POS0014 EFFICACY AND SAFETY OF JAK INHIBITORS IN REFRACTORY OR INITIAL TREATMENT OF ADULT ONSET STILL’S DISEASE

Background

Inappropriate activation of pro-inflammatory cytokines such as interleukin (IL)-1, IL-6 or IL-18, is a pathogenic cornerstone in adult onset Still’s disease (AOSD). Beyond therapies targeting IL-1 and IL-6, Janus kinases (JAK) inhibitors have been suggested to be efficient in refractory AOSD patients [1].

Objectives

To assess the efficacy and safety of JAK inhibitors in the treatment of AOSD patient refractory to, or with initial treatment.

Methods

This retrospective study was based on our single center of the department of rheumatology and immunology. The data was collected from the patients’ medical records using a standardized questionnaire and analyzed at different time points. The response to JAK inhibitors was categorized as complete remission (CR), partial remission (PR) or failure (F) [2].

Results

7 patients were recruited (Table 1), including 4 refractory patients and 3 initial patients. Mean age at JAK inhibitor treatment start was 27.5 years for refractory patients and 35 years for initial patients; and mean disease duration was 66.5 months and 1 month respectively. All patients had fever and polyarthritis, 5 patents had rash. In addition, pulmonary hypertension, abnormal liver function tests, abdominal pain, and heart failure were also observed in our patients. Response to corticosteroids, conventional synthetic or biological Disease Modifying Anti-Rheumatic Drugs (DMARDs) had been considered inadequate in 4 refractory patients. Tofacitinib was added in the initial treatment for 3 patients for high disease activity. In total, baricitinib was used in 2 patients and tofacitinib in 5 patients. Steroids were concurrently used in 6 patients, MTX in three, SASP and NSAIDs in one. At a mean follow up of 3.8 months, complete remission was observed in one patient (with tofacitinib), partial remission was in 5 patients (4 patients with tofacitinib and one with baricitinib), and failure in one (patients with baricitinib). At the last visit, steroids could be decreased but not stopped in those 6 patients. Tolerance of JAK inhibitors was excellent, none infectious disease or other severe side effect were observed.

Table 1.

Characteristics of the AOSD patients

No.SexAge (year)Disease Duration (Month)Main symptomsTreatments before JAKionsetJAKiSteroids at onsetConconmitant treatmentSteroids at the end of F-UF-U(month)Outcome1M2629Fever, polyarthritisPred+MTXTofacitinib0MTX04PR2M259Fever, polyarthritis, rash, pulmonary hypertensionPred+MTXBaricitinib16MTX+Pred124F3M3812Fever, polyarthritis, rashPred+MTX+CsA+NSAIDsTofacitinib24Pred123PR4M21216Fever, polyarthritisPred+MTX+SASP+NSAIDs+TNFiBaricitinib4Pred+MTX+SASP+NSAIDs43PR5F331Fever, polyarthritis, rash, abnormal liver function testsPredTofacitinib40Pred25CR6F471Fever, polyarthritis, rash, abdominal painPredTofacitinib36Pred45PR7F251Fever, polyarthritis, rash, heart failurePredTofacitinib40Pred123PR

Pred: prednisone; MTX: Methotrexate; SASP: salicylazosulfapyridine; CsA: ciclosporin A; NSAIDs: Non-Steroidal Antiinflammatory Drugs; TNFi: Tumor necrosis factor inhibitor. CR: complete remission; PR: partial remission; F: failure.

Conclusion

JAK inhibitors treatment may be helpful for some patients with refractory AOSD, or patients with severe disease activity at initial treatment. Different treatment responses were observed in these short series of cases, which might be due to the phenotype of patients. However, the scale of patients in our study was too low to draw a conclusion. Further study and additional information are needed to evaluate more precisely the risk-benefit ratio of this treatment, and a possible difference in efficacy among the different groups of patients or JAK inhibitors.

References

[1]Aosd T, Table E. Ann Rheum Dis 2020;79:842–4.

[2]Vercruysse F, Barnetche T, Lazaro E, et al. Arthritis Res Ther 2019;21:1–11. doi:10.1186/s13075-019-1838-6.

Figure 1.

Changes in laboratory test (A) WBC; (B) CRP; (C) ESR;(D) Ferritin. M0: baseline; M1: month 1; M3: month 3; M5: month 5.

Acknowledgements

None

Disclosure of Interests

None declared

AB1520 EFFECTIVE TREATMENT OF TOCILIZUMAB IN PATIENTS WITH REFRACTORY ADULT-ONSET STILL’S DISEASE

Background

Pro-inflammatory cytokines such as interleukin 6 (IL-6) are involved in the pathogenesis of adult-onset Still’s disease (AOSD). Anti-IL-6 agents such as tocilizumab have been tried to treat AOSD successfully.

Objectives

To access the efficacy of tocilizumab in the treatment of AOSD patient refractory to,or with initial treatment.

Methods

We reviewed three cases with refractory AOSD treated with tocilizumab. All patients fulfill the Cush criteria for AOSD. All patients performed blood culture, auto-antibodies test and bone marrow test to exclude infectious diseases, other rheumatic diseases and tumors. All patients received broad-spectrum antibiotics and had no response. All patients received glucocorticoid therapy and at least one kind of anti-cytokine therapies but didn’t have full response. Then the three patients received intravenous tocilizumab treatment of 8mg/kg every 2 weeks or 4 weeks.

Results

The first patient, a 21-year-old woman, performed positron emission tomography (PET-CT) and lymphoglandula pathology in addition to routine tests. She received high dose methylprednisolone (500mg per day for 3 days and followed by 80mg per day), gamma globulin injection (20g per day for 3 days) and baricitinib 4mg per day for 12 days, but had no response to the treatment. Then she received tocilizumab of 8mg/kg every 2 weeks and stopped baricitinib. And the symptoms and blood tests improved gradually, and the methylprednisolone dose reduced to 16mg per day at the last follow-up.

The second patient is a 52-year-old man, and performed bone marrow cytology and PET-CT to excluded hematological diseases. He received methylprednisolone 80mg per day, adalimumab and tofacitinib treatment. But the patients still got recurrent fever, high ESR, CRP and serum ferritin. Then he stopped adalimumab and tofacitinib, and received tocilizumab of 8mg/kg every 2 weeks and reduced to 8mg/kg every 4 weeks because of economic factors. The patient did not develop fever and the inflammatory indexes such as ESR/CRP gradually decreased to normal range. And methylprednisolone dose reduced to 32mg nowadays.

The third patient is a 30-year-old woman and has recurrent AOSD for 15 years. She had tried glucocorticoids, methotrexate, iguratimod, baritinib and entanercept successively. Yet she still had recurrent arthritis on hand and knee, and elevated ESR/CRP/serum ferritin. Additionally she suffered femoral head necrosis because of excessive doses of glucocorticoid. The patient received tocilizumab 8mg/kg every 4 weeks, then joint symptoms and inflammatory indicators improved significantly. The methylprednisolone dose was also successfully reduced to 4mg/d.

The Figure 1 showed the main course of disease evolution.

Figure 1.

Conclusion

Tocilizumab may be an effective candidate in refractory AOSD despite no response to other treatments.

Disclosure of Interests

None declared

MicroRNA-4463 facilitates the development of colon cancer by suppression of the expression of PPP1R12B

PURPOSE

In the present work, we investigated the expression pattern of miR-4463 in the non-metastasis and metastasis colorectal cancer (CRC) patients and its regulation axis.

METHODS

RT-qPCR assay was performed to assess miR-4463 expression in the serum and tissues of patients with non-metastasis and metastasis, and in the CRC cell lines. MTT assay, colony formation assay, transwell assay, and flow cytometry assay were used to examine the role of miR-4463 in CRC cell viability, proliferation, and migration. Bioinformatic analysis was used to identify the potential target gene of miR-4463, and the targeting relationship between miR-4463 and PPP1R12B was verified in vitro using dual luciferase assay. Western blotting assay was used to determine the protein level of the target gene PPP1R12B in CRC cells under the transfections of miR-4463 mimic, inhibitor and vectors overexpressing PPP1R12B.

RESULTS

miR-4463 was markedly increased in the non-metastasis CRC tissues, and increased even higher in the metastasis CRC tissues, while miR-4463 expression had no significant difference in serum from non-metastasis and metastasis CRC samples. Besides, miR-4463 was upregulated in CRC cell lines. Functionally, miR-4463 promoted CRC cell proliferation, migration, and inhibiting cell apoptosis. Further analysis revealed that the miR-4463/PPP1R12B axis was responsible for the role of this miRNA.

CONCLUSION

We reported the roles of miR-4463 in CRC proliferation and migration, supporting that miR-4463 could be a potential predictive diagnostic marker for colon cancer.

POS1002 DIAGNOSTIC DELAY AND ITS ASSOCIATED FACTORS IN CHINESE AXIAL SPONDYLOARTHRITIS: A RETROSPECTIVE STUDY

Background

Few data on the prolonged diagnosis and its associated factors in Chinese axial spondyloarthritis (axSpA) is available.

Objectives

To delineate the landscape of diagnostic delay in Chinese axSpA, investigate its associated factors and explore its potential impact on medication modalities.

Methods

A total of 1,295 patients fulfilling the ASAS classification criteria were obtained. Demographic and clinical data were collected through predesigned questionnaires and available medical records. Logistic regression analyses in univariate and multivariable model were performed, using the median of diagnostic delay as cut-off point for group classification. Differences between early and late diagnosed group were subsequently compared by the Pearson chi-square test or Mann-Whitney U test.

Results

The median (IQR) diagnostic delay in Chinese axSpA was 3.0 (1.0~7.0) years and 24.8% of them reported a history of misdiagnosis. Older age at onset (OR=0.97, P<0.001) and higher education attainment (P=0.001) were correlated with early diagnosis of axSpA, whereas coming from less developed areas (P=0.002), a history of peripheral arthritis at the time of diagnosis (OR=1.58, P=0.002) and history of misdiagnosis (OR=1.98, P<0.001) increased the risk of diagnostic delay. Medication modalities were similar between two groups, but the proportion with no medication ever and percentage without regular medication in recent 3 months were higher in the late diagnosed group than early group (26.5% vs. 20.7%, P=0.02; 34.7% vs. 28.6%, P=0.02).

Conclusion

Our findings depicted a detailed spectrum of diagnostic delay in Chinese axSpA, verified five associated factors and pinpointed a remarkable treatment delay even after diagnosis, especially in late diagnosis group.

References

[1]Masson Behar V, Dougados M, Etcheto A, Kreis S, Fabre S, Hudry C, et al. Diagnostic delay in axial spondyloarthritis: A cross-sectional study of 432 patients. Joint bone spine. 2017;84(4):467-71.

Figure 1.

Cumulative distribution of age at onset and age at diagnosis in Chinese axSpA

(A) the entire group. (B) stratified by early and late diagnosed group. (C) stratified by education level (college, middle school, secondary school). (D) stratified by history of peripheral arthritis when diagnosed. (E) stratified by history of misdiagnoses when diagnosed. (F) stratified by native place, as statistical significance was found between eastern coastal and western China, only these two groups were presented.

