity by measuring clinical disease activity indices and by using MSUS. The primary endpoint is the proportion of patients who achieve an American College of Rheumatology 50 response at week 12. Important secondary endpoints are the changes from the baseline of the MSUS scores, PRO, and mTSS. We will also comprehensively analyze the serum levels of multiple biomarkers such as cytokines and chemokines.

Figure 1.

Results

Although the study results cannot be shown because the research entry is in progress, they are expected to show the non-inferiority of filgotinib monotherapy to tocilizumab monotherapy in RA patients with inadequate response to MTX.

Conclusion

The strength of this study is its prospective evaluation of therapeutic efficacy using not only clinical disease activity indices but also MSUS, which accurately and objectively evaluate disease activity at the joint level among patients drawn from multiple centers with a standardized evaluation by MSUS. In addition, we will evaluate the effectiveness of both drugs by integrating multilateral assessments, i.e., clinical disease activity indices, MSUS findings, and serum biomarkers.

References

[1]Gadina M, Le MT, Schwartz DM, Silvennoinen O, Nakayamada S, Yamaoka K, et al. Janus kinases to jakinibs: from basic insights to clinical practice. Rheumatology (Oxford). 2019;58(Suppl 1):i4-i16.

[2]Colebatch AN, Edwards CJ, Ostergaard M, van der Heijde D, Balint PV, D’Agostino MA, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804-14.

Disclosure of Interests

Toshimasa Shimizu: None declared, Shin-ya Kawashiri: None declared, Shimpei Morimoto: None declared, Yurika Kawazoe: None declared, Shohei Kuroda: None declared, Rina Kawasaki: None declared, Yasuko Ito: None declared, Shuntaro Sato: None declared, Hiroshi Yamamoto: None declared, Atsushi Kawakami Grant/research support from: Gilead Sciences, Inc.

OP0112 THE EVER-LARGEST ASIAN GWAS FOR SYSTEMIC SCLEROSIS AND TRANS-POPULATION META-ANALYSIS IDENTIFIED SEVEN NOVEL LOCI AND A CANDIDATE CAUSAL SNP IN A CIS-REGULATORY ELEMENT OF THE FCGR REGION

Background

Genome-wide association studies (GWASs) have identified 29 disease-associated single nucleotide polymorphisms (SNPs) for systemic sclerosis (SSc) in non-human leukocyte antigen (HLA) regions (1-7). While these GWASs have clarified genetic architectures of SSc, study subjects were mainly Caucasians limiting application of the findings to Asians.

Objectives

The study was conducted to identify novel causal variants for SSc specific to Japanese subjects as well as those shared with European population. We also aimed to clarify mechanistic effects of the variants on pathogenesis of SSc.

Methods

A total of 114,108 subjects comprising 1,499 cases and 112,609 controls were enrolled in the two-staged study leading to the ever-largest Asian GWAS for SSc. After applying a strict quality control both for genotype and samples, imputation was conducted using the reference panel of the phase 3v5 1,000 genome project data combined with a high-depth whole-genome sequence data of 3,256 Japanese subjects. We conducted logistic regression analyses and also combined the Japanese GWAS results with those of Europeans (6) by an inverse-variance fixed-effect model. Polygenicity and enrichment of functional annotations were evaluated by linkage disequilibrium score regression (LDSC), Haploreg and IMPACT programs. We also constructed polygenic risk score (PRS) to predict SSc development.

