Correlations Between Parental Lines and Indica Hybrid Rice in Terms of Eating Quality Traits

In this study, by analyzing the relationship between hybrid combinations and parental lines, we found that the eating quality traits of hybrid combinations were determined by both parents. The sterile lines determined the overall eating quality characteristics of the hybrid combinations. For the same sterile line, there were some correlations between the hybrid combinations and restorer lines in terms of taste value, rapid visco analyzer breakdown and setback values, apparent amylose content, and cooked rice hardness and stickiness. Analysis of the starch fine structure between hybrid combinations and their restorer lines demonstrated positive correlations between them in terms of short-branch amylopectin chains and amylose. Moreover, different allelic combinations of the Wx gene showed different genetic effects on the eating quality traits of hybrid rice. Overall, this study provides a framework for the development of hybrid rice with superior eating quality.

Full Concentration Gradient-Tailored Li-Rich Layered Oxides for High-Energy Lithium-Ion Batteries

Lithium-rich layered oxides (LLOs) are prospective cathode materials for next-generation lithium-ion batteries (LIBs), but severe voltage decay and energy attenuation with cycling still hinder their practical applications. Herein, a series of full concentration gradient-tailored agglomerated-sphere LLOs are designed with linearly decreasing Mn and linearly increasing Ni and Co from the particle center to the surface. The gradient-tailored LLOs exhibit noticeably reduced voltage decay, enhanced rate performance, improved cycle stability, and thermal stability. Without any material modifications or electrolyte optimizations, the gradient-tailored LLO with medium-slope shows the best electrochemical performance, with a very low average voltage decay of 0.8 mV per cycle as well as a capacity retention of 88.4% within 200 cycles at 200 mA g^-1 . These excellent findings are due to spinel structure suppression, electrochemical stress optimization, and Jahn-Teller effect inhibition. Further investigation shows that the gradient-tailored LLO reduces the thermal release percentage by as much as about 41% when the battery is charged to 4.4 V. This study provides an effective method to suppress the voltage decay of LLOs for further practical utilization in LIBs and also puts forward a bulk-structure design strategy to prepare better electrode materials for different rechargeable batteries.

Surface self-assembly involving the interaction between S and N atoms

Regulation of the self-assembly nanostructures by recruiting the electrostatic interaction between S and N atoms.

Light Field Image Super-Resolution Using Deformable Convolution

Light field (LF) cameras can record scenes from multiple perspectives, and thus introduce beneficial angular information for image super-resolution (SR). However, it is challenging to incorporate angular information due to disparities among LF images. In this paper, we propose a deformable convolution network (i.e., LF-DFnet) to handle the disparity problem for LF image SR. Specifically, we design an angular deformable alignment module (ADAM) for feature-level alignment. Based on ADAM, we further propose a collect-and-distribute approach to perform bidirectional alignment between the center-view feature and each side-view feature. Using our approach, angular information can be well incorporated and encoded into features of each view, which benefits the SR reconstruction of all LF images. Moreover, we develop a baseline-adjustable LF dataset to evaluate SR performance under different disparity variations. Experiments on both public and our self-developed datasets have demonstrated the superiority of our method. Our LF-DFnet can generate high-resolution images with more faithful details and achieve state-of-the-art reconstruction accuracy. Besides, our LF-DFnet is more robust to disparity variations, which has not been well addressed in literature.

[Current status and enlightenment of teaching models in evidence-based medicine at home and abroad: a qualitative systematic review]

Objective: To summarize the different teaching models and their effects in evidence-based medicine at home and abroad by qualitative method and systematic review. Methods: We searched the following databases (from inception to 13 May, 2019): PubMed, Embase, Proquest, Cochrane, Web of Science database and the Chinese databases (CNKI, Wanfang, SinoMed and VIP). To assess data strength and validity, risk of bias assessments were undertaken. Results: A total of 52 literatures were included in this study, including 21 Chinese-language literature and 31 English-language literature. PBL teaching model, mixed teaching model and workshop teaching model were the three teaching models with the largest number of studies in 20 teaching models. Conclusion: The evidence-based medicine teaching effect was closely related to the teaching models, so it is necessary to explore more suitable teaching models for the evidence-based medicine to improve the teaching effects.

Composite Nanostructure Construction on the Grain Surface of Li-Rich Layered Oxides

Li-rich layered oxides (LLOs) are fascinating high-energy cathodes for lithium-ion batteries (LIBs), but still suffer from critical drawbacks that retard their practical applications. Although surface modification is effective to protect LLOs from structural deterioration, the delicate design of structures on a grain surface with promising scalability for industrial application is still challenging. Herein, using the atomic layer deposition (ALD) technique, a composite nanostructure comprising a uniform LiTaO₃ coating layer (≈3 nm) and a spinel interlayer structure (≈1 nm) is constructed on the grain surface of industrial LLO (Li_1.13 Mn_0.517 Ni_0.256 Co_0.097 O₂ ) agglomerated spheres. The surface composite nanostructure can not only enhance the structural/interfacial stability of the LLO, but also facilitates Li⁺ diffusion, thereby significantly improving its cycle stability, rate performance, thermal stability, and voltage maintenance. Specifically, the LLO coated with 10 ALD cycles exhibits a small voltage decay rate of 0.9 mV per cycle, a reversible capacity of 272.8 mAh g^-1 at 0.1 C, and a capacity retention of 85% after 200 cycles at 1 C, suggesting the important role of surface composite nanostructure for improving the electrochemical performance. This work provides new insights into the composite nanostructure design on the grain surface of cathode materials for high-performance LIBs.

Binary Iron Sulfide as a Low-Cost and High-Performance Anode for Lithium-/Sodium-Ion Batteries

Iron-based sulfides have been deemed as an appealing anode material for lithium-ion batteries (LIBs) and sodium-ion batteries (SIBs) for their high theoretical capacity and low cost. However, their practical application is limited by drastic volume expansion during cycling and low-intrinsic electronic conductivity. In this work, we report a FeS₂/Fe₇S₈-rGO composite synthesized via a facile solvothermal method as an LIB/SIB anode. The FeS₂/Fe₇S₈-rGO anode exhibits an excellent Li-storage capacity of 514 mAh g^-1 at 2.0 A g^-1 after 3000 cycles and a Na-storage capacity of 650 mAh g^-1 at 0.2 A g^-1 after 250 cycles, respectively. The rGO matrix is deemed responsible for providing good electron conduction and alleviating volume expansion during cycling. The electrokinetic analysis confirms a large portion of intercalational pseudocapacitance as a major contribution to the superior rate performance. In situ X-ray diffraction further reveals details of a combined intercalational and conversional Li-ion storage mechanisms in this Fe-sulfide-based anode. Finally, density functional theory calculations suggest that there exists a synergistic effect at the heterointerface between FeS₂ and Fe₇S₈ to promote electrokinetics.

Structure and in vitro digestibility on complex of corn starch with soy isoflavone

Rapid starch digestion rate is negative for the normal level of human blood glucose. This study investigated the protective effects of corn starch (CS) complexed with soy isoflavone (SI) on the control of starch digestibility and glycemic index (GI). The structure of the corn starch-soy isoflavone (CS-SI) complexes was characterized by Fourier transform infrared (FT-IR), X-ray diffraction (XRD), Thermogravimetric analysis (TGA), and Differential scanning calorimetry (DSC), and the complexes digestibility was evaluated using in vitro digestion model. The results of FT-IR spectrum showed that, compared with corn starch, new characteristic peaks were not occurred in CS-SI complexes, and the value of R1047/1022 was decreased, which indicated the short-range structure of CS-SI complexes had been reduced. The V-shaped structure characteristic peaks occurred obviously in CS-SI complexes detected by XRD patterns, which formed a new crystalline structure. The thermal stability was improved in CS-SI complexes revealed by TGA and DTG curves that the thermal cracking temperature increased from 315°C to 320°C. The enthalpy (ΔH) of CS-SI complexes decreased from 2.34 J/g to 1.75 J/g showed by DSC data, which indicated that the ordered structure of starch was destroyed. Furthermore, the content of resistant starch increased from 10.53% to 21.78% and predicted glycemic index (pGI) reduced in CS-SI complexes. In conclusion, the digestibility and pGI of starch can be improved by complexed with soy isoflavone.