Disclosure of Interests

None declared

Observation of B 0 → ψ (2S)K S 0 π + π - and B s 0 → ψ (2S)K S 0 decays

Using a data sample of s = 13 TeV proton-proton collisions collected by the CMS experiment at the LHC in 2017 and 2018 with an integrated luminosity of 103 fb - 1 , the B s 0 → ψ ( 2S ) K S 0 and B 0 → ψ ( 2S ) K S 0 π + π - decays are observed with significances exceeding 5 standard deviations. The resulting branching fraction ratios, measured for the first time, correspond to B ( B s 0 → ψ ( 2S ) K S 0 ) / B ( B 0 → ψ ( 2S ) K S 0 ) = ( 3.33 ± 0.69 ( stat ) ± 0.11 ( syst ) ± 0.34 ( f s / f d ) ) × 10 - 2 and B ( B 0 → ψ ( 2S ) K S 0 π + π - ) / B ( B 0 → ψ ( 2S ) K S 0 ) = 0.480 ± 0.013 ( stat ) ± 0.032 ( syst ) , where the last uncertainty in the first ratio is related to the uncertainty in the ratio of production cross sections of B s 0 and B 0 mesons, f s / f d .

[Investigation on status of dyslipidemia in Chinese females aged 35 years or above]

Objective: To investigate the prevalence, awareness, treatment and control status of dyslipidemia among females aged ≥35 years old across China. Methods: Participants were selected by stratified multistage random sampling method in the "Twelfth Five-Year Plan" National Science and Technology Support Project "Survey on the Prevalence of Important Cardiovascular Diseases and Key Technology Research in China" project. This study is a retrospective, cross-sectional study. A total of 17 418 females aged 35 years and over were included in the current study. The basic information such as age, medical history and menopause was collected by questionnaire. The blood lipid parameters were derived from clinical laboratory examinations. The prevalence of dyslipidemia and the rate of awareness, treatment, and control of dyslipidemia were analyzed in females aged 35 years and over. Results: The age of participants was (56.2±13.0) years old, and the prevalence of dyslipidemia was 33.1% (5 765/17 418). The prevalence rates of high total cholesterol, hypertriglyceridemia, low HDL-C and high LDL-C were 9.7% (1 695/17 418), 11.1% (1 925/17 418), 10.9% (1 889/17 418) and 7.3% (1 262/17 418), respectively. The prevalence of dyslipidemia increased with age and the prevalence of dyslipidemia in women who were not married, Han, menarche age>16 years, obesity, central obesity, alcohol consumption, diabetes, hypertension and family history of cardiovascular disease were higher than those without such characteristics (P<0.05). There were 10 432 (59.9%) menopausal females in this cohort and prevalence of dyslipidemia of these participants was 38.8% (4 048/10 432), which was higher than that of non-postmenopausal females (24.6%, 1 717/6 986) (P<0.05). The awareness rates, treatment rates and control rates of dyslipidemia were 33.9% (1 953/5 765), 15.1% (870/5 765) and 2.5% (143/5 765) respectively among females aged 35 years and over in China. Conclusion: The prevalence of dyslipidemia in Chinese females aged 35 years and over is high, and its awareness, treatment, and control rates need to be optimized.

Measurements of Proton High-Order Cumulants in sqrt[s_{NN}]=3 GeV Au+Au Collisions and Implications for the QCD Critical Point

We report cumulants of the proton multiplicity distribution from dedicated fixed-target Au+Au collisions at sqrt[s_{NN}]=3.0  GeV, measured by the STAR experiment in the kinematic acceptance of rapidity (y) and transverse momentum (p_{T}) within -0.5<y<0 and 0.4<p_{T}<2.0  GeV/c. In the most central 0%-5% collisions, a proton cumulant ratio is measured to be C_{4}/C_{2}=-0.85±0.09 (stat)±0.82 (syst), which is 2σ below the Poisson baseline with respect to both the statistical and systematic uncertainties. The hadronic transport UrQMD model reproduces our C_{4}/C_{2} in the measured acceptance. Compared to higher energy results and the transport model calculations, the suppression in C_{4}/C_{2} is consistent with fluctuations driven by baryon number conservation and indicates an energy regime dominated by hadronic interactions. These data imply that the QCD critical region, if created in heavy-ion collisions, could only exist at energies higher than 3 GeV.

Measurements of _{Λ}^{3}H and _{Λ}^{4}H Lifetimes and Yields in Au+Au Collisions in the High Baryon Density Region

We report precision measurements of hypernuclei _{Λ}^{3}H and _{Λ}^{4}H lifetimes obtained from Au+Au collisions at sqrt[s_{NN}]=3.0  GeV and 7.2 GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider, and the first measurement of _{Λ}^{3}H and _{Λ}^{4}H midrapidity yields in Au+Au collisions at sqrt[s_{NN}]=3.0  GeV. _{Λ}^{3}H and _{Λ}^{4}H, being the two simplest bound states composed of hyperons and nucleons, are cornerstones in the field of hypernuclear physics. Their lifetimes are measured to be 221±15(stat)±19(syst)  ps for _{Λ}^{3}H and 218±6(stat)±13(syst)  ps for _{Λ}^{4}H. The p_{T}-integrated yields of _{Λ}^{3}H and _{Λ}^{4}H are presented in different centrality and rapidity intervals. It is observed that the shape of the rapidity distribution of _{Λ}^{4}H is different for 0%-10% and 10%-50% centrality collisions. Thermal model calculations, using the canonical ensemble for strangeness, describes the _{Λ}^{3}H yield well, while underestimating the _{Λ}^{4}H yield. Transport models, combining baryonic mean-field and coalescence (jam) or utilizing dynamical cluster formation via baryonic interactions (phqmd) for light nuclei and hypernuclei production, approximately describe the measured _{Λ}^{3}H and _{Λ}^{4}H yields. Our measurements provide means to precisely assess our understanding of the fundamental baryonic interactions with strange quarks, which can impact our understanding of more complicated systems involving hyperons, such as the interior of neutron stars or exotic hypernuclei.

The acute haemodynamic response with endocardial biventricular pacing: comparing RV paced and LBBB patients

Funding Acknowledgements

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific

Background

A third of patients that receive cardiac resynchronisation (CRT) are non-responders. Predictors of positive response include broader QRS duration, non-ischaemic aetiology and sinus rhythm, but it is still unclear whether lead placement site determines a positive responder.

Purpose

We assessed the acute haemodynamic response of endocardial biventricular pacing in patients with intrinsic left bundle brunch block (LBBB) versus LBBB due to pre-existing right ventricular pacing (RVP).

Methods

Patients who fulfilled standard criteria for CRT implantation but had failed conventional (coronary sinus) left ventricular (LV) lead placement (primary or revision) or were deemed clinical ‘non-responders after &gt; 6 months of conventional CRT were enrolled. The acute haemodynamic response during endocardial biventricular pacing was assessed with a roving LV lead at 9 different locations (basal and mid: septal, anterior, posterior and lateral walls and apex). Acute changes in beat-to-beat systolic blood pressure (SBP) in the left ventricle were recorded and analysed.

Results

We recruited 23 patients across 10 UK centres: 14 intrinsic LBBB and 9 dependent on RVP. Patient characteristics were comparable: age (mean 67 + 10.6 years vs. 62 + 15.4 years), ischaemic (63% vs 50%), QRS (160 + 18ms vs. 190 + 36ms, p =0.07). Of the RVP group 5/9 had septal RV leads (the remainder apically positioned).

There was no difference in the SBP improvement between the groups: change in SBP ranged from -5.25 – 19.91mmHg (median 3mmHg) in RVP patients vs -5.92 – 23.03mmHg (median 3mmHg) for intrinsic LBBB. However, the improvement in SBP was more consistent across the different segments in the patients with RVP (group A), as compared to intrinsic LBBB (group B), where the lateral wall and then non-septal walls provided the greatest haemodynamic improvement.

Figure 1: depicts SBP improvement (in mmHg) during endocardial biventricular pacing in different positions within the LV for patients with RVP (A) vs underlying intrinsic LBBB (B): 9 segment model of the LV: Ant (anterior wall), Lat (lateral wall), Post (posterior wall), Sept (septum). Outer ring represents the four basal LV locations, middle ring the mid LV locations and centre ring the apex. Scale depicts mmHg improvement in SBP.

Conclusion

When implanting an LV lead for patients who are RV pacing dependent any position within the LV provides an acute haemodynamic improvement, compared with those with intrinsic LBBB, where a targeted lateral wall approach is more important. This finding corroborates the key differences in LV activation patterns for induced versus intrinsic LBBB.

Spin in the Abstracts of Randomized Controlled Trials in Operative Dentistry: A Cross-sectional Analysis

OBJECTIVE

To assess the presence and characteristics of spin in recently published RCT abstracts in operative dentistry and to investigate potential factors associated with the presence of spin.

METHODS AND MATERIALS

The PubMed database was searched to identify parallel-group RCTs published between 2015 and 2019 in the field of operative dentistry, which compared two or more groups and had nonsignificant results for the primary outcome. Two authors evaluated independently the presence and characteristics of spin among these abstracts. Multivariable logistic regression analyses were conducted to identify factors associated with the presence of spin in the Results and the Conclusions sections, respectively.

RESULTS

A total of 77 RCT abstracts were included, among which 58 (75.3%) showed at least one type of spin. Spin was identified in the Results and Conclusions sections of 32 (41.6%) and 45 (58.4%) abstracts, respectively. 19 RCTs (24.7%) presented spin in both the Results and the Conclusions section of abstracts. The presence of spin in the Results section of abstracts was significantly associated with source of funding (OR=8.10; p=0.025) and number of treatment arms was associated with the presence of spin in the Conclusions section of abstracts (OR=5.66; p=0.005).

CONCLUSION

The occurrence rate of spin in the sample of operative dentistry RCTs abstracts is high.

[Aesthetic reconstruction of the scar contracture deformity in chin and neck with expanded flaps based on the "MRIS" principle]

Objective: The surgical reconstruction strategy for scar contracture deformity in chin and neck was explored, aiming to obtain better aesthetic outcome. Methods: A retrospective observational study was conducted. From December 2017 to April 2021, 34 patients with scar contracture deformity in chin and neck after burns were hospitalized in the Department of Plastic Surgery of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), aged 12-54 years, including 13 males and 21 females, 4 cases with chin affected only, 7 cases with neck affected only, and 23 cases with both chin and neck affected. The scar areas were 48-252 cm2. All the patients were treated by operation with expanded flaps, following the "MRIS" principle of matching of the color and thickness of the repair flaps (match), reconstructing of the aesthetic features of subunits (reconstruction), design of incision according to the plastic principle (incision), and prevention of the surgical incision scar (scar). The rectangular or kidney shaped skin and soft tissue expander (hereinafter referred to as the expander) with rated capacity of 80-400 mL was embedded in the first stage, which was routinely expanded to 3-5 times of the rated capacity of the expander. In the second stage, scar resection and expanded flap excision were performed to repair the secondary wound, and the flap donor site was sutured directly. The expansion ratio of the expander (with average value being calculated), the type of flaps used, the reconstruction of local aesthetic morphology, the appearance of postoperative incision, the survival of flap, and the situation of donor and recipient sites observed during follow-up were recorded. Results: Among the 34 patients, the average expansion ratio of the implanted expander was 3.82 times of the rated capacity of the expander. Three cases were repaired by the expanded local pedicled flap only, 19 cases by the expanded shoulder and/or chest perforator pedicled flap only, 10 cases by the expanded local pedicled flap combined with the expanded shoulder and/or chest perforator pedicled flap, and 2 cases by the expanded local pedicled flap combined with the expanded free flap of the second intercostal perforator of internal thoracic artery. After scar resection, the shapes of lower lip and chin-lip groove were reconstructed in 10 cases, chin process reconstruction and chin lengthening were performed in 16 cases, and the cervico-mental angle and mandibular margin contour were reconstructed in 28 cases. The surgical incision was concealed, most of which were located at the natural junction or turning point of the chin and neck subunits. The vertical incision of neck was Z-shaped or fishtail-shaped. All the expanded flaps in 34 patients survived after operation, of which 8 patients had minor necrosis at the edge or tip of the expanded flaps 1-3 days after operation and healed after dressing change. During the follow-up of 3-18 months, little difference in color and thickness between the expanded flap and the skin of chin and neck was observed, and the aesthetic shape of chin and neck was significantly improved, with mild scar hyperplasia of surgical incision. Conclusions: Reconstruction of scar contracture deformity in chin and neck by using expanded flaps based on the "MRIS" principle is beneficial to improve the quality of surgery and achieve better aesthetic outcome.