Results

We identified three (FCRLA-FCGR, TNFAIP3, PLD4) and four (EOMES, ESR1, SLC12A5, TPI1P2) novel loci in Japanese GWAS and a trans-population meta-analysis, respectively. One of Japanese novel risk SNPs, rs6697139, located within FCGR gene clusters had a strong effect size (OR 2.05, P=4.9×10-11). We also found the complete LD variant, rs10917688, was positioned in cis-regulatory element and binding motif for an immunomodulatory transcription factor IRF8 in B cells, another genome-wide significant locus in our trans-ethnic meta-analysis and the previous European GWAS. Notably, the association of risk allele of rs10917688 was significant only in the presence of the risk allele of the IRF8. Intriguingly, rs10917688 was annotated as one enhancer-related histone marks, H3K4me1, in B cells, implying that FCGR gene(s) in B cells may play an important role in the pathogenesis of SSc. Furhtermore, significant heritability enrichment of active histone marks and a transcription factor C-Myc were found in B cells both in European and Japanese populations by LDSC and IMPACT, highlighting a possibility of a shared disease mechanism where abnormal B-cell activation may be one of the key drivers for the disease development. Finally, PRS using effects sizes of European GWAS moderately fit in the development of Japanese SSc (AUC 0.593), paving a path to personalized medicine for SSc.

Conclusion

Our study identified seven novel susceptibility loci in SSc. Downstream analyses highlighted a novel disease mechanism of SSc where an interactive role of FCGR gene(s) and IRF8 may accelerate the disease development and B cells may play a key role on the pathogenesis of SSc.

References

[1]F. C. Arnett et al. Ann Rheum Dis, 2010.

[2]T. R. Radstake et al. Nat Genet, 2010.

[3]Y. Allanore et al. PLoS Genet, 2011.

[4]O. Gorlova et al. PLoS Genet, 2011.

[5]C. Terao et al. Ann Rheum Dis, 2017.

[6]E. López-Isac et al. Nat Commun, 2019.

[7]W. Pu et al. J Invest Dermatol, 2021.

Disclosure of Interests

None declared

Gap Opening in Double-Sided Highly Hydrogenated Free-Standing Graphene

Conversion of free-standing graphene into pure graphane─where each C atom is sp³ bound to a hydrogen atom─has not been achieved so far, in spite of numerous experimental attempts. Here, we obtain an unprecedented level of hydrogenation (≈90% of sp³ bonds) by exposing fully free-standing nanoporous samples─constituted by a single to a few veils of smoothly rippled graphene─to atomic hydrogen in ultrahigh vacuum. Such a controlled hydrogenation of high-quality and high-specific-area samples converts the original conductive graphene into a wide gap semiconductor, with the valence band maximum (VBM) ∼ 3.5 eV below the Fermi level, as monitored by photoemission spectromicroscopy and confirmed by theoretical predictions. In fact, the calculated band structure unequivocally identifies the achievement of a stable, double-sided fully hydrogenated configuration, with gap opening and no trace of π states, in excellent agreement with the experimental results.

Collection of 2429 constrained headshots of 277 volunteers for deep learning

Deep learning has rapidly been filtrating many aspects of human lives. In particular, image recognition by convolutional neural networks has inspired numerous studies in this area. Hardware and software technologies as well as large quantities of data have contributed to the drastic development of the field. However, the application of deep learning is often hindered by the need for big data and the laborious manual annotation thereof. To experience deep learning using the data compiled by us, we collected 2429 constrained headshot images of 277 volunteers. The collection of face photographs is challenging in terms of protecting personal information; we therefore established an online procedure in which both the informed consent and image data could be obtained. We did not collect personal information, but issued agreement numbers to deal with withdrawal requests. Gender and smile labels were manually and subjectively annotated only from the appearances, and final labels were determined by majority among our team members. Rotated, trimmed, resolution-reduced, decolorized, and matrix-formed data were allowed to be publicly released. Moreover, simplified feature vectors for data sciences were released. We performed gender and smile recognition by building convolutional neural networks based on the Inception V3 model with pre-trained ImageNet data to demonstrate the usefulness of our dataset.

Ocular infestation by a juvenile leech, Myxobdella sinanensis in Japan

Purpose

The case of ocular infestation by a leech is rare. We reported that Myxobdella sinanensis infests conjunctiva.