Pulmonary arterial hypertension in families with hereditary hemorrhagic telangiectasia: a 13-year follow-up study

Background

Pulmonary arterial hypertension (PAH) can occur in families with hereditary hemorrhagic telangiectasia (HHT), but it has not been well-characterized.

Purpose

This study sought to characterize the genetic defects, clinical and hemodynamic features, and outcomes of PAH patients in HHT families.

Methods

All HHT families with at least one case of PAH investigated in our center from January 2006 to December 2018 were enrolled in the study. We did whole-exome sequencing (WES) or whole-genome sequencing (WGS) to every proband and available family members. The clinical data, hemodynamic features and outcomes of PAH patients were reviewed.

Results

A total of 64 PAH patients in 57 families were enrolled. Only 7 (12.3%) families had more than one case of PAH. Activin-receptor-like kinase 1 (ALK-1) mutation and Endoglin (ENG) mutation were confirmed in 49 (86.0%) and 3 (5.3%) families and other 5 (8.8%) had no known mutation associated with HHT or PAH. The median age when PAH diagnosis was 22 [9–33] years and female was dominant (70.3%). Most patients (84.4%) had signs of HHT and anemia was recorded in 14 (21.9%) patients. Remarkably, these patients showed severely compromised hemodynamics with elevated mean pulmonary artery pressure (62 [51, 77] mm Hg) and pulmonary vascular resistance index (17.0 [11.2, 22.8] Wood units*m2). Also, impaired exercise capacity was recorded at diagnosis with decreased six-minute walking distance (410 [342–485] meters) and over half (54.7%) were in WHO functional class III or IV. The 1-, 3-, 5- and 10-year transplantation-free survival for the overall PAH patients was 95.0%, 75.9%, 67.1% and 36.4%, respectively. Anemia (HR: 4.24 [1.32–13.65], p=0.016) and CI <2.5 l/min/m2 (HR: 4.39 [1.20–16.09], p=0.026) were independent risk factors for mortality.

Conclusions

PAH in HHT families is a devastating condition characterized by a young age at PAH diagnosis, poor clinical status and outcomes mainly underlying ALK-1 mutation, which emphasizes the importance to pay attention to this group of patients.

Transplantation-free survival

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): The Beijing Natural Science Foundation (7181009), the National Key Research and Development Program of China (2016YFC0901502)

[Analysis on risk factors of the degree of radical resection and prognosis of patients with locally recurrent rectal cancer]

Objective: To evaluate the factors affecting the degree of radical resection and the prognosis of patients with locally recurrent rectal cancer (LRRC). Methods: A retrospective case-control study was performed. Clinical data of 111 patients with LRRC undergoing operation at the General Surgery Department of Peking University First Hospital from January 2009 to August 2019 were analyzed retrospectively. The "Peking University First Hospital F typing" was performed according to the preoperative images of the pelvic involvement. The pelvis was assigned into four directions: the front wall, lateral sides of the pelvic wall and the sacrum. According to the degree of pelvic wall involvement, F typing included F0 type (no involvement of the pelvic wall, the cancer only involved the adjacent organs or invaded conteriorly the urinary tract, genital organs or small intestine), F1 type (cancer involved the pelvic wall in one direction, such as the sacrum, or one side of the pelvic wall), F2 type (cancer involved the pelvic wall in two directions) and F3 type (cancer involved the pelvic wall in three directions). Case inclusion criteria: (1) LRRC was confirmed by imaging and pathological examination of samples (puncture or endoscopic biopsy); (2) complete clinical and follow-up data; (3) informed consent of patient. Those with dysfunction of heart, lung, etc., intolerance of operation, F3 type indicated by image, and distant metastasis were excluded. The degree of radical resection was evaluated according to the postoperative pathological results. Patients were followed up every 12 months and related examinations were arranged. The univariate analysis of radical resection was performed by χ(2) test, and the multivariate analysis was performed by logistic methods. The survival rate was calculated by Kaplan-Meier method and the survival curve was drawn. The survival rate was compared by log-rank test. Cox proportional hazards model was used to analyze the factors affecting the prognosis of patients with LRRC. Results: A total of 111 patients were included in this study. Of 111 patients, 59 were male and 52 were female; recurrent age of 36 cases was ≥ 65 years old; CEA level of 48 cases was ≥15 μg/L. According to the "Peking University First Hospital F typing", 70 cases were F0 type, 38 F1 type and 3 F2 type. Surgical procedures were abdominoperineal resection (n=28), posterior pelvic exenteration (n=32), and total pelvic exenteration (n=51, including 1 case of TPE combined with sacrectomy). According to the postoperative pathological results, R0, R1 and R2 resections were 83, 20 and 8 cases, respectively. Univariate analysis showed that the degree of radical resection was associated with the secondary surgical procedure, F typing and lymph node metastasis (all P<0.05). Multivariate analysis showed that F typing (F1-F2) was an independent risk factor for non- R0 resection (OR=37.256, 95%CI:8.572 to 161.912, P<0.001). The morbidity of operative complications was 22.5% (25/111); the perioperative mortality was 1.8% (2/111); the local recurrence rate after the second operation was 37.8% (42/111). The 3- and 5-year overall survival rates were 41.2% and 21.9% respectively. The 3-year survival rates of patients with and without postoperative chemotherapy were 52.7% and 32.4% respectively (P=0.005). The 3-year survival rates of patients with lower (<15 μg/L) and higher CEA level (≥15 μg/L) were 52.9% and 24.3% respectively (P<0.001). The 3-year survival rates of patients with R0, R1 and R2 resection were 49.8%, 21.3% and 8.5% respectively (P=0.002). The 3-year survival rates of patients with F0, F1 and F2 type were 52.7%, 22.0% and 0 respectively (P<0.001). Cox analysis confirmed that the degree of radical resection (HR=2.088, 95%CI:1.095 to 3.979, P=0.025), the CEA level before the secondary operation (HR=1.857, 95%CI:1.157 to 2.980, P=0.010) and postoperative chemotherapy (HR=1.826, 95%CI:1.137 to 2.934, P=0.013) were independent factors affecting the prognosis. Conclusions: The indication of LRRC surgical treatments must be strictly limited. Evaluation of the fixation site to the pelvic wall is helpful for improving the rate of R0 resection. Lower preoperative CEA level, radical resection and postoperative chemotherapy are protective factors of prolonged overall survival time of patients with LRRC.

Spatial variation of the soil bacterial community in major apple producing regions of China

AIMS

In China, apple production areas are largely from the coastal to inland areas and across varied climate zones. However, the relationship among soil micro-organisms, environmental factors and fruit quality has not been clearly confirmed in orchards. Here we attempted to identify the variation of soil bacteria in the main apple producing regions and reveal the relationship among climatic factor, soil properties, soil bacterial community and fruit quality.

METHODS AND RESULTS

Sixty soil samples were collected from six main apple producing areas in China. We examined the soil bacteria using bacterial 16S rRNA gene amplicon profiling. The results show that the soil bacterial diversity of apple orchards varied from the Bohai Bay Region to the Loess Plateau Region. Proteobacteria, Acidobacteria and Actinobacteria were the predominant taxa at the phylum level for all six areas. In the Bohai Bay and the Loess Plateau region, which are the two largest apple producing areas, Proteobacteria and Actinobacteria had the highest relative abundance, respectively. Furthermore, soil bacterial diversity showed positive correlation with the mean annual temperature (MAT), soil organic matter (SOM) and pH. Excluding a direct effect on the apple fruit quality, MAT exerted an indirect influence through soil SOM and pH to alter the relative abundance of dominant taxa and shift the bacterial diversity, which affects the apple fruit titratable acids and soluble solids.

