[Association between clinical phenotypes of hypertrophic cardiomyopathy and Ca2+ gene variation gene variation]

Objective: To observe the association between clinical phenotypes of hypertrophic cardiomyopathy (HCM) patients and a rare calcium channel and regulatory gene variation (Ca²⁺ gene variation) and to compare clinical phenotypes of HCM patients with Ca²⁺ gene variation, a single sarcomere gene variation and without gene variation and to explore the influence of rare Ca²⁺ gene variation on the clinical phenotypes of HCM. Methods: Eight hundred forty-two non-related adult HCM patients diagnosed for the first time in Xijing Hospital from 2013 to 2019 were enrolled in this study. All patients underwent exon analyses of 96 hereditary cardiac disease-related genes. Patients with diabetes mellitus, coronary artery disease, post alcohol septal ablation or septal myectomy, and patients who carried sarcomere gene variation of uncertain significance or carried>1 sarcomere gene variation or carried>1 Ca²⁺ gene variation, with HCM pseudophenotype or carrier of ion channel gene variations other than Ca²⁺ based on the genetic test results were excluded. Patients were divided into gene negative group (no sarcomere or Ca²⁺ gene variants), sarcomere gene variation group (only 1 sarcomere gene variant) and Ca²⁺ gene variant group (only 1 Ca²⁺ gene variant). Baseline data, echocardiography and electrocardiogram data were collected for analysis. Results: A total of 346 patients were enrolled, including 170 patients without gene variation (gene negative group), 154 patients with a single sarcomere gene variation (sarcomere gene variation group) and 22 patients with a single rare Ca²⁺ gene variation (Ca²⁺ gene variation group). Compared with gene negative group, patients in Ca²⁺ gene variation group had higher blood pressure and higher percentage of family history of HCM and sudden cardiac death (P<0.05); echocardiographic results showed that patients in Ca²⁺ gene variation group had thicker ventricular septum ((23.5±5.8) mm vs. (22.3±5.7) mm, P<0.05); electrocardiographic results showed that patients in Ca²⁺ gene variation group had prolonged QT interval ((416.6±23.1) ms vs. (400.6±47.2) ms, P<0.05) and higher RV5+SV1 ((4.51±2.26) mv vs. (3.50±1.65) mv, P<0.05). Compared with sarcomere gene variation group, patients in Ca²⁺ gene variation group had later onset age and higher blood pressure (P<0.05); echocardiographic results showed that there was no significant difference in ventricular septal thickness between two groups; patients in Ca²⁺ gene variation group had lower percentage of left ventricular outflow tract pressure gradient>30 mmHg (1 mmHg=0.133 kPa, 22.8% vs. 48.1%, P<0.05) and the lower early diastolic peak velocity of the mitral valve inflow/early diastolic peak velocity of the mitral valve annulus (E/e') ratio ((13.0±2.5) vs. (15.9±4.2), P<0.05); patients in Ca²⁺ gene variation group had prolonged QT interval ((416.6±23.1) ms vs. (399.0±43.0) ms, P<0.05) and lower percentage of ST segment depression (9.1% vs. 40.3%, P<0.05). Conclusion: Compared with gene negative group, the clinical phenotype of HCM is more severe in patients with rare Ca²⁺ gene variation; compared with patients with sarcomere gene variation, the clinical phenotype of HCM is milder in patients with rare Ca²⁺ gene variation.

Whole transcriptome analysis reveals dysregulation of molecular networks in schizophrenia

To characterize the regulatory relationships between different types of transcripts and the altered molecular networks in schizophrenia (SCZ), we performed a whole transcriptome study by quantifying mRNAs, long noncoding RNAs (lncRNAs), miRNAs, and circular RNAs (circRNAs) in the same individuals simultaneously. A total of 807 dysregulated genes showed differential expression in SCZ cases compared with controls. Network-based analysis revealed dysregulation of molecular networks in SCZ. Finally, integration of the transcriptome data with published data identified promising SCZ candidate genes. Our study reveals that dysregulated molecular networks and regulatory relationships between different types of transcript may have a role in SCZ.

[Zuogui Jiangtang Jieyu Decoction promotes neural stem cell self-renewal and activates Shh signaling in the hippocampal dentate gyrus of diabetic rats with depression]

OBJECTIVE

To investigate the effect of Zuogui Jiangtang Jieyu Decoction (ZJJ) on Shh signaling and self-renewal of neural stem cells in the hippocampal dentate gyrus of diabetic rats with depression.

METHODS

Diabetic rat models with depression were randomly divided into model group, positive drug (metformin + fluoxetine) group, and low-, medium-, and high-dose ZJJ groups (n=16), with normal SD rats as the control group. The positive drugs and ZJJ were administered by gavage, and the rats in the control and model groups were given distilled water. After the treatment, blood glucose level was detected using test strips, and behavioral changes of the rats were assessed by forced swimming test and water maze test. ELISA was used to examine the serum level of leptin; The expressions of nestin and Brdu proteins in the dentate gyrus of the rats were detected using immunofluorescence assay, and the expressions of self-renewal marker proteins and Shh signaling proteins were detected using Western blotting.

RESULTS

The diabetic rats with depression showed significantly increased levels of blood glucose and leptin (P < 0.01) and prolonged immobility time in forced swimming test (P < 0.01) and increased stage climbing time with reduced stage seeking time and stage crossings in water maze test (P < 0.01). The expressions of nestin and Brdu in the dentate gyrus, the expressions of cyclin D1, SOX2, Shh, Ptch1, Smo in the hippocampus and the nuclear expression of Gli-1 were decreased (P < 0.01) while hippocampal Gli-3 expression was increased significantly (P < 0.01) in the rat models. Treatment of rat models with high-dose ZJJ significantly reduced the blood glucose (P < 0.01) and leptin level (P < 0.05) and improved their performance in behavioral tests (P < 0.01). The treatment also obviously increased the expressions of nestin, Brdu, cyclin D1, SOX2, Shh, Ptch1, and Smo and the nuclear expression of Gli-1 in the dentate gyrus (P < 0.01) and reduced hippocampal expression of Gli-3 (P < 0.05) in the rat models.

CONCLUSION

ZJJ can significantly improve the self-renewal ability of neural stem cells and activate Shh signaling in dentate gyrus of diabetic rats with depression.

Water uptake in germinating pecan (Carya illinoinensis) seed

• Water uptake is the fundamental and essential requirement for seed germination. Pecan seed has a hard woody endocarp and plays an important role during water uptake. • To explore the laws of water uptake during germination, the spatiotemporal pattern of water and the effect of endocarp were analysed by water measuring, high-field magnetic resonance imaging (MRI), dye-tracing, blocking and scanning electron microscopy (SEM). • Isolated seeds finish water uptake in 8h while whole seeds take 6d, and the cracking of endocarp plays an important role. The hilum is the channel for water to enter the seed, the rest of the seed coat consist of cells covered with a waxy layer and act as a barrier that made it difficult to absorb water. The region with the highest water contents in pecan seed was the edge of the U-shaped region and the water progressively diffused from the edge of the U-shaped region to the whole kernel. • There seems to be a new water absorption stage between phase II and phase III of triphasic model of water uptake of pecan seeds. The cracking of endocarp changed the water distribution in pecan seeds, which may be the trigger for further water absorption and radicle elongation.

