Measures of body fatness and height in early and mid-to-late adulthood and prostate cancer: risk and mortality in The Pooling Project of Prospective Studies of Diet and Cancer

BACKGROUND

Advanced prostate cancer etiology is poorly understood. Few studies have examined associations of anthropometric factors (e.g. early adulthood obesity) with advanced prostate cancer risk.

PATIENTS AND METHODS

We carried out pooled analyses to examine associations between body fatness, height, and prostate cancer risk. Among 830 772 men, 51 734 incident prostate cancer cases were identified, including 4762 advanced (T4/N1/M1 or prostate cancer deaths) cases, 2915 advanced restricted (same as advanced, but excluding localized cancers that resulted in death) cases, 9489 high-grade cases, and 3027 prostate cancer deaths. Cox proportional hazards models were used to calculate study-specific hazard ratios (HR) and 95% confidence intervals (CI); results were pooled using random effects models.

RESULTS

No statistically significant associations were observed for body mass index (BMI) in early adulthood for advanced, advanced restricted, and high-grade prostate cancer, and prostate cancer mortality. Positive associations were shown for BMI at baseline with advanced prostate cancer (HR = 1.30, 95% CI = 0.95-1.78) and prostate cancer mortality (HR = 1.52, 95% CI = 1.12-2.07) comparing BMI ≥35.0 kg/m2 with 21-22.9 kg/m2. When considering early adulthood and baseline BMI together, a 27% higher prostate cancer mortality risk (95% CI = 9% to 49%) was observed for men with BMI <25.0 kg/m2 in early adulthood and BMI ≥30.0 kg/m2 at baseline compared with BMI <25.0 kg/m2 in early adulthood and BMI <30.0 kg/m2 at baseline. Baseline waist circumference, comparing ≥110 cm with <90 cm, and waist-to-hip ratio, comparing ≥1.00 with <0.90, were associated with significant 14%-16% increases in high-grade prostate cancer risk and suggestive or significant 20%-39% increases in prostate cancer mortality risk. Height was associated with suggestive or significant 33%-56% risks of advanced or advanced restricted prostate cancer and prostate cancer mortality, comparing ≥1.90 m with <1.65 m.

CONCLUSION

Our findings suggest that height and total and central adiposity in mid-to-later adulthood, but not early adulthood adiposity, are associated with risk of advanced forms of prostate cancer. Thus, maintenance of healthy weight may help prevent advanced prostate cancer.

Analysis of first-episode and chronic schizophrenia using multi-modal magnetic resonance imaging

OBJECTIVE

The brain structure and function differences among first-episode schizophrenia (FESZ) patients, chronic schizophrenia (CSZ) patients, and normal control (NC) subjects were investigated using structural and functional magnetic resonance imaging (MRI). Also, a support vector machine (SVM) combined with recursive feature elimination (RFE) was used for classification.

PATIENTS AND METHODS

First, 44 FESZ patients, 44 CSZ patients, and 56 NC subjects were recruited, and structural MRI images were acquired. The regional gray matter volumes (GMVs) of 90 regions of interest (ROIs) were calculated, two-sample t-tests were conducted to analyze the GMV differences among the groups, and the partial correlations between the Positive and Negative Syndrome Scale (PANSS) scores and altered regional GMVs were calculated. Individual functional MRI images of the three groups were measured. The individual regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and degree of centrality (DC) values of the 90 ROIs were calculated and used to evaluate the differences among the groups. Then, the partial correlations between the PANSS scores and altered regional ReHo, ALFF, and DC were determined. An SVM combined with RFE was employed for classification using both structural and functional MRI input features. The sensitivity and specificity were measured to quantify the SVM performance.