CONCLUSIONS

Geographic variables underlie apple orchard soil bacterial communities vary according to spatial scale. Environmental factors exert an indirect effect on apple fruit quality via shaping soil bacterial community.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides a list of bacteria associated with environmental factors and the ecological attributes of their interactions in apple orchards, which will improve our ability to promote soil bacterial functional capabilities in order to reduce the fertilizer input and enhance the fruit quality.

Development and Assessment of a Brief Tool to Measure Melanoma-Related Health Literacy and Attitude Among Adolescents

The aim of this study is to develop a tool to measure health literacy and attitude towards melanoma and to assess the tool in a group of adolescents through a multicenter cross-sectional survey. The concept, dimensionality, and item pool of the tool were developed by a focus group. The Delphi method was applied to determine the content validity. Newly enrolled students in five universities were invited to an online questionnaire survey. Items were selected according to correlation, factor loading, and item response parameters. Psychometric properties (reliability, construct validity, and measurement invariance) were assessed using McDonald's ω and confirmatory factor analysis (CFA), respectively. A total of 21,086 valid questionnaires were collected. The focus group drafted two subscales and 13 items. Content validity was good for all items (Kappa > 0.7). One item was removed from the tool owing to low factor loading and discrimination parameter. McDonald's ω of the subscales were 0.84 (health literacy) and 0.86 (attitude). Local dependencies were identified in CFA; after modification, the goodness-of-fit was satisfactory (comparative fit index, CFI > 0.98). The tool showed measurement invariance across subgroups of gender, ethnicity, and university (CFI change < 0.01 across models). The brief tool to measure health literacy and attitude towards nevus and melanoma shows good psychometric properties and measurement invariance. It can be used in further investigation.

In situ monitoring of catalytic reaction on single nanoporous gold nanowire with tuneable SERS and catalytic activity

Single nanoporous gold nanowire was introduced as a tunable one-dimensional nano-sensor platform with both SERS and catalytic activity, and it precisely fit the requirement of materials for in situ SERS monitoring of plasmon-assisted catalytic reaction. The nanoporous gold nanowires exhibited much more "hot spots" on their surface and much better SPR effect than the smooth nanowires. We demonstrated that these nanowires could be used as a SERS substrate assuring the sensitivity and reproducibility of Raman signals. Besides, they could be applied as a kind of heterogeneous catalyst for in situ SERS monitoring of the plasmon-assisted catalytic reaction-reduction of p-nitrothiophenol (p-NTP) to p,p-dimercaptoazobenzene (DMAB) at their surface. The SERS and catalytic activity of the nanowires could be respectively optimized by adjusting their dealloying time, similar to the procedure of catalyst screening.

[The effects and immunologic mechanisms of Helicobacter pylori infection on AOM/DSS induced colitis-associated cancer in mice]

Objective: To investigate the effects and potential mechanisms of Helicobacter pylori (H.pylori) infection on azoxymethane (AOM)/dextran sulfate sulphate (DSS) induced colitis-associated cancer (CAC) in mice. Methods: A total of 60 specific pathogen free C57BL/6J mice were randomly divided into four groups: normal control group (control group, n=9), H. pylori-infected group (Hp group, n=9), AOM/DSS-treated group (AOM/DSS group,n=21) and AOM/DSS-treated with H.pylori infection group (Hp+AOM/DSS group, n=21). Mice were sacrificed on day19, 45 or 85 after AOM/DSS challenge. Histopathological changes in colonic tissues were determined by hematoxylin and eosin staining. Flow cytometry analysis was performed to determine T helper cells 17 (Th17) and regulatory T cells (Treg) in colonic lamina propria. The expression levels of Th17-and Treg-associated cytokines and transcription factors [interleukin (IL)-10, IL-17A, retinoic acid receptor-related orphan receptor γt (RORγt) and forkhead box P3 (Foxp3)] were determined by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. Results: There were no histopathological changes in colonic tissues of mice in control group and Hp group. H.pylori colonization reduced the histopathological scores at the stages of colitis (day 19) and dysplasia (day 45), and also decreased tumor load (day 85) in mice treated with AOM/DSS (all P<0.05). Compared with AOM/DSS group, the percentages of CD3(+)CD4(+)IL-17A(+)Th17 and CD3(+)CD4(+)IL-17A(+)Foxp3(+)Treg cells (1.88±0.17 vs 2.07±0.89, 1.06±0.13 vs 1.89±0.23) and the expression levels of RORγt and IL-17A (1.08±0.59 vs 2.35±1.35, 2.96±0.92 vs 7.78±4.57) were decreased in colonic tissues of Hp+AOM/DSS group (all P<0.05). The percentages of CD3(+)CD4(+)CD25(+)Foxp3(+)Treg and CD3(+)CD4(+)IL-10(+)Foxp3(+)Treg cells (20.60±3.39 vs 15.63±2.71, 2.94±0.52 vs 2.14±0.47) and the expression levels of Foxp3 and IL-10 [17.59(13.77,24.87) vs 6.27(4.41,13.36), 3.52(1.59,5.99) vs 1.17(1.15,2.75)] in colonic tissues were higher (all P<0.05) in mice of Hp+AOM/DSS group compared with AOM/DSS group on day 85. Conclusion: H.pylori infection slows the progress from inflammation to tumor in a AOM/DSS induced CAC modal, accompanied with the downregulation of Th17 response and upregulation of Treg response.

Label-free quantitative proteomics analysis reveals the fate of colostrum proteins in the intestine of neonatal calves

The contribution of intestinally absorbed colostral immunoglobulins to the transmission of passive immunity is widely reported in neonatal calves. However, changes in the colostral proteome in the gastrointestinal digesta remain unclear. Therefore, this study aimed to investigate changes in colostral proteome affected by gastrointestinal proteases in neonatal calves. Twenty-one neonatal Holstein calves were used in this study, including 18 colostrum-fed calves slaughtered at 8 (CI, n = 6), 24 (CII, n = 6), and 36 h (CIII, n = 6) postpartum and 3 milk-fed calves slaughtered 24 h postpartum (MI, n = 3). The ingested colostrum and milk samples were collected from the mid-jejunum segment, following the sacrifice. The undigested colostrum or milk along with their ingested colostrum or milk samples were investigated using a label-free proteomics approach. Hierarchical clustering and principal component analysis of the quantified proteins revealed that the ingested colostrum from the CII and CIII groups and the ingested mature milk from the MI group appeared to share similar patterns. Analysis of the intestinal digesta revealed a time-dependent decrease in caseins, lactoferrin, and osteopontin protein levels, and an increase in cationic trypsin, chymotrypsin, and carboxypeptidase. Several protease inhibitors, such as α-1-antiproteinase, α-2-antiplasmin, and early lactation protein, were identified in the colostrum and intestinal digesta. In addition, we detected identical levels in the intestinal digesta and colostrum for albumin, α-1-acid glycoprotein, and plasminogen. Pathway analysis indicated that proteins increased in the intestinal digesta belonged to the following categories: biosynthesis of antibiotics, carbon metabolism, and biosynthesis of amino acids. These results indicated that selected colostral proteins were digested by gastrointestinal proteases, contributing to their intestinal absorption in calves. These findings provide new insights into the fate of the colostral proteome in the gastrointestinal tract and may aid in the identification of factors contributing to health management in neonatal calves.

LncRNA PVT1 knockdown affects proliferation and apoptosis of uveal melanoma cells by inhibiting EZH2

OBJECTIVE

To detect the expression of long non-coding ribonucleic acid (lncRNA) plasmacytoma variant translocation gene 1 (PVT1) in uveal melanoma (UM) tissues, and to investigate its influence on the proliferation and apoptosis of UM cells as well as its mechanism.

PATIENTS AND METHODS

40 cases of UM tissues and 40 cases of adjacent tissues surgically resected in our hospital from October 2015 to April 2018 were collected. The expression level of lncRNA PVT1 in these tissues was determined by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Stable knockdown of lncRNA PVT1 was constructed in human UM cell line OCM-1 using small interfering RNA (siRNA). The impact of lncRNA PVT1 on UM cell proliferation was detected by Cell Counting kit-8 (CCK-8) and colony formation assay. Flow cytometry was applied to measure the apoptotic level of UM cells in the blank control group and lncRNA PVT1 knockdown group. Meanwhile, the expression level of enhancer of zeste homologue 2 (EZH2) was determined by Western blotting.

