POS0081 LONG-TERM EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH PSORIATIC ARTHRITIS: 2-YEAR RESULTS FROM THE PHASE 3 SELECT-PsA 1 STUDY

Background

In SELECT-PsA 1, patients (pts) with psoriatic arthritis (PsA) and an inadequate response or intolerance to ≥1 non-biologic disease-modifying antirheumatic drug showed improvement in the signs and symptoms of PsA with upadacitinib 15 mg (UPA15) or 30 mg (UPA30), an oral Janus kinase (JAK) inhibitor, through week (wk) 56.1

Objectives

To evaluate the efficacy and safety of UPA and UPA vs adalimumab (ADA) at wk 104 from the ongoing long-term extension of SELECT-PsA 1.

Methods

Pts received UPA15, UPA30, ADA 40 mg, or placebo (PBO) for 24 wks, at which point, PBO pts switched to UPA15 or UPA30. Efficacy endpoints were analyzed using non-responder imputation (NRI) and as observed (AO) (binary endpoints) or mixed-effect model repeated measures and AO (continuous endpoints), with nominal P-values shown, for continuous UPA and ADA treatment groups. Treatment-emergent adverse events were summarized for pts who received ≥1 dose of study drug using a visit-based cut-off at wk 104.

Results

1704 pts received ≥1 dose of study drug. At wk 104, 25.4% of patients had discontinued study drug. The proportions of pts who achieved ACR20/50/70, MDA, PASI75/90/100, and resolution of enthesitis or dactylitis showed consistent responses, or further improvements, from wk 561 to wk 104 (Table 1). ACR20/50/70 and MDA responses, as well as mean change from baseline (BL) in HAQ-DI, patient’s assessment of pain, BASDAI, and ASDAS, were greater with UPA vs ADA. Mean change from BL in modified total Sharp/van der Heijde Score (mTSS) was generally similar across groups and comparable to wk 56.1 The safety profile of UPA was generally comparable to ADA (Figure 1) and consistent with wk 561 data. Rates of serious infection, herpes zoster, lymphopenia, and elevated CPK remained numerically higher with UPA30 vs UPA15; rates in both UPA groups were higher vs ADA. Rates of malignancies, MACE, or VTE were similar across groups, and consistent with wk 561 data. Two deaths were reported with UPA15, 1 with UPA30, and 1 with ADA.

Table 1.

Efficacy Endpoints at Week 104

EndpointUPA15(n=429)UPA30(n=423)ADA(n=429)Proportion of Pts (%)aNRIAONRIAONRIAOACR2069.087.969.587.963.485.1ACR5053.667.459.3*74.147.162.3ACR7038.0*47.443.5*54.429.439.1Minimal Disease Activity (MDA)42.054.845.9*56.837.850.3PASI75b57.973.462.478.658.876.5PASI90b46.759.053.366.548.863.3PASI100b34.143.442.451.434.144.0Resolution of enthesitis by LEIc53.375.552.272.049.173.9Resolution of dactylitis by LDId69.994.571.796.272.495.2Change from BLeMMRMAOMMRMAOMMRMAOHealth Assessment Questionnaire - Disability Index (HAQ-DI)-0.55*-0.57-0.55*-0.59-0.45-0.47Patient’s assessment of pain (numeric rating scale)-3.3-3.5-3.4*-3.6-3.0-3.2Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)f-3.0-3.2-3.3-3.6-2.7-2.6Ankylosing Spondylitis Disease Activity Score (ASDAS)f-1.6-1.8-1.9*-2.1-1.5-1.6Modified total Sharp/van der Heijde Score (mTSS)0.030.010.010.000.110.11

ACR20/50/70, ≥20%/50%/70% improvement in American College of Rheumatology criteria; ADA, adalimumab; AO, as observed; BL, baseline; LDI, Leeds Dactylitis Index; LEI, Leeds Enthesitis Index; MMRM, mixed effect model repeated measurement; NRI, non-responder imputation; PASI75/90/100, ≥75%/90%/100% improvement in Psoriasis Area and Severity Index; pts, patients; UPA, upadacitinib.

aData shown as NRI and AO for binary endpoints.

bFor pts with psoriasis affecting ≥3% of body surface area at BL.

cFor pts with LEI >0 at BL; resolution LEI=0.

dFor pts with LDI >0 at BL; resolution LDI=0.

eData shown as MMRM (LS mean) and AO (mean) for continuous endpoints.

fFor pts with psoriatic spondylitis at BL.

Nominal *P<0.05, UPA15 or UPA30 vs ADA for NRI and MMRM; AO descriptive only.

Conclusion

In PsA pts, efficacy responses were similar or greater with UPA15 or UPA30 vs ADA at wk 104, and inhibition of radiographic progression was maintained. No new safety signals were identified with long-term exposure to UPA up to 2 years.

References

[1]McInnes I, et al. RMD Open, 2021; 7(3):e001838.

