[Current status and change trend of violence against children in China from 2006 to 2015, an analysis on data from National Injury Surveillance System]

Objective: To understand the current status and change trend of violence against children in China and provide evidence for the risk factor and intervention priority identifications and intervention strategy development. Methods: The data of National Injury Surveillance System (NISS) from 2006 to 2015 were used to analyze the change in outpatient visit due to violence against children, injury cases'demographic characteristics, incidence of injury and clinical outcomes of injury cases. Results: A total of 44 319 injury cases caused by violence against children were reported through NISS during this period. The proportion of violence related child injury cases in total child injury cases decreased year by year. In child violence cases reported in 2015, boys accounted for 81.31%, the boy to girl ratio was 2.22∶1. Violence related injuries caused by blunt strike accounted for 65.69%. The incidences of child violence were low in February and during July-August and 48.87% of violence related injuries occurred in schools and public places, bruise accounted for 63.52%. The main injured body part caused by child violence was head (51.18%), and most violence caused injuries (82.66%) were mild, while 83.21% of the injury cases went home after treatment. Conclusions: Violence against children should not be ignored. Male students of middle/high schools are at high risk. Schools are the places where violence against children is prone to occur. Health and safety education should be strengthened to prevent the occurrence of campus violence and improve the child's awareness of self-protection and reduce the incidence of serious violence.

Prophage Diversity of 'Candidatus Liberibacter asiaticus' Strains in California

Huanglongbing (HLB) is a highly destructive citrus disease and is associated with a nonculturable bacterium, 'Candidatus Liberibacter asiaticus'. 'Ca. L. asiaticus' in the United States was first found in Florida in 2005 and is now endemic there. In California, 'Ca. L. asiaticus' was first detected in Hacienda Heights in Los Angeles County in 2012 and has now been detected in multiple urban locations in southern California. Knowledge of 'Ca. L. asiaticus' strain diversity in California is important for HLB management. In this study, genomic diversity among 10 'Ca. L. asiaticus' strains from six California locations were analyzed using a next-generation sequencing (NGS) (Illumina MiSeq and HiSeq) approach. Draft genome sequences of 'Ca. L. asiaticus' strains were assembled. Sequences of the 16S ribosomal RNA gene and nrdB confirmed 'Ca. L. asiaticus' identity. Prophages were detected in all 'Ca. L. asiaticus' strains. The California 'Ca. L. asiaticus' strains formed four prophage typing groups (PTGs): PTG1, with type 1 prophage only (strains from Anaheim, San Gabriel, and Riverside); PTG2, with type 2 prophage only (strains from Hacienda Heights); PTG1-3, with both type 1 and 3 prophages (a strain from Cerritos); and PTG1-2, with both type 1 and type 2 prophages (a strain from La Habra). Analyses of the terL sequence showed that all California 'Ca. L. asiaticus' strains were not introduced from Florida but likely from locations in Asia. Miniature inverted-repeat transposable elements were found in all 'Ca. L. asiaticus' strains, yet, a jumping-out event was detected in the 'Ca. L. asiaticus' strain from Cerritos. Altogether, this study demonstrated that the NGS approach focusing on prophage variation was sensitive and effective in revealing diversity of 'Ca. L. asiaticus' strains in California.

Abstract P6-17-39: BAT8001, a potent anti-HER2 antibody-drug conjugate with a novel stable linker for the treatment of HER2-positive breast cancer