Optical Monitoring of the Magnetization Switching of Single Synthetic-Antiferromagnetic Nanoplatelets with Perpendicular Magnetic Anisotropy

Synthetic antiferromagnetic nanoplatelets (NPs) with a large perpendicular magnetic anisotropy (SAF-PMA NPs) have a large potential in future local mechanical torque-transfer applications for e.g., biomedicine. However, the mechanisms of magnetization switching of these structures at the nanoscale are not well understood. Here, we have used a simple and relatively fast single-particle optical technique that goes beyond the diffraction limit to measure photothermal magnetic circular dichroism (PT MCD). This allows us to study the magnetization switching as a function of applied magnetic field of single 122 nm diameter SAF-PMA NPs with a thickness of 15 nm. We extract and discuss the differences between the switching field distributions of large ensembles of NPs and of single NPs. In particular, single-particle PT MCD allows us to address the spatial and temporal heterogeneity of the magnetic switching fields of the NPs at the single-particle level. We expect this new insight to help understand better the dynamic torque transfer, e.g., in biomedical and microfluidic applications.

The Experiences of Patients with Periodontitis and its Treatment: A Qualitative Study

OBJECTIVE

Gain insights into how patients with periodontitis perceive the disease and its treatment, thus identifying their potential needs.

METHODS

Descriptive qualitative research among 19 patients with periodontitis purposefully sampled for semi-structured interviews. Thematic analysis of the interview data used NVivo 11.0.

RESULTS

The data could be summarized in five themes: 1) restricted physiological function of the oral cavity; 2) psychological frustration; 3) impact on social life; 4) focus on patient comfort; 5) accessibility, convenience, and science of oral health services.

CONCLUSIONS

Periodontitis can affect biopsychosocial aspects of patients lives. Some needs remain to be met or improved during treatment. As the paradigm shifts, dental practitioners should also focus on their professional roles and take measures to improve patients' experiences.

[Developmental effects of TCIPP and TnBP on zebrafish (Danio rerio) embryos]

Objective: To investigate the toxicity of tris (2-chloropropyl) phosphate (TCIPP) and tributyl phosphate (TnBP) on the growth and development of zebrafish embryos, as well as to explore the underlying mechanisms at the transcriptional level. Methods: With zebrafish as a model, two hpf zebrafish embryos were exposed to TCIPP and TnBP (0.1, 1, 10, 100, 500, and 1 000 μmol/L) using the semi-static method, and their rates of lethality and hatchability were determined. The transcriptome changes of 120 hpf juvenile zebrafish exposed to environmentally relevant concentrations of 0.1 and 1 μmol/L were measured. Results: The 50% lethal concentrations (LC₅₀) of TCIPP and TnBP for zebrafish embryos were 155.30 and 27.62 μmol/L (96 hpf), 156.5 and 26.05 μmol/L (120 hpf), respectively. The 72 hpf hatching rates of TCIPP (100 μmol/L) and TnBP (10 μmol/L) were (23.33±7.72)% and (91.67±2.97)%, which were significantly decreased compared with the control group (P<0.05). Transcriptome analysis showed that TnBP had more differential genes (DEGs) than TCIPP, with a dose-response relationship. These DEGs were enriched in 32 pathways in total, including those involved in oxidative stress, energy metabolism, lipid metabolism, and nuclear receptor-related pathways, using the IPA pathway analysis. Among them, three enriched pathways overlapped between TCIPP and TnBP, including TR/RXR activation and CAR/RXR activation. Additionally, DEGs were also mapped onto pathways of LXR/RXR activation and oxidative stress for TnBP exposure only. Conclusion: Both TCIPP and TnBP have growth and developmental toxicities in zebrafish embryos, with distinct biomolecular mechanisms, and TnBP has a stronger effect than TCIPP.

Multiple Mechanisms in Proton-Induced Nucleon Removal at ∼100 MeV/Nucleon

We report on the first proton-induced single proton- and neutron-removal reactions from the neutron-deficient ^{14}O nucleus with large Fermi-surface asymmetry S_{n}-S_{p}=18.6  MeV at ∼100  MeV/nucleon, a widely used energy regime for rare-isotope studies. The measured inclusive cross sections and parallel momentum distributions of the ^{13}N and ^{13}O residues are compared to the state-of-the-art reaction models, with nuclear structure inputs from many-body shell-model calculations. Our results provide the first quantitative contributions of multiple reaction mechanisms including the quasifree knockout, inelastic scattering, and nucleon transfer processes. It is shown that the inelastic scattering and nucleon transfer, usually neglected at such energy regime, contribute about 50% and 30% to the loosely bound proton and deeply bound neutron removal, respectively. These multiple reaction mechanisms should be considered in analyses of inclusive one-nucleon removal cross sections measured at intermediate energies for quantitative investigation of single-particle strengths and correlations in atomic nuclei.

[Interpretation of Consolidated Health Economic Evaluation Reporting Standards 2022]

The number of studies related to health economics evaluation is increasing. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) contains 28 items. Based on CHEERS 2013, CHEERS 2022 adds a health economic analysis plan, model sharing, and community, patient, public, and other relevant stakeholders' participation in the statement, taking into account the future development direction of health economics evaluation. It provides a useful review tool for peer reviewers, editors, and readers and supports health technology assessment agencies in establishing standard reporting standards for health economics evaluations. In this study, we briefly introduced and interpreted the CHEERS 2022 statement and analyzed an example of health economics evaluation in infectious disease epidemiology to provide a reference for researchers to report studies regarding health economics evaluation standardly.

[A survey on the current status of cognition of birth safety among married HIV-infected people aged 18-45 years]

Objective: To understand the current status of fertility safety cognition among married HIV-infected people aged 18-45 years and to provide evidence for fertility safety intervention in HIV-infected families. Methods: Six districts in Chongqing and Zigong City in Sichuan Province were selected. A questionnaire survey was conducted among married HIV-infected people aged 18-45 years who were followed up from November 2021 to April 2022 to collect their general demographic characteristics, histories of sex experience, fertility intention, and knowledge of birth safety. Unconditional logistic regression and Poisson regression were used to analyze the factors affecting the cognition of birth safety. Results: A total of 266 HIV-infected people were included in the study; 58.3% (155/266) were women, and 48.9% (130/266) had fertility desire. The cognition rate of knowledge of birth safety was 59.4% (158/266). The cognition rate of women's knowledge of birth safety was 2.14 (95%CI: 1.25-3.66) times that of men's. The cognition rate of knowledge of birth safety among HIV-infected persons with a high school education level or above was 1.88 (95%CI: 1.08-3.27) times that of those with a low education level. The cognition rate of knowledge of reproductive safety among HIV-infected people with fertility intention was 1.88 (95%CI: 1.10-3.22) times that of those without fertility intention. The cognition rate of knowledge of birth safety among HIV-infected persons who received AIDS knowledge promotion and education was 9.06 (95%CI: 2.46-33.32) times that of those who did not. The cognition rate of measures of birth safety was 5.3% (14/266). The Poisson regression analysis showed no significant difference in the cognition rate of specific measures among gender, age, education and other factors. Conclusions: HIV-infected people aged 18-45 years and married with a spouse have a low awareness of birth safety, and there are risks of HIV transmission between couples and mother-to-child in the family. Targeted birth safety education and intervention should be strengthened to reduce HIV transmission.