Acknowledgements

AbbVie and the authors thank the patients, study sites, and investigators who participated in this clinical trial (NCT03104400). AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship. Medical writing support was provided by Monica R.P. Elmore, PhD of AbbVie.

Disclosure of Interests

Iain McInnes Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sanofi Regeneron, and UCB Pharma, Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sanofi Regeneron, and UCB Pharma, Koji Kato Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Marina Magrey Consultant of: UCB, Novartis, Eli Lilly, Pfizer, and Janssen, Grant/research support from: Amgen, AbbVie, and UCB Pharma, Joseph F. Merola Consultant of: Merck, Bristol-Myers Squibb, AbbVie, Dermavant, Eli Lilly, Novartis, Janssen, UCB, Celgene, Sanofi, Regeneron, Arena, Sun Pharma, Biogen, Pfizer, EMD Sorono, Avotres, and Leo Pharma, Mitsumasa Kishimoto Consultant of: AbbVie, Amgen-Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, BMS, Celgene, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Ono Pharma, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB Pharma, Derek Haaland Speakers bureau: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Novartis, Pfizer, Roche, Sanofi Genzyme, Takeda, Consultant of: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Eli-Lilly, GlaxoSmithKline, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi Genzyme, Takeda, UCB, Grant/research support from: AbbVie, Adiga Life-Sciences, Amgen, Bristol-Myers Squibb, Can-Fite Biopharma, Celgene, Eli-Lilly, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, Regeneron, Sanofi-Genzyme, UCB, Liang Chen Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Yuanyuan Duan Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Jianzhong Liu Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Ralph Lippe Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie, Peter Wung Shareholder of: Employee of AbbVie and may hold stock or options, Employee of: Employee of AbbVie

Mechanisms and product toxicity of activated carbon/peracetic acid for degradation of sulfamethoxazole: implications for groundwater remediation

Carbon-based materials activated peracetic acid (PAA) to repair groundwater is an environmentally friendly and low-cost technology to overcome secondary pollution problems. In this study, thermally modified activated carbon (AC600) was applied to activate PAA to degrade sulfamethoxazole (SMX). And the effect of groundwater pH, chloride ion (Cl^-), bicarbonate (HCO₃^-), sulfate ion (SO₄^2-), and natural organic matter (NOM) on SMX removal by AC600/PAA process was studied in detail. PAA could be effectively activated by AC600. Increasing AC600 dose (10-100mg/L) or PAA dosages (0.065-0.39 mM) generally enhanced the SMX removal, the excellent performance in SMX removal was achieved at 50 mg/L AC600 and 0.26 mM PAA. The removal of SMX was well-described by second-order kinetic, with the rate constant (k_obs) of 10.79 M^-1s^-1, both much greater than the removal constants of PAA alone (0.034 M^-1s^-1) and AC600 alone (1.774 M^-1s^-1). R-O·(CH₃C(O)OO·, CH₃C(O)O·) and electron-transfer process were proved to be responsible for the removal of SMX while HO· and ¹O₂ made little to no contribution to the novel PAA/AC600 system, which differs from typical advanced oxidation processes. The SMX can be removed effectively over a wide pH range (3-9), exhibiting a remarkable pH-tolerant performance. Sulfate ion (SO₄^2-), dissolved oxygen (DO), NOM displayed negligible influence on the SMX removal. Bicarbonate (HCO₃^-) exerted an inhibitory effect on SMX abatement, while chloride ion (Cl^-) promoted the removal of SMX. This showed excellent anti-interference capacity and satisfactory decontamination performance under actual groundwater conditions. Furthermore, the degradation pathways of SMX were proposed, there was no obvious difference in the acute toxicity of the mixed products during the degradation process. It will facilitate further research of metal-free catalyst/PAA system as a new strategy for groundwater in-situ remediation technology.

OP0016 EFFICACY AND SAFETY OF UPADACITINIB IN PATIENTS WITH ACTIVE NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED PHASE 3 TRIAL

Background

Janus kinase (JAK) inhibitors have been recognized as a potential therapeutic option in ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis (r-axSpA).1 Upadacitinib (UPA), a JAK inhibitor, has demonstrated efficacy and safety in the treatment of AS2; however, no JAK inhibitor studies have been conducted in non-radiographic axSpA (nr-axSpA) to date.

Objectives

To assess the efficacy and safety of UPA in patients (pts) with active nr-axSpA.