Overexpression of HER2 occurs in approximately 20% of breast cancers and is associated with shortened survival. Trastuzumab emtansine (T-DM1), an anti-HER2 ADC, has shown efficacy in HER2-positive breast cancer patients and was approved by the FDA and EMA for advanced HER2-positive breast cancer. However T-DM1 causes grade 3 and 4 thrombocytopenia in up to 14.5% of patients as its major toxicity. The thrombocytopenia is likely caused by one of T-DM1's catabolites and payload, DM1, indicating T-DM1's linker can be cleaved. Here we adopted a novel noncleavable linker and created an anti-HER2 ADC, BAT8001, which is expected be efficacious in HER2-positive breast cancer and have a better side effect profile relative to T-DM1 due to the stability of BAT8001's noncleavable linker. BAT8001 is internalized in HER2-positive cancer cells. It inhibits proliferation of HER2-positive tumor cells with IC50s of ˜0.1 nM, similar to the potency of T-DM1. BAT8001 also induces apoptosis in HER2-positive cancer cells. In both cell-line and patient-derived mouse xenograft (PDX) models, BAT8001 demonstrates strong inhibition activity on tumor growth. For example, in a cell-line model of breast cancer (BT474), BAT8001 demonstrates potent activity with complete responses in all animals tested at the 15mg/kg dose level. Pharmacokinetics studies in monkey reveals BAT8001 has similar Cmax, AUC, and t1/2 as T-DM1. The major catabolite of BAT8001 is the Cys-linker-payload containing product. No free payload is observed. This compares favorably with T-DM1 where free DM1, T-DM1's payload, is one of the major catabolites. In a multiple dose toxicity study, BAT8001 had a NOAEL of 15 mg/kg versus 10 mg/kg for T-DM1. BAT8001 exhibits similar potency to T-DM1 on inhibiting HER2-positive cell proliferation and tumor growth, yet demonstrates better multiple dose toxicity than T-DM1. The improved toxicity profile of BAT8001 suggests that the novel noncleavable linker utilized in BAT8001 is more stable than the linker utilized in T-DM1. BAT8001 is very efficacious in cell-line xenograft models of breast cancer. The preclinical profile of BAT8001 warrants further development for the treatment of breast cancer and other HER2-positive cancers.

Citation Format: Tang W, Deng X, Ou Z, Gan J, Dong Q, Tan B, Lu L, Chen B, Bao C, Li S, Thomas B, Yu J-C. BAT8001, a potent anti-HER2 antibody-drug conjugate with a novel stable linker for the treatment of HER2-positive breast cancer [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 P6-17-39.

Mechanisms of endogenous repair failure during intervertebral disc degeneration

Intervertebral disc (IVD) degeneration is frequently associated with Low back pain (LBP), which can severely reduce the quality of human life and cause enormous economic loss. However, there is a lack of long-lasting and effective therapies for IVD degeneration at present. Recently, stem cell based tissue engineering techniques have provided novel and promising treatment for the repair of degenerative IVDs. Numerous studies showed that stem/progenitor cells exist naturally in IVDs and could migrate from their niche to the IVD to maintain the quantity of nucleus pulposus (NP) cells. Unfortunately, these endogenous repair processes cannot prevent IVD degeneration as effectively as expected. Therefore, theoretical basis for regeneration of the NP in situ can be obtained from studying the mechanisms of endogenous repair failure during IVD degeneration. Although there have been few researches to study the mechanism of cell death and migration of stem/progenitor cells in IVD so far, studies demonstrated that the major inducing factors (compression and hypoxia) of IVD degeneration could decrease the number of NP cells by regulating apoptosis, autophagy, and necroptosis, and the particular chemokines and their receptors played a vital role in the migration of mesenchymal stem cells (MSCs). These studies provide a clue for revealing the mechanisms of endogenous repair failure during IVD degeneration. This article reviewed the current research situation and progress of the mechanisms through which IVD stem/progenitor cells failed to repair IVD tissues during IVD degeneration. Such studies provide an innovative research direction for endogenous repair and a new potential treatment strategy for IVD degeneration.

Silibinin attenuates Streptococcus suis serotype 2 virulence by targeting suilysin

AIMS

To determine the antivirulence properties of silibinin against suilysin (SLY), a virulence factor of Streptococcus suis serotype 2 (SS2) that plays an important role in the pathogenesis of S. suis infection and its protective effect against SS2 infection in a mouse model.