Osteoblastic RAR Inhibition Causes VAD-Like Craniofacial Skeletal Deformity

Retinoid signaling disorders cause craniofacial deformity, among which infants with maternal vitamin A deficiency (VAD) exhibited malformation of the eye, nose, palate, and parietal and jaw bone. Previous research uncovered the pathogenesis of eye defect and cleft palate of VAD in mice, but the studies on craniofacial skeletal deformity met obstacles, and the cell/lineage and underlying mechanism remain unclear. The retinoic acid receptor (RAR) is the key transcription factor in retinoid signaling, but individual knockout cannot simulate pathway inhibition. Here, we conditionally expressed dominant-negative RARα mutation (dnRARα) in osteoblasts to specifically inhibit the transcription activity of RAR in mice, which mimics the craniofacial deformities caused by VAD in clinical cases: hypomineralization of cranial bones, mandibular deformity, and clavicular hypoplasia. Furthermore, we performed 3-dimensional reconstruction based on micro-computed tomography and confirmed the abnormalities in the shape, size, and ossification of craniofacial bones due to osteoblastic RAR inhibition. Histological analysis indicated that inhibition of RAR in osteoblasts impaired both bone formation and bone resorption, which was confirmed by transcriptome sequencing of the calvaria. Furthermore, mechanism investigation showed that inhibition of RAR in osteoblasts directly decreased osteoblast differentiation in a cell-autonomous manner by impairing osteogenic gene transcription and also inhibited osteoclast differentiation via osteoblast-osteoclast crosstalk by impairing Rankl transcription. In summary, osteoblastic RAR activity is critical to craniofacial skeletal development, and its dysfunction leads to skeletal deformities mimicking VAD craniofacial defects, providing a new insight for VAD pathogenesis.

A novel whole "Joint-in-Motion" device reveals a permissive effect of high glucose levels and mechanical stress on joint destruction

OBJECTIVE

Osteoarthritis (OA) has recently been suggested to be associated with diabetes. However, this association often disappears when accounting for body mass index (BMI), suggesting that mechanical stress may be a confounding factor. We investigated the combined influence of glucose level and loading stress on OA progression using a novel whole joint-in-motion (JM) culture system.

DESIGN

Whole mouse knee joints were placed in an enclosed chamber with culture media and actuated to recapitulate leg movement, with a dynamic stress regimen of 0.5 Hz, 8 h/day for 7 days. These joints were treated with varying levels of glucose and controlled for osmolarity and diffusion. Joint movement and joint space were examined by X-ray fluoroscopy and microCT. Cartilage matrix levels were quantified by blinded Mankin scoring and immunohistochemistry.

RESULTS

Culturing in the JM device facilitated proper leg extension and flexion movements, and adequate mass transport for analyzing the effect of glucose on cartilage. Treatment with higher levels of glucose either via media supplementation or intra-articular injection caused a significant decrease in levels of glycosaminoglycan (GAG) and an increase in aggrecan neoepitope in articular cartilage, but only under dynamic stress. Additionally, collagen II level was slightly reduced by high glucose levels.

CONCLUSIONS

High levels of glucose and dynamic stress have permissive effects on articular cartilage GAG loss and aggrecan degradation, implicating that mechanical stress confounds the association of diabetes with OA. The JM device supports novel investigation of mechanical stress on the integrity of an intact living mouse joint to provide insights into OA pathogenesis.

[Human bone marrow mesenchymal stem cell exosome-derived miR-335-5p promotes osteogenic differentiation of human periodontal ligament stem cells to alleviate periodontitis by downregulating DKK1]

OBJECTIVE

To observe the effect of miR-335-5p derived from human bone marrow mesenchymal stem cell (hBMMSCs) exosomes on osteogenic differentiation of human periodontal ligament stem cell (PDLSCs) model of periodontitis and explore its mechanism.

METHODS

The exosomes extracted from hBMMSCs were identified by transmission electron microscopy, Western blotting and PKH67 labeling. The human PDLSC model of TNF-α-induced periodontitis were co-cultured with the extracted exosomes, and qRT-PCR was performed to detect the changes in the expressions of miR-335-5p and the mRNA levels of pro-inflammatory cytokines (IL-1β, IL-6, and IL-8) and the osteogenic marker genes (RunX2, OCN and BMP-2). Alizarin red staining and ALP staining were used to detect the formation of calcium nodules in the treated cells, and the expression level of DKK1 protein was detected with Western blotting. Dual luciferase reporter gene assay was used to verify the targeting relationship between miR-335-5p and DKK1.

RESULTS

High expressions of CD9 and CD81 were detected in the extracted hBMMSC exosomes (P < 0.05). In TNF-α-induced hPDLSCs, treatment with the extracted exosomes significantly reduced the mRNA expressions of IL-1β, IL-6 and IL-8, enhanced the mRNA expressions of RunX2, OCN, and BMP-2, and promoted the formation of calcium nodules. MiR-335-5p was highly expressed in hBMMSC-derived exosomes, and overexpression of miR-335-5p significantly downregulated DKK1 protein expression, inhibited the mRNA expressions of IL-1β, IL-6 and IL-8, and promoted the mRNA expressions of osteogenic markers and the formation of calcium nodules in hPDLSCs.

CONCLUSION

HBMMSC exosome-derived miR-335-5p promotes osteogenic differentiation of hPDLSCs and inhibits the development of periodontitis by downregulating DKK1.

[Survival efficacy of MDS/AML patients with TP53 abnormal received allogeneic hematopoietic stem cell transplantation]

Objective: TP53-abnormal MDS/acute myeloid leukemia (AML) patients' allogeneic hematopoietic stem cell transplantation (allo-HSCT) treatment's effectiveness and influencing factors should be studied. Methods: 42 patients with TP53 gene status change MDS/AML who underwent allo-HSCT from 2014.8.1 to 2021.7.31 at the Hematology Hospital of the Chinese Academy of Medical Sciences were the subject of a retrospective analysis. The 42 patients were divided into three groups: the TP53 deletion group (group A) , TP53 mono-alle mutation group (group B) , and TP53 multi-hit group (group C) . The differences in clinical features and prognostic factors after transplantation were analyzed. Results: There were 42 MDS/AML patients, including 21 patients with MDS, and 21 patients with AML. The median follow-up period was 34.0 (7.5-75.0) months and the median patient age at the time of transplantation was 41.5 (18-63) years old. The total OS was 66.3% (95% CI 53.4%-82.4%) in 3 years after transplantation, and EFS was 61.0% (95% CI 47.7%-78.0%) in 3 years. For 3 years after receiving hematopoietic stem cell transplantation, there were no statistically significant differences in 3-year OS and EFS in groups A, B, and C (P≥0.05) . The 3 years OS was 82.5% (95% CI 63.1%-100.0%) in group A, 60.6% (95% CI 43.5%-84.4%) in group B, and 57.1% (95% CI 30.1%-100.0%) in group C. Univariate analysis revealed that the number of co-mutant genes, pre-HSCT treatment, and disease type did not affect prognosis, while age, karyotype, co-mutation, positive blast cell before transplantation, and positive blast cell after transplantation were common prognostic factors for OS and EFS (P<0.1) . MRD levels before transplantation were found to be independent risk factors for OS (P=0.037, HR=33.40, 95% CI 1.24-901.17) in a multivariate analysis. Conclusion: Patients with MDS/AML who have TP53 mutations can benefit from allo-HSCT, but patients with complex karyotypes have a worse prognosis. Meanwhile, the final flow cytometry (FCM) monitoring blast cell test before HSCT has a certain guiding significance for prognostic assessment.

Tertiary Lymphoid Structure Raises Survival and Immunotherapy in HPV- HNSCC

Immune checkpoint blockade (ICB) targeting PD-1/PD-L1 has been used for the treatment of head and neck squamous cell carcinoma (HNSCC). However, the overall response rate to ICB therapy for HNSCC remains less than 20%. It has recently been reported that the appearance of tertiary lymphoid structures (TLSs) in tumor tissue is correlated with better prognosis and response to ICB treatment. Here, we demonstrated an immune classification for the tumor microenvironment (TME) of HNSCC by analyzing The Cancer Genome Atlas (TCGA)-HNSCC data set and found that immunotype D with TLS enrichment had a better prognosis and response to ICB treatment. Furthermore, we observed that TLSs were present in a part of tumor samples of human papillomavirus (HPV) infection negative HNSCC (HPV^- HNSCC) and were associated with the densities of dendritic cell (DC)-LAMP⁺ DCs, CD4⁺ T cells, CD8⁺ T cells, and progenitor T cells in TME. We established an HPV^- HNSCC mouse model with TLS-enriched TME by overexpressing LIGHT in a mouse HNSCC cell line. We found that the induction of TLS formation enhanced the response to PD-1 blockade treatment in the HPV^- HNSCC mouse model, accompanied by increases in DCs and progenitor exhausted CD8⁺ T cells in the TME. Elimination of CD20⁺ B cells attenuated the therapeutic effect of PD-1 pathway blockade in TLS⁺ HPV^- HNSCC mouse models. These results indicate that TLSs contribute to the favorable prognosis and antitumor immunity of HPV^- HNSCC. Inducing TLS formation in HPV^- HNSCC tumors is a potential therapeutic method for improving the ICB response rate in patients with HPV^- HNSCC.

