SAT0560 THE PROGNOSTIC VALUE OF ULTRASONOGRAPHIC FINDINGS IN INDIVIDUALS WITH ASYMPTOMATIC HYPERURICEMIA

Background:

Chronic and steady asymptomatic hyperuricemia (AHU) can eventually lead to the deposition of monosodium urate crystals in joints and soft tissues. The rate of progression from AHU to clinically evident gout varies and mainly depends on serum uric acid levels. However, little is known about the prognostic value of ultrasonographic findings in individuals with AHU in detail.

Objectives:

To explore the prognostic value of ultrasonographic findings in individuals with asymptomatic hyperuricemia.

Methods:

We analyzed the ultrasonographic findings (snowstorm sign, double-contour (DC) sign, tophi, bone erosion, and abnormal blood flow) of bilateral knees, ankles and the first metatarsal-phalangeal joints (1st MTP) of individuals with AHU at Peking University People’s hospital between June 2014 and May 2016. All individuals were followed up for two years.

Results:

Among 218 individuals with AHU, the prevalence of snowstorm sign, DC sign, tophi, bone erosion and abnormal blood flow was 41%, 23%, 4%, 9% and 13%, respectively. Gout attacked in 36 patients during 2-year follow-up with 4.5 years of HU duration. The first attack affected the 1st MTP in 60%, the ankle in 31%, and the knee in 11% of the patients with gout. Patients with gout attack has longer hyperuricemia duration compared with individuals with AHU without gout attack. DC sign, tophi, and bone erosion on ultrasound were more frequently presented in patients with gout attack compared with individuals with AHU without gout attack. However, the prevalence of snowstorm sign and and abnormal blood flow on ultrasound has no significant differences between patients with gout attack and individuals with AHU without gout attack.

Conclusion:

Longer hyperuricemia duration, DC sign, tophi, and bone erosion on ultrasound in individuals with AHU could be associated with gout attack.

References:

[1]Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74(10):1789-98.

[2]Estevez-Garcia IO, Gallegos-Nava S, Vera-Pérez E, Silveira LH, Ventura-Ríos L, Vancini G, et al. Levels of cytokines and MicroRNAs in individuals with asymptomatic hyperuricemia and ultrasonographic findings of gout: A Bench-to-Bedside Approach. Arthritis Care Res. 2018;70(12):1814-21.

[3]Elsaman AM, Muhammad EM, Pessler F. Sonographic findings in gouty arthritis: diagnostic value and association with disease duration. Ultrasound Med Biol. 2016;42(6):1330-6.

[4]Joosten LAB, Crişan TO, Bjornstad P, Johnson RJ. Asymptomatic hyperuricaemia: a silent activator of the innate immune system. Nat Rev Rheumatol. 2020;16(2):75-86.

Acknowledgments:

This work was supported by National Natural Science Foundation of China (No. 81571684 to Jiaan Zhu), Peking University People’s Hospital Research and Development Funds (RDC2014-02 to Wenting Fan).

Disclosure of Interests:

None declared

AB0474 CAROTID CONTRAST ENHANCED ULTRASOUND IN CASES OF TAKAYASU ARTERITIS COMPLICATED WITH BEHCET’S DISEASE

Background:

Carotid contrast enhanced ultrasound (CEUS) is used for diagnosis and activity determination of patients with Takayasu’s arteritis (TA). However, very little is known about the carotid CEUS features of TA complicated with Behcet’s disease (BD).

Objectives:

This study reports the carotid CEUS features in cases of TA complicated with BD (TBD).

Methods:

A total of 10 carotid CEUS examinations were performed on 4 patients of TBD. 10 TA patients complicated with no rheumatoid disease were included as control group. For each carotid artery lesion, the carotid CEUS features was graded as follows: Grade 0, artery wall shows no microbubbles, Grade 1, artery wall shows limited or moderate microbubbles, Grade 2, artery wall shows severe microbubbles.