RESULTS

The GMVs in the bilateral calcarine of FESZ and CSZ patients were significantly lower than that of NC subjects. Compared to the NC group, the GMV was significantly reduced in numerous additional brain regions of the CSZ group. In comparison to the NC group, the patient groups exhibited significant ReHo increases in several regions and ReHo reductions in the occipital lobe. ReHo in the insula and left postcentral gyrus of CSZ patients were significantly lower than that of the NC subjects. Compared with the NC group, both patient groups exhibited ALFF aberrances in numerous regions. A significant reduction of ReHo, ALFF, and DC in certain regions were also found in patient groups compared with that of NC group. Significant positive correlations were found between the PANSS scores and ReHo and ALFF of the temporal and frontal lobes, while these correlations were negative in the occipital lobe. The SVM with RFE achieved excellent classification performance. The best performance was obtained using the following inputs: the ReHo and ALFF for FESZ/NC classification; the DC, ReHo, and ALFF for FESZ/CSZ classification; and the ReHo and ALFF for CSZ/NC classification.

CONCLUSIONS

Our data indicate that compared with the FESZ patients, brain GMV aberrances was increased in the CSZ patients. The functional features including DC, ReHo, and ALFF, could facilitate FESZ diagnosis, which is more sensitive than structural features in classification. The SVM with RFE presents excellent classification performance and assists SZ diagnosis.

Role of 3D Pseudocontinuous Arterial Spin-Labeling Perfusion in the Diagnosis and Follow-Up in Patients with Herpes Simplex Encephalitis

BACKGROUND AND PURPOSE

Early diagnosis and treatment of herpes simplex encephalitis are crucial to reduce morbidity and mortality. Our aim was to investigate the role of 3D pseudocontinuous arterial spin-labeling in herpes simplex encephalitis.

MATERIALS AND METHODS

From 2014 to 2019, seventeen consecutive patients with herpes simplex encephalitis and 15 healthy volunteers were recruited in the study. Conventional MR imaging and 3D pseudocontinuous arterial spin-labeling were performed in all subjects. According to the disease duration, the lesions were classified into 3 groups, including acute, subacute, and chronic stages, respectively. Clinical, neuroradiologic, and follow-up features were studied. The normalized lesion/normal tissue CBF values of lesions at different stages were measured and compared with those in the control group, respectively.

RESULTS

Compared with the control group, herpes simplex encephalitis demonstrated hyperperfusion in 11 acute cases and 6 subacute cases and hypoperfusion in 6 chronic cases. The mean normalized lesion/normal tissue CBF values of the lesions were 2.68 ± 0.54 in the acute stage, 2.42 ± 0.52 in the subacute stage, and 0.87 ± 0.30 in the chronic stage, respectively. The mean normalized lesion/normal tissue CBF values of acute and subacute lesions were significantly higher than those of the control group (1.33 ± 0.08; P < .001, respectively), while the mean normalized lesion/normal tissue CBF values of chronic lesions were lower than those of the control group (P < .05). Gradual perfusion reduction on serial 3D pseudocontinuous arterial spin-labeling was observed in herpes simplex encephalitis after effective therapy.

CONCLUSIONS

Conventional MR imaging remains most helpful in the diagnosis of herpes simplex encephalitis, while 3D pseudocontinuous arterial spin-labeling could be an adjunctive technique by providing dynamic CBF features at different stages in herpes simplex encephalitis.

Acupuncture and clomiphene citrate for anovulatory infertility: a systematic review and meta-analysis

Objective:

To evaluate the comparative effectiveness of acupuncture or acupuncture combined with clomiphene citrate (CC) versus CC alone on the outcomes of anovulatory infertility.

Methods:

A literature search in eight databases yielded nine randomised controlled trials (RCTs) that evaluated the comparative effectiveness of acupuncture and CC in anovulatory infertility. Subsequently, data were extracted and the studies were assessed for the quality of their methodological designs and risk of bias. Meta-analyses of the RCT data were conducted.