Methods

SELECT-AXIS 2 (NCT04169373) was conducted under a master protocol comprising two independent studies, one in an AS population with an inadequate response to biologic disease-modifying antirheumatic drugs and one in an nr-axSpA population. The nr-axSpA study is a randomized, double-blind, placebo(PBO)-controlled, phase 3 trial that enrolled adults ≥18 years with a clinical diagnosis of nr-axSpA (who also fulfilled 2009 ASAS classification criteria for axSpA but did not meet the radiologic criterion of modified New York criteria), who had objective signs of active inflammation consistent with axSpA on MRI of the sacroiliac (SI) joints and/or high sensitivity C-reactive protein (hs-CRP) >upper limit of normal (2.87 mg/L) at screening, and who had BASDAI and pt’s assessment of total back pain scores ≥4 based on a 0 to 10 numeric rating scale at study entry. Pts were randomized 1:1 to receive oral UPA 15 mg once daily (QD) or PBO during a 52-week (wk) double-blind treatment period. The primary endpoint was ASAS40 response at wk 14. Multiplicity-controlled secondary endpoints assessed at wk 14 included BASDAI50, ASDAS ID (<1.3), ASDAS LDA (<2.1), ASDAS PR, and ASAS20, and the change from baseline (Δ) in ASDAS (CRP), SPARCC MRI SI joint inflammation score, total and nocturnal back pain, BASFI, ASQoL, ASAS HI, BASMI, and MASES. Treatment-emergent adverse events (TEAEs) are reported through wk 14 for pts who received ≥1 dose of study drug.

Results

Of 314 pts randomized at baseline, 313 received study drug (UPA 15 mg, n=156; PBO, n=157) and 295 (94%) received study drug through wk 14. Baseline demographic and disease characteristics were balanced across treatment groups and consistent with an active nr-axSpA population (58% female; mean age 42.1 years; mean BASDAI 6.9; mean hs-CRP 12.1 mg/L). A significantly higher ASAS40 response rate at wk 14 was achieved with UPA vs PBO (45% vs 23%; P<0.0001; Figure 1). Statistical significance was also achieved in the first 12 of the 14 multiplicity-controlled secondary endpoints (ie, all endpoints except BASMI and MASES) at wk 14 for UPA compared with PBO (P<0.01; Figure 1). The proportion of pts who experienced a TEAE was similar between treatment groups (UPA, 48%; PBO, 46%). Serious TEAEs and TEAEs leading to discontinuation were reported in 4 (2.6%) pts treated with UPA and 2 (1.3%) pts treated with PBO, respectively. Few pts had serious infection or herpes zoster (each 2 [1.3%] pts on UPA; each 1 [0.6%] pt on PBO, respectively). Uveitis was reported in 1 (0.6%) pt on UPA who had a history of uveitis and none on PBO. No malignancy other than non-melanoma skin cancer, major adverse cardiovascular events, venous thromboembolic events, inflammatory bowel disease (IBD), or death were reported in the study; 1 event of basal cell carcinoma occurred with PBO.

Conclusion

UPA 15 mg QD demonstrated significantly greater improvements in disease activity, pain, function, quality of life, and MRI-detected SI joint inflammation than PBO after 14 wks of treatment in pts with active nr-axSpA. The safety profile of UPA was consistent with what has been observed with other inflammatory musculoskeletal diseases,3–5 and no new risks were identified. These results support the potential use of UPA in pts with active nr-axSpA.

References

[1]Ward MM, et al. Arthritis Rheumatol. 2019;71(10):1599–63.

[2]van der Heijde D, et al. Arthritis Rheumatol. 2021;73(suppl 10).

[3]Cohen SB, et al. ARD. 2021;80:304–311.

[4]Burmester G, et al. Rheumatol Ther. 2021;1–19.

[5]van der Heijde D, et al. Lancet. 2019;394(10214):2108–2117.

Acknowledgements

AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Julia Zolotarjova, MSc, MWC, of AbbVie.

Disclosure of Interests

Atul Deodhar Consultant of: AbbVie, Amgen, Aurinia, BMS, Celgene, GSK, Janssen, Lilly, MoonLake, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, GSK, Lilly, Novartis, Pfizer, and UCB, Filip van den Bosch Speakers bureau: AbbVie, Celgene, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Celgene, Janssen, Lilly, Merck, Novartis, Pfizer, and UCB, Denis Poddubnyy Speakers bureau: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Consultant of: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Grant/research support from: AbbVie, MSD, Novartis, and Pfizer, Walter P Maksymowych Consultant of: AbbVie, Boehringer Ingelheim, Celgene, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Novartis, and Pfizer, Désirée van der Heijde Consultant of: AbbVie, Bayer, BMS, Cyxone, Eisai, Galapagos, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, UCB, Employee of: Director of Imaging Rheumatology BV, Tae-Hwan Kim Speakers bureau: AbbVie, Celltrion, Kirin, Lilly, and Novartis, Mitsumasa Kishimoto Consultant of: AbbVie, Amgen Astellas BioPharma, Asahi-Kasei Pharma, Astellas, Ayumid Pharma, BMS, Chugai, Daiichi Sankyo, Eisai, Gilead, Janssen, Kyowa Kirin, Lilly, Novartis, Ono Pharma, Pfizer, Tanabe-Mitsubishi, Teijin Pharma, and UCB, Yuanyuan Duan Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Yihan Li Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Aileen Pangan Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Peter Wung Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, In-Ho Song Shareholder of: May own AbbVie stock or options, Employee of: AbbVie.

Subjective Theories of Chinese Office Workers With Irregular Physical Activity: An Interview-Based Study

Objectives

Individuals with irregular physical activity (PA) participation are defined as fluctuators. This study aimed to comprehend how fluctuators’ perceived barriers and motivators in their subjective theories are exhibited and cognitively represented in relation to their everyday PA practices and lapses.