RESULTS

The expression level of lncRNA PVT1 in UM tissues was remarkably higher than that in the adjacent tissues (p<0.05). UM cell proliferation was notably repressed after lncRNA PVT1 knockdown by siRNA. Flow cytometry results indicated that the number of apoptotic UM cells in lncRNA PVT1 knockdown group significantly increased compared with that in the blank control group (p<0.05). The protein expression of EZH2 was suppressed after lncRNA PVT1 knockdown (p<0.05).

CONCLUSIONS

LncRNA PVT1 knockdown in UM cells can repress the proliferation of UM cells and promote their apoptosis by regulating EZH2 expression.

Efficacy and safety of risankizumab vs. secukinumab in patients with moderate-to-severe plaque psoriasis (IMMerge): results from a phase III, randomized, open-label, efficacy-assessor-blinded clinical trial

Background

Patients with plaque psoriasis treated with biologic therapies need more efficacious, safe and convenient treatments to improve quality of life. Risankizumab and secukinumab inhibit interleukin‐23 and interleukin‐17A, respectively, and are effective in adult patients with moderate‐to‐severe plaque psoriasis but have different dosing regimens.

Objectives

To compare directly the efficacy and safety of risankizumab vs. secukinumab over 52 weeks.

Methods

IMMerge was an international, phase III, multicentre, open‐label, efficacy–assessor‐blinded, active‐comparator study, in which adult patients with chronic, moderate‐to‐severe plaque psoriasis were randomized in a 1 : 1 ratio to treatment with risankizumab 150 mg or secukinumab 300 mg. Primary efficacy endpoints were the proportions of patients achieving ≥ 90% improvement from baseline in Psoriasis Area and Severity Index (PASI 90) at week 16 (noninferiority comparison with margin of 12%) and week 52 (superiority comparison).

Results

In total 327 patients from nine countries were treated with risankizumab (n = 164) or secukinumab (n = 163). Risankizumab was noninferior to secukinumab in the proportion of patients achieving PASI 90 at week 16 [73·8% vs. 65·6%; difference of 8·2%, 96·25% confidence interval (CI)−2·2 to 18·6; within the 12% noninferiority margin] and superior to secukinumab at week 52 (86·6% vs. 57·1%; difference of 29·8%, 95% CI 20·8–38·8; P < 0·001), thus meeting both primary endpoints. All secondary endpoints (PASI 100, static Physician's Global Assessment 0 or 1, and PASI 75) at week 52 demonstrated superiority for risankizumab vs. secukinumab (P < 0·001). No new safety concerns were identified.

Conclusions

At week 52, risankizumab demonstrated superior efficacy and similar safety with less frequent dosing compared with secukinumab.

What is already known about this topic?

The need remains for treatments with sustained efficacy and a more convenient dosing schedule in moderate‐to‐severe psoriasis.

Risankizumab and secukinumab are indicated for the treatment of adults with moderate‐to‐severe plaque psoriasis and target interleukin‐23 and interleukin‐17, respectively.

To date, risankizumab and secukinumab have not been directly compared.

What does this study add?

IMMerge directly compared the safety and efficacy of risankizumab and secukinumab in patients with moderate‐to‐severe plaque psoriasis using ≥ 90% improvement in Psoriasis Area and Severity Index at weeks 16 (noninferiority) and 52 (superiority) as primary endpoints.

In terms of efficacy risankizumab was noninferior to secukinumab at week 16 and superior to secukinumab at week 52 of treatment based on primary endpoint analyses. The two medications had a similar safety profile.

Linked Comment:Schmitt-Egenolf. Br J Dermatol 2021; 184: 3–4.

Plain language summary available online

Preformed Cooper Pairs in Layered FeSe-Based Superconductors

Superconductivity arises from two distinct quantum phenomena: electron pairing and long-range phase coherence. In conventional superconductors, the two quantum phenomena generally take place simultaneously, while in the underdoped high- T_{c} cuprate superconductors, the electron pairing occurs at higher temperature than the long-range phase coherence. Recently, whether electron pairing is also prior to long-range phase coherence in single-layer FeSe film on SrTiO_{3} substrate is under debate. Here, by measuring Knight shift and nuclear spin-lattice relaxation rate, we unambiguously reveal a pseudogap behavior below T_{p}∼60  K in two kinds of layered FeSe-based superconductors with quasi2D nature. In the pseudogap regime, a weak diamagnetic signal and a remarkable Nernst effect are also observed, which indicates that the observed pseudogap behavior is related to superconducting fluctuations. These works confirm that strong phase fluctuation is an important character in the 2D iron-based superconductors as widely observed in high-T_{c} cuprate superconductors.

Prediction models for the risk of cardiovascular diseases in Chinese patients with type 2 diabetes mellitus: a systematic review

OBJECTIVES

Diabetes mellitus (DM) is a serious public health issue worldwide, and DM patients have higher risk of cardiovascular diseases (CVDs), which is the leading cause of DM-related deaths. China has the largest DM population, yet a robust model to predict CVDs in Chinese DM patients is still lacking. This systematic review is carried out to summarize existing models and identify potentially important predictors for CVDs in Chinese DM patients.

STUDY DESIGN

Systematic review.

METHODS

Medline and Embase were searched for data from April 1st, 2011 to May 31st, 2018. A study was eligible if it developed CVD (defined as total CVD or any major cardiovascular component) risk prediction models or explored potential predictors of CVD specifically for Chinese people with type 2 DM. Standardized forms were utilized to extract information, appraise applicability, risk of bias, and availabilities.

RESULTS

Five models and 29 studies focusing on potential predictors were identified. Models for a primary care setting, or to predict total CVD, are rare. A number of common predictors (e.g. age, sex, diabetes duration, smoking status, glycated hemoglobin (HbA1c), blood pressure, lipid profile, and treatment modalities) were observed in existing models, in which urine albumin:creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) are highly recommended for the Chinese population. Variability of blood pressure (BP) and HbA1c should be included in prediction model development as novel factors. Meanwhile, interactions between age, sex, and risk factors should also be considered.

CONCLUSIONS

A 10-year prediction model for CVD risk in Chinese type 2 DM patients is lacking and urgently needed. There is insufficient evidence to support the inclusion of other novel predictors in CVDs risk prediction functions for routine clinical use.

Activity of Cefiderocol Alone and in Combination with Levofloxacin, Minocycline, Polymyxin B, or Trimethoprim-Sulfamethoxazole against Multidrug-Resistant Stenotrophomonas maltophilia

The production of an L1 metallo-β-lactamase and an L2 serine active-site β-lactamase precludes the use of β-lactams for the treatment of Stenotrophomonas maltophilia infections. Preclinical data suggest that cefiderocol is the first approved β-lactam with reliable activity against S. maltophilia, but data on strains resistant to current first-line agents are limited, and no studies have assessed cefiderocol-based combinations. The objective of this study was to evaluate and compare the in vitro activity of cefiderocol alone and in combination with levofloxacin, minocycline, polymyxin B, or trimethoprim-sulfamethoxazole (TMP-SMZ) against a collection of highly resistant clinical S. maltophilia isolates. For this purpose, the MICs of cefiderocol, ceftazidime, levofloxacin, minocycline, polymyxin B, and TMP-SMZ for 37 S. maltophilia isolates not susceptible to levofloxacin and/or TMP-SMZ were determined. Nine strains with various cefiderocol MICs were then tested in time-kill experiments with cefiderocol alone and in combination with comparators. The only agents for which susceptibility rates exceeded 40% were cefiderocol (100%) and minocycline (97.3%). Cefiderocol displayed the lowest MIC50 and MIC90 values (0.125 and 0.5 mg/liter, respectively). In time-kill experiments, synergy was observed when cefiderocol was combined with levofloxacin, minocycline, polymyxin B, or TMP-SMZ against 4/9 (44.4%), 6/9 (66.7%), 5/9 (55.5%), and 6/9 (66.7%) isolates, respectively. These data suggest that cefiderocol displays potent in vitro activity against S. maltophilia, including strains resistant to currently preferred agents. Future dynamic and in vivo studies of cefiderocol alone and in combination are warranted to further define cefiderocol's synergistic capabilities and its place in therapy for S. maltophilia infections.