Results:

Nine trials including 1441 women were included in the meta-analysis. There were no significant differences in the rates of pregnancy (odds ratio (OR) 1.18, 95% CI 0.83 to 1.69), ovulation (OR 2.57, 95% CI 0.59 to 11.29) or pregnancy loss (OR 0.98, 95% CI 0.59 to 1.63) when acupuncture was used as an adjuvant therapy alongside CC. Although acupuncture alone did not increase the ovulation rate (OR 0.41, 95% CI 0.11 to 1.49), our review demonstrated superior effects in patients who received acupuncture as a separate treatment modality with respect to both the pregnancy rate (OR 2.34, 95% CI 1.76 to 3.10) and the maximum follicular diameter (mean difference 0.50 mm, 95% CI 0.44 to 0.56 mm) when compared with CC alone. Statistical analysis also showed a reduction in the rate of pregnancy loss when acupuncture was used as a separate treatment compared with CC alone (OR 0.19, 95% CI 0.08 to 0.45).

Conclusions:

Based on the above pooled results of the studies, the use of acupuncture as a monotherapy significantly improved the rate of pregnancy among the study participants compared with the use of CC alone. However, any results drawn from these studies should be interpreted with caution when considering the context of clinical practice.

Adaptive regulation of detoxification enzymes in Helicoverpa armigera to different host plants

Cotton plants produce gossypol as a major secondary metabolite to resist insect herbivores and pathogens. Helicoverpa armigera may employ multigene families of detoxification enzymes to deal with this metabolite. So far, the strength of the transcriptional response to gossypol detoxification in the cotton bollworms remains poorly understood. Here, we investigated the genomewide transcriptional changes that occur in cotton bollworm larvae after one generation feeding on various host plants (cotton, corn, soybean and chili) or an artificial diet. Six genes potentially involved in detoxification of xenobiotics were highly upregulated in bollworms fed on cotton, and the expression of five of these differed significantly in insects that fed on gossypol diet compared with the artificial diet. When these six genes were downregulated using RNA interference, downregulation only of CYP4L11, CYP6AB9 and CCE001b led to reduced growth of bollworm larvae feeding on gossypol diets. These data suggest that the three genes are involved in response of H. armigera to gossypol of cotton. Our results proved that H. armigera may have a broad mechanism for gossypol detoxification.

Unusual plastic deformation behavior of nanotwinned Cu/high entropy alloy FeCoCrNi nanolaminates

Compared with coarse-grained FeCoCrNi-based high entropy alloys (HEAs), their nanocrystalline (NC) siblings with ultra-high strength often suffer from notably reduced deformability. Here, to enhance the deformability of these NC HEAs without losing their high strength, we design equal layered nanotwinned (NT) Cu/HEA (HEA = FeCoCrNi) crystalline/crystalline nanolaminates (C/CNLs) with coherent crystalline/crystalline interfaces (CCIs). In contrast to the tenet that in conventional bimetal C/CNLs, the soft/ductile phase plays the dominant major role, we discover that in NT Cu/HEA C/CNLs, the hard HEA phase unusually makes more contribution to the plastic deformation. The underlying reason is that the soft NT Cu layers without dislocation pile-up serve as the dislocation donator and export abundant dislocations that transmit across the coherent CCIs into the hard HEA accepter, and thus trigger their great deformability. The size-dependent hardness was explained based on dislocation-based models considering the stability of extremely small nanotwins with thickness less than ∼10 nm. These findings provide a new pathway to achieve great deformability of strong alloys with high lattice friction stresses in ultra-strong metallic composites: control the size of NT soft phases to suppress dislocation pile-up in conjunction with coherent CCIs to facilitate continuity of dislocation slip.