Observations

A 5-year-old girl presented with blood clots in the inner corner of the left eye, and a history bloody eye discharge and bloody tears for 5 days. She was prescribed 0.5% levofloxacin ophthalmic drops for conjunctival damage. However, her parent watched a worm moving in her conjunctiva while taking a bath. She presented again the same day, and a worm was found in the left eye of the lower conjunctival fornix and was adsorbed to the inner corner. We removed a worm under eye drop anesthesia, the next day the patient had no symptoms. We captured the worm, and it was identified morphologically and genetically as Myxobdella sinanensis. This was the first case reported of Myxobdella sinanensis be infestation in a human.

Conclusions and Importance

The ecological trait of Myxobdella sinanensis still did not remain clear, so this case report was helpful to find out a life cycle of Myxobdella sinanensis. As the outdoor population continues to increase, the cases of human parasites such as leech are expected to increase. When a patient with bloody eye discharge and bloody tears presents, we should carefully examine the conjunctiva and ocular surfaces, and interview recent history of exposure to stream water.

A phase II randomized study evaluating azacitidine versus conventional care regimens in newly diagnosed elderly Japanese patients with unfavorable acute myeloid leukemia

A multicenter phase II study was conducted in 44 elderly (≥ 65 years) Japanese patients with newly diagnosed acute myeloid leukemia (AML) to evaluate whether azacitidine is also effective and feasible in Japanese AML patients. The 28 patients with AML with poor-risk cytogenetics and/or myelodysplasia-related changes (unfavorable AML) were randomly assigned to receive either azacitidine or conventional care regimens (CCR), and the other 16 patients without unfavorable AML received azacitidine alone. The primary endpoint was overall survival. At the median follow-up of 29 months, among the 26 evaluable patients with unfavorable AML, the median survival time (MST) of patients who received azacitidine (N = 14) was 9.6 months and that of patients who received CCR (N = 12) was 5.3 months (HR 0.73; 95% CI 0.31-1.69; log-rank P = 0.459). The MST of all 29 patients who received azacytidine, including the 15 evaluable patients without unfavorable AML, was 12.4 months. Adverse events of azacitidine were manageable and consistent with its established safety profile. Azacitidine tended to prolong survival in newly diagnosed elderly Japanese patients with AML, and was feasible as a front-line therapy for elderly AML patients.

Comparison of VWF-ADAMTS13 axis involvement in atrial fibrillation and sinus rhythm in patients with ST-elevation myocardial infarction

Funding Acknowledgements

Type of funding sources: None.

Background

 Previous studies have shown that von Willebrand factor (VWF) increases, and a disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS13) decreases in myocardial infarction. Few studies have examined the involvement of the VWF-ADAMTS13 axis in ST-elevation myocardial infarction (STEMI) patients with atrial fibrillation (AF).

Purpose

 Our aim was to investigate VWF-ADAMTS13 axis involvement in atrial fibrillation in STEMI. 

Methods

 The subjects of this study were participants in an observational study for investigating the difference in the pathology of thrombus retrieved from infarct-related artery between AF and sinus rhythm (SR). From June 2019 to August 2020, patients who underwent thrombus aspiration for STEMI at our hospital. Only subjects whose thrombus could be confirmed were enrolled. They were divided into two groups, the AF group, and the SR group. Serum biomarkers, including ADAMTS13 activity, and VWF were evaluated. 

Results

 34 patients with STEMI who were able to aspirate thrombus were enrolled in the study. They were divided into two groups: 6 patients with AF (AF group, mean age 72.5 years, 100% male) and 28 patients with SR (SR group, mean age 63.0 years, 100% male). ADAMTS13 activity was significantly lower in AF group than SR group (AF: 0.63 ± 0.14 vs. SR: 0.77 ± 0.13 U / mL, p = 0.037). There was no significant difference in VWF antigen between the two groups (AF: 251 ± 56 vs. SR: 204 ± 69%, p = 0.170). VWF/ADAMTS13 activity in AF group were significantly higher than in SR group.

Conclusion

 Our study suggests an association between the VWF-ADAMTS13 axis and atrial fibrillation in STEMI. Abstract Table. Comparison of serum biomarkers

Retinal Nerve Fiber Layer Thickness and Rim Area Profiles in Asians: Pooled Analysis from the Asian Eye Epidemiology Consortium

PURPOSE

To evaluate ethnic variations, ocular and systemic determinants of retinal nerve fibre layer (RNFL) thickness and neuroretinal rim area among Asians, using a large consortium of population-based eye studies.

