Arrhythmia in patients with severe coronavirus disease (COVID-19): a meta-analysis

OBJECTIVE

Many studies have reported arrhythmia to be associated with coronavirus disease (COVID-19), but no meta-analysis has explored whether arrhythmia is related to COVID-19 severity. Therefore, the purpose of this study was to evaluate arrhythmia in patients with severe and non-severe COVID-19 during the current COVID-19 pandemic.

MATERIALS AND METHODS

We searched PubMed, Embase, Web of Science, and the Cochrane Library for case control studies that were published between January 1 and July 25, 2020, and that had data on arrhythmia in patients with COVID-19. Random effects model was used with the odds ratio as the effect size. The frequency of arrhythmia was compared between COVID-19 patients with and without the composite endpoint of severity. We also determined the pooled prevalence of arrhythmia in patients with COVID-19. Publication bias and heterogeneity were considered by using subgroup analyses, meta-regression, and the trim and fill method.

RESULTS

A total of 1553 patients with COVID-19 were included in the 5 articles we obtained. Of these, 349 cases (22.47%) and 1204 cases (77.53%) were severely ill and non-severely ill inpatients with COVID-19 pneumonia, respectively. There were 790 (50.87%) male patients. A total of 105 cases (30.09%) of severely ill inpatients with COVID-19 pneumonia had arrhythmia complications, and 34 cases (2.82%) of non-severely ill inpatients with COVID-19 pneumonia had arrhythmia complications. We found arrhythmia to be significantly associated with severely ill inpatients with COVID-19 pneumonia, with a pooled odds ratio of 17.97 (95% CI (11.30, 28.55), p<0.00001).

CONCLUSIONS

This study showed that the incidence of arrhythmia in patients with severe COVID-19 was greater than that of those with non-severe COVID-19. Patients with severe COVID-19 had a higher risk of arrhythmia complications, which further showed that COVID-19 may be a risk factor for arrhythmia and that the incidence of arrhythmia may increase with the progression of the disease. More importantly, this meta-analysis graded the reliability of evidence for further basic and clinical research into arrhythmia in patients with COVID-19.

Search for Higgs Boson Decays into a Z Boson and a Light Hadronically Decaying Resonance Using 13 TeV pp Collision Data from the ATLAS Detector

A search for Higgs boson decays into a Z boson and a light resonance in two-lepton plus jet events is performed, using a pp collision dataset with an integrated luminosity of 139  fb^{-1} collected at sqrt[s]=13  TeV by the ATLAS experiment at the CERN LHC. The resonance considered is a light boson with a mass below 4 GeV from a possible extended scalar sector or a charmonium state. Multivariate discriminants are used for the event selection and for evaluating the mass of the light resonance. No excess of events above the expected background is found. Observed (expected) 95% confidence-level upper limits are set on the Higgs boson production cross section times branching fraction to a Z boson and the signal resonance, with values in the range 17-340 pb (16_{-5}^{+6}-320_{-90}^{+130}  pb) for the different light spin-0 boson mass and branching fraction hypotheses, and with values of 110 and 100 pb (100_{-30}^{+40} and 100_{-30}^{+40}  pb) for the η_{c} and J/ψ hypotheses, respectively.

Cardiac evaluation in patients with scleroderma_results from screening of pulmonary hypertension in systemic lupus erythermatosus (SOPHIE) study

Background

Pulmonary hypertension (PH) and cardiac involvement were considered as the important prognostic factors in patients with scleroderma. The purpose of this study is to investigate the PH prevalence and related cardiovascular events in patients with scleroderma who were enrolled for screening of PH in systemic lupus erythermatosus (SOPHIE) study.

Methods

One hundred and ninety-four patients with scleroderma were enrolled in this study. Clinical characteristics were collected, all of patients were received echocardiography for screening of the probability of PH using tricuspid regurgitation jet velocity and other echocardiographic “PH” signs. Additionally, Blood test, B type natriuretic peptide (BNP), serum autoantibodies, and 6 minutes walk test, as well as electrocardiograph, were performed in those patients.

Results

Forty (20.6%) patients were divided into intermediate/ high probability PH group (IHPH), 154 Patients were divided into none/ low probability PH group (NLPH). Patients in IHPH group were older compared to NLPH group and has a higher proportion of males (20% VS 7.8%.NLPH), dermatomyositis (10% VS 1.9%.NLPH), and stage 3 chronic kidney disease (7.5% VS 1.3%.NLPH), with a shorter 6MWT distance (390.2±108.3 VS 444.9±88.5.NLPH). B-type natriuretic peptide (BNP) level (181.4±323.8 VS 51.1±61.8. NLPH) and the proportion of BNP level larger than 100 pg/ml (40% VS 10.3%.NLPH) were increased in IHPH group. No significant difference was observed in serum autoantibodies including anti-Scl-70, anti-centromere, anti-RNP, and antiphospholipid antibody between two groups. Thirty-six (18.6%) patients occurred arrythmias, 3 patients (1.6%) with atrial fibrillation and all belong to the IHPH group, patients in IHPH group presented a higher proportion of premature atrial complex (7.5% VS 1.0%.NLPH) and sinus tachycardia (5% VS 0.6%.NLPH), no significant difference was observed in arrythmias in terms of atrial-ventricular blockage or ventricular conduction blockage. Forty patients (20.6%) occurred abnormal electrical activities, the main difference between two groups were lie in T wave abnormality (20% vs 3.9%. NLPH) and P wave high voltage (7.5% VS 0%.NLPH). Receiver operating characteristic (ROC) curve revealed that BNP larger than 100pg/ml to predict PH with sensitivity (52.9%) and specificity (88.2%). Multiple logistic regression analysis indicates age (OR, 1.1; 95% CI, 1.0, 1.10), BNP (OR, 1.0; 95% CI, 1.0, 1.02), diastolic blood pressure (OR, 1.0; 95% CI, 0.91, 0.98) significantly affected right ventricular systolic pressure.