Methods

The design of “Research Program Subjective Theories” was used to explore and present fluctuators’ cognition concerning PA participation. Thirty fluctuators were invited to a semi-structured interview. By inductive and deductive coding, fluctuators’ verbal data were converted into word categories for extracting commonalities and comparing differences. By retaining the remaining word categories of high frequency and exploring the interrelationships among the remained word categories using statistical analyses, a superstructure (i.e., visualized representation of fluctuators’ overall cognition) including fluctuators’ main PA motivators, barriers, and behavioral outcomes was compiled.

Results

Fluctuators face common motivators as barriers, such as lack of time, lack of willpower, lack of social support, and physical reasons (discomfort, injuries, or diseases). Fluctuators’ subjective theories primarily differed in motivational configurations. The physically motivated fluctuators (i.e., those predominantly motivated by physically related motivators) were more linked with low PA level, while the mixed motivated fluctuators (i.e., motivated by both physically related and emotionally or socially related motivators) were more likely associated with moderate PA level. The exemplars of the three typical fluctuators were also demonstrated to reveal their real experiences and situations in the daily life context.

Conclusion

Due to the fact that fluctuation research is still in its infancy, this study represents a significant opportunity to promote knowledge growth in this area. Future studies are recommended to convert findings of the present study into interventions that benefit fluctuators in overcoming perceived barriers and enhancing motivations to eventually participate in regular PA.

Individual Preventive Behaviors of COVID-19 and Associated Psychological Factors Among Chinese Older Adults: A Cross-Sectional Online Survey

Purpose

Older adults aged 60 years and above are classified as being of high-risk for infection during the COVID-19 pandemic. This study aimed to investigate the associations of psychological factors (motivational factors: risk perception, health knowledge, attitude, subjective norm, motivational self-efficacy, and intention; volitional factors: volitional self-efficacy, planning, and action control) of preventive behaviors with three preventive behaviors (hand washing, facemask wearing, and social distancing) among Chinese older adults during the COVID-19 pandemic.

Methods

A cross-sectional questionnaire survey was administered via SOJUMP, a widely used online survey platform in China. A total of 928 older adults (mean = 67.24 years, age range: 60–90 years, SD = 6.43, 55.9% females) were recruited using a snowball sampling approach from Hubei Province (n = 667) and outside Hubei Province (n = 261) in China during May 18, 2020 to June 7, 2020. Multiple hierarchical regressions were conducted with four models to examine the association between demographic, past behavior, psychological factors and each preventive behavior.

Principal Findings

All three preventive behaviors in older adults increased dramatically during the pandemic of COVID-19. Gender, living status, educational level, past behavior, health knowledge, intention and planning significantly predicted hand washing behavior, R² = 0.395, F(10, 927) = 54.372, p < 0.001. Gender, education level, important others (e.g., family members or friends) infection, past behavior, health knowledge, planning and action control significantly predicted mask wearing behavior, R² = 0.202, F(10, 927) = 23.197, p < 0.001. Living place, past behavior and health knowledge significantly predicted social distancing behavior, R² = 0.204, F(9, 927) = 26.201, p < 0.001.

Major Conclusions

Past behavior and health knowledge predicted all three preventive behaviors. Planning was an important psychological factor for both hand washing and mask wearing behaviors. All those critical demographic and psychological factors are critical for future interventions to facilitate older adults to comply with three preventive behaviors in daily life and to stay healthy during the COVID-19 pandemic.

Review on the contamination and remediation of polycyclic aromatic hydrocarbons (PAHs) in coastal soil and sediments

The rapid economic and population growth in coastal areas is causing increasingly serious polycyclic aromatic hydrocarbons (PAHs) pollution in these regions. This review compared the PAHs pollution characteristics of different coastal areas, including industrial zones, commercial ports, touristic cities, aquacultural & agricultural areas, oil & gas exploitation areas and megacities. Currently there are various treatment methods to remediate soils and sediments contaminated with PAHs. However, it is necessary to provide a comprehensive overview of all the available remediation technologies up to date, so appropriate technologies can be selected to remediate PAHs pollution. In view of that, we analyzed the characteristics of the remediation mechanism, summarized the remediation methods for soil or sediments in coastal areas, which were physical repair, chemical oxidation, bioremediation and integrated approaches. Besides, this review also reported the development of new multi-functional green and sustainable systems, namely, micro-nano bubble (MNB), biochar, reversible surfactants and peracetic acid. While physical repair, expensive but efficient, was regarded as a suitable method for the PAHs remediation in coastal areas because of land shortage, integrated approaches would produce better results. The ultimate aim of the review was to ensure the successful restructuring of PAHs contaminated soil and sediments in coastal areas. Due to the environment heterogeneity, PAHs pollution in coastal areas remains as a daunting challenge. Therefore, new and suitable technologies are still needed to address the environmental issue.