A123 COMPARING SIZE MEASUREMENT OF SIMULATED COLORECTAL POLYPS WHEN USING A NOVEL VIRTUAL SCALE ENDOSCOPE, ENDOSCOPIC RULER OR FORCEPS: A BLINDED RANDOMIZED TRIAL

Background

Accurate polyp size measurement is important for guideline conforming choice of polypectomy techniques and subsequent surveillance interval assignments. Some endoscopic tools (forceps or endoscopic rulers [ER]) exist to help with visual size estimation. A virtual scale endoscope (VSE) has been developed that allows superimposing a virtual measurement scale during live endoscopies.

Purpose

Our aim was to evaluate the performance of VSE when compared to ER and forceps-based measurement.

Method

We conducted a randomized trial to evaluate the relative accuracy of size measurement of simulated colorectal polyps when using: VSE, ER, and forceps. Six endoscopists performed 60 measurements randomized at a 1:1:1 ratio using each method. Primary outcome was relative accuracy in polyp size measurement. Secondary outcomes included misclassification of sizes at the 5, 10, and 20mm thresholds.

Result(s)

A total of 360 measurements were performed. The relative accuracy of biopsy forceps, ER, and VSE was 78.9% (95%CI=76.2-81.5), 78.4% (95%CI=76.0-80.8), and 82.7% (95%CI=80.8-84.8). VSE had significantly higher accuracy compared to biopsy forceps (p=0.02) and ER (p=0.006). VSE misclassified a lower percentage of polyps >5mm as ≤5mm (9.4%) compared to forceps (15.7%) and ER (20.9%). VSE misclassified a lower percentage of ≥20mm polyps as <20mm (8.3%) compared with forceps (66.7%) and ER (75.0%). 25.6%, 25.5%, and 22.5% of polyps ≥10mm were misclassified as <10mm with ER, forceps, and VSE, respectively.

Conclusion(s)

VSE had significantly higher relative accuracy in measuring polyps compared to ER or forceps assisted measurement. VSE improves correct classification of polyps at clinically important size thresholds.

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None

Disclosure of Interest

R. Djinbachian: None Declared, M. Taghiakbari: None Declared, C. Haumesser: None Declared, M. Zarandi-Nowroozi: None Declared, M. Abou-Khalil: None Declared, S. Sidani: None Declared, J. Liu: None Declared, B. Panzini: None Declared, D. von Renteln Grant / Research support from: Daniel von Renteln is supported by a “Fonds de Recherche du Québec Santé” (FRQS) career development award and has received research funding from ERBE, Ventage, Pendopharm, Fujifilm, and Pentax., Consultant of: Boston Scientific and Pendopharm,

A106 COMPARING SIZE MEASUREMENTS OF SIMULATED COLORECTAL POLYPS SIZE AND MORPHOLOGY GROUPS WHEN USING A VIRTUAL SCALE ENDOSCOPE OR VISUAL SIZE ESTIMATION: A BLINDED RANDOMIZED CONTROLLED TRIAL

Background

The polypectomy technique used to remove colorectal polyps is influenced by the size of the polyp. Furthermore, the criteria for assigning surveillance intervals after polypectomy are based on size and pathology results. Visual size assessment is potentially fraught with being inaccurate. The virtual scale endoscope (VSE) allows projection of a virtual scale onto colorectal polyps allowing real-time size measurements.

Purpose

We studied the relative accuracy of VSE compared to visual assessment (VA) for the measuring simulated polyps of different size and morphology groups.

Method

We conducted a blinded randomized controlled trial using simulated polyps imbedded within a colon model. Sixty simulated polyps were created and evenly distributed across four different size groups (0-4.9 mm, 5-9.9 mm, 10-19.9 mm and ≥ 20 mm) and 3 different Paris morphology groups (flat, sessile and pedunculated). Six endoscopists (3 staff gastroenterologists and 3 trainees) performed size measurements of all sixty simulated polyps using random allocation of either VA or VSE.

Result(s)

A total of 359 measurements were completed. The relative accuracy of VSE was significantly higher when compared to VA for polyps ≥ 5 and <10mm, ≥ 10 and <20mm, ≥ 20mm (p=0.004; p<0.001, p<0.001). For polyps <5mm, the relative accuracy of VSE compared to VA was nominally higher (79.4% versus 74.1%) but this was not statistically significant (p = 0.186). The relative accuracy of VSE was higher when compared to visual assessment for sessile (p = 0.001), flat (p < 0.001) and pedunculated polyps (p = 0.002). VSE misclassified a lower percentage of ≥ 5 mm polyps as < 5 mm (2.9%), ≥ 10 mm polyps as < 10 mm (5.5%) and ≥ 20 mm polyps as < 20 mm (21.7%) compared to visual estimation (11.2; 24.7 and 52.3% respectively; p=0.008, p<0.001 and p=0.003).

Conclusion(s)

VSE had significantly higher relative accuracies for every polyp size group or morphology type aside from diminutive where VSE had a non-significantly higher relative accuracy. VSE enables endoscopist to better classify polyps into correct size categories at clinically relevant size thresholds of 5-, 10- and 20-mm. Implementing VSE as a standard measurement tool could allow improving clinical decision making for accurate surveillance interval assignment and choice of polypectomy technique.

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Other

Please indicate your source of funding;

The study was supported by a "Fonds de Recherche du Québec Santé" career development award (Daniel von Renteln) and a University of Montreal student award “PRogramme d’Excellence en Médecine pour l’Initiation En Recherche – PREMIER (Claire Haumesser).

Disclosure of Interest

C. Haumesser: None Declared, M. Zarandi-Nowroozi: None Declared, M. Taghiakbari: None Declared, R. Djinbachian: None Declared, M. Abou Khalil: None Declared, S. Sidani: None Declared, J. Liu: None Declared, B. Panzini: None Declared, I. Popescu Crainic: None Declared, D. von Renteln Grant / Research support from: ERBE Elektromedizin GmbH, Ventage, Pendopharm, Fuji and Pentax, Consultant of: Boston Scientific Inc., ERBE Elektromedizin GmbH, and Pendopharm

Mendelian Randomization Study Using Dopaminergic Neuron-Specific eQTL Identifies Novel Risk Genes for Schizophrenia

Multiple integrative studies have been performed to identify the potential target genes of the non-coding schizophrenia (SCZ) risk variants. However, all the integrative studies used expression quantitative trait loci (eQTL) data from bulk tissues. Considering the cell type-specific regulatory effect of many genetic variants, it is important to conduct integrative studies using cell type-specific eQTL data. Here, we conduct a Mendelian randomization (MR) study by integrating genome-wide associations of SCZ (74,776 cases and 101,023 controls) and eQTL data (N = 215) from dopaminergic neurons, which were differentiated from human-induced pluripotent stem cell (iPSC) lines. For eQTL from young post-mitotic dopaminergic neurons (differentiation of iPSC for 30 days, D30), we identified 34 genes whose genetically regulated expression in dopaminergic neurons may have a causal role in SCZ. Among which, ARL3 showed the most significant associations with SCZ. For eQTL from more mature dopaminergic neurons (D52), we identified 37 potential SCZ causal genes, and ARL3 and GNL3 showed the most significant associations. Only 12 genes showed significant associations with SCZ in both D30 and D52 eQTL datasets, indicating the time point-specific genetic regulatory effects in young post-mitotic dopaminergic neurons and more mature dopaminergic neurons. Comparing the results from dopaminergic neurons with bulk brain tissues prioritized 2 high-confidence risk genes, including DDHD2 and GALNT10. Our study identifies multiple risk genes whose genetically regulated expression in dopaminergic neurons may have a causal role in SCZ. Further mechanistic investigation will provide pivotal insights into SCZ pathophysiology.