Long-term safety and efficacy of anacetrapib in patients with atherosclerotic vascular disease

AIMS

REVEAL was the first randomized controlled trial to demonstrate that adding cholesteryl ester transfer protein inhibitor therapy to intensive statin therapy reduced the risk of major coronary events. We now report results from extended follow-up beyond the scheduled study treatment period.

METHODS AND RESULTS

A total of 30 449 adults with prior atherosclerotic vascular disease were randomly allocated to anacetrapib 100 mg daily or matching placebo, in addition to open-label atorvastatin therapy. After stopping the randomly allocated treatment, 26 129 survivors entered a post-trial follow-up period, blind to their original treatment allocation. The primary outcome was first post-randomization major coronary event (i.e. coronary death, myocardial infarction, or coronary revascularization) during the in-trial and post-trial treatment periods, with analysis by intention-to-treat. Allocation to anacetrapib conferred a 9% [95% confidence interval (CI) 3-15%; P = 0.004] proportional reduction in the incidence of major coronary events during the study treatment period (median 4.1 years). During extended follow-up (median 2.2 years), there was a further 20% (95% CI 10-29%; P < 0.001) reduction. Overall, there was a 12% (95% CI 7-17%, P < 0.001) proportional reduction in major coronary events during the overall follow-up period (median 6.3 years), corresponding to a 1.8% (95% CI 1.0-2.6%) absolute reduction. There were no significant effects on non-vascular mortality, site-specific cancer, or other serious adverse events. Morbidity follow-up was obtained for 25 784 (99%) participants.

CONCLUSION

The beneficial effects of anacetrapib on major coronary events increased with longer follow-up, and no adverse effects emerged on non-vascular mortality or morbidity. These findings illustrate the importance of sufficiently long treatment and follow-up duration in randomized trials of lipid-modifying agents to assess their full benefits and potential harms.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number (ISRCTN) 48678192; ClinicalTrials.gov No. NCT01252953; EudraCT No. 2010-023467-18.