A WeChat Mini Program-Based Intervention for Physical Activity, Fruit and Vegetable Consumption Among Chinese Cardiovascular Patients in Home-Based Rehabilitation: A Study Protocol

Background

Cardiac rehabilitation programs aim to avoid further progression and relapse of cardiovascular diseases (CVDs). Patients with CVDs undergoing rehabilitation often experience difficulties in integrating and transferring the learned health behaviors into their daily life after returning home. This includes regular physical activity (PA) and sufficient fruit and vegetable consumption (FVC). eHealth individualized interventions have shown to be effective in increasing PA and FVC in home settings. As WeChat is the most popular social media site in China, this should be used for the intervention. The aim of this study is to develop and examine a WeChat mini program-based intervention on PA and FVC promotion among Chinese cardiovascular patients in home-based rehabilitation.

Methods

The study will adopt a randomized controlled trial (RCT), comprising a WeChat mini program-based intervention group and a waiting-list control group. The intervention content will be designed based on the Health Action Process Approach (HAPA). One hundred fifty-eight outpatients will be recruited from the cardiac rehabilitation center of a hospital in southern China and randomly assigned to one of the two groups. During the 10-week duration of the intervention, participants will be invited to access a WeChat mini program comprising two Modules. Module 1 provides weekly learning sessions addressing PA and FVC simultaneously for 10 weeks. Module 2 provides a platform, where participants can review their progress with Module 1 at any time and attend incentive activities aiming at promoting engagement and retention. The outcome variables include PA (mins/week), FVC (portion/day), healthy lifestyle (the synthesis of PA and FVC), social-cognitive predictors of behavior change (risk perception, outcome expectancies, self-efficacy, intention, planning, social support, and action control) as well as health outcomes (Body mass index, depression, and quality of life). Data collection will be implemented at pre-test, post-test and a post-test after 3-month respectively.

Discussion

The current study will be significant to understand how such a cost-effective social media mini program-based intervention enables participants to adopt and maintain a healthy lifestyle. If it is effective, it will enrich home-based cardiac rehabilitation approaches which can in turn save the lives of patients as well as much monetary, time and other investments.

Trial Registration

The study was registered at ClinicalTrials.gov (Identifier: NCT03636724; Last update posted: July 28, 2020).

Acceleration of Brain Susceptibility-Weighted Imaging with Compressed Sensitivity Encoding: A Prospective Multicenter Study

BACKGROUND AND PURPOSE

While three-dimensional susceptibility-weighted imaging has been widely suggested for intracranial vessel imaging, hemorrhage detection, and other neuro-diseases, its relatively long scan time has necessitated the clinical verification of recent progresses of fast imaging techniques. Our aim was to evaluate the effectiveness of brain SWI accelerated by compressed sensitivity encoding to identify the optimal acceleration factors for clinical practice.

MATERIALS AND METHODS

Ninety-nine subjects, prospectively enrolled from 5 centers, underwent 8 brain SWI sequences: 5 different folds of compressed sensitivity encoding acceleration (CS2, CS4, CS6, CS8, and CS10), 2 different folds of sensitivity encoding acceleration (SF2 and SF4), and 1 without acceleration. Images were assessed quantitatively on both the SNR of the red nucleus and its contrast ratio to the CSF and, subjectively, with scoring on overall image quality; visibility of the substantia nigra-red nucleus, basilar artery, and internal cerebral vein; and diagnostic confidence of the cerebral microbleeds and other intracranial diseases.

RESULTS

Compressed sensitivity encoding showed a promising ability to reduce the acquisition time (from 202 to 41 seconds) of SWI while increasing the acceleration factor from 2 to 10, though at the cost of decreasing the SNR, contrast ratio, and the scores of visual assessments. The visibility of the substantia nigra-red nucleus and internal cerebral vein became unacceptable in CS6 to CS10. The basilar artery was well-distinguished, and diseases including cerebral microbleeds, cavernous angiomas, intracranial gliomas, venous malformations, and subacute hemorrhage were well-diagnosed in all compressed sensitivity encoding sequences.

CONCLUSIONS

Compressed sensitivity encoding factor 4 is recommended in routine practice. Compressed sensitivity encoding factor 10 is potentially a fast surrogate for distinguishing the basilar artery and detecting susceptibility-related abnormalities (eg, cerebral microbleeds, cavernous angiomas, gliomas, and venous malformation) at the sacrifice of visualization of the substantia nigra-red nucleus and internal cerebral vein.

Predicting hand washing, mask wearing and social distancing behaviors among older adults during the covid-19 pandemic: an integrated social cognition model

BACKGROUND

Older adults are at a higher risk from COVID-19. Individual preventive behaviors including frequent hand washing, mask wearing, and social distancing play important roles in reducing the transmission of COVID-19 in the community. This study aimed to identify the determinants of three preventive behaviors of older adults during the COVID-19 pandemic by using an Integrated Social Cognition Model.