[Bivariate heritability estimation of resting heart rate and common chronic disease based on extended pedigrees]

OBJECTIVE

To estimate the univariate heritability of resting heart rate and common chronic disease such as hypertension, diabetes, and dyslipidemia based on extended pedigrees in Fujian Tulou area and to explore bivariate heritability to test for the genetic correlation between resting heart rate and other relative phenotypes.

METHODS

The study was conducted in Tulou area of Nanjing County, Fujian Province from August 2015 to December 2017. The participants were residents with Zhang surname and their relatives from Taxia Village, Qujiang Village, and Nanou Village or residents with Chen surname and their relatives from Caoban Village, Tumei Village, and Beiling Village. The baseline survey recruited 1 563 family members from 452 extended pedigrees. The pedigree reconstruction was based on the family information registration and the genealogy booklet. Univariate and bivariate heritability was estimated using variance component models for continuous variables, and susceptibility-threshold model for binary variables.

RESULTS

The pedigree reconstruction identified 1 seven-generation pedigree, 2 five-generation pedigrees, 23 four-generation pedigrees, 186 three-generation pedigrees, and 240 two-generation pedigrees. The mean age of the participants was 57.2 years and the males accounted for 39.4%. The prevalence of hypertension, diabetes, dyslipidemia in this population was 49.2%, 10.0%, and 45.2%, respectively. The univariate heritability estimation of resting heart rate, hypertension, and dyslipidemia was 0.263 (95%CI: 0.120－0.407), 0.404 (95%CI: 0.135－0.673), and 0.799 (95%CI: 0.590－1), respectively. The heritability of systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol was 0.379, 0.306, 0.393, 0.452, 0.568, 0.852, and 0.387, respectively. In bivariate analysis, there were phenotypic correlations between resting heart rate with hypertension, diabetes, diastolic blood pressure, fasting glucose, and triglyceride. After taking resting heart rate into account, there were strong genetic correlations between resting heart rate with fasting glucose (genetic correlation 0.485, 95%CI: 0.120－1, P<0.05) and diabetes (genetic correlation 0.795, 95%CI: 0.181－0.788, P<0.05).

CONCLUSION

Resting heart rate was a heritable trait and correlated with several common chronic diseases and related traits. There was strong genetic correlation between resting heart rate with fasting glucose and diabetes, suggesting that they may share common genetic risk factors.

In vitro activity of oritavancin alone or in combination against vancomycin-susceptible and -resistant enterococci

OBJECTIVES

The optimal treatment for serious infections due to Enterococcus spp. is unknown although combination antimicrobial therapy is often recommended for invasive infections to achieve bactericidal activity and improve clinical outcomes. Oritavancin is a novel lipoglycopeptide agent with in vitro activity against enterococci, including vancomycin-resistant VanA-type Enterococcus faecium. Data on its activity in combination with other antibacterials are limited. The objective of this study was to evaluate the activity of oritavancin alone and in combination with ceftriaxone, daptomycin, gentamicin, linezolid and rifampicin against vancomycin-susceptible and -resistant enterococci in in vitro time-kill analyses.

METHODS

Five enterococcal strains were used for all experiments: three vancomycin-resistant VanA-type E. faecium clinical bloodstream isolates, vancomycin-resistant VanA-type E. faecium ATCC 700221 and vancomycin-susceptible Enterococcus faecalis ATCC 29212. Individual drugs were tested at ¼, ½, 1, 2 and 4× MIC. Oritavancin combination experiments were performed with each agent at ¼× MIC.

RESULTS

Daptomycin was the most active single agent and was bactericidal against all strains at 4× MIC, followed by oritavancin, which was bactericidal against all three clinical VRE strains at ≥2× MIC. In combination experiments at ¼× MIC, oritavancin was synergistic with gentamicin against strains not displaying high-level aminoglycoside resistance. No other synergy against VRE strains was observed in any experiment. Strain- and drug-dependent antagonism was observed for many combinations.

CONCLUSIONS

These in vitro data do not support the routine use of combination therapy with oritavancin in the treatment of infections due to VRE.

[Heritability of alcohol intake among adult twins, calculate by the structural equation model]

Objective: To explore the genetic and environmental effects on alcohol intake. Methods: Data on 9 231 pairs of adult twins of the same sex was collected from the Chinese National Twin Registry (CNTR), between 2015 and 2018 and used in this study. Structural equation model was used to estimate the effects of genetic and environmental factors on alcohol intake. Results: A total of 9 231 pairs of twins were included in the analysis, of which 6 085 pairs were monozygotic (MZ). The average age of MZ was (36.91±13.07) years old, and males accounted for 56.80%. The average age of dizygotic twins (DZ) was (35.22±12.48) years old, and males accounted for 55.91%. There were 350 pairs of alcohol-drinking twins were with high-risk, accounting for 1.90% and another 367 pairs (1.99%) were with medium-risk. Alcohol-drinkers with medium-risk were affected by additive genetics, common and unique environmental factors, seen among the twins. The overall heritability appeared as 24.3% (95%CI: 0 to 56.8%). Furthermore, 50.7% of the variation (95%CI: 20.4%-79.0%) could be explained by the common environmental factors and 24.9% (95%CI: 18.3%-36.5%) by unique environmental factors. High-risk related drinking behavior was affected by both common and unique environmental factors. The common environmental component appeared as 75.6% (95%CI: 69.6%-80.8%) and unique environmental component as 24.4% (95%CI: 19.2%-30.4%), respectively. Gender difference was seen in the heritability of those with medium or high-risk drinking behaviors. The heritability of men was 30.8% (95%CI: 9.8%-53.5%), while in women it was mainly affected by the environment. Conclusion: Both alcohol drinkers with medium and high-risk drinking behaviors were mainly affected by the environment factors and gender. With the increase of drinking volume, the effect of environment on drinking behaviors became more obvious.

AB0054 SYNOVIAL CD163+ MACROPHAGES ARE ASSOCIATED WITH RADIOGRAPHIC JOINT DESTRUCTION IN RHEUMATOID ARTHRITIS

Background:

CD163, a hemoglobin scavenger receptor, has been identified as a marker of M2 macrophages, it can promote the release of IL-10 and carbon oxide. Researches on inflammatory diseases and tumors have suggested that CD163 plays anti-inflammatory effect and promotes tumor growth and metastasis. Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by chronic synovitis with inflammatory cells infiltration including considerable macrophages. However, little is known about the role of CD163+ macrophages in RA synovium.

Objectives:

To investigate the expression and clinical significance of synovial CD163+ macrophages in RA.

Methods:

Seventy-five RA patients were recruited and clinical data including disease activity, HAQ and Sharp/van der Heijde-modified Sharp score of bilateral hands and wrists were collected. Synovial tissues were obtained by needle biopsies or arthroscopy of knee joints. Eighteen osteoarthritis (OA) and seventeen orthopedic arthropathies (orth.A) patients were included as controls. All synovium were stained with H&E and immunohistochemically for CD163, CD3, CD20, CD38, CD68, and CD15. Histologic changes of synovitis in H&E stained sections were graded with Krenn’s synovitis score.

Results:

Positive CD163 expression were found in both lining synoviocytes and sublining inflammatory cells. Both densities of lining and sublining CD163+ macrophages in RA synovium were significantly higher than that in OA or Orth.A synovium (140.47±66.93 vs. 17.85±7.70 vs. 19.76±5.26 and 417.92±249.62 vs. 27.58±14.19 vs. 29.87±9.33, allP<0.001, Figure 1).