Results:

2/10 patients in TBD group has oral ulcer during the CEUS examination, while all the other patients included in our study showed no clinical symptoms related to active TA or BD. The carotid wall thickness was greater of CEUS grade 2 than grade 1 in both group(TBD: 2.62±0.74mm vs 1.66±0.22mm,p=0.001; TA:1.84±0.31mm vs 1.53±0.5mm,p=0.136). The carotid wall thickness was significantly greater in TBD group than TA group, but there was no significant differences between the two groups in clinical data and CEUS grade (table 1).

Table 1.

Clinical data and carotid CEUS features of both groups

TBDTApAge (year)32.5±3.4430.5±9.20.487Male320.605ESR (mm/h)4(2, 10)7(3.5, 11)0.406CRP (mg/L)6.42(0.55, 15.38)0.58(0.44, 5.05)0.168Wall thickness (mm)2.10±0.701.67±0.440.030CEUS grade 29120.527

Conclusion:

This study first shows carotid CEUS features in cases of TA complicated with BD, which may help with the comprehensive treatments of the disease.

Disclosure of Interests: :

None declared

DFT study on Ag loaded 2H-MoS2 for understanding the mechanism of improved photocatalytic reduction of CO2

Transition metal modified molybdenum disulfide to improve the performance of photocatalytic reduction of carbon dioxide has been receiving much attention. Herein, a novel high-efficiency photocatalytic composite Ag/2H-MoS2 has been constructed and simulated using density functional theory (DFT) for unveiling the mechanism of improved photocatalytic reduction of CO2 in our experimental research. Our calculations about the band structure and electronic and optical properties indicate that the loading of Ag atoms enhances the photocatalytic performance of 2H-MoS2 nanosheets by transferring the photogenerated electrons from the valence band of 2H-MoS2 to the loaded Ag atoms. Furthermore, 20 wt% Ag loaded 2H-MoS2 is the most suitable for the thermodynamic requirement of reducing CO2 to CH4 among the catalysts with different Ag loadings, and the formation of *CHO in 20 wt% Ag/2H-MoS2 is the potential-determining step, whose Gibbs free energy reduces from 2.830 eV of 2H-MoS2 to 0.925 eV. Meanwhile the thermochemical results predict the best path for reducing CO2 on such a photocatalyst as CO2 → *COOH → *CO → *CHO → *CH2O → *OCH3 → *CH3OH → CH4. The photocatalytic performance of pristine 2H-MoS2 in CO2 reduction is therefore significantly improved by loading silver. This research provides a theoretical reference for transition metal modified 2H-MoS2 nanosheets.

The Nab experiment: A precision measurement of unpolarized neutron beta decay

Neutron beta decay is one of the most fundamental processes in nuclear physics and provides sensitive means to uncover the details of the weak interaction. Neutron beta decay can evaluate the ratio of axial-vector to vector coupling constants in the standard model, λ = gA/gV, through multiple decay correlations. The Nab experiment will carry out measurements of the electron-neutrino correlation parameter a with a precision of δa/a = 10−3 and the Fierz interference term b to δb = 3 × 10−3 in unpolarized free neutron beta decay. These results, along with a more precise measurement of the neutron lifetime, aim to deliver an independent determination of the ratio λ with a precision of δλ/λ = 0.03% that will allow an evaluation of Vud and sensitively test CKM unitarity, independent of nuclear models. Nab utilizes a novel, long asymmetric spectrometer that guides the decay electron and proton to two large area silicon detectors in order to precisely determine the electron energy and an estimation of the proton momentum from the proton time of flight. The Nab spectrometer is being commissioned at the Fundamental Neutron Physics Beamline at the Spallation Neutron Source at Oak Ridge National Lab. We present an overview of the Nab experiment and recent updates on the spectrometer, analysis, and systematic effects.

Smart identification of psoriasis by images using convolutional neural networks: a case study in China

BACKGROUND

Psoriasis is a chronic inflammatory skin disease, which holds a high incidence in China. However, professional dermatologists who can diagnose psoriasis early and correctly are insufficient in China, especially in the rural areas. A smart approach to identify psoriasis by pictures would be highly adaptable countrywide and could play a useful role in early diagnosis and regular treatment of psoriasis.

