Poleward migration of western North Pacific tropical cyclones related to changes in cyclone seasonality

The average location of observed western North Pacific (WNP) tropical cyclones (TCs) has shifted north over the last several decades, but the cause remains not fully understood. Here we show that, for the annual average, the observed northward migration of WNP TCs is related to changes in TC seasonality, not to a northward migration in all seasons. Normally, peak-season (July–September) TCs form and travel further north than late-season (October–December) TCs. In recent decades, related to less frequent late-season TCs, seasonally higher-latitude TCs contribute relatively more to the annual-average location and seasonally lower-latitude TCs contribute less. We show that the change in TC seasonality is related to the different responses of late-season and peak-season TC occurrence to a stronger Pacific Walker Circulation. Our findings provide a perspective on long-term trends in TC activity, by decomposing the annual-average statistics into seasonal components, which could respond differently to anthropogenic forcing.

Tropical cyclones in the western North Pacific have shifted north in recent decades, but the reasons for this are not well understood. Here, the authors show that this is caused by changes in the seasonality of tropical cyclones and is mainly driven by fewer late-season storms.

Impact of nodular calcification on the outcomes of patients with acute coronary syndrome (ACS) treated with primary percutaneous coronary intervention (PCI)

Background

Calcified plaque is thought to adversely impact clinical outcomes but the impact of nodular calcification after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) remains unclear.

Purpose

This study sought to explore the impact of nodular calcification on the outcomes of patients undergoing percutaneous coronary intervention for acute coronary syndromes.

Methods

Five-hundred culprit plaque with calcification were analysed from 495 ACS patients in whom PCI was performed. Plaques were divided into nodular calcification group (n=238) and non-nodular calcification group (n=262). Calcification is defined as an area with low back-scattering signal and a sharp border. Nodular calcification was defined as a protruding mass with an irregular surface, high backscattering, and signal attenuation on optical coherence tomography (OCT).

Results

Patients with nodular calcification were older (p<0.001) and had lower left ventricular ejection fraction (p=0.006) compared to patients with non-nodular calcification. Lesion length (31 (25.2, 38.5) vs. 29 (22.8, 34.1), p<0.001) was longer in plaques with nodular calcification. A higher prevalence of superficial calcium (p<0.001) was observed in plaques with nodular calcification compared with non-nodular calcification group. Minimum stent area (MSA) (5.0 (3.9, 6.3) vs. 5.4 (4.2, 6.7), p=0.011) and stent expansion (70 (62.7, 81.8) vs. 75 (65.2, 86.6), p=0.004) were significantly smaller in the nodular calcification group than in the non-nodular calcification group. Independent predictors of nodular calcification were age (p<0.001) lesion length (p=0.002) and calcium depth (p<0.001).

Conclusion

This study demonstrated that the presence of nodular calcification is associated with unfavourable outcomes with smaller minimum stent area and higher incidence of stent under expansion in patients with ACS treated with primary PCI.

Funding Acknowledgement

Type of funding sources: None.

Frequency and predictors of thin-cap fibroatheroma progression: a comprehensive and dynamic in-vivo OCT study

Purpose

To assess the evolution of thin-cap fibroatheroma (TCFA) and to explore predictors for its progression by using optical coherence tomography (OCT) in patients with acute coronary syndrome (ACS).

Methods

We enrolled ACS patients with non-culprit TCFA at baseline and corresponding OCT images at follow-up of 9 to 15 months. Clinical, angiographic and OCT data were collected and analyzed according to established methods. TCFA was defined as a lipid plaque with maximum lipid arc >90° and fibrous cap thickness <65μm. Considering the resolution of OCT, the regression of TCFA was defined as an increase of fibrous cap thickness >10μm. Inversely, TCFA progression was defined as a decrease, constant or ≤10μm increase of fibrous cap thickness.