Risk factors of common bile duct stones recurrence and nomogram for predicting recurrence after endoscopic retrograde cholangiopancreatography: a dual-center retrospective cohort study

OBJECTIVE

Common bile duct stone (CBDS) is one of the common diseases in the digestive system, for which endoscopic retrograde cholangiopancreatography (ERCP) is a treatment procedure. However, the risk factors for CBDS recurrence after ERCP remains unclear. This study aims to compare the risk factors of CBDS recurrence after ERCP, and to set up a nomogram model to predict the long-term risk.

PATIENTS AND METHODS

A retrospective analysis of 355 patients was reviewed. Univariate and multivariate analyses were performed to identify the risk factors for recurrence. The R packages were used for the model building. The validation set contained 100 patients.

RESULTS

The patients were divided into three subgroups: treated by cholecystectomy after ERCP (11.76% recurrence rate), treated without surgery after ERCP (19.70%), and with a prior history of cholecystectomy (43.64%). Each of them has different independent risk factors, and high body mass index (BMI) is correlated with an increased risk among all the subgroups. A prior history of cholecystectomy is a candidate factor that increases the risk of CBDS recurrence in patients older than 60 years, with a greater BMI, or receiving ERCP combined with EPBD. We built a nomogram model to predict the risk of long-term CBDS recurrence based on the risk factors including age, BMI, CBD diameter, the number of CBDS, and the gallbladder- or biliary tract-related events.

CONCLUSIONS

CBDS recurrence is related to congenital and anatomical factors. Cholecystectomy would not be helpful to prevent CBDS recurrence, and a prior history of cholecystectomy may indicate a high risk of recurrence.

Clinical Feasibility of Using Single-isocentre Non-coplanar Volumetric Modulated Arc Therapy Combined with Non-coplanar Cone Beam Computed Tomography in Hypofractionated Stereotactic Radiotherapy for Five or Fewer Multiple Intracranial Metastases

AIMS

To evaluate the clinical feasibility of single-isocentre non-coplanar volumetric modulated arc therapy (NC-VMAT) with non-coplanar cone beam computed tomography (NC-CBCT) in hypofractionated stereotactic radiotherapy (HSRT) for five or fewer multiple brain metastases.

MATERIALS AND METHODS

Ten patients with multiple brain metastases who underwent single-isocentre NC-VMAT HSRT with limited couch rotations (within ±45°) and NC-CBCT with a limited scanning range (150-200°) were included in the current analysis. Conventional single-isocentre coplanar VMAT (C-VMAT) plans were generated and compared with NC-VMAT plans. The intracranial response and toxicities of single-isocentre NC-VMAT HSRT were also evaluated.

RESULTS

Compared with C-VMAT, NC-VMAT generated better target conformity (P < 0.05), a lower gradient index (P < 0.05) and better normal brain tissue sparing, especially for volume ≥12 Gy, with a median reduction of 12.65 cm³. For 45° couch rotation, NC-CBCT produced sufficient image quality to differentiate bony anatomy, even with a 150° scanning range, which could be successfully used for patient set-up correction. After NC-CBCT, 57.1% of the measured non-coplanar set-up errors exceeded the threshold value. The median gamma passing rate of NC-VMAT was higher than that of C-VMAT plans (P < 0.05). The non-coplanar beam of NC-VMAT with NC-CBCT corrections exhibited superior gamma passing rate to that without NC-CBCT corrections. The intracranial objective response rate and disease control rate for all patients were 80% (8/10) and 100% (10/10), respectively, and the most common toxicities were headache (20%) and dizziness (20%).

CONCLUSION

NC-VMAT with limited couch rotation (within ±45°) combined with NC-CBCT with a limited scanning range (150-200°) markedly improves the plan quality and set-up accuracy in single-isocentre multiple-target HSRT.

[Short-term exposure to gossypol causes reversible reproductive toxicity and nephrotoxicity in mice]

OBJECTIVE

To study the toxic effects of short-term exposure to gossypol on the testis and kidney in mice and whether these effects are reversible.

METHODS

Twenty 7 to 8-week-old male mice were randomized into blank control group, solvent control group, gossypol treatment group and drug withdrawal group. In the former 3 groups, the mice were subjected to daily intragastric administration of 0.3 mL of purified water, 1% sodium carboxymethylcellulose solution, and 30 mg/mL gossypol solution for 14 days, respectively; In the drug withdrawal group, the mice were treated with gossypol solution in the same manner for 14 days followed by treatment with purified water for another 14 days. After the last administration, the mice were euthanized and tissue samples were collected. The testicular tissue was weighed and observed microscopically with HE and PAS staining; the kidney tissue was stained with HE and examined for mitochondrial ATPase activity.

RESULTS

Compared with those in the control group, the mice with gossypol exposure showed reduced testicular seminiferous epithelial cells with rounded seminiferous tubules, enlarged space between the seminiferous tubules, interstitium atrophy of the testis, and incomplete differentiation of the spermatogonia. The gossypol-treated mice also presented with complete, non-elongated spermatids, a large number of cells in the state of round spermatids, and negativity for acrosome PAS reaction; diffuse renal mesangial cell hyperplasia, increased mesangial matrix, and adhesion of the mesangium to the wall of the renal capsule were observed, with significantly shrinkage or even absence of the lumens of the renal capsules and reduced kidney mitochondrial ATPase activity. Compared with the gossypol-treated mice, the mice in the drug withdrawal group showed obvious recovery of morphologies of the testis and the kidney, acrosome PAS reaction and mitochondrial ATPase activity.

CONCLUSIONS

Shortterm treatment with gossypol can cause reproductive toxicity and nephrotoxicity in mice, but these toxic effects can be reversed after drug withdrawal.

[Analysis of morphometric changes in the anterior alveolar bone in bimaxillary protrusion adult patients after retraction with cone-beam CT]