OBJECTIVES

Design and evaluation of a smart psoriasis identification system based on clinical images (without relying on a dermatoscope) that works effectively similar to a dermatologist.

METHODS

A set of deep learning models using convolutional neural networks (CNNs) was explored and compared in the system for automatic identification of psoriasis. The work was carried out on a standardized dermatological dataset with 8021 clinical images of 9 common disorders including psoriasis along with full electronic medical records of patients built over the last 9 years in China. A two-stage deep neural network was designed and developed to identify psoriasis. In the first stage, a multilabel classifier was trained to learn the visual patterns for each individual skin disease. In the second stage, the output of the first stage was utilized to distinguish psoriasis from other skin diseases.

RESULTS

The area under the curve (AUC) of the two-stage model reached 0.981 ± 0.015, which outperforms a single-stage model. And, the classifier showed superior performance (missed diagnosis rate: 0.03, misdiagnosis rate: 0.04) than 25 Chinese dermatologists (missed diagnosis rate: 0.19, misdiagnosis rate: 0.10) in the diagnosis of psoriasis on 100 clinical images.

CONCLUSIONS

Using clinical images to identify psoriasis is feasible and effective based on CNNs, which also builds a solid technical base for smart care of skin diseases especially psoriasis using mobile/tablet applications for teledermatology in China.

Nuclear Dependence of the Transverse Single-Spin Asymmetry in the Production of Charged Hadrons at Forward Rapidity in Polarized p+p, p+Al, and p+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the nuclear dependence of transverse single-spin asymmetries (TSSAs) in the production of positively charged hadrons in polarized p^{↑}+p, p^{↑}+Al, and p^{↑}+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements have been performed at forward rapidity (1.4<η<2.4) over the range of transverse momentum (1.8<p_{T}<7.0  GeV/c) and Feynman x (0.1<x_{F}<0.2). We observed positive asymmetries for positively charged hadrons in p^{↑}+p collisions, and significantly reduced asymmetries in p^{↑}+A collisions. These results reveal a nuclear dependence of TSSAs for charged-hadron production in a regime where perturbative techniques are applicable. These results provide new opportunities to use p^{↑}+A collisions as a tool to investigate the rich phenomena behind TSSAs in hadronic collisions and to use TSSAs as a new handle in studying small-system collisions.

Beam Energy and Centrality Dependence of Direct-Photon Emission from Ultrarelativistic Heavy-Ion Collisions

The PHENIX collaboration presents first measurements of low-momentum (0.4<p_{T}<3  GeV/c) direct-photon yields from Au+Au collisions at sqrt[s_{NN}]=39 and 62.4 GeV. For both beam energies the direct-photon yields are substantially enhanced with respect to expectations from prompt processes, similar to the yields observed in Au+Au collisions at sqrt[s_{NN}]=200. Analyzing the photon yield as a function of the experimental observable dN_{ch}/dη reveals that the low-momentum (>1  GeV/c) direct-photon yield dN_{γ}^{dir}/dη is a smooth function of dN_{ch}/dη and can be well described as proportional to (dN_{ch}/dη)^{α} with α≈1.25. This scaling behavior holds for a wide range of beam energies at the Relativistic Heavy Ion Collider and the Large Hadron Collider, for centrality selected samples, as well as for different A+A collision systems. At a given beam energy, the scaling also holds for high p_{T} (>5  GeV/c), but when results from different collision energies are compared, an additional sqrt[s_{NN}]-dependent multiplicative factor is needed to describe the integrated-direct-photon yield.

Hyaluronidase Pretreatment Improves the Cryopreservation of Human Ovarian Tissue

BACKGROUND

Slow freezing has been widely applied to preserve human ovarian tissue.

OBJECTIVE

The aim of this study is to determine whether human ovarian cortex pretreated with hyaluronidase can improve the protective effect of cryopreservation.