METHODS

Using a prospective study design, 516 Chinese older adults from Hubei province of China (mean age = 67.55 years, SD = 6.60, 57.9% females) completed two online questionnaire surveys. The demographics, social cognition constructs (motivational self-efficacy, risk perception, attitude, subjective norm, health knowledge, intention, volitional self-efficacy, planning, action control) and three preventive behaviors were measured during the first-wave online survey from 18 May 2020 to 7 June 2020. One month later, three preventive behaviors were measured again during the second-wave online survey. Data were analyzed by structural equation modelling.

RESULTS

Models showed attitude, motivational self-efficacy and subjective norm were consistent predictors of intention, motivational self-efficacy was a consistent predictor of volitional self-efficacy, planning and volitional self-efficacy were consistent predictors of action control, and health knowledge was a consistent predictor of behaviors across all three preventive behaviors. In addition, mediating relationships were found in the model of hand washing behavior. In particular, planning (β = .109, p = .042) and action control (β = .056, p = .047) mediated between volitional self-efficacy and hand washing respectively. Action control also mediated between planning and hand washing (β = .087, p = .044). Moreover, the inclusion of past behaviors in three models attenuated most of the structural relations.

CONCLUSIONS

The current study's findings basically supported the Integrated Social Cognition Model and identified key modifiable determinants of preventive behaviors. Based on this model, future interventions aiming to promote COVID-19 preventive behaviors among older adults are warranted.

Transport of TiO2 and CeO2 nanoparticles in saturated porous media in the presence of surfactants with environmentally relevant concentrations

Nanomaterials are threatening the environment and human health, but there has been little discussion about the stability and mobility of nanoparticles (NPs) in saturated porous media at environmentally relevant concentrations of surfactants, which is a knowledge gap in exploring the fate of engineered NPs in groundwater. Therefore, the influences of the anionic surfactant (sodium dodecylbenzene sulfonate, SDBS), the cationic surfactant (cetyltrimethylammonium bromide, CTAB), and the nonionic surfactant (Tween-80) with environmentally relevant concentrations of 0, 5, 10, and 20 mg/L on nano-TiO₂ (nTiO₂, negatively charged) and nano-CeO₂ (nCeO₂, positively charged) transport through saturated porous media were examined by column experiments. On the whole, with increasing SDBS concentration from 0 to 20 mg/L, the concentration peak of nTiO₂ and nCeO₂ in effluents increased by approximately 0.2 and 0.3 (dimensionless concentration, C/C₀), respectively, because of enhanced stability and reduced aggregate size resulting from enhanced electrostatic and steric repulsions. By contrast, the transportability of NPs significantly decreased with increasing CTAB concentration due to the attachment of positive charges, which was opposite to the charge on the medium surface and facilitated the NP deposition. On the other hand, the addition of Tween-80 had no significant influence on the stability and mobility of nTiO₂ and nCeO₂. The results were also demonstrated by the colloid filtration theory (CFT) modeling and the Derjaguin-Landau-Verwey-Overbeek (DLVO) interaction calculations; it might promote the assessment and remediation of NP pollution in subsurface environments.

The Effectiveness of Sequentially Delivered Web-Based Interventions on Promoting Physical Activity and Fruit-Vegetable Consumption Among Chinese College Students: Mixed Methods Study

Background

Web-based interventions for multiple health behavior change (MHBC) appear to be a promising approach to change unhealthy habits. Limited research has tested this assumption in promoting physical activity (PA) and fruit-vegetable consumption (FVC) among Chinese college students. Moreover, the timing of MHBC intervention delivery and the order of components need to be addressed.

Objective

This study aims to examine the effectiveness of 2 sequentially delivered 8-week web-based interventions on physical activity, FVC, and health-related outcomes (BMI, depression, and quality of life) and the differences in the intervention effects between the 2 sequential delivery patterns. The study also aims to explore participants’ experiences of participating in the health program.

Methods

We conducted a randomized controlled trial, in which 552 eligible college students (mean 19.99, SD 1.04 years, 322/552, 58.3% female) were randomly assigned to 1 of 3 groups: PA-first group (4 weeks of PA followed by 4 weeks of FVC intervention), FVC-first group (4 weeks of FVC followed by 4 weeks of PA intervention), and a control group (8 weeks of placebo treatment unrelated to PA and FVC). The treatment content of two intervention groups was designed based on the Health Action Process Approach (HAPA) framework. A total of four web-based assessments were conducted: at baseline (T1, n=565), after 4 weeks (T2, after the first behavior intervention, n=486), after 8 weeks (T3, after the second behavior intervention, n=420), and after 12 weeks (T4, 1-month postintervention follow-up, n=348). In addition, after the completion of the entire 8-week intervention, 18 participants (mean 19.56, SD 1.04 years, 10/18, 56% female) who completed the whole program were immediately invited to attend one-to-one and face-to-face semistructured interviews. The entire study was conducted during the fall semester of 2017.