METHODS AND RESULTS

Susceptibility testing, haemolysis assay and Western blot assays were employed to evaluate the performance of silibinin on SLY pore-forming activity. Cytotoxicity assays and mouse infection tests were also performed to determine the efficacy of silibinin against SS2 infection. The results showed that silibinin, a flavonoid with little anti-S. suis activity, was identified to be a potent antagonist of SLY-mediated haemolysis through the inhibition of its oligomerization. Treatment with silibinin reduced S. suis-induced cytotoxicity in macrophages (J774 cells). In addition, S. suis-infected mice that received silibinin showed a lower bacterial burden.

CONCLUSIONS

Our results demonstrated that silibinin is a promising candidate for the development of antivirulence therapeutic agents to treat S. suis infections.

SIGNIFICANCE AND IMPACT OF THE STUDY

The antivirulent property of silibinin against SS2 by targeting SLY provides the possibility for the future pharmaceutical application of silibinin to prevent and treat S. suis infection.

Natural variation in a CENTRORADIALIS homolog contributed to cluster fruiting and early maturity in cotton

BACKGROUND

Plant architecture and the vegetative-reproductive transition have major impacts on the agronomic success of crop plants, but genetic mechanisms underlying these traits in cotton (Gossypium spp.) have not been identified.

RESULTS

We identify four natural mutations in GoCEN-D_t associated with cluster fruiting (cl) and early maturity. The situ hybridization shows that GhCEN is preferentially expressed in cotton shoot apical meristems (SAM) of the main stem and axillary buds. Constitutive GhCEN-Dt overexpression suppresses the transition of the cotton vegetative apex to a reproductive shoot. Silencing GoCEN leads to early flowering and determinate growth, and in tetraploids causes the main stem to terminate in a floral bud, a novel phenotype that exemplifies co-adaptation of polyploid subgenomes and suggests new research and/or crop improvement approaches. Natural cl variations are enriched in cottons adapted to high latitudes with short frost-free periods, indicating that mutants of GoCEN have been strongly selected for early maturity.

CONCLUSION

We show that the cotton gene GoCEN-Dt, a homolog of Antirrhinum CENTRORADIALIS, is responsible for determinate growth habit and cluster fruiting. Insight into the genetic control of branch and flower differentiation offers new approaches to develop early maturing cultivars of cotton and other crops with plant architecture appropriate for mechanical harvesting.

AFOMP policy number 6: code of ethics for medical physicists in AFOMP Countries

This policy statement, which is the sixth of a series of documents prepared by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) Professional Development Committee, gives guidance on how medical physicists in AFOMP countries should conduct themselves in an ethical manner in their professional practice (Ng et al. in Australas Phys Eng Sci Med 32:175-179, 2009; Round et al. in Australas Phys Eng Sci Med 33:7-10, 2010; Round et al. in Australas Phys Eng Sci Med 34:303-307, 2011; Round et al. in Australas Phys Eng Sci Med 35:393-398, 2012; Round et al. in Australas Phys Eng Sci Med 38:217-221, 2015). It was developed after the ethics policies and codes of conducts of several medical physics societies and other professional organisations were studied. The policy was adopted at the Annual General Meeting of AFOMP held in Jaipur, India, in November 2017.

Dendritic cells cross-talk with tumour antigen-specific CD8+ T cells, Vγ9γδT cells and Vα24NKT cells in patients with glioblastoma multiforme and in healthy donors