M, Kveton A, Tomsa J, Ayala E, Jarrin EC, Abdalla H, Assran Y, Khalil S, Lotfy A, Mahmoud MA, Bhowmik S, De Oliveira ACA, Dewanjee RK, Ehataht K, Kadastik M, Raidal M, Veelken C, Eerola P, Forthomme L, Kirschenmann H, Osterberg K, Voutilainen M, Brücken E, Garcia F, Havukainen J, Karimäki V, Kim MS, Kinnunen R, Lampén T, Lassila-Perini K, Lehti S, Lindén T, Siikonen H, Tuominen E, Tuominiemi J, Luukka P, Tuuva T, Amendola C, Besancon M, Couderc F, Dejardin M, Denegri D, Faure JL, Ferri F, Ganjour S, Givernaud A, Gras P, de Monchenault GH, Jarry P, Lenzi B, Locci E, Malcles J, Rander J, Rosowsky A, Sahin MÖ, Savoy-Navarro A, Titov M, Yu GB, Ahuja S, Beaudette F, Bonanomi M, Perraguin AB, Busson P, Charlot C, Davignon O, Diab B, Falmagne G, de Cassagnac RG, Hakimi A, Kucher I, Lobanov A, Perez CM, Nguyen M, Ochando C, Paganini P, Rembser J, Salerno R, Sauvan JB, Sirois Y, Zabi A, Zghiche A, Agram JL, Andrea J, Bloch D, Bourgatte G, Brom JM, Chabert EC, Collard C, Fontaine JC, Gelé D, Goerlach U, Grimault C, Bihan ACL, Van Hove P, Asilar E, Beauceron S, Bernet C, Boudoul G, Camen C, Carle A, Chanon N, Contardo D, Depasse P, Mamouni HE, Fay J, Gascon S, Gouzevitch M, Ille B, Jain S, Laktineh IB, Lattaud H, Lesauvage A, Lethuillier M, Mirabito L, Torterotot L, Touquet G, Donckt MV, Viret S, Khvedelidze A, Tsamalaidze Z, Feld L, Klein K, Lipinski M, Meuser D, Pauls A, Preuten M, Rauch MP, Schulz J, Teroerde M, Eliseev D, Erdmann M, Fackeldey P, Fischer B, Ghosh S, Hebbeker T, Hoepfner K, Keller H, Mastrolorenzo L, Merschmeyer M, Meyer A, Mocellin G, Mondal S, Mukherjee S, Noll D, Novak A, Pook T, Pozdnyakov A, Rath Y, Reithler H, Roemer J, Schmidt A, Schuler SC, Sharma A, Wiedenbeck S, Zaleski S, Dziwok C, Flügge G, Ahmad WH, Hlushchenko O, Kress T, Nowack A, Pistone C, Pooth O, Roy D, Sert H, Stahl A, Ziemons T, Petersen HA, Martin MA, Asmuss P, Babounikau I, Baxter S, Behnke O, Martínez AB, Anuar AAB, Borras K, Botta V, Brunner D, Campbell A, Cardini A, Connor P, Rodríguez SC, Danilov V, De Wit A, Defranchis MM, Didukh L, Damiani DD, Eckerlin G, Eckstein D, Eichhorn T, Banos LIE, Gallo E, Geiser A, Giraldi A, Grohsjean A, Guthoff M, Harb A, Jafari A, Jomhari NZ, Jung H, Kasem A, Kasemann M, Kaveh H, Kleinwort C, Knolle J, Krücker D, Lange W, Lenz T, Lidrych J, Lipka K, Lohmann W, Mankel R, Melzer-Pellmann IA, Metwally J, Meyer AB, Meyer M, Missiroli M, Mnich J, Mussgiller A, Myronenko V, Otarid Y, Adán DP, Pflitsch SK, Pitzl D, Raspereza A, Saggio A, Saibel A, Savitskyi M, Scheurer V, Schwanenberger C, Singh A, Ricardo RES, Tonon N, Turkot O, Vagnerini A, Van De Klundert M, Walsh R, Walter D, Wen Y, Wichmann K, Wissing C, Wuchterl S, Zenaiev O, Zlebcik R, Aggleton R, Bein S, Benato L, Benecke A, De Leo K, Dreyer T, Ebrahimi A, Eich M, Feindt F, Fröhlich A, Garbers C, Garutti E, Gunnellini P, Haller J, Hinzmann A, Karavdina A, Kasieczka G, Klanner R, Kogler R, Kutzner V, Lange J, Lange T, Malara A, Niemeyer CEN, Nigamova A, Rodriguez KJP, Rieger O, Schleper P, Schumann S, Schwandt J, Schwarz D, Sonneveld J, Stadie H, Steinbrück G, Vormwald B, Zoi I, Bechtel J, Berger T, Butz E, Caspart R, Chwalek T, De Boer W, Dierlamm A, Droll A, Morabit KE, Faltermann N, Flöh K, Giffels M, Gottmann A, Hartmann F, Heidecker C, Husemann U, Iqbal MA, Katkov I, Keicher P, Koppenhöfer R, Maier S, Metzler M, Mitra S, Müller D, Müller T, Musich M, Quast G, Rabbertz K, Rauser J, Savoiu D, Schäfer D, Schnepf M, Schröder M, Seith D, Shvetsov I, Simonis HJ, Ulrich R, Wassmer M, Weber M, Wolf R, Wozniewski S, Anagnostou G, Asenov P, Daskalakis G, Geralis T, Kyriakis A, Loukas D, Paspalaki G, Stakia A, Diamantopoulou M, Karasavvas D, Karathanasis G, Kontaxakis P, Koraka CK, Manousakis-katsikakis A, Panagiotou A, Papavergou I, Saoulidou N, Theofilatos K, Vellidis K, Vourliotis E, Bakas G, Kousouris K, Papakrivopoulos I, Tsipolitis G, Zacharopoulou A, Evangelou I, Foudas C, Gianneios P, Katsoulis P, Kokkas P, Manitara K, Manthos N, Papadopoulos I, Strologas J, Bartók M, Csanad M, Gadallah MMA, Lökös S, Major P, Mandal K, Mehta A, Pasztor G, Surányi O, Veres GI, Bencze G, Hajdu C, Horvath D, Sikler F, Veszpremi V, Vesztergombi G, Czellar S, Karancsi J, Molnar J, Szillasi Z, Teyssier D, Raics P, Trocsanyi ZL, Ujvari B, Csorgo T, Nemes F, Novak T, Choudhury S, Komaragiri JR, Kumar D, Panwar L, Tiwari PC, Bahinipati S, Dash D, Kar C, Mal P, Mishra T, Bindhu VKMN, Nayak A, Sahoo DK, Sur N, Swain SK, Bansal S, Beri SB, Bhatnagar V, Chaudhary G, Chauhan S, Dhingra N, Gupta R, Kaur A, Kaur S, Kumari P, Meena M, Sandeep K, Sharma S, Singh JB, Virdi AK, Ahmed A, Bhardwaj A, Choudhary BC, Garg RB, Gola M, Keshri S, Kumar A, Naimuddin M, Priyanka P, Ranjan K, Shah A, Bharti M, Bhattacharya R, Bhattacharya S, Bhowmik D, Dutta S, Ghosh S, Gomber B, Maity M, Nandan S, Palit P, Rout PK, Saha G, Sahu B, Sarkar S, Sharan M, Singh B, Thakur S, Behera PK, Behera SC, Kalbhor P, Muhammad A, Pradhan R, Pujahari PR, Sharma A, Sikdar AK, Dutta D, Kumar V, Naskar K, Netrakanti PK, Pant LM, Shukla P, Aziz T, Bhat MA, Dugad S, Verma RK, Mohanty GB, Sarkar U, Banerjee S, Bhattacharya S, Chatterjee S, Chudasama R, Guchait M, Karmakar S, Kumar S, Majumder G, Mazumdar K, Mukherjee S, Roy D, Dube S, Kansal B, Pandey S, Rane A, Rastogi A, Sharma S, Bakhshiansohi H, Zeinali M, Chenarani S, Etesami SM, Khakzad M, Najafabadi MM, Felcini M, Grunewald M, Abbrescia M, Aly R, Aruta C, Colaleo A, Creanza D, De Filippis N, De Palma M, Florio AD, Pilato AD, Elmetenawee W, Fiore L, Gelmi A, Gul M, Iaselli G, Ince M, Lezki S, Maggi G, Maggi M, Margjeka I, Mastrapasqua V, Merlin JA, My S, Nuzzo S, Pompili A, Pugliese G, Ranieri A, Selvaggi G, Silvestris L, Simone FM, Venditti R, Verwilligen P, Abbiendi G, Battilana C, Bonacorsi D, Borgonovi L, Braibant-Giacomelli S, Campanini R, Capiluppi P, Castro A, Cavallo FR, Ciocca C, Cuffiani M, Dallavalle GM, Diotalevi T, Fabbri F, Fanfani A, Fontanesi E, Giacomelli P, Giommi L, Grandi C, Guiducci L, Iemmi F, Meo SL, Marcellini S, Masetti G, Navarria FL, Perrotta A, Primavera F, Rossi AM, Rovelli T, Siroli GP, Tosi N, Albergo S, Costa S, Mattia AD, Potenza R, Tricomi A, Tuve C, Barbagli G, Cassese A, Ceccarelli R, Ciulli V, Civinini C, D’Alessandro R, Fiori F, Focardi E, Latino G, Lenzi P, Lizzo M, Meschini M, Paoletti S, Seidita R, Sguazzoni G, Viliani L, Benussi L, Bianco S, Piccolo D, Bozzo M, Ferro F, Mulargia R, Robutti E, Tosi S, Benaglia A, Beschi A, Brivio F, Cetorelli F, Ciriolo V, De Guio F, Dinardo ME, Dini P, Gennai S, Ghezzi A, Govoni P, Guzzi L, Malberti M, Malvezzi S, Massironi A, Menasce D, Monti F, Moroni L, Paganoni M, Pedrini D, Ragazzi S, de Fatis TT, Valsecchi D, Zuolo D, Buontempo S, Cavallo N, De Iorio A, Fabozzi F, Fienga F, Iorio AOM, Lista L, Meola S, Paolucci P, Rossi B, Sciacca C, Voevodina E, Azzi P, Bacchetta N, Bisello D, Bortignon P, Bragagnolo A, Carlin R, Checchia P, De Castro Manzano P, Dorigo T, Gasparini F, Gasparini U, Hoh SY, Layer L, Margoni M, Meneguzzo AT, Presilla M, Ronchese P, Rossin R, Simonetto F, Strong G, Tosi M, YARAR H, Zanetti M, Zotto P, Zucchetta A, Zumerle G, Aimè C, Braghieri A, Calzaferri S, Fiorina D, Montagna P, Ratti SP, Re V, Ressegotti M, Riccardi C, Salvini P, Vai I, Vitulo P, Biasini M, Bilei GM, Ciangottini D, Fanò L, Lariccia P, Mantovani G, Mariani V, Menichelli M, Moscatelli F, Piccinelli A, Rossi A, Santocchia A, Spiga D, Tedeschi T, Androsov K, Azzurri P, Bagliesi G, Bertacchi V, Bianchini L, Boccali T, Castaldi R, Ciocci MA, Dell’Orso R, Domenico MRD, Donato S, Giannini L, Giassi A, Grippo MT, Ligabue F, Manca E, Mandorli G, Messineo A, Palla F, Ramirez-Sanchez G, Rizzi A, Rolandi G, Chowdhury SR, Scribano A, Shafiei N, Spagnolo P, Tenchini R, Tonelli G, Turini N, Venturi A, Verdini PG, Cavallari F, Cipriani M, Re DD, Marco ED, Diemoz M, Longo E, Meridiani P, Organtini G, Pandolfi F, Paramatti R, Quaranta C, Rahatlou S, Rovelli C, Santanastasio F, Soffi L, Tramontano R, Amapane N, Arcidiacono R, Argiro S, Arneodo M, Bartosik N, Bellan R, Bellora A, Antequera JB, Biino C, Cappati A, Cartiglia N, Cometti S, Costa M, Covarelli R, Demaria N, Kiani B, Legger F, Mariotti C, Maselli S, Migliore E, Monaco V, Monteil E, Monteno M, Obertino MM, Ortona G, Pacher L, Pastrone N, Pelliccioni M, Angioni GLP, Ruspa M, Salvatico R, Siviero F, Sola V, Solano A, Soldi D, Staiano A, Tornago M, Trocino D, Belforte S, Candelise V, Casarsa M, Cossutti F, Da Rold A, Ricca GD, Vazzoler F, Dogra S, Huh C, Kim B, Kim DH, Kim GN, Lee J, Lee SW, Moon CS, Oh YD, Pak SI, Radburn-Smith BC, Sekmen S, Yang YC, Kim H, Moon DH, Francois B, Kim TJ, Park J, Cho S, Choi S, Go Y, Ha S, Hong B, Lee K, Lee KS, Lim J, Park J, Park SK, Yoo J, Goh J, Gurtu A, Kim HS, Kim Y, Almond J, Bhyun JH, Choi J, Jeon S, Kim J, Kim JS, Ko S, Kwon H, Lee H, Lee K, Lee S, Nam K, Oh BH, Oh M, Oh SB, Seo H, Yang UK, Yoon I, Jeon D, Kim JH, Ko B, Lee JSH, Park IC, Roh Y, Song D, Watson IJ, Yoo HD, Choi Y, Hwang C, Jeong Y, Lee H, Lee Y, Yu I, Maghrbi Y, Veckalns V, Juodagalvis A, Rinkevicius A, Tamulaitis G, Vaitkevicius A, Abdullah WATW, Yusli MN, Zolkapli Z, Benitez JF, Hernandez AC, Quijada JAM, Palomo LV, Ayala G, Castilla-Valdez H, De La Cruz-Burelo E, La Cruz IHD, Lopez-Fernandez R, Herrera CAM, Navarro DAP, Sanchez-Hernandez A, Moreno SC, Barrera CO, Ramirez-Garcia M, Valencia FV, Eysermans J, Pedraza I, Ibarguen HAS, Estrada CU, Pineda AM, Mijuskovic J, Raicevic N, Krofcheck D, Bheesette S, Butler PH, Ahmad A, Asghar MI, Awais A, Awan MIM, Hoorani HR, Khan WA, Shah MA, Shoaib M, Waqas M, Avati V, Grzanka L, Malawski M, Bialkowska H, Bluj M, Boimska B, Frueboes T, Górski M, Kazana M, Szleper M, Traczyk P, Zalewski P, Bunkowski K, Doroba K, Kalinowski A, Konecki M, Krolikowski J, Walczak M, Araujo M, Bargassa P, Bastos D, Boletti A, Faccioli P, Gallinaro M, Hollar J, Leonardo N, Niknejad T, Seixas J, Shchelina K, Toldaiev O, Varela J, Baginyan A, Bunin P, Ershov Y, Golunov A, Golutvin I, Gorbounov N, Gorbunov I, Kamenev A, Karjavine V, Lanev A, Malakhov A, Matveev V, Palichik V, Perelygin V, Savina M, Shalaev V, Shmatov S, Teryaev O, Voytishin N, Yuldashev BS, Zarubin A, Zhizhin I, Gavrilov G, Golovtcov V, Ivanov Y, Kim V, Kuznetsova E, Murzin V, Oreshkin V, Smirnov I, Sosnov D, Sulimov V, Uvarov L, Volkov S, Vorobyev A, Andreev Y, Dermenev A, Gninenko S, Golubev N, Karneyeu A, Kirsanov M, Krasnikov N, Pashenkov A, Pivovarov G, Tlisov D, Toropin A, Epshteyn V, Gavrilov V, Lychkovskaya N, Nikitenko A, Popov V, Safronov G, Spiridonov A, Stepennov A, Toms M, Vlasov E, Zhokin A, Aushev T, Chistov R, Danilov M, Oskin A, Parygin P, Polikarpov S, Andreev V, Azarkin M, Dremin I, Kirakosyan M, Terkulov A, Belyaev A, Boos E, Bunichev V, Dubinin M, Dudko L, Gribushin A, Klyukhin V, Kodolova O, Lokhtin I, Obraztsov S, Perfilov M, Petrushanko S, Savrin V, Blinov V, Dimova T, Kardapoltsev L, Ovtin I, Skovpen Y, Azhgirey I, Bayshev I, Kachanov V, Kalinin A, Konstantinov D, Petrov V, Ryutin R, Sobol A, Troshin S, Tyurin N, Uzunian A, Volkov A, Babaev A, Iuzhakov A, Okhotnikov V, Sukhikh L, Borchsh V, Ivanchenko V, Tcherniaev E, Adzic P, Cirkovic P, Dordevic M, Milenovic P, Milosevic J, Aguilar-Benitez M, Maestre JA, Fernández AÁ, Bachiller I, Luna MB, Bedoya CF, Cifuentes JAB, Montoya CAC, Cepeda M, Cerrada M, Colino N, De La Cruz B, Peris AD, Ramos JPF, Flix J, Fouz MC, Alonso AG, Lopez OG, Lopez SG, Hernandez JM, Josa MI, Holgado JL, Moran D, Tobar ÁN, Yzquierdo APC, Pelayo JP, Redondo I, Romero L, Navas SS, Soares MS, Triossi A, Gómez LU, Willmott C, Albajar C, de Trocóniz JF, Reyes-Almanza R, Gonzalez BA, Cuevas J, Erice C, Menendez JF, Folgueras