Conclusions

Patients with scleroderma belonged to IHPH group are relatively older than that of NLPH group and manifested with a higher proportion of males, dermatomyositis, more severely chronic kidney disease, arrhythmias, and abnormal electrical activities. Increased age, BNP levels, and diastolic blood pressure can serve as the predicting factors for pulmonary hypertension in patients with scleroderma.

Figure 1

Funding Acknowledgement

Type of funding source: None

A metabolically engineered spin-labeling approach for studying glycans on cells

Metabolic glycan engineering (MGE) coupled with nitroxide spin-labeling (SL) was utilized to investigate the heterogeneous environment of cell surface glycans in select cancer and normal cells. This approach exploited the incorporation of azides into cell surface glycans followed by a click reaction with a new nitroxide spin label. Both sialic acid and N-acetylglucosamine (GlcNAc) were targeted for spin labelling. Although each of these moieties experiences a diverse and heterogeneous glycan environment, their EPR spectra and hence mobility are both characterized as a linear combination of two distinct spectra where one component reflects a highly mobile or uncrowded micro-environment with the second component reflecting more restricted motion, reflective of increased crowding and packing within the glycocalyx. What differs among the spectra of the targeted glycans is the relative percentage of each component, with sialic acid moieties experiencing on average an ∼80% less crowded environment, where conversely GlcNAc/GalNAz labeled sites reported on average a ∼50% more crowded environment. These distinct environments are consistent with the organization of sugar moieties within cellular glycans where some residues occur close to the cell membrane/protein backbone (i.e. more restricted) and others are more terminal in the glycan (i.e. more mobile). Strikingly, different cell lines displayed varied relative populations of these two components, suggesting distinctive glycan packing, organization, and composition of different cells. This work demonstrates the capability of SDSL EPR to be a broadly useful tool for studying glycans on cells, and interpretation of the results provides insights for distinguishing the differences and changes in the local organization and heterogeneity of the cellular glycocalyx.

Dijet Resonance Search with Weak Supervision Using sqrt[s]=13 TeV pp Collisions in the ATLAS Detector

This Letter describes a search for narrowly resonant new physics using a machine-learning anomaly detection procedure that does not rely on signal simulations for developing the analysis selection. Weakly supervised learning is used to train classifiers directly on data to enhance potential signals. The targeted topology is dijet events and the features used for machine learning are the masses of the two jets. The resulting analysis is essentially a three-dimensional search A→BC, for m_{A}∼O(TeV), m_{B},m_{C}∼O(100  GeV) and B, C are reconstructed as large-radius jets, without paying a penalty associated with a large trials factor in the scan of the masses of the two jets. The full run 2 sqrt[s]=13  TeV pp collision dataset of 139  fb^{-1} recorded by the ATLAS detector at the Large Hadron Collider is used for the search. There is no significant evidence of a localized excess in the dijet invariant mass spectrum between 1.8 and 8.2 TeV. Cross-section limits for narrow-width A, B, and C particles vary with m_{A}, m_{B}, and m_{C}. For example, when m_{A}=3  TeV and m_{B}≳200  GeV, a production cross section between 1 and 5 fb is excluded at 95% confidence level, depending on m_{C}. For certain masses, these limits are up to 10 times more sensitive than those obtained by the inclusive dijet search. These results are complementary to the dedicated searches for the case that B and C are standard model bosons.

[Clinical analysis of 26 children with postoperative residual or recurrent fibrosarcoma]

Objective: To evaluate the long-term outcomes and prognostic factors of postoperative residual or recurrent fibrosarcoma in children. Methods: Clinical data of 26 patients continually admitted to Shanghai Children's Medical Center between April 2004 and February 2019 with postoperative residual or recurrent fibrosarcoma were analyzed retrospectively. All patients were treated with Shanghai Children's Medical Center-rhabdomyosarcoma-1999 (SCMC-RS-99) regimen and timely radical tumor resection. Before chemotherapy, according to the surgery and imaging examination, 26 patients were divided into 2 groups: postoperative residual group and postoperative recurrent group. Clinical features and long-term follow-up results of patients were summarized. Kaplan-Meier analysis was used to evaluate the overall survival (OS) and event-free survival (EFS) rates, Log-Rank test and Cox proportional hazards models were used for univariate and multivariate prognostic analysis of factors including age (<3 years or 3-18 years old), gender, primary tumor site, postoperative stage, disease status, ETS variant 6 (ETV6) gene and chemotherapy drugs. Results: Among 26 cases, 13 were male and 13 were female, 17 cases were in postoperative residual group and 9 cases were in postoperative recurrent group. Until the last follow-up at December 31, 2019, the median follow-up time was 73 months (ranged from 10 to 188 months).The 5-year OS and EFS rates were (86±7)% and (77±9)%. Univariate analysis showed that, the 5-year EFS rate of postoperative residual group was significantly higher than that of the postoperative recurrent group ((94±5)% vs.(63±16)%,χ(2)=5.106,P=0.024), the 5-year EFS rate of patients <3 years old was significantly higher than that of patients 3-18 years old ((94±5)% vs. (62±17)%, χ(2)=6.507, P=0.011). Gender (χ(2)=0.445), primary tumor site (χ(2)=0.258), postoperative stage (χ(2)=3.046), ETV6 gene (χ(2)=1.496), and whether doxorubicin-containing drugs in chemotherapy (χ(2)=1.692) did not exhibit significant impact on 5-EFS rate (all P>0.05). Age, postoperative stage and disease status were included in COX proportional risk model for multivariate analysis, which showed that age >3 years old (HR=8.95, 95%CI 0.73-109.50, P=0.086), stage Ⅲ-Ⅳ (HR=16.50, 95%CI 0.84-321.40, P=0.065) and postoperative recurrence (HR=10.60, 95%CI 0.84-134.30, P=0.068) had no significant impact on EFS rate. Conclusion: Children with postoperative residual or postoperative recurrent fibrosarcoma still had good remission rate and long-term survival, especially young children without recurrence have a significant survival advantage.