Results

41 patients with 55 non-culprit TCFAs were taken into final analysis. 17 patients (41.5%) had patient-level progression and 22 TCFAs (40.0%) progressed at plaque-level with a median follow-up duration of 371 days. 11 (20.0%) of the 55 TCFAs happened subclinical rupture at follow-up, including 10 with the formation a new layer and 1 without the detection of the new layer. Besides, another patient suffered re-myocardial infarction because of the rupture of TCFA induced acute thrombosis and lumen occlusion during follow-up. The baseline clinical and angiographic characteristics were similar between the two cohorts. The progression group had a significantly higher prevalence of macrophage infiltration and vasa vasorum at baseline than the non-progression group (Figure 1). Multivariate analysis identified macrophage infiltration (odds ratio [OR]: 5.30; 95% confidence interval [CI]: 1.01 to 27.91; p=0.049]) as the independent predictor of TCFA progression. When it came to the evolution of lesion morphology and lipid components, the progression cohort had a higher percent change of lumen stenosis and lipid length (Figure 2).

Conclusions

About 40% of non-culprit TCFAs in ACS patients progressed in fibrous cap thickness at a median interval of 1 year. Macrophage infiltration was the independent predictor of non-culprit TCFA progression. The progression of fibrous cap thickness was usually accompanied with an aggressive evolution of other lesion characteristics.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): the National Key R&D Program of China Baseline OCT characteristicsPercent change of lesion morphology

Comparison of peripheral artery plaque characteristics between ACS patients with plaque rupture and plaque erosion in culprit coronary artery: an OCT and ultrasound study

Background

Recent research has found that the characteristics of peripheral arterial plaque are related to the increased risk of cardiovascular disease, however, the relationship of plaque characteristics between peripheral artery and coronary is still unknown.

Purpose

To assess the correlation between coronary plaque characteristics assessed by optical coherence tomography (OCT) and peripheral artery plaque characteristics assessed by ultrasound.

Methods

150 patients with acute coronary syndrome (ACS) underwent coronary angiography were prospectively enrolled. OCT imaging of culprit vessel were performed during the procedure and ultrasound examination of bilateral carotid, iliofemoral and popliteal arteries was performed during hospitalization after procedure. Panvascular disease was defined as the presence of observable plaques in two or more vascular beds. Patients were divided into plaque rupture (PR) group and plaque erosion (PE) group according to culprit plaque characteristics on OCT.

Results

There were 132 (88%) ACS patients had panvascular disease in which 36 (24%) with generalized atherosclerosis (4 sites) and the prevalence of panvascular atherosclerosis in PR group was significantly higher than in PE group especially in carotid arteries and iliofemoral arteries (Figure 1, Figure 2). Compared to PE group, PR group had higher carotid plaque score (p=0.001) which indicates more plaques and severer atherosclerosis. Moreover, there were larger intima-media thickness (IMT) of iliofemoral arteries (6.9±1.4mm vs. 6.5±1.1mm, p=0.036) and more calcified plaques in PR group.

Conclusions

Panvascular disease is highly prevalent in ACS patients especially in patients with plaque rupture in culprit vessel, in which more than half of the patients had plaques in more than 3 sites of vascular beds. In addition, patients with plaque rupture had thicker iliofemoral IMT and higher panvascular atherosclerosis burden, which indicates that characteristics of coronary plaques are the focal expression of plaques in the whole panvcascular system.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Key R&D Program of China Figure 1. Prevalence of panvascular disease in ACSFigure 2. Comparison of peripheral artery plaques

Prevalence, predictors, and clinical prognosis of macrophage infiltrates in patients with ST-segment elevation myocardial infarction caused by plaque erosion as assessed by OCT

Background

Autopsy series showed that one of most common plaque phenotypes underlying coronary thrombi was plaque erosion. Identification of erosion may permit a less invasive management. Chronic inflammation is a common process in atherosclerosis. The severity of plaque inflammation can be assessed by optical coherence tomography (OCT) defined macrophages density. The impact of macrophage infiltrates (MØI) in ST-segment elevation myocardial infarction (STEMI) patients caused by plaque erosion was still unknown.

Purpose

The aim of this study was to evaluate plaque morphology and clinical prognosis associated with MØI as assessed by optical coherence tomography in STEMI patients caused by plaque erosion.

Methods

From October 2014 to December 2017, 1561 STEMI with OCT imaging before percutaneous coronary intervention were enrolled in this study. Finally, 312 STEMI patients caused by plaque erosion were split into two group according to the presence of MØI in culprit eroded plaques.