According to Krenn’s synovitis score, there were 68% RA patients showing high synovitis (score>4). Both lining and sublining synovial CD163+ macrophages were significantly higher than those showing low synovitis (lining: 158.40±62.91 vs. 122.06±66.74, sublining: 462.96±62.91 vs. 371.65±271.54, bothP<0.05). Meanwhile, the densities of lining and sublining CD163+ macrophages were both positively correlated with Krenn’s synovitis score (r=0.238 and 0.343, bothP<0.05).

For clinical relationship in RA, the density of sublining CD163+ macrophages was positively correlated with total Sharp score (mTSS) (r=0.399,P<0.001), joint space narrowing subscore (r=0.248,P=0.032) and joint erosion subscore (r=0.457,P<0.001). While the density of lining CD163+ macrophages was positively correlated with mTSS (r=0.319,P=0.005) and joint erosion subscore (r=0.358,P=0.002). Meanwhile, the densities of sublining and lining CD68+ macrophages were also positively correlated with mTSS (r=0.253 and 0.242, bothP<0.05), of which the correlation was weaker than that of CD163+ macrophages (Figure 2). There were no significant correlation between the density of CD163+ macrophages and disease activity or HAQ (allP>0.05).

Conclusion:

Synovial CD163+ macrophages are associated with radiographic joint destruction, which imply that CD163+ macrophages may play role in the pathogenisis of joint destruction in RA.

Figure 1.

Representative immunohistochemical findings of synovial CD163 expression. (A) Synovial CD163 expression in an Orth.A patient, an OA patient and a RA patient. (B) Densities of lining and sublining CD163+ macrophages in Orth.A, OA and RA patients.

Figure 2.

Spearman’s rank correlation analysis for synovial macrophages and mTSS in RA. (A) Correlation between sublining CD163+ macrophages and mTSS, joint space narrowing subscore, joint erosion subscore. (B) Correlation between lining CD163+ macrophages and mTSS, joint space narrowing subscore, joint erosion subscore.

Funding: :

This work was supported by National Natural Science Foundation of China (no. 81801606 and 81971527), Guangdong Natural Science Foundation (no. 2017A030313576, 2018A030313541 and 2019A1515011928).

Figures:

Disclosure of Interests:

None declared

Use of conductivity to indicate long-term changes in pollution processes in Lake Taihu, a large shallow lake

Conductivity is a very reliable, sensitive, and easily obtained indicator of surface water conditions; however, whether it could be used to evaluate lake pollution is less understood. To verify the effectiveness of using conductivity to evaluate the pollution status in lakes, Lake Taihu was analyzed, the third largest freshwater lake in China, which provides drinking water to about 10 million of residents. We analyzed 25-year conductivity data in 32 sampling sites in Lake Taihu, in relation to human population, industrial development, and GDP. The results showed that the conductivity first increased and then decreased following rapid economic growth and subsequent strict pollution control activities. The conductivity is related to industrial sewage (r = 0.90); SO₄^2- and Cl^- concentrations in the water were closely related to the industrial production value (r = 0.98, 0.99) before 2007. The conductivity increased rapidly from 1992 to 2007 due to eutrophication processes. After 2007, with the implementation of various pollution control measures, the pollution situation gradually abated. The conductivity was closely related to the concentrations of nitrogen and phosphorus (r = 0.53, 0.14) in Lake Taihu, which suggests that conductivity could be indicator of eutrophication in lakes to some extent. Based on the research results, conductivity can largely be used to characterize the impact of human activities on lakes. Our study suggests that conductivity is a very reliable parameter for evaluating lake pollution. In addition to providing ion information, this measurement could successfully determine pollution sources and restoration effectiveness in lakes, such as ecologically complex Lake Taihu.

AB1140 ABNORMAL RIGHT VENTRICLE RESERVE FOLLOWING EXERCISE IN PATIENTS WITH CONNECTIVE TISSUE DISEASES

Background:

Recent studies have indicated that cardiac autonomic dysfunction is an early sign of cardiovascular impairment in patients with connective tissue disease (CTD). Previous studies have mainly focused on autonomic regulation during rest in this population. The cardiac autonomic responses to an acute physiological stress might provide additional information on the autonomic dysfunction, serving as a powerful predictor of cardiovascular disease and mortality in patients with CTD.

Objectives:

We aimed to use exercise stress echocardiography to detect early right heart dysfunction in patients with CTD and healthy controls.

Methods:

Treadmill exercise stress echocardiography was performed in 19 CTD patients (8 systemic sclerosis, 6 mixed CTD and 5 SLE) and 20 healthy volunteers. Parameters of right ventricular (RV) systolic function (RV fractional area change, Doppler tissue s’ velocity, and systolic strain and strain rate) and diastolic function (peak E and A velocity, Doppler tissue e’, a’ and early and late diastolic strain rate) were evaluated at baseline and after exercise, with the difference (Δ) being systolic and diastolic reserve. The immunoblotting assay was performed to detect the levels of rheumatoid factor (RF) and C-reactive protein (CRP) as well as autoantibodies such as, antinuclear antibody (ANA), anti-U1 ribonucleoproteins (U1RNP), anti-dsDNA, anti-Sm, anti-SSA, anti-SSB, anti-SCL-70 and RO-52. The correlation between these proteins and RV function was analyzed.

Results:

Both the patients with CTD and healthy controls had a normal range of BMI, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG). The average age of patients with CTD was 46.0 ± 10.4 years. At baseline, these patients presented no cardiovascular disease or pulmonary hypertension. No significant difference in the body weight, height, age, sex, blood pressure, RV and left ventricular (LV) function at rest between the two groups (allP>0.05). The parameters of RV systolic reserve decreased significantly in CTD group compared to those of the healthy controls (Δs’: 5.8±2.1 vs 8.3±2.5cm-1,P<0.01; ΔSr: 2.5±0.8 vs 2.8±0.7s-1,P<0.01). Consistently, RV diastolic reserve was significantly decreased in CTD patients compared to controls (Δe’: 2.8±1.5 vs 3.9±2.3cm-1,P<0.05; Δa’: 5.8±2.5 vs 10.9±6.3cm-1,P<0.05; ΔE-Sr: 0.8±0.2 vs 1.2±0.5s-1,P<0.05; ΔA-Sr: 0.9±0.3 vs 1.3±0.6s-1,P<0.05). To identify independent predictors of RV function in CTD patients, linear regression was conducted. This suggested that ANA, anti-U1RNP, anti-dsDNA, anti-Sm, anti-SSA, anti-SSB, anti-SCL-70 and RO-52 were not correlated with RV reserve (allP>0.05). A logistic regression analysis revealed that RF (P<0.05) and CRP (P<0.01) were independently associated with RV reserve in CTD patients in response to an acute physiological stress.

Conclusion:

Treadmill exercise echocardiography could detect right heart dysfunction early before diagnosed as cardiovascular diseases in patients with CTD. RV reserve after exercise might be a promising parameter to detect cardiovascular disease early in CTD patients.

References:

[1]Lazzerini PE, Capecchi PL, Laghi-Pasini F. Systemic inflammation and arrhythmic risk: lessons from rheumatoid arthritis.Eur Heart J. 2017;38(22):1717–1727.

[2]Peçanha T, Rodrigues R, Pinto AJ, et al. Chronotropic Incompetence and Reduced Heart Rate Recovery in Rheumatoid Arthritis.J Clin Rheumatol. 2018;24(7):375–380.

Disclosure of Interests:

None declared

Young-onset type 2 diabetes and younger current age: increased susceptibility to retinopathy in contrast to other complications

BACKGROUND

Type 2 diabetes diagnosed during youth and early adulthood is aggressive and associated with a high burden of vascular complications. The increase in complications is often attributed to long disease duration and poor metabolic control. Whether people with young-onset type 2 diabetes are inherently more susceptible to long-term complications than those diagnosed in later adulthood is unclear.