[Emotional and behavioral problems associated with sleep problems in preschool aged children]

Objective: To examine whether sleep problems are related to both emotional and behavioral problems in children aged 3-6 years. Methods: A large cross-sectional study was conducted in Anqing, Wuhu, Tongling and Yangzhou from March to June 2015. A total of 8 900 preschool aged children were included. Sleep problems were obtained by using adapted BISQ completed by the parents or the people who took care of children. Emotional and behavioral problems of the children were accessed by using Strengths and Difficulties Questionnaire (SDQ), and multivariate logistic regression model was used for statistical analyses. Results: The detected rates of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior in preschool aged children were 9.0%, 13.9%, 18.9%, 25.5%, 13.6% and 16.2% respectively. All the detected rates were higher in boys than in girls except the higher rate of emotional symptoms. The proportions of children with high sleep quality, moderate sleep quality and poor or worse sleep quality were 3.9%, 52.9% and 43.2% respectively. After controlling the confounding factors of demographic variables, including gender, age, delivery mode, birth weight, birth height and patent's educational level, multinomial logistic regression analysis showed that the risk of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior in children with longer sleep duration was lower than that in children with shorter sleep duration, the ORs were 0.86 (95%CI: 0.77-0.95), 0.85 (95%CI: 0.78-0.93), 0.85 (95%CI: 0.79-0.92), 0.87(95%CI: 0.81-0.93), 0.83 (95%CI: 0.76-0.91) and 0.82 (95%CI: 0.76-0.89) respectively. Compared with the children with good sleep quality, the risk of emotional symptoms, conduct problems, hyperactivity problems, peer problems, total difficulties and prosocial behavior were higher in children with poor or worse sleep quality, the ORs were 3.26 (95%CI: 2.40-4.42), 2.86 (95%CI: 2.16-3.78), 2.60 (95%CI: 2.00-3.38), 1.96 (95%CI: 1.52-2.54), 4.02 (95%CI: 3.06-5.27) and 2.56 (95%CI: 1.96-3.35) respectively. Conclusion: There was a negative impact of shorter sleep and poor or worse sleep on emotional and behavioral problems of preschool aged children.

Abstract P4-08-33: The significance of Oncotype DX recurrence score in T1-2N1M0 ER positive HER2 negative breast cancer: An analysis combined with the prognostic stage in the updated AJCC 8th edition

Purpose: Oncotype DX recurrence score (Oncotype DX RS) is applied in the prognostic stage in T1-2N0M0 ER+/HER2- breast cancer. But its significance is unclear in cases with T1-2N1M0 ER+/HER2- disease. Our study was to evaluate the prognostic significance of Oncotype DX RS in combination with the prognostic stage in the updated AJCC 8th edition. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was searched to identify invasive ductal breast cancer cases in T1-2N1M0 stage with ER positive HER2 negative status and Oncotype DX RS diagnosed between 2004 and 2012. Patients with unknown histologic grade or PR status, no or unknown surgery performed, or less than 6 months of follow up were excluded. Patients with RS 0-10, 11-25, &gt;25 were categorized into low risk, midrange risk and high risk groups respectively. Comparisons of the distribution of RS groups among prognostic stages were performed using Pearson's chi-square. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared across RS groups using the log-rank statistic. Cox models were fitted to compare the association between RS groups, prognostic stages and BCSS or OS after adjusting for other characteristics. Results: Altogether 4059 cases were enrolled, which were categorized into prognostic stage IA-IIIA (only 357 cases in stage IIB and 35 cases in stage IIIA). More than 60% cases in prognostic stage IA-IIA had their RS in midrange risk group. There were decreasing proportion of low risk RS group and increasing proportion of high risk RS group with the ascending of prognostic stages (P&lt;0.001). The median follow up was 59 months. There were significant differences in BCSS and OS among RS groups (log-rank P&lt;0.001). In the subgroup analysis, there were also significant differences in BCSS and OS among RS groups in prognostic stages IA-IIA. In the multivariate Cox analysis, the RS group was an independent prognostic factor for BCSS (midrange risk vs. low risk, HR=3.647, 95% CI: 1.124-11.837, P=0.031; high risk vs. low risk, HR=15.372, 95% CI: 4.600-51.374, P&lt;0.001) and OS (midrange risk vs. low risk, HR=1.718, 95% CI: 1.039-2.840, P=0.035; high risk vs. low risk, HR=4.225, 95% CI: 2.462-7.251, P&lt;0.001) along with the prognostic stage. Conclusions: Oncotype DX RS has prognostic significance in T1-2N1M0 ER+/HER2- disease. Further prospective research is warranted.