Results

163 (52.2%) STEMI patients presented plaque erosion with MØI, whereas 149 (47.8%) patients had no evidence of MØI. MØI were more frequency appeared in older patients (p=0.015). The severity and vulnerability of culprit lesions were higher in patients with MØI characterized by more aggressive and vulnerable features. Patients with MØI had worse long-term prognosis, compared with patient without MØI, mainly driven by a higher rate of target lesion revascularization (p=0.046), especially in STEMI patients presented plaque erosion with intensive antiplatelet therapy (p=0.035).

Conclusions

In the present study, we demonstrated that macrophage infiltrates at the site of erode plaques were associated with severity and vulnerability of culprit lesions. The long-term prognosis in patients with MØI were poorer especially in patients without stent implantation.

Funding Acknowledgement

Type of funding sources: None. Study flow chartPredictors of plaque erosion with MØI

Gender-specific difference of clinical and plaque characteristics in myocardial infarction with non-obstructive artery (MINOCA): insights from optical coherence tomography

Background

To date, sparse data are available with regard to gender differences in coronary plaque morphology and composition as underlying mechanism of MINOCA.

Purpose

To assess the differences in coronary plaque morphology in culprit lesion between women and men with MINOCA using intravascular optical coherence tomography.

Methods

Totally, 7404 consecutives acute myocardial infarction patients who underwent emergency coronary angiography between 2016 and 2019 were screened. MINOCA were identified in 292 patients (mean age: 72.6% male, 54.1% with ST-segment elevation). Optical coherence tomography was performed in 190 patients (men, n=142).

Results

Women with MINOCA were older (62.5±10.6 vs. 54.0±11.5, P<0.001) and more over 55 years (75.3% vs. 43.6%, P<0.001). Although women with MINOCA more frequently presented with NSTEMI (56.8% vs. 41.7%, P=0.025) and prior coronary artery disease (CAD) (33.3% vs. 6.3%, P<0.001), they were less likely smoker (27.2% vs. 58.8%, P<0.001). There was no significant difference in incidence of plaque rupture, erosion and calcified nodule between men and women. However, women were more likely to have thin-cap fibroatheroma (TCFA) (39.6% vs. 22.5%, P=0.025).

Conclusion

Women with MINOCA were older, more frequently presented with NSTEMI and less smoking compared to men. Besides, more TCFA were observed in women.

Funding Acknowledgement

Type of funding sources: None. Clinical and OCT plaque profilesProportion of clinical and OCT profiles

Sulforaphane overcomes T790M-mediated gefitinib resistance in vitro through epithelial-mesenchymal transition

The purpose of the present study was to investigate the effects of sulforaphane (SFN) on gefitinib-resistant cell lines with a T790 mutation (PC-9/AB11). The PC-9 and PC-9/AB11 cells were stained with H&E and visualized with a light microscope. The CCK-8 assay method was used to evaluate the antiproliferative activity of gefitinib and SFN on the cells. Cell cycle arrest and apoptosis were analyzed via flow cytometry. The cytotoxic interaction between the two drugs was evaluated in vitro using the combination index method, and epithelial-mesenchymal transition (EMT)-related proteins and alterations in the signaling pathways were determined by Western blot analysis. Compared to the PC-9 cells, the gefitinib-resistant PC-9/AB11 cells acquired a T790M mutation and had characteristics in accordance with EMT. The combination of gefitinib and SFN induced dose-dependent antiproliferative effects in the PC-9 and PC-9/AB11 cells, while both induced cell cycle arrest and cell apoptosis only in the PC-9/AB11 cells. The synergistic effect in the PC-9/AB11 cells was associated with this drug combination, as it caused an expression change of the epithelial (E-cadherin, claudin-1) and matrix proteins (vimentin, N-cadherin) in the cells, related to the reversal of EMT, as well as an expression change of the epidermal growth factor receptor (EGFR), p-EGFR, p-AKT, and p-ERK proteins. In this study, SFN overcame T790M-mediated gefitinib resistance in vitro through EMT. Thus, a combination of gefitinib and SFN may be a beneficial treatment strategy for lung cancer patients with acquired resistance due to T790M mutation.