Objective: To measure and analyze the morphometric changes in the anterior alveolar bone during treatment and retention stage after retraction in bimaxillary adults using cone-beam CT(CBCT). Methods: Fifteen adult patients, four males and 11 females, aged 19 to 28 years[(22.2±3.1) years], who have completed orthodontic treatment and extracted four first premolar teeth for retraction in the Department of Orthodontics, The Affiliated Stomatological Hospital of Nanchang University from January 2016 to December 2018 were selected. CBCT was taken to assess the labial and palatal vertical bone level, total bone thickness at crest area, middle root area and apical area in pre-treatment (T1), post-treatment (T2) and at follow-up (maintained for more than two years) (T3). The differences in alveolar bone morphology at different stages were compared by single factor repeated measure ANOVA, and Pearson correlation analysis was performed on the amount of alveolar bone change in treatment stage and retention stage. Results: There were statistically significant differences in the alveolar bone height of the palatal side of maxillary anterior teeth, the labial side of maxillary lateral incisors and canine among three time points (P<0.05). The height difference of palatal alveolar bone of anterior teeth in T1-T2 stage was statistically significant (P<0.05). Palatal alveolar bone of upper and lower central incisors decreased by (1.52±0.32) and (4.96±0.46) mm, respectively. The height difference of anterior palatal alveolar bone was statistically significant in T2-T3 stage(P<0.05), the palatal alveolar bone height of central incisors increased by (1.20±0.27) and (3.14±0.35) mm respectively. The height difference of palatal alveolar bone in the anterior teeth of T1-T3 stage was statistically significant (P<0.05), and the height of palatal alveolar bone of central incisors was decreased (0.33±0.11) and (1.82±0.39) mm, respectively. There were statistically significant differences in the thickness of the cervical and middle root alveolar bone of anterior teeth among three time points (P<0.05). The difference of alveolar bone thickness of the cervical and middle root of anterior teeth at T1-T2 was statistically significant (P<0.05). decreased by (0.63±0.10) and (0.67±0.09) mm in lateral incisors, respectively. In the T2-T3 stage, the alveolar bone thickness of the crest area of the lower anterior teeth was significantly different (P<0.05), the alveolar bone thickness of mandibular central incisor crest area increased (0.09±0.03) mm. There were statistically significant differences in alveolar bone thickness in crest area and middle root of the incisors during T1-T3 stage (P<0.05), among which the middle root decreased by (0.38±0.16) mm and (0.63±0.13) mm, respectively. There was no statistically significant difference in other areas (P>0.05). The change of alveolar bone height in palatal side of upper anterior teeth at T2-T3 was very strongly negatively correlated with the change in T1-T2. The change of alveolar bone height in labial side of upper anterior teeth and lingual side of lower anterior teeth and the thickness of incisor root and neck were moderately strongly negatively correlated (r≤-0.8, P<0.001), the change of alveolar bone height in labial side of upper anterior teeth and lingual side of lower anterior teeth and the thickness of incisor crest area were moderately strongly negatively correlated (-0.8<r≤-0.4, P<0.05). Conclusions: For adult patients after retraction, anterior alveolar bone decreased significantly. In the retention stage, the same degree of bone apposition will occur, but still have alveolar bone loss compared with pre-treatment. The amount of alveolar bone change in the retention stage correlated with the amount of alveolar bone change in the treatment stage.

PLGA nanoparticle with Amomum longiligulare polysaccharide 1 increased the immunogenicity of infectious bursal disease virus VP2 protein

1. The purpose of this study was to create ALP1-VP2-PLGA nanoparticle (AVPN) and to study the immunogenicity of AVPN. AVPN was prepared and observed by scanning and transmission electron microscopies.2. Chickens were divided into five groups and vaccinated with normal saline, VP2 protein, ALP1 and VP2 protein, AVPN or PLGA, respectively. After 28 days, the immune organ indexes were calculated; specific antibody levels in blood were detected by enzyme-linked immunosorbent assay (ELISA). Additionally, the spleen and bursa of Fabricius were determined by HE staining, immunological cytokine mRNA levels in bursa of Fabricius were detected by qPCR andchicken body weight was determined.3. The results indicated that AVPN was a spherical nanoparticle with a diameter of about 85 nm. It increased bursal indexes and IBDV-specific antibody levels and promoted the expression of IL-2 mRNA in blood and TNF-α and IgG mRNA in bursa of Fabricius. This promoted growth.4. This study suggested that AVPN can increase immunogenicity of VP2 protein, and it could possibly be used as an IBDV subunit vaccine.

Measurement of the ν_{e}-Nucleus Charged-Current Double-Differential Cross Section at ⟨E_{ν}⟩=2.4 GeV Using NOvA

The inclusive electron neutrino charged-current cross section is measured in the NOvA near detector using 8.02×10^{20} protons-on-target in the NuMI beam. The sample of GeV electron neutrino interactions is the largest analyzed to date and is limited by ≃17% systematic rather than the ≃7.4% statistical uncertainties. The double-differential cross section in final-state electron energy and angle is presented for the first time, together with the single-differential dependence on Q^{2} (squared four-momentum transfer) and energy, in the range 1  GeV≤E_{ν}<6  GeV. Detailed comparisons are made to the predictions of the GENIE, GiBUU, NEUT, and NuWro neutrino event generators. The data do not strongly favor a model over the others consistently across all three cross sections measured, though some models have especially good or poor agreement in the single differential cross section vs Q^{2}.

First Probe of Sub-GeV Dark Matter beyond the Cosmological Expectation with the COHERENT CsI Detector at the SNS

The COHERENT Collaboration searched for scalar dark matter particles produced at the Spallation Neutron Source with masses between 1 and 220  MeV/c^{2} using a CsI[Na] scintillation detector sensitive to nuclear recoils above 9  keV_{nr}. No evidence for dark matter is found and we thus place limits on allowed parameter space. With this low-threshold detector, we are sensitive to coherent elastic scattering between dark matter and nuclei. The cross section for this process is orders of magnitude higher than for other processes historically used for accelerator-based direct-detection searches so that our small, 14.6 kg detector significantly improves on past constraints. At peak sensitivity, we reject the flux consistent with the cosmologically observed dark-matter concentration for all coupling constants α_{D}<0.64, assuming a scalar dark-matter particle. We also calculate the sensitivity of future COHERENT detectors to dark-matter signals which will ambitiously test multiple dark-matter spin scenarios.

Enhancing gosling growth and secretion of somatotrophic and thyrotrophic axis hormones through egg turning during incubation

1. Growth performance of Yangzhou geese hatched from eggs with turning angles of 50° or 70° was evaluated in association with serum hormones and somatotrophic gene mRNA expression.2. Egg turning at 70° significantly (P< 0.05) increased hatchability, gosling quality and hatching weight. Gosling post-hatch body weight, leg and breast muscle weight in the 70° turning group was significantly heavier until 50 d of age.3. Serum concentrations of GH were significantly higher until 30 d of age in the 70° turning group goslings, and those of IGF-I and T3 were higher from hatching to 50 d of age.4. The mRNA expression of GHRH, pituitary GH, liver and leg muscle IGF-I were all significantly higher at 1 and 30 d of age after hatch, but not at 70 d after hatch, in the 70° turning group.5. Egg turning at 70° during incubation improves embryo and gosling quality and growth performance through up-regulation of gene expression and secretion of somatotrophic axis hormones, GHRH, GH and IGF-I, as well as T3.

Baicalein Inhibits the Growth of Transplanted Esophageal Cancer in Mice and the Effect on the Expression of PAK4

We studied the mechanism underlying the effect of baicalein on the growth of transplanted esophageal cancer in NOG mice and its effect on the expression of PAK4. For that purpose, we developed a new model of transplanted esophageal cancer (human esophageal cancer OE19 cells (10⁷ cells/ml) were inoculated to NOG mice). Three experimental groups with transplanted esophageal cancer cells received baicalein in different doses (1, 1.5, and 2 mg/kg). In 32 days, the tumors were resected, and the expression of PAK4 and the level of activated PAK4 were assayed by reverse transcription PCR and Western blotting, respectively. The results showed a dose-depending anti-tumor effect of baicalein on the transplanted esophageal cancer in NOG mice: this effect of baicalein (determined by the size and weight of the tumor) increased with increasing the dose of the substance. Furthermore, the anti-tumor effect of baicalein was also confirmed by reduction of PAK4 expression. Thus, baicalein can inhibit tumor growth by inhibiting activation of PAK4. Therefore, our results showed that baicalein could inhibit the growth of esophageal cancer cells by inhibiting the activity of PAK4, which can be an important mechanism of its antitumor effect.

Neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy followed by minimally invasive esophagectomy for locally advanced esophageal squamous cell carcinoma: a prospective multicenter randomized clinical trial

BACKGROUND

Neoadjuvant therapy is recommended for locally advanced esophageal cancer, but the optimal strategy remains unclear. We aimed to evaluate the safety and efficacy of neoadjuvant chemoradiotherapy (nCRT) versus neoadjuvant chemotherapy (nCT) followed by minimally invasive esophagectomy (MIE) for locally advanced esophageal squamous cell carcinoma (ESCC).