S, Caballero IG, Cortezon EP, Álvarez CR, Sau JR, Bouza VR, Cruz SS, Trapote A, Cabrillo IJ, Calderon A, Quero BC, Campderros JD, Fernandez M, Manteca PJF, Gomez G, Rivero CM, Arbol PMRD, Matorras F, Gomez JP, Prieels C, Ricci-Tam F, Rodrigo T, Ruiz-Jimeno A, Scodellaro L, Vila I, Garcia JMV, Jayananda MK, Kailasapathy B, Sonnadara DUJ, Wickramarathna DDC, Dharmaratna WGD, Liyanage K, Perera N, Wickramage N, Aarrestad TK, Abbaneo D, Akgun B, Auffray E, Auzinger G, Baechler J, Baillon P, Ball AH, Barney D, Bendavid J, Beni N, Bianco M, Bocci A, Bossini E, Brondolin E, Camporesi T, Garrido MC, Cerminara G, Cristella L, d’Enterria D, Dabrowski A, Daci N, Daponte V, David A, De Roeck A, Deile M, Maria RD, Dobson M, Dünser M, Dupont N, Elliott-Peisert A, Emriskova N, Fallavollita F, Fasanella D, Fiorendi S, Florent A, Franzoni G, Fulcher J, Funk W, Giani S, Gigi D, Gill K, Glege F, Gouskos L, Guilbaud M, Gulhan D, Haranko M, Hegeman J, Iiyama Y, Innocente V, James T, Janot P, Kaspar J, Kieseler J, Komm M, Kratochwil N, Lange C, Laurila S, Lecoq P, Long K, Lourenço C, Malgeri L, Mallios S, Mannelli M, Meijers F, Mersi S, Meschi E, Moortgat F, Mulders M, Niedziela J, Orfanelli S, Orsini L, Pantaleo F, Pape L, Perez E, Peruzzi M, Petrilli A, Petrucciani G, Pfeiffer A, Pierini M, Quast T, Rabady D, Racz A, Rieger M, Rovere M, Sakulin H, Salfeld-Nebgen J, Scarfi S, Schäfer C, Schwick C, Selvaggi M, Sharma A, Silva P, Snoeys W, Sphicas P, Summers S, Tavolaro VR, Treille D, Tsirou A, Van Onsem GP, Vartak A, Verzetti M, Wozniak KA, Zeuner WD, Caminada L, Erdmann W, Horisberger R, Ingram Q, Kaestli HC, Kotlinski D, Langenegger U, Rohe T, Backhaus M, Berger P, Calandri A, Chernyavskaya N, De Cosa A, Dissertori G, Dittmar M, Donegà M, Dorfer C, Gadek T, Espinosa TAG, Grab C, Hits D, Lustermann W, Lyon AM, Manzoni RA, Meinhard MT, Micheli F, Nessi-Tedaldi F, Pauss F, Perovic V, Perrin G, Pigazzini S, Ratti MG, Reichmann M, Reissel C, Reitenspiess T, Ristic B, Ruini D, Becerra DAS, Schönenberger M, Stampf V, Steggemann J, Olsson MLV, Wallny R, Zhu DH, Amsler C, Botta C, Brzhechko D, Canelli MF, Burgo RD, Heikkilä JK, Huwiler M, Jofrehei A, Kilminster B, Leontsinis S, Macchiolo A, Meiring P, Mikuni VM, Molinatti U, Neutelings I, Rauco G, Reimers A, Robmann P, Schweiger K, Takahashi Y, Adloff C, Kuo CM, Lin W, Roy A, Sarkar T, Yu SS, Ceard L, Chang P, Chao Y, Chen KF, Chen PH, Hou WS, Li YY, Lu RS, Paganis E, Psallidas A, Steen A, Yazgan E, Asavapibhop B, Asawatangtrakuldee C, Srimanobhas N, Boran F, Damarseckin S, Demiroglu ZS, Dolek F, Dozen C, Dumanoglu I, Eskut E, Gokbulut G, Guler Y, Guler EG, Hos I, Isik C, Kangal EE, Kara O, Topaksu AK, Kiminsu U, Onengut G, Ozdemir K, Polatoz A, Simsek AE, Tali B, Tok UG, Turkcapar S, Zorbakir IS, Zorbilmez C, Isildak B, Karapinar G, Ocalan K, Yalvac M, Atakisi IO, Gülmez E, Kaya M, Kaya O, Özçelik Ö, Tekten S, Yetkin EA, Cakir A, Cankocak K, Komurcu Y, Sen S, Sen FA, Cerci S, Kaynak B, Ozkorucuklu S, Cerci DS, Grynyov B, Levchuk L, Bhal E, Bologna S, Brooke JJ, Clement E, Cussans D, Flacher H, Goldstein J, Heath GP, Heath HF, Kreczko L, Krikler B, Paramesvaran S, Sakuma T, Nasr-Storey SSE, Smith VJ, Stylianou N, Taylor J, Titterton A, Bell KW, Belyaev A, Brew C, Brown RM, Cockerill DJA, Ellis KV, Harder K, Harper S, Linacre J, Manolopoulos K, Newbold DM, Olaiya E, Petyt D, Reis T, Schuh T, Shepherd-Themistocleous CH, Thea A, Tomalin IR, Williams T, Bainbridge R, Bloch P, Bonomally S, Borg J, Breeze S, Buchmuller O, Bundock A, Cepaitis V, Chahal GS, Colling D, Dauncey P, Davies G, Negra MD, Fedi G, Hall G, Iles G, Langford J, Lyons L, Magnan AM, Malik S, Martelli A, Milosevic V, Nash J, Palladino V, Pesaresi M, Raymond DM, Richards A, Rose A, Scott E, Seez C, Shtipliyski A, Stoye M, Tapper A, Uchida K, Virdee T, Wardle N, Webb SN, Winterbottom D, Zecchinelli AG, Cole JE, Hobson PR, Khan A, Kyberd P, Mackay CK, Reid ID, Teodorescu L, Zahid S, Abdullin S, Brinkerhoff A, Call K, Caraway B, Dittmann J, Hatakeyama K, Kanuganti AR, Madrid C, McMaster B, Pastika N, Sawant S, Smith C, Wilson J, Bartek R, Dominguez A, Uniyal R, Hernandez AMV, Buccilli A, Charaf O, Cooper SI, Gleyzer SV, Henderson C, Rumerio P, West C, Akpinar A, Albert A, Arcaro D, Cosby C, Demiragli Z, Gastler D, Rohlf J, Salyer K, Sperka D, Spitzbart D, Suarez I, Yuan S, Zou D, Benelli G, Burkle B, Coubez X, Cutts D, Duh YT, Hadley M, Heintz U, Hogan JM, Kwok KHM, Laird E, Landsberg G, Lau KT, Lee J, Narain M, Sagir S, Syarif R, Usai E, Wong WY, Yu D, Zhang W, Band R, Brainerd C, Breedon R, De La BarcaSanchez MC, Chertok M, Conway J, Conway R, Cox PT, Erbacher R, Flores C, Funk G, Jensen F, Ko W, Kukral O, Lander R, Mulhearn M, Pellett D, Pilot J, Shi M, Taylor D, Tos K, Tripathi M, Yao Y, Zhang F, Bachtis M, Cousins R, Dasgupta A, Hamilton D, Hauser J, Ignatenko M, Lam T, Mccoll N, Nash WA, Regnard S, Saltzberg D, Schnaible C, Stone B, Valuev V, Burt K, Chen Y, Clare R, Gary JW, Hanson G, Karapostoli G, Long OR, Manganelli N, Negrete MO, Paneva MI, Si W, Wimpenny S, Zhang Y, Branson JG, Chang P, Cittolin S, Cooperstein S, Deelen N, Duarte J, Gerosa R, Gilbert D, Krutelyov V, Letts J, Masciovecchio M, May S, Padhi S, Pieri M, Sharma V, Tadel M, Würthwein F, Yagil A, Amin N, Campagnari C, Citron M, Dorsett A, Dutta V, Incandela J, Marsh B, Mei H, Ovcharova A, Qu H, Quinnan M, Richman J, Sarica U, Stuart D, Wang S, Bornheim A, Cerri O, Dutta I, Lawhorn JM, Lu N, Mao J, Newman H, Ngadiuba J, Nguyen TQ, Pata J, Spiropulu M, Vlimant JR, Wang C, Xie S, Zhang Z, Zhu RY, Alison J, Andrews MB, Ferguson T, Mudholkar T, Paulini M, Sun M, Vorobiev I, Cumalat JP, Ford WT, MacDonald E, Mulholland T, Patel R, Perloff A, Stenson K, Ulmer KA, Wagner SR, Alexander J, Cheng Y, Chu J, Cranshaw DJ, Datta A, Frankenthal A, Mcdermott K, Monroy J, Patterson JR, Quach D, Ryd A, Sun W, Tan SM, Tao Z, Thom J, Wittich P, Zientek M, Albrow M, Alyari M, Apollinari G, Apresyan A, Apyan A, Banerjee S, Bauerdick LAT, Beretvas A, Berry D, Berryhill J, Bhat PC, Burkett K, Butler JN, Canepa A, Cerati GB, Cheung HWK, Chlebana F, Cremonesi M, Elvira VD, Freeman J, Gecse Z, Gottschalk E, Gray L, Green D, Grünendahl S, Gutsche O, Harris RM, Hasegawa S, Heller R, Herwig TC, Hirschauer J, Jayatilaka B, Jindariani S, Johnson M, Joshi U, Klabbers P, Klijnsma T, Klima B, Kortelainen MJ, Lammel S, Lincoln D, Lipton R, Liu M, Liu T, Lykken J, Maeshima K, Mason D, McBride P, Merkel P, Mrenna S, Nahn S, O’Dell V, Papadimitriou V, Pedro K, Pena C, Prokofyev O, Ravera F, Hall AR, Ristori L, Schneider B, Sexton-Kennedy E, Smith N, Soha A, Spalding WJ, Spiegel L, Stoynev S, Strait J, Taylor L, Tkaczyk S, Tran NV, Uplegger L, Vaandering EW, Weber HA, Woodard A, Acosta D, Avery P, Bourilkov D, Cadamuro L, Cherepanov V, Errico F, Field RD, Guerrero D, Joshi BM, Kim M, Konigsberg J, Korytov A, Lo KH, Matchev K, Menendez N, Mitselmakher G, Rosenzweig D, Shi K, Sturdy J, Wang J, Wang S, Zuo X, Adams T, Askew A, Diaz D, Habibullah R, Hagopian S, Hagopian V, Johnson KF, Khurana R, Kolberg T, Martinez G, Prosper H, Schiber C, Yohay R, Zhang J, Baarmand MM, Butalla S, Elkafrawy T, Hohlmann M, Noonan D, Rahmani M, Saunders M, Yumiceva F, Adams MR, Apanasevich L, Gonzalez HB, Cavanaugh R, Chen X, Dittmer S, Evdokimov O, Gerber CE, Hangal DA, Hofman DJ, Mills C, Oh G, Roy T, Tonjes MB, Varelas N, Viinikainen J, Wang X, Wu Z, Ye Z, Alhusseini M, Dilsiz K, Durgut S, Gandrajula RP, Haytmyradov M, Khristenko V, Köseyan OK, Merlo JP, Mestvirishvili A, Moeller A, Nachtman J, Ogul H, Onel Y, Ozok F, Penzo A, Snyder C, Tiras E, Wetzel J, Amram O, Blumenfeld B, Corcodilos L, Eminizer M, Gritsan AV, Kyriacou S, Maksimovic P, Mantilla C, Roskes J, Swartz M, Vámi TÁ, Barrera CB, Baringer P, Bean A, Bylinkin A, Isidori T, Khalil S, King J, Krintiras G, Kropivnitskaya A, Lindsey C, Minafra N, Murray M, Rogan C, Royon C, Sanders S, Schmitz E, Takaki JDT, Wang Q, Williams J, Wilson G, Duric S, Ivanov A, Kaadze K, Kim D, Maravin Y, Mitchell T, Modak A, Mohammadi A, Rebassoo F, Wright D, Adams E, Baden A, Baron O, Belloni A, Eno SC, Feng Y, Hadley NJ, Jabeen S, Jeng GY, Kellogg RG, Koeth T, Mignerey AC, Nabili S, Seidel M, Skuja A, Tonwar SC, Wang L, Wong K, Abercrombie D, Allen B, Bi R, Brandt S, Busza W, Cali IA, Chen Y, D’Alfonso M, Ceballos GG, Goncharov M, Harris P, Hsu D, Hu M, Klute M, Kovalskyi D, Krupa J, Lee YJ, Luckey PD, Maier B, Marini AC, Mcginn C, Mironov C, Narayanan S, Niu X, Paus C, Rankin D, Roland C, Roland G, Shi Z, Stephans GSF, Sumorok K, Tatar K, Velicanu D, Wang J, Wang TW, Wang Z, Wyslouch B, Chatterjee RM, Evans A, Hansen P, Hiltbrand J, Jain S, Krohn M, Kubota Y, Lesko Z, Mans J, Revering M, Rusack R, Saradhy R, Schroeder N, Strobbe N, Wadud MA, Acosta JG, Oliveros S, Bloom K, Chauhan S, Claes DR, Fangmeier C, Finco L, Golf F, Fernández JRG, Kravchenko I, Siado JE, Snow GR, Tabb W, Yan F, Agarwal G, Bandyopadhyay H, Harrington C, Hay L, Iashvili I, Kharchilava A, McLean C, Nguyen D, Pekkanen J, Rappoccio S, Roozbahani B, Alverson G, Barberis E, Freer C, Haddad Y, Hortiangtham A, Li J, Madigan G, Marzocchi B, Morse DM, Nguyen V, Orimoto T, Parker A, Skinnari L, Tishelman-Charny A, Wamorkar T, Wang B, Wisecarver A, Wood D, Bhattacharya S, Bueghly J, Chen Z, Gilbert A, Gunter T, Hahn KA, Odell N, Schmitt MH, Sung K, Velasco M, Bucci R, Dev N, Goldouzian R, Hildreth M, Anampa KH, Jessop C, Karmgard DJ, Lannon K, Loukas N, Marinelli N, Mcalister I, Meng F, Mohrman K, Musienko Y, Ruchti R, Siddireddy P, Taroni S, Wayne M, Wightman A, Wolf M, Zygala L, Alimena J, Bylsma B, Cardwell B, Durkin LS, Francis B, Hill C, Lefeld A, Winer BL, Yates BR, Das P, Dezoort G, Elmer P, Greenberg B, Haubrich N, Higginbotham S, Kalogeropoulos A, Kopp G, Kwan S, Lange D, Lucchini MT, Luo J, Marlow D, Mei K, Ojalvo I, Olsen J, Palmer C, Piroué P, Stickland D, Tully C, Malik S, Norberg S, Barnes VE, Chawla R, Das S, Gutay L, Jones M, Jung AW, Negro G, Neumeister N, Peng CC, Piperov S, Purohit A, Qiu H, Schulte JF, Stojanovic M, Trevisani N, Wang F, Wildridge A, Xiao R, Xie W, Cheng T, Dolen J, Parashar N, Baty A, Dildick S, Ecklund KM, Freed S, Geurts FJM, Kilpatrick M, Kumar A, Li W, Padley BP, Redjimi R, Roberts J, Rorie J, Shi W, Leiton AGS, Bodek A, de Barbaro P, Demina R, Dulemba JL, Fallon C, Ferbel T, Galanti M, Garcia-Bellido A, Hindrichs O, Khukhunaishvili A, Ranken E, Taus R, Chiarito B, Chou JP, Gandrakota A, Gershtein Y, Halkiadakis E, Hart A, Heindl M, Hughes E, Kaplan S, Karacheban O, Laflotte I, Lath A, Montalvo R, Nash K, Osherson M, Salur S, Schnetzer S, Somalwar S, Stone R, Thayil SA, Thomas S, Wang H, Acharya H, Delannoy AG, Spanier S, Bouhali O, Dalchenko M, Delgado A, Eusebi R, Gilmore J, Huang T, Kamon T, Kim H, Luo S, Malhotra S, Mueller R, Overton D, Perniè L, Rathjens D, Safonov A, Akchurin N, Damgov J, Hegde V, Kunori S, Lamichhane K, Lee SW, Mengke T, Muthumuni S, Peltola T, Undleeb S, Volobouev I, Wang Z, Whitbeck A, Appelt E, Greene S, Gurrola A, Janjam R, Johns W, Maguire C, Melo A, Ni H, Padeken K, Romeo F, Sheldon P, Tuo S, Velkovska J, Arenton MW, Cox B, Cummings G, Hakala J, Hirosky R, Joyce M, Ledovskoy A, Li A, Neu C, Tannenwald B, Wang Y, Wolfe E, Xia F, Karchin PE, Poudyal N, Thapa P, Black K, Bose T, Buchanan J, Caillol C, Dasu S, De Bruyn I, Everaerts P, Galloni C, He H, Herndon M, Hervé A, Hussain U, Lanaro A, Loeliger A, Loveless R, Sreekala JM, Mallampalli A, Pinna D, Savin A, Shang V, Sharma V, Smith WH, Teague D, Trembath-reichert S, Vetens W. Search for low-mass dilepton resonances in Higgs boson decays to four-lepton final states in proton-proton collisions at s = 13 TeV