The finding that dendritic cells (DCs) orchestrate innate and adaptive immune responses has stimulated research on harnessing DCs for developing more effective vaccines for DC therapy. The expression of cytomegalovirus (CMV) antigens in glioblastoma multiforme (GBM) presents a unique opportunity to target these viral proteins for tumour immunotherapy. Here, we demonstrate that Vγ9γδT cells, innate immune cells activated by zoledronate (Z) and Vα24 natural killer (Vα24NK) cells, innate/adaptive immune cells activated by α‐galactosylceramide (G) can link innate and adaptive immunities through cross‐talk with interferon (IFN) DCs from patients with glioblastoma multiforme (GBM) and healthy donors in a manner that can amplify the activation and proliferation of CMVpp65‐specific CD8⁺ T cells. The IFN DCs derived from patients with GBM used in this study express lower levels of programmed cell death ligand (PD)‐L1 and PD‐L2 and higher levels of C‐C receptor 7 (CCR7) than the most commonly used mature interleukin (IL)‐4 DCs. The expression level of programmed cell death 1 (PD‐1) on CD8⁺ T cells, including CMVpp65‐specific CD8⁺ T cells, expanded by IFN DCs pulsed with the CMVpp65‐peptide and Z plus G (IFN DCs/P+Z+G), was lower than that expanded by IFN DCs pulsed with the peptide alone (IFN DCs/P). Multi‐functional T cells, including human leucocyte antigen (HLA)‐A*0201‐restricted CMVpp65‐specific CD8⁺ T cells, Vγ9γδT cells and Vα24NKT cells, efficiently kill the HLA‐A*0201‐positive GBM cell line expressing CMVpp65 protein (T98G). These findings indicate that DC therapy using IFN DCs/P+Z+G and/or CTL therapy using CMVpp65‐specific CD8⁺ T cells expanded by IFN DCs/P+Z+G may lead to a good clinical outcome for patients with GBM.

Serum hepatitis B surface antigen correlates with fibrosis and necroinflammation: A multicentre perspective in China

The kinetics of serum hepatitis B surface antigen (HBsAg) during the natural history of hepatitis B virus (HBV) infection has been studied, but the factors affecting them remain unclear. We aimed to investigate the factors affecting HBsAg titres, using data from multicentre, large-sized clinical trials in China. The baseline data of 1795 patients in 3 multicentre trials were studied, and the patients were classified into 3 groups: hepatitis B early antigen (HBeAg)-positive chronic HBV infection (n = 588), HBeAg-positive chronic hepatitis B (n = 596), and HBeAg-negative chronic hepatitis B (n = 611). HBsAg titres in the different phases were compared, and multiple linear progression analyses were performed to investigate the implicated factors. HBsAg titres varied significantly in different phases (P = .000), with the highest (4.60 log10 IU/mL [10%-90% confidence interval: 3.52 log10 IU/mL-4.99 log10 IU/mL]) in patients with HBeAg-positive chronic HBV infection. In all phases, age and HBV DNA were correlated with serum HBsAg level. In HBeAg-positive chronic hepatitis B patients, a negative correlation between HBsAg titres and fibrosis stage was observed. Alanine amonitransferase or necroinflammatory activity was also correlated with HBsAg titres in HBeAg-negative chronic hepatitis B patients. In conclusion, decreased HBsAg titres may be associated with advancing fibrosis in HBeAg-positive chronic hepatitis B patients or increased necroinflammation in those with HBeAg-negative chronic hepatitis B. Our findings may help clinicians better understand the kinetics of HBsAg and provide useful insights into the management of this disease.

Column-integrated aerosol optical properties of coarse- and fine-mode particles over the Pearl River Delta region in China

The sun-photometer data from 2011 to 2013 at Panyu site (Panyu) and from 2007 to 2013 at Dongguan site (Dg) in the Pearl River Delta region, were used for the retrieving of the aerosol optical depth (AOD), single scattering albedo (SSA), Ångström exponent (AE) and volume size distribution of coarse- and fine-mode particles. The coarse-mode particles presented low AOD (ranging from 0.05±0.03 to 0.08±0.05) but a strong absorption property (SSA ranged from 0.70±0.03 to 0.90±0.02) for the wavelengths between 440 and 1020nm. However, these coarse particles accounted for <10% of the total particles. The AOD of fine particles (AODf) was over 3 times as large as that of coarse particles (AODc). The fine particles SSA (SSAf) generally decreased as a function of wavelength, and the relatively lower SSAf value in summer was likely to be due to the stronger solar radiation and higher temperature. More than 70% of the aerosols at Panyu site were dominated by fine-mode absorbing particles, whereas about 70% of the particles at Dg site were attributed to fine-mode scattering particles. The differences of the aerosol optical properties between the two sites are likely associated with local emissions of the light-absorbing carbonaceous aerosols and the scattering aerosols (e.g., sulfate and nitrate particles) caused by the gas-phase oxidation of gaseous precursors (e.g., SO₂ and NO₂). The size distribution exhibited bimodal structures in which the accumulation mode was predominant. The fine-mode volume showed positive dependence on AOD (500nm), and the growth of peak value of the fine-mode volume was higher than that of the coarse volume. Both the AOD and SSA increased with increasing relative humidity (RH), while the AE decreased with increasing RH. These correlations imply that the aerosol properties are greatly modified by condensation growth.