MATERIALS AND METHODS

Human ovarian biopsies from seven patients were cryopreserved using slow freezing. The samples in the experimental group were incubated in culture medium with hyaluronidase for a short time before cryopreservation. The histology of the thawed ovarian tissue was investigated; the levels of steroid hormone in the culture media were then used to evaluate the development and function of thawed ovarian tissue.

RESULTS

The result showed that the percentage of morphologically abnormal primordial follicles was higher in the freezing control than in the experimental group (P<0.05). 17β-estradiol (E₂) and progesterone (P₄) concentrations were significantly higher in the experimental group than in the freezing control group (P<0.05).

CONCLUSION

Our study showed that human ovarian cortex pretreatment with hyaluronidase can improve the protective effect of cryopreservation by improving the penetration of cryoprotectant.

Pseudorapidity Dependence of Particle Production and Elliptic Flow in Asymmetric Nuclear Collisions of p+Al, p+Au, d+Au, and ^{3}He+Au at sqrt[s_{NN}]=200 GeV

Asymmetric nuclear collisions of p+Al, p+Au, d+Au, and ^{3}He+Au at sqrt[s_{NN}]=200  GeV provide an excellent laboratory for understanding particle production, as well as exploring interactions among these particles after their initial creation in the collision. We present measurements of charged hadron production dN_{ch}/dη in all such collision systems over a broad pseudorapidity range and as a function of collision multiplicity. A simple wounded quark model is remarkably successful at describing the full data set. We also measure the elliptic flow v_{2} over a similarly broad pseudorapidity range. These measurements provide key constraints on models of particle emission and their translation into flow.

Towards high-energy, high-resolution computed tomography via a laser driven micro-spot gamma-ray source

Computed Tomography (CT) is a powerful method for non-destructive testing (NDT) and metrology awakes with expanding application fields. To improve the spatial resolution of high energy CT, a micro-spot gamma-ray source based on bremsstrahlung from a laser wakefield accelerator was developed. A high energy CT using the source was performed, which shows that the resolution of reconstruction can reach 100 μm at 10% contrast. Our proof-of-principle demonstration indicates that laser driven micro-spot gamma-ray sources provide a prospective way to increase the spatial resolution and toward to high energy micro CT. Due to the advantage in spatial resolution, laser based high energy CT represents a large potential for many NDT applications.

Nosocomial outbreak of Candida parapsilosis sensu stricto fungaemia in a neonatal intensive care unit in China

BACKGROUND

Candida parapsilosis is a common agent of fungaemia, but few outbreaks of Candida parapsilosis infection have been reported in China.

AIM

To elaborate an outbreak of nosocomial Candida parapsilosis sensu stricto fungaemia in a neonatal intensive care unit (NICU) of a comprehensive hospital in China from July to October 2017.

METHODS

Epidemics and characteristics of fungaemia cases were investigated. Surveillance samples were collected. Vitek 2 Compact System, internal transcribed spacer sequencing, and random amplified polymorphic DNA (RAPD) typing were conducted to identify the isolates. Antifungal susceptibility test was performed for all bloodstream isolates.

FINDINGS

Sixteen neonates were diagnosed as Candida parapsilosis sensu stricto fungaemia during this period. Presenting symptoms included leucopenia, thrombocytopenia, and respiratory crackles. Fifteen cases were cured whereas one case who suffered from severe concomitant diseases died. The isolates were susceptible to fluconazole, amphotericin B, itraconazole, voriconazole, and 5-fluorocytosine. A total of 313 surveillance samples were collected, and Candida parapsilosis sensu stricto was identified from 16 environmental samples and one sample from an ultrasonographer's hand. The colonized locations included wiping cloths, faucets, sinks, operating table, puddles in the bathroom, a ventilator, and an ultrasonic probe. The RAPD patterns of all the Candida parapsilosis sensu stricto isolates from bloodstream and surveillance samples were identical. The outbreak was controlled after a series of infection control measures.

CONCLUSION

Contaminated environment was associated with this outbreak. Close attention to immunocompromised patients, thorough environmental disinfection and hand hygiene should be strengthened in NICU.