DESIGN

Cross-sectional pooled-analysis.

PARTICIPANTS

22436 participants (22436 eyes) from 10 population-based studies (China, Hong Kong, India, Japan, Russia and Singapore) of the Asian Eye Epidemiology Consortium.

METHODS

Participants aged ≥40 years without glaucoma were included. All participants underwent spectral domain optical coherence tomography (OCT) imaging, systemic and ocular examinations. Data were pooled from each study. Multivariable regression analysis was performed to evaluate inter-ethnic, inter-machine variations, ocular and systemic factors associated with RNFL thickness and rim area, adjusting for age, gender, diabetes, intraocular pressure (IOP), spherical equivalent (SE), ethnicity, OCT model, and study group. When evaluating body mass index, smoking, and hypertension as exposures, these factors were additionally adjusted in the model.

MAIN OUTCOME MEASURE

Average RNFL thickness (μm) and rim area (mm²) RESULTS: Indian and Japanese eyes showed thinner RNFL, compared to other Asian ethnicities (β values ranging 7.31-12.76μm, P<0.001 for all pair-wise comparisons). Compared to measurements by Cirrus HD-OCT, RNFL was on average 7.29μm thicker when measured by Spectralis, 12.85μm thicker by Nidek, and 17.48μm thicker by Optovue (all P<0.001). Additionally, older age (per decade, β=-2.70; 95% confidence interval [CI], -2.85 to -2.55), diabetes (β=-0.72; 95%CI, -1.20 to -0.24), ), higher IOP (per mmHg, β=-0.07; 95% CI, -0.10 to -0.04), more myopic SE (per dioptre, β=-1.13; 95% CI, -1.19 to -1.07), cardiovascular disease (CVD, β=-0.94; 95% CI, -1.49 to -0.40), and hypertension (β=-0.68; 95% CI, -1.04 to -0.32), were associated with thinner RNFL (all P≤0.003). Similarly, older age (β=-0.019; 95% CI, -0.028 to -0.009), higher IOP (β=-0.010; 95% CI, -0.013 to -0.008) and more myopic SE (β=-0.025; 95% CI, -0.029 to -0.021) were associated with smaller rim area (all P<0.001).

CONCLUSIONS

In this large pooled-analysis of multiple Asian population studies, Indian and Japanese eyes were observed to have thinner RNFL profiles. In addition to previously known determinants, hypertension and CVD were associated with thinner RNFL. These findings further suggest the need of ethnic-specific normative database to improve glaucoma detection.

Nanoporous ultra-high-entropy alloys containing fourteen elements for water splitting electrocatalysis

High-entropy alloys (HEAs) are near-equimolar alloys comprising five or more elements. In recent years, catalysis using HEAs has attracted considerable attention across various fields. Herein, we demonstrate the facile synthesis of nanoporous ultra-high-entropy alloys (np-UHEAs) with hierarchical porosity via dealloying. These np-UHEAs contain up to 14 elements, namely, Al, Ag, Au, Co, Cu, Fe, Ir, Mo, Ni, Pd, Pt, Rh, Ru, and Ti. Furthermore, they exhibit high catalytic activities and electrochemical stabilities in the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) in acidic media, superior to that of commercial Pt/graphene and IrO₂ catalysts. Our results offer valuable insights for the selection of elements as catalysts for various applications.