Citation Format: Chen H, Wang M, Zhang P, Zhang M, Wu K. The significance of Oncotype DX recurrence score in T1-2N1M0 ER positive HER2 negative breast cancer: An analysis combined with the prognostic stage in the updated AJCC 8th edition [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-33.

Role of a two-step suture in the prevention of postoperative transoral salivary fistulas during reconstruction of the oral cavity

Transoral salivary fistulas are one of the most serious postoperative complications after operations for oral cancer, and we propose a new, two-step suture method to avoid them. From January 2005 to September 2017, 240 patients were recruited at the Shanghai Ninth People's Hospital and divided into experimental (n=89) or control (n=151) groups. The experimental group was treated by a two-step suture technique, while the control group had conventional sutures. Statistical differences were assessed using the chi squared and t tests, as appropriate. Only two patients developed transoral salivary fistulas in the experimental group, while in the control group there were 14 (9%). The incidence of fistulas in the experimental group was significantly lower than that in the control group (p=0.035). Regression analysis showed that there was a significant correlation between the groups and the incidence of salivary fistulas (p=0.032). The two-step suture technique is safe, effective, and easy to learn, and could reduce the incidence of postoperative salivary fistulas.

Expression of Tripartite Motif-Containing Proteactiin 11 (TRIM11) is Associated with the Progression of Human Prostate Cancer and is Downregulated by MicroRNA-5193

Background

Tripartite motif-containing protein 11 (TRIM11), encoded by the TRIM11 gene, has been studied in some human malignant tumors. MicroRNA-5193 (miRNA-5193) was predicted to target TRIM11, according to bioinformatics data from TargetScan. However, the roles of TRIM11 and miRNA-5193 in prostate cancer remain unknown. This study aimed to investigate the regulatory effects of miRNA-5193 on the expression of TRIM11 in prostate cancer tissues compared with adjacent normal prostate, and in human prostate cancer cell lines, PC3 and DU145 in vitro.

Material/Methods

Prostate tumor tissue and adjacent normal tissue from 137 patients with stage T1c (n=66), stage T2 (n=48), and stage T3 (n=23) prostate cancer were studied. Expression levels of the TRIM 11 protein and the TRIM11 gene in prostate cancer, normal prostate tissue, and human prostate cancer cell lines, PC3 and DU145, were measured by Western blot and quantitative real-time polymerase chain reaction (qRT-PCR), respectively. Transfection with TRIM11 small interfering RNA (siRNA) resulted in gene knockdown. Transfection with a miR-5193 mimic resulted in overexpression of miR-5193. Proliferation and invasion assays were performed for PC3 and DU145 cells in vitro.

Results

TRIM11 expression was upregulated in prostate cancer specimens compared with normal prostate tissue and was significantly correlated with reduced outcome. In human prostate cancer cell lines, PC3 and DU145, TRIM11 overexpression promoted cell proliferation. Upregulation of miR-5193 downregulated the expression of TRIM11.

Conclusions

TRIM11 was upregulated in prostate cancer tissue and was associated with reduced prognosis. TRIM11 expression increased cell proliferation in vitro and was downregulated by miR-5193.

Bio-orthogonal chemistry-based method for fluorescent labelling of ribosomal RNA in live mammalian cells

A bio-orthogonal chemistry-based approach for fluorescent labelling of ribosomal RNA is described.