Atomic Resolution Imaging of CrBr3 Using Adhesion-Enhanced Grids

Suspended specimens of 2D crystals and their heterostructures are required for a range of studies including transmission electron microscopy (TEM), optical transmission experiments, and nanomechanical testing. However, investigating the properties of laterally small 2D crystal specimens, including twisted bilayers and air-sensitive materials, has been held back by the difficulty of fabricating the necessary clean suspended samples. Here we present a scalable solution that allows clean free-standing specimens to be realized with 100% yield by dry-stamping atomically thin 2D stacks onto a specially developed adhesion-enhanced support grid. Using this new capability, we demonstrate atomic resolution imaging of defect structures in atomically thin CrBr₃, a novel magnetic material that degrades in ambient conditions.

GW190521: A Binary Black Hole Merger with a Total Mass of 150 M_{⊙}

On May 21, 2019 at 03:02:29 UTC Advanced LIGO and Advanced Virgo observed a short duration gravitational-wave signal, GW190521, with a three-detector network signal-to-noise ratio of 14.7, and an estimated false-alarm rate of 1 in 4900 yr using a search sensitive to generic transients. If GW190521 is from a quasicircular binary inspiral, then the detected signal is consistent with the merger of two black holes with masses of 85_{-14}^{+21}  M_{⊙} and 66_{-18}^{+17}  M_{⊙} (90% credible intervals). We infer that the primary black hole mass lies within the gap produced by (pulsational) pair-instability supernova processes, with only a 0.32% probability of being below 65  M_{⊙}. We calculate the mass of the remnant to be 142_{-16}^{+28}  M_{⊙}, which can be considered an intermediate mass black hole (IMBH). The luminosity distance of the source is 5.3_{-2.6}^{+2.4}  Gpc, corresponding to a redshift of 0.82_{-0.34}^{+0.28}. The inferred rate of mergers similar to GW190521 is 0.13_{-0.11}^{+0.30}  Gpc^{-3} yr^{-1}.

Utility of data-driven clusters for the prevention of type 2 diabetes

Background

Type 2 diabetes (T2D) is an important cause of mortality, disability and health care expenditures. Prevention is crucial to counter global trends, but individual variability of different risk factors leading to T2D has made prevention difficult to achieve. We aimed to identify clusters of individuals based on individual level characteristics of different risk factors using a data driven approach.

Methods

We used data from the Stockholm Diabetes Prevention Program. A population-based, prospective study. Healthy participants who were born in Sweden and aged 35 to 55 years old were recruited between 1992 and 1998 and followed up after 10 and 20 years. At each visit, participants answered extensive questionnaires, anthropometric measures, laboratory examinations and an oral glucose tolerance test. We used age, sex, family history of diabetes, fasting and two hours glucose and insulin, body mass index (BMI), systolic and diastolic blood pressure, and level of education were at baseline to group participants using the k-prototype algorithm. We then examined the risk of diabetes between clusters using survival analysis.

Results

A total of 7,173 participants representing 138,942 person years of follow-up were included in this study. Among them, 998 (14%) developed T2D. We identified six stable clusters: the group with the lowest cumulative incidence of T2D (2.3%) was used as reference (n = 1,265). In the group with the highest risk, 47% developed T2D (n = 772, HR 26.3, 95%CI 17.9-38.5) followed by 17.1% (n = 1,146, HR 7.6, 95%CI 5.1-11.22), 15.2% (n = 1,453, HR 6.7, 95%CI 4.5-9.8), 9.5% (n = 1,384, HR 4.1, 95%CI 2.8-6.2) and 5.2% (n = 1,157, HR 2.0, 95%CI 1.3-3.1) in the remaining groups.

Conclusions

There is important variability between individuals regarding the effect of different risk factors on the incidence of T2D. Data driven categorization strategies can be useful epidemiological tools to pave the way for more precise T2D intervention programs.

Key messages

Prevention strategies for T2D usually follow a one-size fits all approach, ignoring the important variability of risk factors and their consequences among individuals. It is possible to identify subgroups of people with different risk of T2D based on simple clinical and phenotypical characteristics, and could help to improve prevention and treatment of T2D.

Discovery of Pyrido[2,3-b]indole Derivatives with Gram-Negative Activity Targeting Both DNA Gyrase and Topoisomerase IV

The rise of multidrug resistant (MDR) Gram-negative (GN) pathogens and the decline of available antibiotics that can effectively treat these severe infections are a major threat to modern medicine. Developing novel antibiotics against MDR GN pathogens is particularly difficult as compounds have to permeate the GN double membrane, which has very different physicochemical properties, and have to circumvent a plethora of resistance mechanisms such as multiple efflux pumps and target modifications. The bacterial type II topoisomerases DNA gyrase (GyrA₂B₂) and Topoisomerase IV (ParC₂E₂) are highly conserved targets across all bacterial species and validated in the clinic by the fluoroquinolones. Dual inhibitors targeting the ATPase domains (GyrB/ParE) of type II topoisomerases can overcome target-based fluoroquinolone resistance. However, few ATPase inhibitors are active against GN pathogens. In this study, we demonstrated a successful strategy to convert a 2-carboxamide substituted azaindole chemical scaffold with only Gram-positive (GP) activity into a novel series with also potent activity against a range of MDR GN pathogens. By systematically fine-tuning the many physicochemical properties, we identified lead compounds such as 17r with a balanced profile showing potent GN activity, high aqueous solubility, and desirable PK features. Moreover, we showed the bactericidal efficacy of 17r using a neutropenic mouse thigh infection model.

Preoperative status and treatment of osteoradionecrosis of the jaw: a retrospective study of 252 cases

Osteoradionecrosis of the jaw (ORNJ) is one of the most devastating and progressive complications of head and neck radiotherapy. It can cause emaciation, deformity, and pathological fractures, resulting in decreased quality of life. The aim of this study was to evaluate the preoperative index and outcomes of treatment for ORNJ. A retrospective study of 252 ORNJ cases treated at one institution between January 2010 and January 2018 was made. The abnormal items from the preoperative examination and follow-up after different treatments were recorded, and the differences between the noteworthy items were compared using univariate and multivariate models. Most ORNJ patients in the middle and late stages had abnormal items, such as hypoproteinaemia, anaemia, and leucocytosis. Partial mandibulectomy with flap reconstruction was significantly more effective than without reconstruction. Advanced ORNJ patients tended to have more abnormal items, which might have a negative influence on treatment. For better outcomes, it is essential and effective to completely remove the necrotic lesion and reconstruct it with a flap. The surgeons should provide sufficient perioperative management and strive for suitable surgical treatment.

Humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer

A relative humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer (MZI) is proposed in this paper. The MZI was made by splicing a segment of the few-mode fiber (FMF) between two segments of a no-core fiber (NCF) and two segments of a single mode fiber (SMF) located outside the two NCFs. The core and cladding of the FMF acted as interferometric arms, while the NCFs acted as couplers for splitting and recombining light due to mismatch of mode field diameter. The cladding of the FMF was corroded with hydrofluoric acid, and a layer of graphene oxide (GO) film was coated on the corroded cladding of FMF via the natural deposition method. The refractive index of GO varied upon absorption the water molecules. As a result, the phase difference of the MZI varied and the wavelength of the resonant dip shifted with a change in the ambient relative humidity (RH). High humidity sensitivity of 0.191 and 0.061 nm/%RH in the RH range of 30-55% and 55-95%, respectively, were achieved experimentally. The high sensitivity, compact size, and simple manufacturing of the proposed sensor could offer attractive applications in fields of chemical sensors and biochemical detection.

Abstract CT401: The experience of treating patients with cancer during the COVID-19 pandemic in China

Background: Cancer patients are regarded as highly vulnerable group in the current SARS-CoV-2/COVID-19 pandemic. Up to date, the clinical characteristics of cancer patients with COVID-19 are largely unknown.

Patients and methods: In this retrospective cohort study, we collected and analyzed data of the cancer patients with y confirmed COVID-19 infection from three designated hospitals in Wuhan, China from Jan 13, 2020, to Feb 26, 2020. Univariate and multivariate analyses were performed to assess the risk factors associated with severe events defined as a condition that admission to an intensive care unit, the use of mechanical ventilation, or death. We also followed 124 cancer patients with immune checkpoint inhibitors (ICI) and their families for their infection rate and clinical outcome.

Results: Twenty-eight COVID-19 infected cancer patients were included with median age of 65.0 years (IQR:56.0-70.0) and male gender of 60.7% (17/28). Amount of these 28 patients, 7 (25%) had lung cancer, and 8 (28.6%) were considered to be infected via hospital-associated transmission. Fifteen (53.6%) patients had severe events with the mortality rate of 28.6%. The last anti-tumor treatment within 14 days from the diagnoses of COVID significant increased risk of developing severe events (HR=4.079, 95%CI 1.086-15.322, P=0.037). The common chest CT findings were ground-glass opacity (21, 75.0%) and patchy consolidation (13, 46.3%). The patchy consolidation on CT had a higher risk for developing severe events (HR=5.438, 95%CI 1.498-19.748, P=0.010). There was only one patient (1/124, 0.8%) who have been on ICI treatment for his metastatic HCC confirmed with COVID infection, and with mild clinic presentation and a short hospital course.

Conclusions: Cancer patients showed aggressive presentation and poor outcomes with the COVID-19 infection. It is recommended that vigorous screening for COVID-19 infection should be performed for cancer patients with anti-tumor. From our limited data, there is no evidence to suggest difference in cancer patients on ICI treatment.

Citation Format: Li Zhang, F Zhu, L Xie, C Wang, J Wang, R Chen, P Jia, H Q. Guan, L Peng, P Peng, P Zhang, Q Chu, Q Shen, Y Wang, S Y. Xu, J P. Zhao, M Zhou, Y Chen. The experience of treating patients with cancer during the COVID-19 pandemic in China [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT401.

CP Properties of Higgs Boson Interactions with Top Quarks in the tt[over ¯]H and tH Processes Using H→γγ with the ATLAS Detector

A study of the charge conjugation and parity (CP) properties of the interaction between the Higgs boson and top quarks is presented. Higgs bosons are identified via the diphoton decay channel (H→γγ), and their production in association with a top quark pair (tt[over ¯]H) or single top quark (tH) is studied. The analysis uses 139  fb^{-1} of proton-proton collision data recorded at a center-of-mass energy of sqrt[s]=13  TeV with the ATLAS detector at the Large Hadron Collider. Assuming a CP-even coupling, the tt[over ¯]H process is observed with a significance of 5.2 standard deviations. The measured cross section times H→γγ branching ratio is 1.64_{-0.36}^{+0.38}(stat)_{-0.14}^{+0.17}(sys)  fb, and the measured rate for tt[over ¯]H is 1.43_{-0.31}^{+0.33}(stat)_{-0.15}^{+0.21}(sys) times the Standard Model expectation. The tH production process is not observed and an upper limit on its rate of 12 times the Standard Model expectation is set. A CP-mixing angle greater (less) than 43 (-43)° is excluded at 95% confidence level.

Search for Heavy Higgs Bosons Decaying into Two Tau Leptons with the ATLAS Detector Using pp Collisions at sqrt[s]=13 TeV

A search for heavy neutral Higgs bosons is performed using the LHC Run 2 data, corresponding to an integrated luminosity of 139  fb^{-1} of proton-proton collisions at sqrt[s]=13  TeV recorded with the ATLAS detector. The search for heavy resonances is performed over the mass range 0.2-2.5 TeV for the τ^{+}τ^{-} decay with at least one τ-lepton decaying into final states with hadrons. The data are in good agreement with the background prediction of the standard model. In the M_{h}^{125} scenario of the minimal supersymmetric standard model, values of tanβ>8 and tanβ>21 are excluded at the 95% confidence level for neutral Higgs boson masses of 1.0 and 1.5 TeV, respectively, where tanβ is the ratio of the vacuum expectation values of the two Higgs doublets.