Accessory right hepatic artery and aberrant bile duct in the hepatocystic triangle: a rare case with clinical implications

Awareness of variations in the hepatic vasculature and biliary system is extremely important for avoiding iatrogenic injury in upper-abdominal surgery. The objective of this study is to describe a rare case of abnormal vascular and biliary structures in the hepatocystic triangle (HCT) (the modern Calot's triangle). During anatomical dissection of the celiac trunk (CT) in an old man, the authors observed the presence of a hepatosplenic trunk arising from the CT and bifurcating into common hepatic and splenic arteries. The common hepatic artery divided into hepatic artery proper and gastroduodenal artery. The presence of accessory right hepatic artery (ARHA) arising from the superior mesenteric artery was also notable. The aberrant artery ascended retropancreatically ventral to the splenic vein, then posterolaterally to the portal vein before termination into the right hepatic lobe in the HCT. Within this triangle, there was an aberrant bile duct originating in the right hepatic lobe and ending in the common hepatic duct. This accessory duct crossed the ARHA and an associated branch (the cystic artery). There is no known previous report on the co-existence of an AHAR and an aberrant bile duct within the HCT, in addition to the hepatosplenic trunk. The clinical implications of the current case are addressed in discussion.

Graphene-coated nanoporous nickel towards a metal-catalyzed oxygen evolution reaction

Developing highly active electrocatalysts with low costs and long durability for oxygen evolution reactions (OERs) is crucial towards the practical implementations of electrocatalytic water-splitting and rechargeable metal-air batteries. Anodized nanostructured 3d transition metals and alloys with the formation of OER-active oxides/hydroxides are known to have high catalytic activity towards OERs but suffer from poor electrical conductivity and electrochemical stability in harsh oxidation environments. Here we report that high OER activity can be achieved from the metallic state of Ni which is passivated by atomically thick graphene in a three-dimensional nanoporous architecture. As a free-standing catalytic anode, the non-oxide transition metal catalyst shows a low OER overpotential, high OER current density and long cycling lifetime in alkaline solutions, benefiting from the high electrical conductivity and low impedance resistance for charge transfer and transport. This study may pave a new way to develop high efficiency transition metal OER catalysts for a wide range of applications in renewable energy.

Short-term interaction between silent and devastating earthquakes in Mexico

Either the triggering of large earthquakes on a fault hosting aseismic slip or the triggering of slow slip events (SSE) by passing seismic waves involve seismological questions with important hazard implications. Just a few observations plausibly suggest that such interactions actually happen in nature. In this study we show that three recent devastating earthquakes in Mexico are likely related to SSEs, describing a cascade of events interacting with each other on a regional scale via quasi-static and/or dynamic perturbations across the states of Guerrero and Oaxaca. Such interaction seems to be conditioned by the transient memory of Earth materials subject to the "traumatic" stress produced by seismic waves of the great 2017 (Mw8.2) Tehuantepec earthquake, which strongly disturbed the SSE cycles over a 650 km long segment of the subduction plate interface. Our results imply that seismic hazard in large populated areas is a short-term evolving function of seismotectonic processes that are often observable.

Towards free-standing graphane: atomic hydrogen and deuterium bonding to nano-porous graphene

Graphane is formed by bonding hydrogen (and deuterium) atoms to carbon atoms in the graphene mesh, with modification from the pure planar sp² bonding towards an sp³ configuration. Atomic hydrogen (H) and deuterium (D) bonding with C atoms in fully free-standing nano porous graphene (NPG) is achieved, by exploiting low-energy proton (or deuteron) non-destructive irradiation, with unprecedented minimal introduction of defects, as determined by Raman spectroscopy and by the C 1s core level lineshape analysis. Evidence of the H- (or D-) NPG bond formation is obtained by bringing to light the emergence of a H- (or D-) related sp³-distorted component in the C 1s core level, clear fingerprint of H-C (or D-C) covalent bonding. The H (or D) bonding with the C atoms of free-standing graphene reaches more than 1/4 (or 1/3) at% coverage. This non-destructive H-NPG (or D-NPG) chemisorption is very stable at high temperatures up to about 800 K, as monitored by Raman and x-ray photoelectron spectroscopy, with complete healing and restoring of clean graphene above 920 K. The excellent chemical and temperature stability of H- (and D-) NPG opens the way not only towards the formation of semiconducting graphane on large-scale samples, but also to stable graphene functionalisation enabling futuristic applications in advanced detectors for the β-spectrum analysis.