PharmaPy: An object-oriented tool for the development of hybrid pharmaceutical flowsheets

Process design and optimization continue to provide computational challenges as the chemical engineering and process optimization communities seek to address more complex and larger scale applications. Software tools for digital design and flowsheet simulation are readily available for traditional chemical processing applications such as in commodity chemicals and hydrocarbon processing; however, tools for pharmaceutical manufacturing are much less well developed. This paper introduces, PharmaPy, a Python-based modelling platform for pharmaceutical manufacturing systems design and optimization. The versatility of the platform is demonstrated in simulation and optimization of both continuous and batch processes. The structure and features of a Python-based modeling platform, PharmaPy are presented. Illustrative examples are shown to highlight key features of the platform and framework.

What is an appropriate caesarean delivery rate for China: a multicentre survey

Objective

To assess the current status of caesarean delivery (CD) in China, propose reference CD rates for China overall, and by regions, investigate the main indications for CDs and identify possible areas for safe reduction.

Design

A multicentre cross‐sectional study.

Setting

A total of 94 hospitals across 23 provinces in China.

Population

A total of 73 977 randomly selected deliveries.

Methods

We used a modified Robson classification to characterise CDs in subgroups and by regions, and the World Health Organization (WHO) C‐Model to calculate reference CD rates.

Main outcome measures

CD rates in China.

Results

In 2015–2016, the overall CD rate in China was 38.9% (95% CI 38.6–39.3%). Considering the obstetric characteristics of the population, the multivariable model‐based reference CD rate was estimated at 28.5% (95% CI 28.3–28.8%). Accordingly, an absolute reduction of 10.4% (or 26.7% relative reduction) may be considered. The CD rate varied substantially by region. Previous CD was the most common indication in all regions, accounting for 38.2% of all CDs, followed by maternal request (9.8%), labour dystocia (8.3%), fetal distress (7.7%) and malpresentation (7.6%). Overall, 12.7% of women had prelabour CDs, contributing to 32.8% of the total CDs.

Conclusions

Nearly 39% of births were delivered by caesarean in China but a reduction of this rate by a quarter may be considered attainable. Repeat CD contributed more than one‐third of the total CDs. Given the large variation in maternal characteristics, region‐specific or even hospital‐specific reference CD rates are needed for precision management of CD.

Tweetable abstract

The caesarean rate in 2015–2016 in China was 38.9%, whereas the reference rate was 28.5%.

The caesarean rate in 2015–2016 in China was 38.9%, whereas the reference rate was 28.5%.

Linked article This article is commented on by M Varner, p. 148 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16953.

Pyroptosis: the pathological process that dominates granulomatous lobular mastitis

The aim of this study is to explore the pathogenesis of granulomatous lobular mastitis (GLM) via pathology and molecular biology. This single-center study included 28 female patients who received a diagnosis of pathologically confirmed GLM from January 2020 to September 2020 at Dongzhimen Hospital of Beijing University of Chinese Medicine. Tissue samples and serum were collected during radical surgery. Western blot and immunohistochemistry were employed to determine caspase-1 and gasdermin D (GSDMD). Transmission electron microscopy (TEM) was used to observe the ultrastructure of cells. Finally, the results were analyzed. The expression of activated GSDMD and caspase-1 were all increased in the lesion group (P < 0.05). The TEM results showed clear features of pyroptosis. We concluded that pyroptosis was important in the development of GLM and inhibitad apoptosis to some degree. The inhibition of pyroptosis response may help to discover new drugs for GLM.

Development of an 11-channel multi wavelength imaging diagnostic for divertor plasmas in MAST Upgrade

Divertor detachment and alternative divertor magnetic geometries are predicted to be promising approaches to handle the power exhaust of future fusion devices. In order to understand the detachment process caused by volumetric losses in alternative divertor magnetic geometries, a Multi-Wavelength Imaging (MWI) diagnostic has recently been designed and built for the Mega Amp Spherical Tokamak Upgrade. The MWI diagnostic will simultaneously capture 11 spectrally filtered images of the visible light emitted from divertor plasmas and provide crucial knowledge for the interpretation of observations and modeling efforts. This paper presents the optical design, mechanical design, hardware, and test results of an 11-channel MWI system with a field of view of 40°. The optical design shows better than 5 mm FWHM spatial resolution at the plasma on all 11 channels across the whole field of view. The spread of angle of incidence on the surface of each filter is also analyzed to inform the bandwidth specification of the interference filters. The results of the initial laboratory tests demonstrate that a spatial resolution of better than 5 mm FWHM is achieved for all 11 channels, meeting the specifications required for accurate tomography.