Results

The quantitative data supported superior effects on physical activity, FVC, and BMI in the 2 sequential intervention groups compared with the control group. There were no significant differences in physical activity, FVC, and health-related outcomes between the 2 intervention groups after 8 weeks. The FVC-first group contributed to more maintenance of FVC compared with the PA-first group after 12 weeks. Four major themes with several subthemes were identified in the qualitative thematic analysis: PA and FVC behavior, health-related outcomes, correlates of behavior change, and contamination detection.

Conclusions

This study provides empirical evidence for the effectiveness of sequentially delivered, web-based MHBC interventions on PA and FVC among Chinese college students. The timing issue of MHBC intervention delivery was preliminarily addressed. Qualitative findings provide an in-depth understanding and supplement the quantitative findings. Overall, this study may contribute considerably to future web-based MHBC interventions.

Trial Registration

ClinicalTrials.gov NCT03627949; https://clinicaltrials.gov/ct2/show/NCT03627949

International Registered Report Identifier (IRRID)

RR2-10.1186/s12889-019-7438-1

Human health risk assessment of selected pharmaceuticals in the five major river basins, China

Pharmaceuticals in aquatic environment have raised wide attention in recent years due to their potential adverse effects and bioaccumulation in biota. China has been a major producer and consumer of pharmaceuticals, however, the potential human health risk of these chemicals is yet to be determined in China. In this study, we evaluated available exposure data for twenty pharmaceuticals in surface waters from Chinese five major river basins (the Yangtze, Haihe, Pearl, Songliao, and Yellow River Basins), and human health risk assessment was performed. Based on the concentration data and risk data, we conducted research on the source, cause, and control measures of the pharmaceuticals. The twenty pharmaceuticals were found to be ubiquitous in China with median concentrations between 0.09 and 304 ng/L. The estimated daily intake of pharmaceuticals from drinking water and eating fish was calculated. The intake via drinking water was significantly lower than that via eating fish. The risk quotients via water intake and fish consumption ranged from 0 to 17.2, with estrogen and sulfapyridine highest among the twenty pharmaceuticals. High risks of exposure were mainly in North China, including the Haihe and Songliao River Basins. This is the first analysis in Chinese major river basins that has filled the gaps in the research on the human health risks of pharmaceuticals. The results of the study provide basic information of pharmaceutical intake from drinking water and eating fish in China and provide insights into the risk management guidance of pharmaceuticals, and will facilitate the optimization of health advisories and policy making.

Lifestyle Behaviors and Quality of Life Among Older Adults After the First Wave of the COVID-19 Pandemic in Hubei China

Background: Older adult quality of life (QoL) is facing huge challenges during the COVID-19 pandemic. New normal lifestyle behaviors, including getting adequate physical activity (PA), consuming sufficient fruits and vegetables (FV) and enacting individual preventive behaviors (frequent hand washing, facemask wearing, and social distancing), as a significant determinant for QoL, have not been adequately addressed in older adults during the pandemic. This study aimed to investigate the characteristics of QoL in Chinese older adults after the first wave of the COVID-19 pandemic in Hubei China. The objective of the study was to examine any associations of lifestyle behaviors with QoL, and to identify the moderating role of socioeconomic indicators in the associations identified. Methods: A cross-sectional study was conducted in Hubei, China, from June 15, 2020, to July 10, 2020. Five hundred sixteen older adults completed an online survey (mean age = 67.6 ± 6.6; 57.9% women). The questionnaire consisted of demographic information, covariates (chronic diseases and infected cases of acquaintances), lifestyle behaviors [PA stage, FV intake (FVI) stage and three preventive behaviors], and QoL. T-tests, ANOVA tests, multiple linear regression models with simple slope analyses were used to test the hypotheses. Results: QoL significantly differed in relation to economic situation, chronic diseases, marital status, education, living situation, age group, and professional status. Participants' economic situation (βaverage vs. below average = 0.17, p < 0.01; βabove average vs. below average = 0.15, p < 0.01), chronic diseases (βyes vs. no = 0.19, p < 0.001), FVI stage (β = 0.21, p < 0.001), and preventive behaviors (β = 0.10, p < 0.05) indicated a significant association with QoL. Education level and economic situation significantly interacted with preventive behaviors on QoL, respectively (βpreventive behaviors × educational level = -1.3, p < 0.01; βpreventive behaviors × economic situation = -0.97, p < 0.05). Conclusions: Findings emphasize the importance of enhancing FVI and preventive behaviors on QoL improvement in older adults during the COVID-19 pandemic. Older adults who are in a lower economic situation with lower education levels should be given priority when implementing interventions to improve preventive behaviors and QoL in older adults.