Atomic reconstruction in twisted bilayers of transition metal dichalcogenides

Van der Waals heterostructures form a unique class of layered artificial solids in which physical properties can be manipulated through controlled composition, order and relative rotation of adjacent atomic planes. Here we use atomic-resolution transmission electron microscopy to reveal the lattice reconstruction in twisted bilayers of the transition metal dichalcogenides, MoS₂ and WS₂. For twisted 3R bilayers, a tessellated pattern of mirror-reflected triangular 3R domains emerges, separated by a network of partial dislocations for twist angles θ < 2°. The electronic properties of these 3R domains, featuring layer-polarized conduction-band states caused by lack of both inversion and mirror symmetry, appear to be qualitatively different from those of 2H transition metal dichalcogenides. For twisted 2H bilayers, stable 2H domains dominate, with nuclei of a second metastable phase. This appears as a kagome-like pattern at θ ≈ 2°, transitioning at θ → 0 to a hexagonal array of screw dislocations separating large-area 2H domains. Tunnelling measurements show that such reconstruction creates strong piezoelectric textures, opening a new avenue for engineering of 2D material properties.

Measurement of the Lund Jet Plane Using Charged Particles in 13 TeV Proton-Proton Collisions with the ATLAS Detector

The prevalence of hadronic jets at the LHC requires that a deep understanding of jet formation and structure is achieved in order to reach the highest levels of experimental and theoretical precision. There have been many measurements of jet substructure at the LHC and previous colliders, but the targeted observables mix physical effects from various origins. Based on a recent proposal to factorize physical effects, this Letter presents a double-differential cross-section measurement of the Lund jet plane using 139  fb^{-1} of sqrt[s]=13  TeV proton-proton collision data collected with the ATLAS detector using jets with transverse momentum above 675 GeV. The measurement uses charged particles to achieve a fine angular resolution and is corrected for acceptance and detector effects. Several parton shower Monte Carlo models are compared with the data. No single model is found to be in agreement with the measured data across the entire plane.

Antimicrobial resistance in southern China: results of prospective surveillance in Dongguan city, 2017

BACKGROUND

Few studies have estimated the burden of infections due to antimicrobial-resistant (AMR) pathogens in China.

AIM

To summarize antimicrobial resistance and assess the frequency of community-associated infections (CAIs) and healthcare-associated infections (HCAIs) due to AMR pathogens in Dongguan city, China.

METHODS

Seven acute care hospitals provided antimicrobial susceptibility data for 2017, from which 'bug-drug' combinations were analysed. To calculate incidence proportions of CAI and incidence densities of HCAI, data from three tertiary care hospitals were merged with patient data, obtained from the Dongguan Nosocomial Infection Surveillance System.

FINDINGS

A total of 16,548 pathogens were analysed. Non-susceptibility to third-generation cephalosporins (3GCs) in Escherichia coli and Klebsiella pneumoniae was 43.9% and 30.2%, respectively. Non-susceptibility to carbapenems in Pseudomonas aeruginosa and Acinetobacter baumannii was 29.5% and 50.9%, respectively. A quarter of Staphylococcus aureus (26.3%) were non-susceptible to oxacillin. The incidence density of HCAI due to E. coli non-susceptible to 3GCs and fluoroquinolones combined was 0.09 (95% confidence interval: 0.07-0.11) per 1000 patient-days. Both E. coli and K. pneumoniae were the predominant pathogens isolated from blood. Compared with the 2017 European Antimicrobial Resistance Surveillance Network report, the incidence proportion of bloodstream infections due to multidrug-resistant E. coli was significantly higher (14.9% and 4.6%, respectively).

CONCLUSION

The incidence of non-susceptible bug-drug combinations in Dongguan city was lower compared with China as a whole. Non-susceptible bug-drug combinations were significantly more frequent in HCAI compared with CAI. The incidence proportion of bloodstream infections due to multidrug-resistant pathogens in Dongguan City was higher compared with Europe.

0198 Psychomotor/Cognitive Effects, Pharmacokinetics and Safety of V117957, a Novel, Highly Potent and Selective Partial Agonist for Nociceptin/Orphanin-FQ Peptide (NOP) Receptors, Administered in Combination with Alcohol in Healthy Subjects

Introduction

V117957 is an investigational nociceptin/orphanin-FQ peptide (NOP) receptor partial agonist designed to treat insomnia by promoting sleep onset and maintenance with minimal residual next-day somnolence or psychomotor impairment. The satisfactory safety/tolerability profile of V117957 has been previously established in ~200 healthy subjects with maximum doses at 30mg following a single oral administration and 10mg once daily for 2 weeks. The present study was conducted to assess the safety/tolerability and pharmacokinetics (PK) of V117957 with co-administered alcohol.

Methods

A randomized, double-blind, double-dummy, placebo-controlled, balanced six-period crossover design was employed. Single doses (2mg, 6mg) of V117957 and placebo were administered orally to healthy subjects in the morning with and without alcohol (0.7g/kg). Pharmacodynamic (PD) effects of V117957 were assessed, and safety/tolerability and PK interactions were also characterized. The primary PD endpoints (body sway, Digit Vigilance Test, and numeric working memory) were measured through 12 hours postdosing.

Results

Forty-eight subjects were enrolled and randomized; 46 completed. Compared with placebo, alcohol alone showed an impairment on psychomotor/cognitive performances through 2 hours postdose. V117957 alone showed a dose-dependent impairment. Compared with V117957 alone and alcohol alone, co-administration of alcohol and V117957 showed greater impairment until 8 hours postdose. No subject discontinued due to an adverse event (AE). No clinically meaningful treatment-emergent (TE) changes in clinical laboratory values, vital signs, SpO2 measurements, or 12-lead ECG results were observed. The most common TEAE was somnolence. All plasma and urine PK parameters for V117957 and alcohol were comparable when V117957 or alcohol was administered alone or in combination.

Conclusion

Single oral doses of V117957, 2mg or 6mg, administered alone or in combination with alcohol in healthy subjects resulted in no notable PK interaction between V117957 and alcohol. A dose-effect relationship in the magnitude and duration of impairment was observed for most psychomotor/cognitive performance parameters. Greater effects of V117957 with alcohol were observed for most psychomotor/cognitive performance parameters up to 8 hours post-dose.