Pulmonary hemorrhage in neonatal respiratory distress syndrome: Radiographic evolution, course, complications and long-term clinical outcomes

BACKGROUND

Pulmonary hemorrhage (PH) is occasionally seen in premature infants after surfactant treatment for respiratory distress syndrome (RDS). These infants receive frequent chest radiographs (CXR) during and after hospitalization enabling long-term radiographic-clinical correlation.

OBJECTIVE

To chart the natural evolution of CXR findings of PH in RDS and correlate radiographic patterns to supplemental oxygen requirement.

MATERIALS AND METHODS

Retrospective review of clinical notes for gestational age (GA), birth weight (BW), intraventricular hemorrhage (IVH) and oxygen requirement were performed. CXRs were reviewed at 4 time-points; during PH, 28 days postnatal age, 36 weeks and at farthest available clinical follow-up.

RESULTS

18 infants born (2003-2016), GA (24-30 weeks); BW (482-1590 grams) were included. Mean onset of PH was 1.94 (0-5) days. 9/18 (50%) had IVH. 3 died during PH; all had IVH. During PH, CXR showed whiteout 9/18 (50%); patchy opacities 5/18 (27%); diffuse haziness 1/18 (6%) and no change 3/18 (17%). At 28 days postnatal age, CXR showed fine-interstitial (FI) markings 14/15 (93%) and whiteout 1/15 (7%). At 36 weeks,12/14 (85%) had FI and 2/14 (15%) developed cystic-interstitial changes. At farthest follow-up, FI 3/13 (23%); coarse-interstitial 4/13 (30%); peri-bronchial cuffing 5/13 (38%); normal 1/13 (9%) and the majority had hyperinflation 9/13 (69%). At discharge, 9/14 (64%) required home-oxygen and 5/14 (36%) were on room-air. At farthest follow-up, 6/14 (42%) required home-oxygen and 8/14 (58%) were on room-air.

CONCLUSION

Premature infants that survive PH may later develop chronic lung disease of prematurity with an evolving interstitial pattern on CXR that clears overtime as they outgrow the need for supplemental oxygen.

Probing the size- and constituent-mediated mechanical properties and deformation behavior in crystalline/amorphous nanolaminates

Two kinds of crystalline/amorphous nanolaminates (C/ANLs), i.e., Ag/Cu-Zr and Mo/Cu-Zr, with a wide range of modulation ratios η (thickness ratio of the amorphous layer to the crystalline layer) from 0.1 up to 9.0 were, respectively, prepared using magnetron sputtering. The hardness and the strain rate sensitivity m were measured for comparison through nanoindentation testing. The mechanical properties displayed a strong η-dependence, which was tuned by the crystalline phases. With the increase of η, the hardness increased in the Ag/Cu-Zr nanolaminates while it decreased in the Mo/Cu-Zr ones. However, the two C/ANLs showed similar variations in m that was reduced gradually from positive values at small η to negative values at large η. Microstructural examination demonstrated that the amorphous Cu-Zr layers in both the C/ANLs showed a deformation-induced crystallization (DIC) phenomenon within the nanoindentation deformation zone. The DIC was highly dependent on η and became more intense in the Mo/Cu-Zr than in the Ag/Cu-Zr C/ANLs. The η- and constituent-dependent DIC behaviors were rationalized in light of the stress field applied on the amorphous layers that is sensitive to both the amorphous layer thickness and the crystalline constituents. This DIC-induced negative m in amorphous layers competed with the positive m in crystalline layers, leading to a negative-to-positive change in m on reducing η. The underlying deformation mechanism was revealed to be the cooperation between dislocation activities in the crystalline layers and shear transformation zone motions in the amorphous layers. Furthermore, a modified mechanistic model was utilized to quantitatively describe the η-dependent hardness at different crystalline constituents.

[Germline gene testing of the RET, VHL, SDHD and SDHB genes in patients with pheochromocytoma/paraganglioma]

OBJECTIVE

To analyze the germline variations of genes RET, VHL, SDHD and SDHB in patients with pheochromocytoma and/or paraganglioma and to evaluate variations of these genes in Chinese patients.