Preliminary Analysis of Competency Assessment of Organ Donation Coordinators in Hunan Province, China

BACKGROUND

The organ donation coordinator is indispensable in the process of organ donation and transplantation. The competency of coordinators is closely related to the organ donation rate.

OBJECTIVE

1) To construct a competency assessment system for organ donation coordinators; and 2) to evaluate the competency level of coordinators in Hunan province.

METHODS

We constructed the competency model framework for coordinators based on the McClelland competency model and then extracted and screened the competency indicators by interview and Delphi methods. Next, we determined the weight of the indicators by an analytic hierarchy process method. Finally, we evaluated the competency level of 42 coordinators in Hunan province with the use of our assessment system.

RESULTS

1) We constructed the competency evaluation system for organ donation coordinators, which included 6 dimensions and 21 competency indicators. 2) The average competency score of 42 coordinators was 79.43 ± 8.51. Five coordinators were at qualified level (11.9%), 18 at moderate level (42.9%), 12 at good level (25.6%), and 7 at excellent level (16.7%).

CONCLUSIONS

1) This competency evaluation system for organ donation coordinators will provide scientific evidence for human resource management in health institutions. 2) The organ donation coordinators in Hunan were qualified, but their number was insufficient.

Duality in Power-Law Localization in Disordered One-Dimensional Systems

The transport of excitations between pinned particles in many physical systems may be mapped to single-particle models with power-law hopping, 1/r^{a}. For randomly spaced particles, these models present an effective peculiar disorder that leads to surprising localization properties. We show that in one-dimensional systems almost all eigenstates (except for a few states close to the ground state) are power-law localized for any value of a>0. Moreover, we show that our model is an example of a new universality class of models with power-law hopping, characterized by a duality between systems with long-range hops (a<1) and short-range hops (a>1), in which the wave function amplitude falls off algebraically with the same power γ from the localization center.

Characteristics, management, and outcome of primary hyperparathyroidism at a single clinical center from 2005 to 2016

This study presents the clinical and biochemical profiles of patients with PHPT between 2005 and 2016 at our center. Most PHPT patients in China show symptomatic features. The number of symptomatic and asymptomatic patients increased during that time, and the number of individuals with parathyroid carcinoma is now increasing.

INTRODUCTION

Over the last decade, the prevalence of primary hyperparathyroidism (PHPT) has increased sharply, and the number of individuals with parathyroid cancer is still trending upward. Little is known about the clinical outlook of the disease over the last decade in China. The aim of this study was to describe the clinical characteristics of PHPT patients at our center from January 2005 to December 2016.

METHODS

Two hundred sixty patients with PHPT visiting Shanghai Jiao Tong University Affiliated Sixth People's Hospital were enrolled retrospectively. The clinical manifestations and biochemical abnormalities of these patients were analyzed.

RESULTS

Among all patients, 73.1% had symptomatic PHPT, while the number of symptomatic and asymptomatic patients increased 1 to 2.5 times and 1.5 to 3 times, respectively, from 2005 to 2016. Bone pain and single adenoma were the most frequent signs and pathological results. The patients with parathyroid carcinoma over the last 5 years accounted for 90% (9/10) of all parathyroid carcinoma patients from 2005 to 2016, and parathyroid carcinoma patients had higher levels of serum calcium, parathyroid hormone (PTH), and serum creatinine (P < 0.05) than parathyroid hyperplasia and parathyroid adenoma patients.