PATIENTS AND METHODS

Eligible patients staged as cT3-4aN0-1M0 ESCC were randomly assigned (1 : 1) to the nCRT or nCT group stratified by age, cN stage, and centers. The chemotherapy, based on paclitaxel and cisplatin, was administered to both groups, while concurrent radiotherapy was added for the nCRT group; then MIE was carried out. The primary endpoint was 3-year overall survival. This study is registered with ClinicalTrials.gov (NCT03001596).

RESULTS

A total of 264 patients were eligible for the intention-to-treat analysis. By 30 November 2021, 121 deaths had occurred. The median follow-up was 43.9 months (interquartile range 36.6-49.3 months). The overall survival in the intention-to-treat population was comparable between the nCRT and nCT strategies [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.58-1.18; P = 0.28], with a 3-year survival rate of 64.1% (95% CI 56.4% to 72.9%) versus 54.9% (95% CI 47.0% to 64.2%), respectively. There were also no differences in progression-free survival (HR 0.83, 95% CI 0.59-1.16; P = 0.27) and recurrence-free survival (HR 1.07, 95% CI 0.71-1.60; P = 0.75), although the pathological complete response in the nCRT group (31/112, 27.7%) was significantly higher than that in the nCT group (3/104, 2.9%; P < 0.001). Besides, a trend of lower risk of recurrence was observed in the nCRT group (P = 0.063), while the recurrence pattern was similar (P = 0.802).

CONCLUSIONS

NCRT followed by MIE was not associated with significantly better overall survival than nCT among patients with cT3-4aN0-1M0 ESCC. The results underscore the pending issue of the best strategy of neoadjuvant therapy for locally advanced bulky ESCC.

Sexual well-being among older adults in China (SWELL): protocol for a multicenter cross-sectional study

INTRODUCTION

Existing studies on sexual health generally focus on younger populations, while the sexual well-being of older adults has received insufficient attention. This protocol describes the design of a study on sexual well-being and its correlates among older adults in China.

METHODS AND ANALYSIS

We present the protocol for a multicentre observational study to investigate sexual well-being among Chinese older adults (SWELL). Eligible participants are men and women aged 50 years and older from East, West, South and North China, including older adults living in the community and older adults living with HIV. A multistage sampling approach is used in the SWELL Study. We will collect a questionnaire about sexual health (sexual knowledge, sexual attitude, sexual behaviours, sexually transmitted infections, etc). Blood specimens will be tested for sex hormones (estradiol for women, testosterone for men), biochemical items (eg, cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, urea, creatinine and uric acid) and syphilis (determined by toluidine red unheated serum test and Treponema pallidum particle agglutination test). The primary analysis will elucidate the current status of sexual health among older adults in China and its correlates. Secondary analyses will compare sexual well-being among older adults in four regions across China. Approximately 3540 older adults will be recruited into the SWELL Study.

ETHICS AND DISSEMINATION

This study was approved by the Human Research Ethics Committee of the School of Public Health (Shenzhen), Sun Yat-sen University (approval number SYSU-PHS[2019]006). Verbal informed consent will be obtained from all participants before any study procedure. Data will be anonymised, and participants will not be identified through any data, transcripts or publications. Findings from the SWELL Study will be disseminated widely through peer-reviewed scientific journals and at national and international conferences.

Impact of vitamin D on the occurrence and development of intestinal diseases: a systematic review and meta-analysis of randomized controlled trials

AIM

To determine the impact of vitamin D on the occurrence and progression of intestinal disorders, the authors of this study have conducted a systematic review and meta-analysis.

BACKGROUND

Vitamin D regulates inflammation and immunity in association with reducing the disease symptoms of several gastrointestinal diseases, including inflammatory bowel diseases (IBD), Crohn's disease (CD), ulcerative colitis (UC), and colorectal cancer (CRC). However, the exact role of vitamin D in the occurrence and development of intestinal diseases is unclear so far.

METHODOLOGY

The relevant studies were searched in PubMed and screened based on inclusion and exclusion criteria. The quality of full-text studies was assessed using National Heart, Lung, and Blood Institute (NIH) scale. The study was conducted as per the PRISMA guidelines. The overall estimate was calculated in terms of risk ratio with a 95% confidence interval. The publication bias was assessed qualitatively using a funnel plot, and heterogeneity among studies was calculated using I2 statistics. All analyses were done using RevMan 5.0.

RESULTS

The overall risk ratio using random effect model was found to be 0.89 [0.70, 1.12], which indicates the non-significant role of vitamin D in the occurrence and development of intestinal diseases as compared to the non-vitamin D group. However, after exclusion of studies with low and high sample sizes, a significant reduction in intestinal diseases was observed in the vitamin D group as compared to the non-vitamin D group. Further, no heterogeneity among the studies was observed.

CONCLUSION

Based on available evidence, vitamin D might play a significant role in the reduction of intestinal diseases; however, more studies with high sample sizes are required to draw a valid conclusion.

Molecular cloning and expression analysis of Myxovirus resistance gene in Yangzhou goose (Anser cygnoides domesticus)

1. Myxovirus resistance (Mx) is a protein produced by the interferon-induced natural immune response with broad spectrum antiviral function. However, the role and expression characteristics of the Mx gene in immune defence against viral infection in goose have not yet been reported.2. This study found a 2576 bp genomic sequence and a 2112 bp mRNA sequence for Mx, encoding 703 amino acids. Multiple sequence alignments of the amino acid sequences showed that the Yangzhou goose Mx (goMx) had 86.99% similarity to the mallard duck (Anas platyrhynchos).3. Tissue-specific expression profiling revealed that the expression of goMx was highest in the lung and spleen. Both poly (I:C) and GPV were found to elevate the expression of goMx. The upregulated expression of goMx was associated with interferon pathway-related genes IRF7, JAK1, STAT1, and STAT2. Furthermore, overexpression of goMx significantly activated the transcription of poly (I:C) induced TNF-α, IL-1β, IL-6, and IL-18.4. The findings of this study suggest that the goMx modulation of the antiviral response is mediated by the interferon pathway.

Study of the N=32 and N=34 Shell Gap for Ti and V by the First High-Precision Multireflection Time-of-Flight Mass Measurements at BigRIPS-SLOWRI

The atomic masses of ^{55}Sc, ^{56,58}Ti, and ^{56-59}V have been determined using the high-precision multireflection time-of-flight technique. The radioisotopes have been produced at RIKEN's Radioactive Isotope Beam Factory (RIBF) and delivered to the novel designed gas cell and multireflection system, which has been recently commissioned downstream of the ZeroDegree spectrometer following the BigRIPS separator. For ^{56,58}Ti and ^{56-59}V, the mass uncertainties have been reduced down to the order of 10 keV, shedding new light on the N=34 shell effect in Ti and V isotopes by the first high-precision mass measurements of the critical species ^{58}Ti and ^{59}V. With the new precision achieved, we reveal the nonexistence of the N=34 empirical two-neutron shell gaps for Ti and V, and the enhanced energy gap above the occupied νp_{3/2} orbit is identified as a feature unique to Ca. We perform new Monte Carlo shell model calculations including the νd_{5/2} and νg_{9/2} orbits and compare the results with conventional shell model calculations, which exclude the νg_{9/2} and the νd_{5/2} orbits. The comparison indicates that the shell gap reduction in Ti is related to a partial occupation of the higher orbitals for the outer two valence neutrons at N=34.