METHODS

Prospective data from 3322 individuals, diagnosed between the age of 15 and 70 years and collected 10-25 years after diabetes diagnosis, were analysed. The cross-sectional associations between age at diagnosis and microvascular and macrovascular complications were analysed using logistic regression models, adjusted for duration of diabetes exposure and metabolic risk factors including blood pressure, cholesterol and updated mean HbA_1c .

RESULTS

The prevalence of retinopathy was highest in those with young-onset type 2 diabetes (diagnosed at age 15 to <40 years). After 10-15 years' diabetes duration, the adjusted odds ratio for retinopathy in this population was 2.8 (95% CI 1.9-4.1; reference group those diagnosed at 60 to <70 years of age). The odds of retinopathy remained higher in people with young-onset type 2 diabetes after longer durations of diabetes exposure; the odds decreased with increasing age at diagnosis. This pattern was not observed in models of other complications: after 10-15 years' diabetes exposure, the adjusted odds ratios for albuminuria, peripheral neuropathy and macrovascular disease in people with young-onset type 2 diabetes were 0.5 (95% CI 0.4-0.8), 0.7 (95% CI 0.5-1.1) and 0.2 (95% CI 0.1-0.3), respectively.

CONCLUSION

After accounting for disease duration and other important confounders, people with type 2 diabetes diagnosed in youth and early adulthood (or with a younger current age) appeared to be inherently more susceptible to retinopathy. For other complications, adjusted risk appears highest in the oldest age of diagnosis group. These data have screening and treatment target implications.

0871 Air Pollution Exposure And Adverse Sleep Health Across The Life Course: A Systematic Review

Introduction

An increasing number of epidemiologic studies have examined air pollution as a possible contributor to adverse sleep health, but the results were mixed. The aims of this systematic review are to investigate and summarize the associations between exposures to air pollutants and various sleep measures across the lifespan.

Methods

PubMed, CINAHL, Cochrane, Scopus, Web of Science, and PsycInfo were searched through October 2019 to identify original data-based research examining the direct epidemiological associations between air pollution exposures, both ambient and indoor, and various sleep health measures, including sleep quality, sleep duration, sleep disturbances, and daytime sleepiness.

Results

Twenty-two articles from 2010-2019 spanning a wide range of study populations (from early childhood to elderly) and locations (10 Asian, 4 North American, 3 European, 5 other) were selected for inclusion. Due to variation in both exposure and outcome assessments, conducting a meta-analysis was not plausible. Twenty-one reported a generally positive association between exposure and poor sleep quality. While most studies focused on ambient air pollutants, five assessed the specific effect of indoor exposure. Increased exposure to both ambient and indoor pollutants is associated with increased respiratory sleep problems and a variety of additional adverse sleep outcomes in children and adolescents. In adults, air pollution exposure was most notably related to sleep disordered breathing severity.

Conclusion

Existing literature generally show negative relationships between exposure to air pollution and sleep health across different ages, countries, and measures. While many associations between air pollution and sleep outcomes have been investigated, the mixed study methodologies and use of subjective air pollution and sleep measures result in a wide range of specific associations. Plausible toxicological mechanisms remain inconclusive. Future studies utilizing objective sleep measures and controlling for all air pollution exposures an individual encounters may help ameliorate variability in the results reported by current published literature.

Support

yes

Multiple-centre clinical evaluation of an ultrafast single-tube assay for SARS-CoV-2 RNA

OBJECTIVE

To evaluate the performance of an ultrafast single-tube nucleic acid isothermal amplification detection assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA using clinical samples from multiple centres.

METHODS

A reverse transcription recombinase-aided amplification (RT-RAA) assay for SARS-CoV-2 was conducted within 15 minutes at 39°C with portable instruments after addition of extracted RNA. The clinical performance of RT-RAA assay was evaluated using 947 clinical samples from five institutions in four regions of China; approved commercial fluorescence quantitative real-time PCR (qRT-PCR) kits were used for parallel detection. The sensitivity and specificity of RT-RAA were compared and analysed.

RESULTS

The RT-RAA test results of 926 samples were consistent with those of qRT-PCR (330 were positive, 596 negative); 21 results were inconsistent. The sensitivity and specificity of RT-RAA was 97.63% (330/338, 95% confidence interval (CI) 95.21 to 98.90) and 97.87% (596/609, 95% CI 96.28 to 98.81) respectively. The positive and negative predictive values were 96.21% (330/343, 95% CI 93.45 to 97.88) and 98.68% (596/604, 95% CI 97.30 to 99.38) respectively. The total coincidence rate was 97.78% (926/947, 95% CI 96.80 to 98.70), and the kappa was 0.952 (p < 0.05).

CONCLUSIONS

With comparable sensitivity and specificity to the commercial qRT-PCR kits, RT-RAA assay for SARS-CoV-2 exhibited the distinctive advantages of simplicity and rapidity in terms of operation and turnaround time.

Digital scanned laser light-sheet fluorescence lifetime microscopy with wide-field time-gated imaging

We develop a multidimensional fluorescence imaging technique by implementing a wide-field time-gated fluorescence lifetime imaging into digital scanned laser light-sheet microscopy (FLIM-DSLM) to measure 3D fluorescence lifetime distribution in mesoscopic specimens with high resolution. This is achieved by acquiring a series of time-gated images at different relative time delays with respect of excitation pulses at different depths. The lifetime is determined for each voxel by iteratively fitting to single exponential decay. The performance of the developed system is evaluated with the measurements of a lifetime reference Rhodamine 6G solution and a subresolution fluorescent bead phantom. We also demonstrate the application performances of this system to ex vivo and in vivo imaging of Tg(kdrl:EGFP) transgenic zebrafish embryos, illustrating the lifetime differences between the GFP signal and the autofluorescence signal. The results show that FLIM-DSLM can be used for sample size up to a few millimetres and can be utilised as a powerful and robust method for biomedical research, for example as a readout of protein-protein interactions via Förster resonance energy transfer.

Prophylactic low-molecular-weight heparin administration protected against severe acute pancreatitis partially by VEGF/Flt-1 signaling in a rat model

BACKGROUND

The present study was aimed to explore the effects and the underlying mechanism of prophylactic low-molecular-weight heparin (LMWH) treatment on taurocholate-induced severe acute pancreatitis (SAP) in a rat model.

METHODS

Rat SAP model was induced by injection of 4% sodium taurocholate into the pancreatic duct. LMWH was applied half an hour before the induction of pancreatitis at the dose of 200 IU/kg subcutaneous injection. The rats were euthanized at 1 h, 6 h, and 12 h after taurocholate-induced SAP. The inflammatory and oxidative response markers were assessed. And the vascular endothelial growth factor (VEGF) and Fms-related tyrosine kinase 1 (Flt-1) expression were evaluated by immunohistochemistry (IHC) and western blot methods.

RESULTS

The expression of inflammatory and oxidative response markers increased after induction of SAP. IHC and western blot results showed the VEGF and Flt-1 expression were increased in SAP group. Prophylactic LMWH administration reduced the inflammatory and oxidative response markers expression and decreased the expression of VEGF and Flt-1.

CONCLUSIONS

This study suggested that prophylactic LMWH treatment mitigated the severity of pancreatitis in rat SAP model by anti-inflammation and oxidative response. The underlying mechanism may result from downregulating VEGF/Flt-1 signaling of LMWH in SAP rat model.

Highly Reproducible and Efficient FASnI3 Perovskite Solar Cells Fabricated with Volatilizable Reducing Solvent

Lead-free tin halide perovskite solar cells (PSCs) have attracted great attention because of their low toxicity, ideal band gap, and high carrier mobilities. However, the efficiency and reproducibility of tin halide PSCs has been limited because of the facile oxidation of Sn²⁺ to Sn⁴⁺. Herein, liquid formic acid (LFA) was introduced as a reducing solvent in the FASnI₃ (FA: formamidinium) perovskite precursor solution. Unlike solid reducing additives, the LFA solvent is volatile, so no residual LFA remained in the FASnI₃ perovskite film. Use of the LFA solvent resulted in production of the FASnI₃ perovskite film with high crystallinity, low Sn⁴⁺ content, reduced background doping, and low electronic trap density. As a result, an efficiency of over 10% was obtained for lead-free tin halide PSCs with improved reproducibility.