[Analysis of the detection of metals and metalloids in the bronchoalveolar lavage fluid for the etiological diagnosis value of pneumoconiosis]

Objective: To analyze the differences of the concentrations of metals and metalloids in bronchoalveolar lavage fluid (BALF) of patients with pneumoconiosis, so as to provide reference for the etiological diagnosis of pneumoconiosis. Methods: From September 2019 to August 2020, 47 pneumoconiosis patients hospitalized in Chongqing Prevention and Treatment Center for Occupational Diseases and undergoing bronchoalveolar lavage were selected as the research objects using cluster sampling method. The general situation and occupational history of patients were investigated by questionnaire, The BALF of 47 pneumoconiosis patients was collected, and the concentrations of metals and metalloids in BALF were detected by inductively coupled plasma mass spectrometry (ICP-MS) , the differences among patients with different types of pneumoconiosis, different stages of silicosis and different occupational history were analyzed by one-way ANOVA. Results: The concentrations of 50 metals and metalloids in BALF were detected, and 21 of them were analyzed. Compared with different types of pneumoconiosis, the concentrations of Zn, Mn and Sn in BALF were statistically significant (F=9.959, 3.635, 9.488, P<0.05) . The concentrations of K, Mg, Fe, Zn, Cu and Ni in BALF were significantly different in different stages of silicosis (F=4.271, 4.334, 3.588, 5.120, 7.340, 3.905, P<0.05) . The concentrations of Zn and Sn in pneumoconiosis patients with different types of work and types of exposed dust were significantly different (P<0.05) . Conclusion: The detection of Zn, Mn, Sn, and other metals in BALF can provide reference basis for the etiological diagnosis of pneumoconiosis and provide a new idea for the diagnostic method of pneumoconiosis.

Nuclear localization of duck Tembusu virus NS5 protein attenuates viral replication in vitro and NS5-NS2B3 interaction

Duck Tembusu virus (TMUV) belongs to the flavivirus genus whose genome replication involved in capping and RNA synthesis dominating by nonstructural protein 5 (NS5). Flaviviral replication has been well documented to occur in the cytoplasm, but the effect of NS5 to gain access to the nucleus remains controversial. Here, TMUV NS5 was observed to localize within the cytoplasm of transfected and infected cells and co-localized with the endoplasmic reticulum. We introduced two arginine mutations into the N390 and Q392 (N390R and Q392R) of the NS5 bipartite nuclear localization sequence (α/βNLS) and designated that mutagenesis as NS5_NLSmut, which has shown the ability to access the nucleus and hence attenuates viral replication and production in vitro. Additionally, there was no significant difference between the recovered wild-type TMUV (rTMUV-WT) and engineered mutant (rTMUV-NS5_NLSmut) on plaque morphology, survival rate of infected duck embryos or virus copies in tissues. Considering that NS5_NLSmut is mainly located in the cytoplasm of rTMUV-NS5_NLSmut infected cells at the early stage of infection. We further confirmed that NS5_NLSmut attenuated its interaction with nonstructural NS2B-NS3 (NS2B3) following transfection and infection. Meanwhile, the rTMUV-NS5_NLSmut tended to stimulate more interferon beta (IFNβ) than rTMUV-WT. However, preliminary study on transient NS5 and NS5_NLSmut detected the same levels of IFNβ mRNA mediated by RIG-I detection of NS5 RNA polymerase activity in cell. In summary, these results provide further insights into the relationship between the viral property and subcellular localization of flavivirus NS5 in terms of the NS5-NS2B3 interaction.

Motif C in nonstructural protein 5 of duck Tembusu virus is essential for viral proliferation

Nonstructural protein 5 (NS5) is required for duck Tembusu virus (DTMUV) genome replication, and the GDD motif in motif C is considered the hallmark of RdRp. However, the role of GDD-adjacent amino acids in motif C in viral proliferation is still unclear. To explore the role of motif C in the virus life cycle, DTMUV infectious clones and replicons were used to study the basic characteristics of rDTMUV through mutation of the amino acids in motif C. The replicon replication capability, virus titer, virus copy number, virulence and viral loads in organs were compared. Our results showed that V671A and V672A in motif C impaired DTMUV RNA replication in the replication system. Using an infectious clone system of DTMUV, we further demonstrated that the mutations of these two sites decreased viral titer and delayed the times of CPE appearance and duck embryo death. An in vivo study suggested that rDTMUV and DTMUV caused no obvious differences in ducklings. Similar clinical signs, including splenomegaly with hyperemia and hemorrhage dots of the thymus, were observed. There was no obvious difference in tissue viral loads between wild-type (rDTMUV-WT) and rDTMUV-NS5-V671A or rDTMUV-NS5-V672A. Determining the role of motif C can help in improving the understanding of the mechanism underlying DTMUV proliferation.

Search for Displaced Leptons in sqrt[s]=13 TeV pp Collisions with the ATLAS Detector

A search for charged leptons with large impact parameters using 139  fb^{-1} of sqrt[s]=13  TeV pp collision data from the ATLAS detector at the LHC is presented, addressing a long-standing gap in coverage of possible new physics signatures. Results are consistent with the background prediction. This search provides unique sensitivity to long-lived scalar supersymmetric lepton partners (sleptons). For lifetimes of 0.1 ns, selectron, smuon, and stau masses up to 720, 680, and 340  GeV, respectively, are excluded at 95% confidence level, drastically improving on the previous best limits from LEP.