The cross-polarization scattering system for the magnetic fluctuation measurement in the Experimental Advanced Superconducting Tokamak

The cross-polarization scattering (CPS) system for magnetic fluctuation measurements in the Experimental Advanced Superconducting Tokamak (EAST) has been designed and installed. Different from the Doppler reflectometer (DR) system, the CPS system detects the perpendicular polarization of the electromagnetic wave induced by magnetic fluctuations B̃. The CPS system in the EAST has been developed from the existing Doppler reflectometer system, and they are integrated together for simultaneous measurement of magnetic and density fluctuations. Ray-tracing simulations are used to calculate the scattering locations and the wavenumber coverage of the magnetic fluctuation for CPS. In the experiments, the CPS and DR system data were different in Doppler shift, amplitude, and spectrum broadening. In this article, the hardware design, the ray tracing, and the preliminary results of the system in the EAST are presented.

[Progress of researches on animal models of Blastocystis hominis infections]

Blastocystis hominis is a common parasitic protozoa in human and animal intestines; however, its pathogenicity remains controversial. Construction of animal models is of great significance to investigate the pathogenicity, pathogenic mechanisms and drug screening of B. hominis. Experimental animals, mode of infections, parasite strains and host immune status are important factors affecting the successful modeling of B. hominis infections in animals. Hereby, we review the progress of researches on animal models of B. hominis infections, and summarize the influencing factors and application of animal models of B. hominis infections, in order to provides insights into the selection of animals models of B. hominis infections.

[Progress of researches on global prevalence of Blastocystis hominis human infections and its subtypes]

Blastocystis hominis is a parasite that parasitizes in the intestines of humans and animals, and is closely related to a variety of gastrointestinal diseases such as abdominal pain and diarrhea. B. hominis is distributed worldwide, and the prevalence of B. hominis infections and dominant subgenotypes vary in countries and in regions from the same country. This paper reviews the global prevalence of B. hominis human infections, its subtypes and geographical distribution, so as to provide insights into the understanding of the global epidemiology of B. hominis and the management of B. hominis infections.

ORAOV1-B Promotes OSCC Metastasis via the NF-κB-TNFα Loop

Metastasis, a powerful prognostic indicator of oral squamous cell carcinoma (OSCC), is chiefly responsible for poor cancer outcomes. Despite an increasing number of studies examining the mechanisms underlying poor outcomes, the development of potent strategies is hindered by insufficient characterization of the crucial regulators. Long noncoding RNAs (lncRNAs) have recently been gaining interest as significant modulators of OSCC metastasis; however, the detailed mechanisms underlying lncRNA-mediated OSCC metastasis remain relatively uncharacterized. Here, we identified a novel alternative splice variant of oral cancer overexpressed 1 (ORAOV1), named as ORAOV1-B, which was subsequently validated as an lncRNA and correlated with OSCC lymph node metastasis; significantly increased invasion and migration were observed in ORAOV1-B-overexpressing OSCC cells. RNA pulldown and mass spectrometry identified Hsp90 as a direct target of ORAOV1-B, and cDNA microarrays suggested TNFα as a potential downstream target of ORAOV1-B. ORAOV1-B was shown to directly bind to and stabilize Hsp90, which maintains the function of client proteins, receptor-interaction protein, and IκB kinase beta, thus activating the NF-κB pathway and inducing TNFα. Additionally, TNFα reciprocally enhanced p-NF-κB-p65 and the downstream epithelial-mesenchymal transition. ORAOV1-B effects were reversed by a TNFα inhibitor, demonstrating that TNFα is essential for ORAOV1-B-regulated metastatic ability. Consistent epithelial-mesenchymal transition in the ORAOV1-B group was demonstrated via an orthotopic model. In the metastatic model, ORAOV1-B significantly contributed to OSCC-related lung metastasis. In summary, the novel splice variant ORAOV1-B is an lncRNA, which significantly potentiates OSCC invasion and metastasis by binding to Hsp90 and activating the NF-κB-TNFα loop. These findings demonstrate the versatile role of ORAOV1 family members and the significance of genes located within 11q13 in promoting OSCC. ORAOV1-B might serve as an attractive OSCC metastasis intervention target.