Development and multicenter validation of a novel radiomics-based model for identifying eosinophilic chronic rhinosinusitis with nasal polyps

BACKGROUND

Reliable noninvasive methods are needed to identify endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) to facilitate personalized therapy. Previous computed tomography (CT) scoring system has limited and inconsistent performance in identifying eosinophilic CRSwNP. We aimed to develop and validate a radiomics-based model to identify eosinophilic CRSwNP.

METHODS

Surgical patients with CRSwNP were recruited from Tongji Hospital and randomly divided into training (n = 232) and internal validation cohort (n = 61). Patients from two additional hospitals served as external validation cohort-1 (n = 84) and cohort-2 (n = 54), respectively. Data were collected from October 2013 to May 2021. Eosinophilic CRSwNP was determined by histological criterion. The least absolute shrinkage and selection operator and the logistic regression (LR) algorithm were used to develop a radiomics model. Univariate and multivariate LR were employed to build models based on CT scores, clinical characteristics, and the combination of radiological and clinical characteristics. Model performance was evaluated by assessing discrimination, calibration, and clinical utility.

RESULTS

The radiomics model based on 10 radiomic features achieved an area under the curve (AUC) of 0.815 in the training cohort, significantly better than the CT score model based on ethmoid-to-maxillary sinus score ratio with an AUC of 0.655. The combination of radiomic features and blood eosinophil count had a further improved performance, achieving an AUC of 0.903. The performance of these models was confirmed in all validation cohorts with satisfying predictive calibration and clinical application value.

CONCLUSIONS

A CT radiomics-based model is promising to identify eosinophilic CRSwNP. This radiomics-based method may provide novel insights in solving other clinical concerns, such as guiding personalized treatment and predicting prognosis in patients with CRSwNP.

Theoretical design of a photodetector based on a two-dimensional SnSe2/GaP type-II heterostructure

The low-dimensional structure and excellent optical properties of two-dimensional (2D) materials have made them a hot theme for research in materials science. In this paper, the geometrical properties, electrical properties,...

Effect of Multicomponent Intervention on Functional Decline in Chinese Older Adults: A Multicenter Randomized Clinical Trial

OBJECTIVES

To confirm whether multicomponent exercise following vivifrail recommendations was an effective method for improving physical ability, cognitive function, gait, balance, and muscle strength in Chinese older adults.

METHODS

This was a multicenter and randomized clinical trial conducted in Jiangsu, China, from April 2021 to April 2022. Intervention lasted for 12 weeks and 104 older adults with functional declines were enrolled. All participants were randomly assigned to a control (usual care plus health education) or exercise group (usual care plus health education plus exercise). Primary outcomes were the change score of Short Physical Performance Battery (SPPB) and activities of daily living (ADL). The secondary outcomes included instrumental activities of daily living, Tinetti scores, Frailty score, short-form Mini Nutritional Assessment, Mini-Mental State Examination, Geriatric Depression Scale-15, the 12-item Short Form Survey, 4-meter gait speed test, 6-min walking distance, grip strength, and body composition analysis.

RESULTS

Among the participants, the average age was 85 (82, 88) years. After 12 weeks of follow-up, the exercise group showed a significant improvement in SPPB, with a change of 2 points (95% confidence interval [0, 3.5], P<0.001) compared to control. In contrast, SPPB remained stable in the control group. Compared to the control group, ADL improved in the exercise group, as did instrumental activities of daily living, Tinetti, Frailty, Short Form Survey, 4-meter gait speed test, and 6-min walking distance. Although there was no significant difference between groups in body composition analysis after post-intervention, the exercise group still improved in soft lean mass (P=0.002), fat-free mass (P=0.002), skeletal muscle mass index (P<0.001), fat-free mass index (P=0.004), appendicular skeletal muscle mass (P<0.001), and leg muscle mass (P<0.001), while the control group had no significant increase. No difference was observed in adverse events during trial period.

CONCLUSIONS

The multicomponent exercise intervention following vivifrail recommendations is an effective method for older adults with functional decline and can reverse the functional decline and improve gait, balance, and muscle strength. Additionally, the 12-week multicomponent exercise method provides guidance for Chinese medical professionals working in the field of geriatrics and is a promising method to improve physical function in the general population.

A Canine Surgical Model of Stroke by Minimally Invasive Occlusion of the Proximal Middle Cerebral Artery

In this study, a model of ischemic stroke by surgical proximal middle cerebral artery (MCA) occlusion was developed on 10 beagle dogs. The advantages of this model are the transtemporal approach and a minimally invasive surgical procedure. Dogs were randomly assigned to two groups: sham-operated (proximal MCA exposure without occlusion) and experimental (permanent proximal MCA occlusion) groups. Different evaluation methods were used to assess the consequences of MCA occlusion in dogs, including neurobehavioral tests, MRI, and immunohistochemical staining. Clear signs of cerebral infarction associated with the region supplied by MCA were confirmed and the model showed good repeatability and consistency. The model can serve as an appropriate large animal model to improve the translation of stroke therapeutics research from the laboratory to the clinical practice.

[Effect analysis of myectomy guided by personalized three-dimensional reconstruction and printing in the treatment of obstructive hypertrophic cardiomyopathy]

Objective: To examine the clinical efficacy of myectomy guided by personalized three-dimensional reconstruction and printing for patients with obstructive hypertrophic cardiomyopathy. Methods: The clinical data of 28 patients with obstructive hypertrophic cardiomyopathy, who underwent septal myectomy guided by personalized three-dimensional reconstruction and printing in the Department of Cardiaovascular Surgery, Guangdong Provincial People's Hospital from May 2020 to December 2021, were retrospectively analyzed. There were 14 males and 14 females, aging (51.1±14.0) years (range: 18 to 72 years). Enhanced cardiac computed tomography images were imported into Mimics software for preoperative three-dimensional reconstruction. The direction of the short axial plane of each segment was marked perpendicularly to the interventricular septum on the long axial plane of the digital cardiac model, then the thickness was measured on each short axial plane. A figurative digital model was used to determine the extent of resection and to visualize mitral valve and papillary muscle abnormalities. Correlation between the length, width, thickness, and volume of the predicted resected myocardium and those of the surgically resected myocardium was assessed by Pearson correlation analysis or Spearman correlation analysis. The accuracy of detecting mitral valve and papillary muscle abnormalities of transthoracic echocardiography and three-dimensional reconstruction was also compared. Results: There was no death or serious complications like permanent pacemaker implantation, re-sternotomy for bleeding, low cardiac output syndrome, stroke, or multiple organ dysfunction syndromes in the whole group. Namely, the obstruction of the left ventricular outflow tract was effectively relieved. The systolic anterior motion of the anterior mitral valve leaflet was absent in all patients after myectomy. The length, width, and thickness of the predicted resected myocardium by three-dimensional reconstruction were significantly positively correlated with the length (R=0.65, 95%CI: 0.37 to 0.82, P<0.01), width (R=0.39, 95%CI: 0.02 to 0.67, P<0.01), and thickness (R=0.82, 95%CI: 0.65 to 0.92, P<0.01) of the surgically resected myocardium, while the relation of the volume of the predicted resected myocardium and the volume of the surgically resected myocardium was a strong positive correlation (R=0.88, 95%CI: 0.76 to 0.94, P<0.01). Importantly, the interventricular septal myocardial thickness measured by preoperative transthoracic echocardiography showed a moderate positive correlation with the volume of surgically resected myocardium (R=0.52, 95%CI: 0.19 to 0.75, P<0.01). During a follow-up of (14.4±6.8) months (range: 3 to 22 months), no death occurred, and 1 patient was readmitted for endocardial radiofrequency ablation due to atrial fibrillation. Conclusion: Personalized three-dimensional reconstruction and printing can not only visualize the intracardiac structure but also guide septal myectomy by predicting the thickness, volume, and extent of resected myocardium to achieve ideal resection.