CONCLUSIONS

Most patients with PHPT in China still exhibit classic clinical and biochemical features. Both symptomatic and asymptomatic patients have increased over the last 12 years. Although the proportion of parathyroid carcinoma was small, a noticeable upward tendency was observed at our center.

[Disease burden caused by violence in the Chinese population, in 1990 and 2013]

Objective: To analyze the disease burden of violence in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) related to violence, were extracted from the Global Burden of Disease 2013 and used to describe the burden of disease caused by violence in the Chinese population. Data related to corresponding parameters on disease burden of violence in 1990 and 2013 were described. Results: In 2013, a total of 20 500 people died of violent events, with the death rate as 1.44 per 100 000, in China. DALY caused by violence was 1.08 million person years in 2013. DALY caused by sharp violence was 0.47 million person years, with 0.09 million person years lost due to firearm violence. Disease burden caused by violence appeared higher in males than in females. When comparing with data from the 1990s, reductions were seen by 67.35% on the standardized death rate of violence, by 68.07% on the DALY attributable to violence, and by 70.47% on the standardized DALY rate attributable to violence, respectively, in 2013. Disease burden of violence among young adults and elderly was among the highest. When comparing with data from the 1990, DALY in 2013 decreased among all the age groups except for the 70-year-old showed an increase of 9.36%. The standardized DALY rate in 2013 showed a declining trend in all the age groups, mostly in the 0-4-year-old group. The standardized DALY rates caused by sharp violence or firearm decreased by75.11% and 83.20% in the 0-4-year-old group. Conclusion: In recent years, the disease burden caused by violence showed a decreasing trend but appeared higher in males however with the increase of DALY in the elder population.

[Disease burden on falls among elderly aged 70 and over in the Chinese population, in 1990 and 2013]

Objective: To analyze the disease burden of falls in Chinese population aged 70 and over, in 1990 and 2013 and to provide evidence for the development of prevention strategies on falls in the elderly. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted of life years (DALY) on falls, were gathered from the results of Global Burden of Disease 2013 and used to describe the disease burden of falls in China by calculating the changing rates on corresponding parameters in 1990 and 2013. Results: In 2013, the number of deaths, YLLs, YLDs, DALYs caused by falls among Chinese population aged 70 and over were 48 800, 0.44 million person years, 0.30 millions person years, and 0.74 million person years, respectively. The standardized mortality rate, rates on YLLs, YLDs and DALYs of falls were 561.71 per 100 000, 55.87 per 100 000, 373.98 per 100 000 and 929.85 per 100 000, respectively. The burden of falls increased along with the increase of age. Compared with 1990, the number of deaths, YLLs, YLDs and DALYs caused by falls increased by 308.80%, 161.01%, 54.67% and 104.47%, respectively, in 2013, more seen in males than in females. The standardized mortality rate, YLLs and DALYs caused by falls increased by 63.67%, 38.54% and 73.08%, respectively, during 1990 and 2013. However, the standardized YLDs rate fell by 17.90% during the same period. Conclusion: Falls caused heavy disease burden which increased in 1990 and 2013 among the Chinese population aged 70 and over.

[Disease burden caused by suicide in the Chinese population, in 1990 and 2013]

Objective: To provide basic suicide prevention strategy through analyzing the disease burden of suicide in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) on suicide, were from the results of Global Burden of Disease 2013 and used to describe the burden of disease caused by suicide in Chinese population. Data described the disease burden of suicide in China by comparing the corresponding parameters in 1990 and 2013. Results: In 2013, the standard mortality on suicide was 9.08 per 100 000, and 73.39 per 100 000 in the 80 and above year-old, with the highest rates on DALY and YLL seen in the 75-79-year-old. Each parameter related to suicide burden in males appeared higher than that in females. Compare to data in the 1990s, these parameters declined in 2013, especially seen in females. The rate of YLLs/YLDs on suicide was 90.03 in 2013, 89.83 in males and 89.00 in females. Conclusion: The disease burden of suicide decreased sharply between 1990 and 2013 but was still a serious issue in the elderly that called for more attention.