Thermal Stability Enhancement through Structure Modification on the Microsized Crystalline Grain Surface of Lithium-Rich Layered Oxides

Lithium-rich layered oxides have been considered as the most promising candidate for offering a high specific capacity and energy density for lithium-ion batteries. However, their practical applications are still suffered by the cycle instability and also closely related thermal stability. Here, microsized crystalline grains with good dispersion of lithium-rich layered oxides are prepared by a molten-salt method, while a spinel structure is also introduced on a grain surface by following chemical oxidation and annealing process, and their thermal performance with different cutoff voltages during the charge process is systematically studied using differential scanning calorimetry method. Results have shown that thermal stability of microsized crystalline grains is better than that of spherical secondary agglomerates, the spinel structure introduction on the grain surface of microsized crystalline grains can contribute obviously to their thermal stability, in which the onset temperature of the exothermic peak has been increased by 103 °C, and the thermal release value can be reduced as much as about 40% when the battery was charged to 4.8 V. Furthermore, the electrochemical performance, especially cycle stability under a high temperature, has also been enhanced for spinel-modified microsized crystalline grains. This work not only develops the microsized crystalline grains with good dispersion of lithium-rich layered oxides, confirming the advantages of these materials compared to spherical secondary agglomerates, but also reveals the method to improve their thermal stability by grain surface structure modification, opening the way to optimize the comprehensive performance of electrode materials for batteries.

Tuning rotation axes of single molecular rotors by a combination of single-atom manipulation and single-molecule chemistry

Defining the axis of a molecular rotation is vital for the bottom-up design of molecular rotors. The rotation of tin-phthalocyanine molecules on the Ag(111) surface is studied by scanning tunneling microscopy and atomic/molecular manipulation at 4 K. Tin-phthalocyanine acts as a molecular rotor that binds to Ag adatoms and the substrate. Four different rotation axes are constructed at positions from the center to the periphery of the molecule. Furthermore, using the asymmetric appearance of the modified molecule, the rotation direction of the molecules is identified. This work provides a new approach for designing molecular rotors or motors with definable rotation radii and functions.

Age distribution of human papillomavirus infection and neutralizing antibodies in healthy Chinese women aged 18-45 years enrolled in a clinical trial

OBJECTIVES

Data from clinical trials of human papillomavirus (HPV) vaccines showed that women naïve (negative for both type-specific antibodies and DNA) to vaccine types would derive benefit from vaccination; therefore, an understanding of the proportion of naïve women in different age groups is important for developing HPV vaccination strategies.

METHODS

From November 2012 to April 2013, a total of 7372 healthy women aged 18-45 years were recruited in five provinces in China. Cervical specimens and serum samples were collected for each woman at entry. Cervical specimens were first tested by the HPV DNA enzyme immunoassay method; if positive, the specimens were then tested by reverse hybridization line probe assay and HPV-16 and HPV-18 specific polymerase chain reactions. Neutralizing antibodies against HPV-16 or HPV-18 were tested with a pseudovirion-based neutralization assay.

RESULTS

The overall prevalence of high-risk HPV DNA was 14.8% (1088/7367, 95% CI 14.0-15.6), and the seroprevalence of neutralizing antibodies against HPV-16 and HPV-18 was 12.6% (925/7367) and 4.9% (364/7367), respectively. In younger women (18-26 years) and middle-aged women (27-45 years), 83.8% (3116/3719) and 81.4% (2968/3648) were naïve to both HPV-16 and HPV-18 (both neutralizing antibodies and DNA were negative), respectively. In addition, 98.5% (3664/3719) and 98.0% (3575/3648) of the younger or middle-aged women were naïve to at least one HPV type (HPV-16 or HPV-18).

DISCUSSION

This study revealed that the majority of Chinese women aged 18-26 years and 27-45 years were naïve to both HPV-16 and HPV-18 and would thus derive full benefit from bivalent HPV vaccination.

[Preoperative evaluation using multi-slice spiral CT angiography of right-side colon vascular in laparoscopic radical operation for right colon cancer]

Objectives: To examine the value of multi-slice spiral CT angiography (MSCTA) in the analysis of anatomical variation and structural classification of right colon vessels. Methods: From August 2015 to August 2017, 198 patients (96 of whom underwent laparoscopic radical resection of right colon cancer) at Department of General surgery of Peking University First Hospital were retrospectively collected, and the results of abdominal enhanced CT scan were collected and three-dimensional reconstruction of blood vessels was performed. There were 104 males and 94 females. The age was 64(27) years (M(Q(R)), range: 19 to 87 years). Right gastroepiploic vein, anterior superior pancreaticoduodenal vein, right colonic vein (RCV), superior right colonic vein, ileocolon artery or vein (ICA or ICV), middle colon artery or vein (MCA or MCV) and Henle trunk were observed and recorded respectively. The anatomical relationship between the positions of blood vessels, the length of Henle trunk and surgical trunk were measured. Results: ICV and ICA were the most constant anatomic structures. The ICV/ICA of all patients came directly from SMV/SMA, 36.9% (73/198) ICV going in front of SMV and 63.1% (125/198) behind SMV. 72.2% (143/198) of the patients had RCV imported into Henle trunk and the rest into SMV. Middle colonic vein (MCV) could be observed in 81.3% (161/198) of the cases. 81.4% (131/161) of MCV were imported into SMV, 16.8% (27/161) into Henle trunk, 1.2% (2/161) into the first jejunal vein and 0.6% (1/161) into the splenic vein. Henle trunk was divided into 4 types, among which the occurrence probability of gastric node and pancreatic trunk was the highest. The dry length of Henle trunk was (0.82±0.39) cm (range: 0.37 to 1.68 cm). The length of surgical trunk was (2.54±0.83) cm (range: 1.57 to 3.95 cm). Accuracy of MSCTA results was 96.9%(93/96). Conclusions: Anatomical variation of blood vessels in the right colon is common. Abdominal CT angiography can accurately determine the anatomical structure of the blood vessels in the right colon.

Apple rootstocks with different phosphorus efficiency exhibit alterations in rhizosphere bacterial structure

AIMS

The purpose of this study was to select phosphorus-efficient apple rootstocks under phosphorus deficiency and to reveal the effects of different apple rootstocks on the rhizosphere bacterial community.

METHODS AND RESULTS

We used 83 hybrid lines of Malus robusta Rehd. × Malling 9 (M.9) to investigate their physiological traits and the phosphorus deficiency phenotypes of leaves in response to phosphorus deficiency (0·1 mmol l^-1 PO₄ ^3- ). All the plants were cultivated in pots in the greenhouse and watered using drip irrigation. In accordance with the results of investigation, we selected the phosphorus-efficient hybrid lines (PE) and the phosphorus-inefficient hybrid lines (PI) to research their root morphology and root hairs (RH). In addition, we used Illumina MiSeq sequencing to determine the bacterial community of the rhizosphere from different rootstocks. The results showed that the PE plants had better growth characteristics and stronger root plasticity than that of the PI plants, and phosphorus deficiency can stimulate the RH growth of PE plants. There was no significant difference in the rhizosphere bacterial diversity, but we found that the bacterial community structure was significantly different at the genus levels; in addition, 89 genera were found to have significant differences between PE and PI plants, especially Bacillus. The PE rhizosphere had more abundant Bacillus compared to the PI. High positive Pearson correlations with the phosphorus concentration in the plantlets of apple rootstocks were detected for the bacterial genera Bacillus (r: 0·776).

CONCLUSIONS

The phosphorus-efficient apple rootstocks adapted to phosphorus deficiency by shaping the root morphology. Notably, different apple rootstocks showed alteration of the microbes in rhizosphere.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study can provide the materials for exploring the mechanism of apple rootstock phosphorus absorption. In accordance with the different bacterial community compositions, we can develop the inoculants to promote nutrient uptake.