METHODS

Patients who were treated in Peking University First Hospital from September 2012 to March 2014 and diagnosed with pheochromocytoma and/or paraganglioma by pathologists were included in this study. Twelve patients were included in total, of whom 11 had pheochromocytoma, and 1 had paraganglioma. Deoxyribonucleic acid (DNA) was extracted from the leukocytes of peripheral blood of the patients. The exons 10, 11, 13-16 of the RET gene, and all exons of VHL, SDHB and SDHD genes and their nearby introns (±20 bp) were amplified with polymerase chain reactions, and the products were sent to a biotechnology company for sequencing. The sequencing results were compared with wildtype sequences of these genes to identify variations. One of the patients was diagnosed with multiple endocrine neoplasia type 2A. A family analysis was performed in his kindred, and his family members received genetic tests for the related variations.

RESULTS

Three patients were found to have germline gene variations. A c.136C>T (p.R46X) variation of the SDHB gene was found in a patient with malignant pheochromocytoma. A c.1901G>A (C634Y) variation, as well as c.2071G>A (p.G691S) and c.2712C>G (p.S904S) variations of the RET gene were found in a patient with multiple endocrine neoplasia type 2A. After a family analysis, five family members of this patient were found to have the same variations. c.2071G>A (p.G691S) and c.2712C>G (p.S904S) variations of the RET gene were also found in a clinical sporadic patient without evidence of malignancy. A patient with congenital single ventricle malformation and pheochromocytoma was included in this study, and no variation with clinical significance was found in the four genes of this patient.

CONCLUSION

25% (3/12) patients with pheochromocytoma or paraganglioma were found to have missense or nonsense germline gene variations in this study, including the c.136C>T (p.R46X) variation of the SDHB gene, the c.1901G>A (C634Y) variation of the RET gene, and c.2071G>A (p.G691S) and c.2712C>G (p.S904S) variations of the RET gene. The former two variations have already been confirmed to be pathogenic. The existence of these variations in Chinese patients with pheochromocytoma and/or paraganglioma was validated in this study, which supports the conclusion that genetic testing is necessary to be generally performed in patients with pheochromocytoma and/or paraganglioma.

Unraveling the discrepancies in size dependence of hardness and thermal stability in crystalline/amorphous nanostructured multilayers: Cu/Cu-Ti vs. Cu/HfO2

Crystalline/amorphous interfaces (CAIs) confer outstanding mechanical properties on crystalline/amorphous nanostructured multilayers (C/ANMs), which are widely used in micro/nanodevices, because their unique interfacial structure possesses high strain compatibility. In this study, Cu/X (X = Cu-Ti, HfO2) C/ANMs with equal layer thicknesses (h) were comparatively investigated in terms of size-dependent hardness (H) and thermal stability to uncover the fundamental difference(s) between Cu/Cu-Ti and Cu/HfO2. It was found that both as-deposited Cu/Cu-Ti and Cu/HfO2 C/ANMs exhibited a maximum hardness at a critical thickness of h ∼30 nm, which was caused by a transition from confined dislocation gliding to dislocation transmission across the interface. Specifically, the Cu/Cu-Ti C/ANMs exhibited annealing hardening, whereas the Cu/HfO2 C/ANMs exhibited annealing softening associated with a minimum softening at h ∼ 30 nm, which was closely correlated with their thermal stability. In comparison with monolithic amorphous X thin films, the glassy X nanolayers in the present Cu/X C/ANMs exhibited reduced thermal stability and a trend that smaller sizes led to higher stability. The underlying mechanism of the size-dependent crystallization behavior of X nanolayers is discussed in terms of the constraining effects of the interface. These findings provide deep insights into the design of Cu/metallic-glass and Cu/ceramic-glass C/ANMs with optimal performance.