Support

Funded by Imbrium Therapeutics, a subsidiary of Purdue Pharma L.P.

0500 Evaluation of the Human Abuse Potential of Single Oral Doses of V117957, a Novel, Highly Potent and Selective Partial Agonist for Nociceptin/Orphanin-FQ Peptide (NOP) Receptors

Introduction

The satisfactory safety/tolerability profile of V117957, an investigational NOP receptor partial agonist, has been previously established in ~200 healthy subjects with maximum doses at 30mg following a single oral administration and 10mg once daily for 2 weeks. V117957 exhibited linear plasma exposures at doses up to 10mg. In patients with insomnia disorder, V117957 demonstrated dose-dependent improvement in sleep efficiency and sleep maintenance between 0.5mg and 10mg as measured by polysomnography and patient diaries. The current study evaluated the abuse potential and safety of V117957 in healthy, nondependent recreational polydrug users with a history of central nervous system (CNS) depressant use.

Methods

The abuse potential of V117957 (1mg, 6mg, 10mg), placebo, and triazolam (0.5mg, 1mg) were assessed in a randomized, double-blind, double-dummy, placebo- and positive-controlled crossover study. Triazolam was utilized as a positive control based on its comparable pharmacokinetic and pharmacodynamic characteristics. V117957 doses (1mg, 6mg, 10mg) were selected to represent therapeutic, mid-range supratherapeutic, and maximum-tolerated supratherapeutic doses, respectively. Subjects were qualified based on pharmacodynamic responses following a single oral 0.75mg triazolam dose. Drug liking was measured through 24 hours, including the primary endpoint of maximum “at the moment” Drug-Liking Visual Analog Scale, as recommended by FDA. Secondary endpoints included Divided Attention Test (DAT) and Choice Reaction Time (CRT).

Results

The positive control (triazolam 0.5mg, 1mg) produced statistically significant greater abuse potential and cognitive/motor impairment versus placebo, which demonstrated study validity. In contrast, V117957 at 1mg was not statistically significantly different from placebo. At the supra-therapeutic doses of 6 and 10mg, V117957 was associated with abuse potential and cognitive/motor impairment greater than placebo, yet similar to those of triazolam 0.5 and 1mg.

Conclusion

Overall, in this valid study, V117957 1mg and placebo were associated with statistically significant lower potential for abuse and reduced cognitive/motor impairment compared with the two supratherapeutic doses of V117957 (6mg, 10mg), and triazolam (0.5mg, 1mg). V117957 1mg met FDA’s statistical criterion for similarity to placebo.

Support

Funded by Imbrium Therapeutics, a subsidiary of Purdue Pharma L.P.

Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China

Background

Cancer patients are regarded as a highly vulnerable group in the current Coronavirus Disease 2019 (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients remain largely unknown.

Patients and methods

In this retrospective cohort study, we included cancer patients with laboratory-confirmed COVID-19 from three designated hospitals in Wuhan, China. Clinical data were collected from medical records from 13 January 2020 to 26 February 2020. Univariate and multivariate analyses were carried out to assess the risk factors associated with severe events defined as a condition requiring admission to an intensive care unit, the use of mechanical ventilation, or death.

Results

A total of 28 COVID-19-infected cancer patients were included; 17 (60.7%) patients were male. Median (interquartile range) age was 65.0 (56.0–70.0) years. Lung cancer was the most frequent cancer type (n = 7; 25.0%). Eight (28.6%) patients were suspected to have hospital-associated transmission. The following clinical features were shown in our cohort: fever (n = 23, 82.1%), dry cough (n = 22, 81%), and dyspnoea (n = 14, 50.0%), along with lymphopaenia (n = 23, 82.1%), high level of high-sensitivity C-reactive protein (n = 23, 82.1%), anaemia (n = 21, 75.0%), and hypoproteinaemia (n = 25, 89.3%). The common chest computed tomography (CT) findings were ground-glass opacity (n = 21, 75.0%) and patchy consolidation (n = 13, 46.3%). A total of 15 (53.6%) patients had severe events and the mortality rate was 28.6%. If the last antitumour treatment was within 14 days, it significantly increased the risk of developing severe events [hazard ratio (HR) = 4.079, 95% confidence interval (CI) 1.086–15.322, P = 0.037]. Furthermore, patchy consolidation on CT on admission was associated with a higher risk of developing severe events (HR = 5.438, 95% CI 1.498–19.748, P = 0.010).

Conclusions

Cancer patients show deteriorating conditions and poor outcomes from the COVID-19 infection. It is recommended that cancer patients receiving antitumour treatments should have vigorous screening for COVID-19 infection and should avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19 coinfection.

Measurement of Azimuthal Anisotropy of Muons from Charm and Bottom Hadrons in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

The elliptic flow of muons from the decay of charm and bottom hadrons is measured in pp collisions at sqrt[s]=13  TeV using a data sample with an integrated luminosity of 150  pb^{-1} recorded by the ATLAS detector at the LHC. The muons from heavy-flavor decay are separated from light-hadron decay muons using momentum imbalance between the tracking and muon spectrometers. The heavy-flavor decay muons are further separated into those from charm decay and those from bottom decay using the distance-of-closest-approach to the collision vertex. The measurement is performed for muons in the transverse momentum range 4-7 GeV and pseudorapidity range |η|<2.4. A significant nonzero elliptic anisotropy coefficient v_{2} is observed for muons from charm decays, while the v_{2} value for muons from bottom decays is consistent with zero within uncertainties.

Depressive costs: medical expenditures on depression and depressive symptoms among rural elderly in China

OBJECTIVES

To provide an evaluation of medical expenditures induced by depression and depressive symptoms among rural elderly in China.

STUDY DESIGN

The panel dataset used for this study is taken from the China Family Panel Studies (CFPS) data for the years 2012 and 2016. We examined the case of rural elderly who were 60 years old or older at the time of the 2012 survey and 64 years old or older at the time of the 2016 survey and then created a panel dataset that includes 2938 rural elderly for both years to estimate the influence of depressive symptoms/depression on medical cost.