A search for low-mass dilepton resonances in Higgs boson decays is conducted in the four-lepton final state. The decay is assumed to proceed via a pair of beyond the standard model particles, or one such particle and a Z boson. The search uses proton-proton collision data collected with the CMS detector at the CERN LHC, corresponding to an integrated luminosity of 137 fb - 1 , at a center-of-mass energy s = 13 TeV . No significant deviation from the standard model expectation is observed. Upper limits at 95% confidence level are set on model-independent Higgs boson decay branching fractions. Additionally, limits on dark photon and axion-like particle production, based on two specific models, are reported.

Measurement of Lepton-Jet Correlation in Deep-Inelastic Scattering with the H1 Detector Using Machine Learning for Unfolding

The first measurement of lepton-jet momentum imbalance and azimuthal correlation in lepton-proton scattering at high momentum transfer is presented. These data, taken with the H1 detector at HERA, are corrected for detector effects using an unbinned machine learning algorithm (multifold), which considers eight observables simultaneously in this first application. The unfolded cross sections are compared with calculations performed within the context of collinear or transverse-momentum-dependent factorization in quantum chromodynamics as well as Monte Carlo event generators.

Probing the Gluonic Structure of the Deuteron with J/ψ Photoproduction in d+Au Ultraperipheral Collisions

Understanding gluon density distributions and how they are modified in nuclei are among the most important goals in nuclear physics. In recent years, diffractive vector meson production measured in ultraperipheral collisions (UPCs) at heavy-ion colliders has provided a new tool for probing the gluon density. In this Letter, we report the first measurement of J/ψ photoproduction off the deuteron in UPCs at the center-of-mass energy sqrt[s_{NN}]=200  GeV in d+Au collisions. The differential cross section as a function of momentum transfer -t is measured. In addition, data with a neutron tagged in the deuteron-going zero-degree calorimeter is investigated for the first time, which is found to be consistent with the expectation of incoherent diffractive scattering at low momentum transfer. Theoretical predictions based on the color glass condensate saturation model and the leading twist approximation nuclear shadowing model are compared with the data quantitatively. A better agreement with the saturation model has been observed. With the current measurement, the results are found to be directly sensitive to the gluon density distribution of the deuteron and the deuteron breakup process, which provides insights into the nuclear gluonic structure.

Using Z Boson Events to Study Parton-Medium Interactions in Pb-Pb Collisions

The spectra measurements of charged hadrons produced in the shower of a parton originating in the same hard scattering with a leptonically decaying Z boson are reported in lead-lead nuclei (Pb-Pb) and proton-proton (pp) collisions at a nucleon-nucleon center-of-mass energy of 5.02 TeV. Both Pb-Pb and pp data sets are recorded by the CMS experiment at the LHC and correspond to an integrated luminosity of 1.7  nb^{-1} and 320  pb^{-1}, respectively. Hadronic collision data with one reconstructed Z boson candidate with the transverse momentum p_{T}>30  GeV/c are analyzed. The Z boson constrains the initial energy and direction of the associated parton. In heavy ion events, azimuthal angular distributions of charged hadrons with respect to the direction of a Z boson are sensitive to modifications of the in-medium parton shower and medium response. compared to reference data from pp interactions, the results for central Pb-Pb collisions indicate a modification of the angular correlations. The measurements of the fragmentation functions and p_{T} spectra of charged particles in Z boson events, which are sensitive to medium modifications of the parton shower longitudinal structure, are also reported. Significant modifications in central Pb-Pb events compared to the pp reference data are also found for these observables.

Search for strongly interacting massive particles generating trackless jets in proton-proton collisions at s = 13 TeV

A search for dark matter in the form of strongly interacting massive particles (SIMPs) using the CMS detector at the LHC is presented. The SIMPs would be produced in pairs that manifest themselves as pairs of jets without tracks. The energy fraction of jets carried by charged particles is used as a key discriminator to suppress efficiently the large multijet background, and the remaining background is estimated directly from data. The search is performed using proton-proton collision data corresponding to an integrated luminosity of 16.1 fb - 1 , collected with the CMS detector in 2016. No significant excess of events is observed above the expected background. For the simplified dark matter model under consideration, SIMPs with masses up to 100 GeV are excluded and further sensitivity is explored towards higher masses.

[Analysis of articles on dental pulp biology research in China published in international journals from 2011 to 2020]

Objective: To analyze the articles on research of dental pulp biology in China and to understand the situation of China in the entire field of dental pulp biology around the world in order to provide references for further in-depth research in dental pulp biology in China. Methods: Based on Web of Science core collection database, the articles published in the international journals in the field of dental pulp biology from 2011 to 2020 were retrieved and identified. Six indicators including research scale, academic influence, high-ranking and the high-influence journals, research areas, international partnership and project funding were statistically analyzed. Results: Totally 1 215 articles were published by Chinese researchers, which is the most in the research field of dental pulp biology. The total number of citations was 18 328, however the average number of citations of above mentioned articles was slightly lower than that of the world average. The number of articles published in Natural Index Journals and Journal of Dental Research is lower than that of the United States. The research areas of dental pulp biology in China were not only in dentistry, oral surgery and medicine, but also in cell biology, experimental medicine, materials science, engineering, molecular biology and applied microbiology. Articles of internationally cooperated researches were scarce. Most of the researches of dental pulp biology field conducted in China were supported by the National Natural Science Foundation of China. Conclusions: Although there were fruitful research outcomes in the field of dental pulp biology from 2011 to 2020, the academic influence of these researches still needed to be improved. It was recommended that great efforts should be made in developing interdisciplinary, inter-unit and international cooperation, focusing on hotspot and major projects, actively applying for and using of project fundings in order to produce more high-quality research outcomes.

Search for the Chiral Magnetic Effect via Charge-Dependent Azimuthal Correlations Relative to Spectator and Participant Planes in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

The chiral magnetic effect (CME) refers to charge separation along a strong magnetic field due to imbalanced chirality of quarks in local parity and charge-parity violating domains in quantum chromodynamics. The experimental measurement of the charge separation is made difficult by the presence of a major background from elliptic azimuthal anisotropy. This background and the CME signal have different sensitivities to the spectator and participant planes, and could thus be determined by measurements with respect to these planes. We report such measurements in Au+Au collisions at a nucleon-nucleon center-of-mass energy of 200 GeV at the Relativistic Heavy-Ion Collider. It is found that the charge separation, with the flow background removed, is consistent with zero in peripheral (large impact parameter) collisions. Some indication of finite CME signals is seen in midcentral (intermediate impact parameter) collisions. Significant residual background effects may, however, still be present.

Fiber Spinning with Molecular Models

The isothermal fiber spinning of ciscoelastic liquid is analyzed successfully by means of the Curtiss-Bird integral constitutive equation derived from molecular theory, Glaerkin/finite element method, and Newton iteration. The analysis accounts for shear and elongational prehistories, and specified draw ratio or drawing force. Solutions are obtained at high values of elasticity, draw ratio and drawing force. The predictions agree with the analytic solution for Newtonian liquid in the limit of zero relaxation time and with experimental data from the literature on spinning of polystyrene and polypropylene melts.