Research progress in structural and nutritional characterization and technologically processing impact on cool-season adapted oat and barley cereal kernels with wet chemistry and advanced vibrational molecular spectroscopy

This study aims to provide research progress and update on structural, physicochemical, nutritional characteristics and technologically processing impact on cool-season adapted oat and barley cereal kernels. The study focused on cool-season adapted oats grain production and nutrition in ruminant systems and strategies to improve the utilization of the oat grain through processing techniques. The updated evaluation methods and advanced molecular spectroscopy techniques to study molecular structures with attenuated total reflectance Fourier transform infrared spectroscopy, synchrotron-based Fourier transform infrared microspectroscopy were reviewed. This study summarizes the methods and provides a potential approach on how to use vibrational molecular spectroscopy to study molecular chemistry and molecular structure and molecular nutrition interaction of grain.

Spectroscopic Determination of Key Energy Scales for the Base Hamiltonian of Chromium Trihalides

The van der Waals (vdW) chromium trihalides (CrX₃) exhibit field-tunable, two-dimensional magnetic orders that vary with the halogen species and the number of layers. Their magnetic ground states with proximity in energies are sensitive to the degree of ligand-metal (p-d) hybridization and relevant modulations in the Cr d-orbital interactions. We use soft X-ray absorption (XAS) and resonant inelastic X-ray scattering (RIXS) spectroscopy at Cr L-edge along with the atomic multiplet simulations to determine the key energy scales such as the crystal field 10 Dq and interorbital Coulomb interactions under different ligand metal charge transfer (LMCT) in CrX₃ (X= Cl, Br, and I). Through this systematic study, we show that our approach compared to the literature has yielded a set of more reliably determined parameters for establishing a base Hamiltonian for CrX₃.

[Emergency laboratory construction and reflection in infectious hospital under the epidemic situation]

Emerging infectious diseases are a common type of public health emergencies, which occur frequently around the world in recent years, seriously threatening the safety of human life and property. In the process of dealing with epidemic situation, medical laboratories have played an important role in disease diagnosis, treatment, efficacy evaluation and prognosis judgment and so on. Beijing Youan Hospital, as the designated hospital of the coronavirus disease 2019 (COVID-19), has set up an emergency laboratory in the capital for the prevention and control of the COVID-19 by carrying out routine tests and virus nucleic acid tests, it provides timely and effective evidence for clinical diagnosis and treatment. To provide ideas and references for the building of the Emergency Laboratory in infectious hospitals. This article discuss how to set up an independent emergency laboratory efficiently, strengthen the cooperation with the Center for Disease Control and Prevention, make the best use of all resources, and share the enlightenment gained in the process of construction.

Time-resolved RIXS experiment with pulse-by-pulse parallel readout data collection using X-ray free electron laser

Time-resolved resonant inelastic X-ray scattering (RIXS) is one of the developing techniques enabled by the advent of X-ray free electron laser (FEL). It is important to evaluate how the FEL jitter, which is inherent in the self-amplified spontaneous emission process, influences the RIXS measurement. Here, we use a microchannel plate (MCP) based Timepix soft X-ray detector to conduct a time-resolved RIXS measurement at the Ti L₃-edge on a charge-density-wave material TiSe₂. The fast parallel Timepix readout and single photon sensitivity enable pulse-by-pulse data acquisition and analysis. Due to the FEL jitter, low detection efficiency of spectrometer, and low quantum yield of RIXS process, we find that less than 2% of the X-ray FEL pulses produce signals, preventing acquiring sufficient data statistics while maintaining temporal and energy resolution in this measurement. These limitations can be mitigated by using future X-ray FELs with high repetition rates, approaching MHz such as the European XFEL in Germany and LCLS-II in the USA, as well as by utilizing advanced detectors, such as the prototype used in this study.