METHODS

Both two part model and four part model were used to estimate the influence of depressive symptoms and depression on medical expenditure. Then a counter-factual method was used to calculate the cost of depressive symptoms and depression among rural elderly in China.

RESULTS

Mental health status has significant effects on individual medical expenses, and they aggregately contribute to 47.26% of total personal expected medical expenditures. Specifically, the rural group, the female group, the widowed group, and the poorly educated group have higher medical expenditures because of depressive status than the other groups.

CONCLUSIONS

Mental health status significantly increased both the chance of undergoing medical care and the degree of medical expenditure among rural elderly in China. This situation is more serious in some vulnerable groups. Therefore, the Chinese government needs to reform its mental health of rural elderly and insurance institutions to eliminate the policy-caused barriers to mental health resources, especially for vulnerable groups.

Search for Magnetic Monopoles and Stable High-Electric-Charge Objects in 13 Tev Proton-Proton Collisions with the ATLAS Detector

A search for magnetic monopoles and high-electric-charge objects is presented using 34.4  fb^{-1} of 13 TeV pp collision data collected by the ATLAS detector at the LHC during 2015 and 2016. The considered signature is based upon high ionization in the transition radiation tracker of the inner detector associated with a pencil-shape energy deposit in the electromagnetic calorimeter. The data were collected by a dedicated trigger based on the tracker high-threshold hit capability. The results are interpreted in models of Drell-Yan pair production of stable particles with two spin hypotheses (0 and 1/2) and masses ranging from 200 to 4000 GeV. The search improves by approximately a factor of 5 the constraints on the direct production of magnetic monopoles carrying one or two Dirac magnetic charges and stable objects with electric charge in the range 20≤|z|≤60 and extends the charge range to 60<|z|≤100.

Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA

We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star-black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 10 5 , 10 6 , 10 7 Mpc 3 for binary neutron star, neutron star-black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1 - 1 + 12 ( 10 - 10 + 52 ) for binary neutron star mergers, of 0 - 0 + 19 ( 1 - 1 + 91 ) for neutron star-black hole mergers, and 17 - 11 + 22 ( 79 - 44 + 89 ) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers.

[Clinical research and drug review of epidermal growth factor receptor tyrosine kinase inhibitors in advanced non-small cell lung cancer]

Lung cancer is the most frequently diagnosed cancer and the most common cause of cancer mortality in China. Non-small cell lung cancer (NSCLC) accounts for about 85% of lung cancers. The mutation rate of epidermal growth factor receptor (EGFR) gene is relatively high, accounts for 32%~38% of all NSCLC. During the last decade, the application of EGFR specific tyrosine kinase inhibitors (TKI) significantly improved prognosis of NSCLC patients with sensitive EGFR mutations. Thus, the research and development of third generation EGFR-TKI have entered the period of rapid development. The fourth generation EGFR-TKI which targeting EGFR C797S has even begun clinical development in China. This review will discuss the clinical research and drug review of EGFR-TKI from the perspective of drug review.

Long non-coding RNA H19 protects acute myocardial infarction through activating autophagy in mice

OBJECTIVE

We investigate the effect of long non-coding RNA H19 in acute myocardial infarction (AMI) and the underlying mechanism.

MATERIALS AND METHODS

C57BL/6 mice were subjected to AMI and injected with lentivirus pcDNA-H19. After AMI procedures for 3 weeks, cardiac function was detected by echocardiography. The infarct size was stained by triphenyltetrazolium chloride. H19 expression in mice was measured by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Protein expressions of LC3, Beclin-1, and ATG-7 in mice were measured by Western blot.

RESULTS

Our results indicated that H19 expression was significantly downregulated in the infarcted myocardium. Overexpression of H19 after injection with pcDNA-H19 in mice could reduce infarct size and improve cardiac function through upregulating the ratio of LC3-II/I and expressions of Beclin-1 and ATG-7.

CONCLUSIONS

Overexpression of H19 could protect AMI in mice via activating autophagy.

URG4-silencing suppresses cell proliferation in nasopharyngeal carcinoma through induction of apoptosis

OBJECTIVE

To investigate the expression and function of up-regulator of gene-4 (URG4) in nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS

Fresh NPC tumor tissue samples with paired adjacent normal nasopharyngeal tissues samples of 9 NPC patients were collected from NPC curative resection surgery. NPC cell lines (CNE1, CNE2 and HONE1) were cultured. Lentivirus-mediated URG4-specific short hairpin RNA (shRNA) stable transfection was done. The effect of URG4 on CNE4 and HONE1 cells viability was determined via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT). The plate-colony-formation assay was performed. Apoptosis analysis was done by flow cytometry. The expression levels of protein and RNA were detected by Western blotting and quantitative polymerase chain reaction (qPCR).

RESULTS

We determined the expression of URG4/URGCP in NPC tissues and cell lines using qPCR analysis and found it was significantly upregulated in NPC. After that, stable URG4-silencing NPC cells were constructed by transfection with lentivirus-mediated shRNA. Functionally analyses indicated that knockdown of URG4 significantly impaired cell viability and colony formation ability, as confirmed by MTT and colony formation assays. Furthermore, URG4-silencing NPC cells showed more cells in the stage of early and late apoptosis compared with controls by flow cytometry assay. Western blot analysis further confirmed that knockdown of URG4 enhanced the expression of cleaved caspase-3, cleaved PARP and Bax, while decreased the expression of Bcl-2 and survivin.

CONCLUSIONS

URG4/URGCP might play an essential role in NPC cell growth and proliferation and its silencing might be as a potential therapeutic target for NPC.

Excessive daytime sleepiness with snoring or witnessed apnea is associated with handgrip strength: a population-based study

BACKGROUND

Sarcopenia is emerging as an important public health problem, and evidences have determined that poor sleep is associated with muscle strength, but the potential effects of excessive daytime sleepiness (EDS), snoring and witnessed apnea on handgrip strength have not been evaluated.