Dlx3 Ubiquitination by Nuclear Mdm2 Is Essential for Dentinogenesis in Mice

Dentin is a major mineralized component of teeth. Odontoblasts are responsible for synthesis and secretion of dentin matrix. Previously, it has been demonstrated in a cell culture system that the E3 ubiquitin ligase, murine double minute 2 (Mdm2), promotes odontoblast-like differentiation of mouse dental papilla cells (mDPCs) by ubiquitinating p53 and the odontoblast-specific substrate Dlx3. However, whether Mdm2 plays an essential role in vivo in odontoblast differentiation and dentin formation remains unknown. In this study, we investigated the in vivo functions of Mdm2 using Dmp1-Cre;Mdm2 flox/flox mice combined with multiple histological and molecular biological methods. The results showed that Mdm2 deletion in the odontoblast layer led to defects in odontoblast differentiation and dentin formation. Unexpectedly, specific inhibition of the Mdm2-p53 axis in wild-type mice by injection of a small-molecule inhibitor Nutlin-3a indicated that the role of Mdm2 in dentinogenesis was p53 independent, which was inconsistent with the previous in vitro study. In situ proximity ligation assay (PLA) showed that Mdm2 interacted with and ubiquitinated Dlx3 in the odontoblast nucleus of mouse molars. Dlx3 promoted the translocation of Mdm2 to the nucleus, and in turn, the nuclear Mdm2 mediated ubiquitination of Dlx3 and promoted the odontoblast-like differentiation of mDPCs. Dlx3 interacted with Mdm2 through its C-terminal domain. Deletion of the C-terminal domain of Dlx3 reversed the enhanced odontoblast-like differentiation and the activation of Dspp promoter mediated by overexpression of wild-type or nuclear Mdm2. Our findings suggest that nuclear Mdm2 mediates ubiquitination of the transcription factor Dlx3, which is essential for Dlx3 transcriptional activity on Dspp as well as subsequent odontoblast differentiation and dentin formation.

Measurement of the Inclusive and Differential Higgs Boson Production Cross Sections in the Decay Mode to a Pair of τ Leptons in pp Collisions at sqrt[s]=13 TeV

Measurements of the inclusive and differential fiducial cross sections of the Higgs boson are presented, using the τ lepton decay channel. The differential cross sections are measured as functions of the Higgs boson transverse momentum, jet multiplicity, and transverse momentum of the leading jet in the event, if any. The analysis is performed using proton-proton collision data collected with the CMS detector at the LHC at a center-of-mass energy of 13  TeV and corresponding to an integrated luminosity of 138  fb^{-1}. These are the first differential measurements of the Higgs boson cross section in the final state of two τ leptons. In final states with a large jet multiplicity or with a Lorentz-boosted Higgs boson, these measurements constitute a significant improvement over measurements performed in other final states.

Search for long-lived particles decaying to leptons with large impact parameter in proton-proton collisions at s = 13 Te

A search for new long-lived particles decaying to leptons using proton-proton collision data produced by the CERN LHC at s = 13 Te is presented. Events are selected with two leptons (an electron and a muon, two electrons, or two muons) that both have transverse impact parameter values between 0.01 and 10 cm and are not required to form a common vertex. Data used for the analysis were collected with the CMS detector in 2016, 2017, and 2018, and correspond to an integrated luminosity of 118 (113) fb - 1 in the e e channel ( e μ and μ μ channels). The search is designed to be sensitive to a wide range of models with displaced e μ , e e , and μ μ final states. The results constrain several well-motivated models involving new long-lived particles that decay to displaced leptons. For some areas of the available phase space, these are the most stringent constraints to date.

[Epidemiological trends of schistosomiasis in Poyang County of Jiangxi Province from 2004 to 2020 based on the Joinpoint regression model]

OBJECTIVE

To analyze the dynamic changes of schistosomiasis in Poyang County of Jiangxi Province from 2004 to 2020, so as to provide insight into the development of the schistosomiasis elimination strategy.

METHODS

Schistosomiasis control data were captured from Poyang County from 2004 to 2020, and the epidemiological data of schistosomiasis were collected from national schistosomiasis surveillance sites in Poyang County from 2005 to 2020. The endemic status of schistosomiasis was analyzed in Poyang County from 2004 to 2020, and a Joinpoint regression analysis was performed to investigate the trends of schistosomiasis in Poyang County from 2004 to 2020.

RESULTS

The sero-prevalence and egg-prevalence of human Schistosoma japonicum infections reduced from 24.39% (24 976/102 397) and 4.53% (259/5 721) in 2004 to 5.37% (2 421/45 100) [annual percent change (APC) = average annual percent change (AAPC) = -8.64%] and 0 (0/3 963) in 2020 (APC = AAPC = -32.07%) in Poyang County, and the trends were both significant (both P < 0.01). The sero-prevalence of S. japonicum infections reduced from 1.21% (294/24 332) in bovines in 2013 to 0.58% (35/5 999) in 2020 in Poyang County, with one turning point (AAPC = -8.20%, P > 0.05). There were no townships or villages with emerging snail habitats in Poyang County from 2004 to 2020, and there were three turning points of trend in the proportion of snail areas detected in total snail areas (AAPC = -2.30%, P > 0.01). The sero-prevalence and adjusted prevalence of S. japonicum infections reduced from 60.82% (742/1 220) and 10.16% (124/1 220) in local residents in 2005 to 5.73% (70/1 221) and 0 in 2020 in national schistosomiasis surveillance sites of Poyang County, and the trends for sero-prevalence (APC = AAPC = 17.47%, P < 0.01) and adjusted prevalence of S. japonicum infections (APC = AAPC = -44.92%, P < 0.01) were both statistically significant. S. japonicum infections were identified in 10 (2005) and 2 local livestock (2007), with prevalence of 10.00% (10/100) and 13.33% (2/15), respectively, and S. japonicum infections were detected in snails in 2008 and 2009; however, no positive samples of mixed O. hupensis were detected by loop-mediated isothermal amplification.

CONCLUSIONS

The endemic situation of schistosomiasis control had remarkably reduced in Poyang County from 2004 to 2020; however, there are still challenges for consolidating schistosomiasis control achievements and even elimination of schistosomiasis.

Unique motif shared by HLA-B*59:01 and HLA-B*55:02 is associated with methazolamide-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Han Chinese

BACKGROUND

Methazolamide (MTZ) has been occasionally linked to the lethal Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are associated with HLA-B*59:01. However, some MTZ-induced SJS/TEN (MTZ-SJS/TEN) cases are negative for HLA-B*59:01, implying that other genetic factors besides HLA-B*59:01 are contributing to MTZ-SJS/TEN.

OBJECTIVES

To comprehensively identify HLA and non-HLA genetic susceptibility to MTZ-SJS/TEN in Han Chinese.

METHODS

Eighteen patients with MTZ-SJS/TEN, 806 subjects of the population control and 74 MTZ-tolerant individuals were enrolled in this study. Both exome-wide and HLA-based association studies were conducted. Molecular docking analysis was employed to simulate the interactions between MTZ and risk HLA proteins.

RESULTS

We found a strong signal in the major histocompatibility complex region on chromosome 6 with 22 SNPs reaching exome-wide significance. Compared with MTZ-tolerant controls, a significant association of HLA-B*59:01 with MTZ-SJS/TEN was validated (odds ratio [OR] = 146.00, 95% confidence interval [CI]: 16.12-1321.98; P = 6.19 × 10^-10 ). Moreover, 66.7% of MTZ-SJS/TEN patients negative for HLA-B*59:01 were carriers of HLA-B*55:02, while 2.7% of the tolerant individuals were observed with HLA-B*55:02 (OR = 71.00, 95% CI: 7.84-643.10; P = 1.43 × 10^-4 ). Within HLA-B protein, the E45-L116 motif could completely explain the association of HLA-B*59:01 and HLA-B*55:02 with MTZ-SJS/TEN (OR = 119.33, 95% CI: 29.19-1227.96; P = 4.36 × 10^-13 ). Molecular docking analysis indicated that MTZ binds more stably to the pocket of HLA-B*59:01 and HLA-B*55:02 than to that of non-risk alleles of HLA-B*40:01 and HLA-C*01:02.

CONCLUSIONS

This study confirmed the association of HLA-B*59:01 with MTZ-SJS/TEN and identified HLA-B*55:02 as a novel risk allele in Han Chinese with the largest sample size to date. Notably, the rs41562914(A)-rs12697944(A) haplotype, encoding E45-L116, is capable of serving as a powerful genetic predictor for MTZ-SJS/TEN with a sensitivity of 89% and specificity of 96%.

Search for Relativistic Magnetic Monopoles with Eight Years of IceCube Data

We present an all-sky 90% confidence level upper limit on the cosmic flux of relativistic magnetic monopoles using 2886 days of IceCube data. The analysis was optimized for monopole speeds between 0.750c and 0.995c, without any explicit restriction on the monopole mass. We constrain the flux of relativistic cosmic magnetic monopoles to a level below 2.0×10^{-19}  cm^{-2} s^{-1} sr^{-1} over the majority of the targeted speed range. This result constitutes the most strict upper limit to date for magnetic monopoles with β≳0.8 and up to β∼0.995 and fills the gap between existing limits on the cosmic flux of nonrelativistic and ultrarelativistic magnetic monopoles.

Iodine-125 brachytherapy for the treatment of central mucoepidermoid carcinoma of the jaw in a pre-teen

Central mucoepidermoid carcinoma (MEC) of the jaw is a rare malignant neoplasm, even rarer in teenagers. Radical surgical resection, such as en bloc resection or segmental resection, is the main treatment for MEC of the jaw. This surgical treatment results in a loss of integrity of the jaw. The successful application of iodine-125 brachytherapy for the treatment of intraosseous MEC of the mandible in an 11-year-old girl is reported here. No local recurrence or distant metastasis was observed during 6 years of follow-up. The integrity of the mandible was preserved and the development of the mandible was not significantly affected. Iodine-125 brachytherapy is a potential alternative treatment for central mucoepidermoid carcinoma of the jaw, especially in teenagers, and may preserve the continuity and function of the jaw.

Genetic analyses of blood β-hydroxybutyrate predicted from milk infrared spectra and its association with longevity and female reproductive traits in Holstein cattle

Ketosis is one of the most prevalent and complex metabolic disorders in high-producing dairy cows and usually detected through analyses of β-hydroxybutyrate (BHB) concentration in blood. Our main objectives were to evaluate genetic parameters for blood BHB predicted based on Fourier-transform mid-infrared spectra from 5 to 305 d in milk, and estimate the genetic relationships of blood BHB with 7 reproduction traits and 6 longevity traits in Holstein cattle. Predicted blood BHB records of 11,609 Holstein cows (after quality control) were collected from 2016 to 2019 and used to derive 4 traits based on parity number, including predicted blood BHB in all parities (BHBp), parity 1 (BHB1), parity 2 (BHB2), and parity 3+ (BHB3). Single- and multitrait repeatability models were used for estimating genetic parameters for the 4 BHB traits. Random regression test-day models implemented via Bayesian inference were used to evaluate the daily genetic feature of BHB variability. In addition, genetic correlations were calculated for the 4 BHB traits with reproduction and longevity traits. The heritability estimates of BHBp, BHB1, BHB2, and BHB3 ranged from 0.100 ± 0.026 (± standard error) to 0.131 ± 0.023. The BHB in parities 1 to 3+ were highly genetically correlated and ranged from 0.788 (BHB1 and BHB2) to 0.911 (BHB1 and BHB3). The daily heritability of BHBp ranged from 0.069 to 0.195, higher for the early and lower for the later lactation periods. A similar trend was observed for BHB1, BHB2, and BHB3. There are low direct genetic correlations between BHBp and selected reproductive performance and longevity traits, which ranged from -0.168 ± 0.019 (BHBp and production life) to 0.157 ± 0.019 (BHBp and age at first calving) for the early lactation stage (5 to 65 d). These direct genetic correlations indicate that cows with higher BHBp (greater likelihood of having ketosis) in blood usually have shorter production life (-0.168 ± 0.019). Cows with higher fertility and postpartum recovery, such as younger age at first calving (0.157 ± 0.019) and shorter interval from calving to first insemination in heifer (0.111 ± 0.006), usually have lower BHB concentration in the blood. Furthermore, the direct genetic correlations change across parity and lactation stage. In general, our results suggest that selection for lower predicted BHB in early lactation could be an efficient strategy for reducing the incidence of ketosis as well as indirectly improving reproductive and longevity performance in Holstein cattle.