AIM

We aimed to examine the association between EDS, snoring, witnessed apnea and muscle strength in an adult population.

DESIGN

Cross-sectional study.

METHODS

This cross-sectional study comprised 19 434 adults. Handgrip strength was measured using a handheld digital dynamometer. EDS was assessed by Epworth Sleepiness Scale, snoring and witnessed apnea during sleep were reported through simple yes/no questions. Analysis of covariance was carried out to determine the association between EDS with snoring or witnessed apnea and muscle strength.

RESULTS

The means (95% confidence interval) for average handgrip strength/body weight (kg/kg) across symptoms categories were 0.396 (0.333-0.472), 0.393 (0.330-0.467), 0.396 (0.333-0.471) and 0.386 (0.325-0.460) (P < 0.0001), respectively. Similar results were observed with maximal handgrip strength/body weight (kg/kg).

CONCLUSIONS

Self-reported EDS accompanied with snoring or apnea is associated with lowest handgrip strength, independently of confounding factors. Whether improvement of EDS, snoring and apnea, can ameliorate age-associated decline in muscle strength warrants further studies.

Identification of New QTL Contributing to Barley Yellow Dwarf Virus-PAV (BYDV-PAV) Resistance in Wheat

Barley yellow dwarf (BYD) is a major virus disease which dramatically reduces wheat yield. Introducing BYD resistance genes into commercial varieties has been proven to be effective in reducing damage caused by barley yellow dwarf virus (BYDV). However, only one major resistance gene is readily deployable for breeding; Bdv2 derived from Thinopyrum intermedium is deployed as a chromosomal translocation. In this study, a double haploid (DH) population was developed from a cross between XuBYDV (introduced from China showing very good resistance to BYD) and H-120 (a BYD-sensitive Chinese accession), and was used to identify QTL for BYD resistance. The population was genotyped using an Infinium iSelect bead chip array targeting 90K gene-based SNPs. The disease resistance of DH lines inoculated with BYDV was assessed at the heading stage. The infections were assessed by tissue blot immunoassay (TBIA). Three new QTL were identified on chromosomes 5A, 6A, and 7A for both symptom and TBIA, with all three resistance alleles being inherited from XuBYDV. Some DH lines with the resistance alleles from all three QTL showed high level resistance to BYD. These new QTL will be useful in breeding programs for pyramiding BYD resistance genes.

Search for Subsolar Mass Ultracompact Binaries in Advanced LIGO's Second Observing Run

We present a search for subsolar mass ultracompact objects in data obtained during Advanced LIGO's second observing run. In contrast to a previous search of Advanced LIGO data from the first observing run, this search includes the effects of component spin on the gravitational waveform. We identify no viable gravitational-wave candidates consistent with subsolar mass ultracompact binaries with at least one component between 0.2  M_{⊙}-1.0  M_{⊙}. We use the null result to constrain the binary merger rate of (0.2  M_{⊙}, 0.2  M_{⊙}) binaries to be less than 3.7×10^{5}  Gpc^{-3} yr^{-1} and the binary merger rate of (1.0  M_{⊙}, 1.0  M_{⊙}) binaries to be less than 5.2×10^{3}  Gpc^{-3} yr^{-1}. Subsolar mass ultracompact objects are not expected to form via known stellar evolution channels, though it has been suggested that primordial density fluctuations or particle dark matter with cooling mechanisms and/or nuclear interactions could form black holes with subsolar masses. Assuming a particular primordial black hole (PBH) formation model, we constrain a population of merging 0.2  M_{⊙} black holes to account for less than 16% of the dark matter density and a population of merging 1.0  M_{⊙} black holes to account for less than 2% of the dark matter density. We discuss how constraints on the merger rate and dark matter fraction may be extended to arbitrary black hole population models that predict subsolar mass binaries.

Observation of Electroweak Production of a Same-Sign W Boson Pair in Association with Two Jets in pp Collisions at sqrt[s]=13 TeV with the ATLAS Detector

This Letter presents the observation and measurement of electroweak production of a same-sign W boson pair in association with two jets using 36.1  fb^{-1} of proton-proton collision data recorded at a center-of-mass energy of sqrt[s]=13  TeV by the ATLAS detector at the Large Hadron Collider. The analysis is performed in the detector fiducial phase-space region, defined by the presence of two same-sign leptons, electron or muon, and at least two jets with a large invariant mass and rapidity difference. A total of 122 candidate events are observed for a background expectation of 69±7 events, corresponding to an observed signal significance of 6.5 standard deviations. The measured fiducial signal cross section is σ^{fid}=2.89_{-0.48}^{+0.51}(stat)_{-0.28}^{+0.29}(syst)  fb.

Protein arginine methyltransferase 1 promotes epithelial-mesenchymal transition via TGF-β1/Smad pathway in hepatic carcinoma cells

Protein arginine methyltransferase 1 (PRMT1) is dysregulated in a number of human cancers. Herein, we report that PRMT1 expression is directly associated with epithelial-mesenchymal transition (EMT) in hepatic carcinoma cells. Firstly, we find that PRMT1 expression is higher in hepatic carcinoma tissues than that in normal liver tissues at both mRNA and protein levels, and higher expression of PRMT1 correlates with poor survival in liver tumors. The data in vitro reveals that PRMT1 knockdown inhibits the abilities of proliferation, migration and invasion, while PRMT1 overexpression promotes the above behaviors in hepatic carcinoma cells. Further studies indicate that PRMT1 knockdown remarkably decreases the expression of mesenchymal markers including Vimentin, Snail and N-cadherin, and upregulates expression of epithelial markers E-cadherin. Conversely, PRMT1 overexpression results in the opposite effects. Additionally, we identified that PRMT1 knockdown resulted in downregulation of TGF-β1, p-Smad2 and p-Smad3, while PRMT1 overexpression activated TGF-β1, p-Smad2 and p-Smad3. These findings suggest that PRMT1 promotes EMT in hepatic carcinoma cells probably via TGF-β1/Smad pathway, and might represent a novel anti-liver cancer strategy.