A new approach for contralateral C7 nerve transfer via retrospinal route

Anterior and posterior approaches exist for the treatment of spinal pathologies. Anatomically, the 7th cervical spinal nerve(C7)crosses the C6-C7 intervertebral foramen bilaterally, allowing contralateral prevertebral or posterior C7 nerve transfer to be used. The advantage of the posterior rather than the anterior spinal approach is that it does not require retraction of important blood vessels, nerves, or other structures. In this paper, we describe transfer of the contralateral C7 nerve using a posterior approach.

[Chronic cough in China: progress and perspectives]

Great progress has been made in regard of mechanism, etiological diagnosis and treatment of chronic cough since the beginning of the 20th century, and Chinese guidelines of diagnosis, management of cough was developed. Moreover, Chinese experts also participated in the formulation of international cough guidelines. Through the promotion of the guidelines, the level of diagnosis and treatment of chronic cough has been significantly improved in China. In the future, we should strengthen the studies on the epidemiology of chronic cough, the central regulation of chronic cough, and the treatment of refractory chronic cough, and promote the cough guidelines in primary community hospitals.

[Bioactive materials in endodontics]

Bioactive materials is defined as substances that elicit special chemical bonding at the interface between tissues and the material. In recent years, more and more bioactive materials have emerged in endodontic treatment. The present article introduces the definition, classification and application of bioactive materials in endodontics. Combined with evidence-based medicine and bioactive materials, optimum treatment recommendations for various endodontic diseases are provided and the development trend of bioactive materials in endodontics is also discussed.

D-Galactose-Induced Accelerated Aging Model on Auditory Cortical Neurons by Regulating Oxidative Stress and Apoptosis in Vitro

OBJECTIVES

Age-related hearing loss (ARHL) is much more prevalent with age, affecting not only peripheral but central auditory system. We have previously established an aging model of peripheral auditory system in vitro using cultured cochlear basilar membrane. However, there is no ideal accelerated aging model on central auditory system in vitro. To establish the aging model, auditory cortical neurons (ACNs) were primary cultured and treated with either vehicle or different doses of D-galactose (D-gal). We studied the effect of D-gal on ACNs by evaluating the hallmarks of aging, including cell proliferation, oxidative stress, mitochondrial function, and neuronal apoptosis. Compared with the control group, cell viability was significantly inhibited in the D-gal-treated group in a dose-dependent manner. The production of reactive oxygen species was strongly increased in the D-gal-treated group. Meanwhile, the level of 8-hydroxy-2'-deoxyguanosine, which is a biomarker of DNA oxidative damage, was even higher in the D-gal-treated group than that in the control group. Conversely, the levels of ATP and mitochondrial membrane potential were notably decreased in the D-gal-treated group contrast to that in the control group. Furthermore, the number of neuronal apoptosis in the D-gal-treated group, compared with that in the control group, was dramatically increased in a dose-dependent approach. Together, our results demonstrate that ACNs treated with D-gal in vitro display senescence characteristics by regulating oxidative stress and apoptosis, indicating accelerated aging model on ACNs are successfully established. And the model provides a promising approach for exploring underlying mechanisms of the ARHL.

Accuracy of in vivo microCT imaging in assessing the microstructural properties of the mouse tibia subchondral bone

Osteoarthritis (OA) is one of the most common musculoskeletal diseases. OA is characterized by degeneration of the articular cartilage as well as the underlying subchondral bone. Post-traumatic osteoarthritis (PTOA) is a subset of OA caused by mechanical trauma. Mouse models, such as destabilization of the medial meniscus (DMM), are useful to study PTOA. Ex vivo micro-Computed Tomography (microCT) imaging is the predominant technique used to scan the mouse knee in OA studies. Nevertheless, in vivo microCT enables the longitudinal assessment of bone microstructure, reducing measurement variability and number of animals required. The effect of image resolution in measuring subchondral bone parameters was previously evaluated only for a limited number of parameters. The aim of this study was to evaluate the ability of in vivo microCT imaging in measuring the microstructural properties of the mouse tibia trabecular and cortical subchondral bone, with respect to ex vivo high resolution imaging, in a DMM model of PTOA. Sixteen male C57BL/6J mice received DMM surgery or sham operation at 14 weeks of age (N=8 per group). The right knee of each mouse was microCT scanned in vivo (10.4μm voxel size) and ex vivo (4.35μm voxel size) at the age of 26 weeks. Each image was aligned to a reference image using rigid registration. The subchondral cortical bone plate thickness was measured at the lateral and medial condyles. Standard morphometric parameters were measured in the subchondral trabecular bone. In vivo microCT imaging led to significant underestimation of bone volume fraction (-14%), bone surface density (-3%) and trabecular number (-16%), whereas trabecular thickness (+3%) and separation (+5%) were significantly overestimated. Nevertheless, most trabecular parameters measured in vivo were well correlated with ex vivo measurements (R^{2 =} 0.69-0.81). Degree of anisotropy, structure model index and connectivity density were measured in vivo with lower accuracy. Excellent accuracy was found for cortical thickness measurements. In conclusion, this study identified what bone morphological parameters can be reliably measured by in vivo microCT imaging of the subchondral bone in the mouse tibia. It highlights that this approach can be used to study longitudinal effects of diseases and treatments on the subchondral cortical bone and on most subchondral trabecular bone parameters, but systematic over- or under-estimations should be considered when interpreting the results.

Search for Long-Lived Particles Decaying in the CMS End Cap Muon Detectors in Proton-Proton Collisions at sqrt[s]=13 TeV

A search for long-lived particles (LLPs) produced in decays of standard model (SM) Higgs bosons is presented. The data sample consists of 137  fb^{-1} of proton-proton collisions at sqrt[s]=13  TeV, recorded at the LHC in 2016-2018. A novel technique is employed to reconstruct decays of LLPs in the end cap muon detectors. The search is sensitive to a broad range of LLP decay modes and to masses as low as a few GeV. No excess of events above the SM background is observed. The most stringent limits to date on the branching fraction of the Higgs boson to LLPs subsequently decaying to quarks and τ^{+}τ^{-} are found for proper decay lengths greater than 6, 20, and 40 m, for LLP masses of 7, 15, and 40 GeV, respectively.

Measurement of the Sixth-Order Cumulant of Net-Proton Multiplicity Distributions in Au+Au Collisions at sqrt[s_{NN}]=27, 54.4, and 200 GeV at RHIC

According to first-principle lattice QCD calculations, the transition from quark-gluon plasma to hadronic matter is a smooth crossover in the region μ_{B}≤T_{c}. In this range the ratio, C_{6}/C_{2}, of net-baryon distributions are predicted to be negative. In this Letter, we report the first measurement of the midrapidity net-proton C_{6}/C_{2} from 27, 54.4, and 200 GeV Au+Au collisions at the Relativistic Heavy Ion Collider (RHIC). The dependence on collision centrality and kinematic acceptance in (p_{T}, y) are analyzed. While for 27 and 54.4 GeV collisions the C_{6}/C_{2} values are close to zero within uncertainties, it is observed that for 200 GeV collisions, the C_{6}/C_{2} ratio becomes progressively negative from peripheral to central collisions. Transport model calculations without critical dynamics predict mostly positive values except for the most central collisions within uncertainties. These observations seem to favor a smooth crossover in the high-energy nuclear collisions at top RHIC energy.

[Photothermal effect of nano-copper sulfide against tongue squamous cell carcinoma]

OBJECTIVE

To investigate the anti-tumor effect of BSA@CuS-PEG nanocomposites on tongue squamous cell carcinoma.

METHODS

Transmission electron microscopy, dynamic light scattering, Zeta potential and ultraviolet absorption spectroscopy were used to characterize the synthesized BSA@CuS-PEG nanocomposite, whose photothermal properties was assessed with near infrared Ⅱ region excitation light (1064 nm). The cytotoxicity of the nanocomposite in Cal27 and SCC9 cells was evaluated using CCK-8 assay, and its effect on cell cycle distribution was analyzed using flow cytometry. The in vivo antitumor effect of BSA@CuS-PEG was investigated in a Balb/c mouse model bearing subcutaneous Cal27 tumor xenograft.

RESULTS

The synthesized BSA@CuS-PEG nanocomposite showed a temperature variation (ΔT) of about 30 ℃ under near-infrared (NIR) irradiation (0.5 W/cm2), suggesting its excellent photothermal sensitivity. CCK-8 assay showed that BSA@CuS-PEG had no significant toxicity to tumor cells, but upon NIR irradiation, the nanocomposite produced a significant stronger inhibitory effect on Cal27 and SCC9 cells than free nanocomposites (P < 0.001). Cell cycle analysis showed that compared with free nanocomposites, BSA@CuS-PEG plus NIR irradiation caused more obvious cell cycle arrest at G2/M phase in tongue cancer cells (P < 0.001). In the tumor-bearing mice, BSA@CuS-PEG combined with NIR irradiation produced a significant anti-tumor effect as compared with saline treatment plus NIR irradiation (P < 0.001).

CONCLUSION

The BSA@CuS-PEG nanocomposite shows prominent photothermal properties and good anti-tumor effects both in vivo and in vitro, and thus provides a promising method for non-invasive early diagnosis and non-surgical treatment of primary tongue cancer.

Realizing topologically ordered states on a quantum processor

[Figure: see text].

Application of a shear-wave elastography prediction model to distinguish between benign and malignant breast lesions and the adjustment of ultrasound Breast Imaging Reporting and Data System classifications

AIM

To explore a real-time shear-wave elastography (SWE) prediction model distinguishing benign from malignant breast lesions and to determine its application in adjusting ultrasound Breast Imaging Reporting and Data System (BI-RADS) classifications.

MATERIALS AND METHODS

Four hundred and sixty-eight patients with 488 breast lesions were enrolled. Patients underwent hollow-needle puncture or surgical resection for histopathological examinations. Ultrasound examinations, both conventional ultrasound and real-time SWE, were performed <2 weeks prior to sampling. Statistical analyses were implemented to distinguish benign from malignant breast lesions and adjust ultrasound BI-RADS 3 and 4a classifications.

RESULTS

The real-time SWE indicators Emax and Ecol showed the highest diagnostic efficiency in distinguishing between benign and malignant lesions through quantitative and qualitative indicators, respectively. The area under the curve (AUC) for Emax was 0.837 while that for Ecol was 0.828. The AUC of the real-time SWE prediction model, constructed by multivariate logistic regression, for diagnosing benign and malignant breast lesions was 0.850.

CONCLUSION

The real-time SWE prediction model aids in the differential diagnosis of benign and malignant breast lesions but cannot replace conventional ultrasound. The model improves the diagnostic performance of ultrasound BI-RADS 3 and 4a classifications.

China county-based prostate specific antigen screening for prostate cancer and a cost-effective analysis

Background

Prostate cancer is one of the most common malignant tumors worldwide, and is the third-leading cause of cancer death in men. Nearly 70% of new prostate cancer patients in China are locally advanced or widely metastatic with poor prognosis. Providing active treatment to early stage prostate cancer patients can improve the prognosis of prostate cancer patients. Thus, this study sought to evaluate the economy of early prostate specific antigen (PSA) screening for high-risk prostate cancer.

Methods

Based on the data collected from the PSA screening activities of 11 county hospitals from October 2019 to April 2021, this study evaluated a high-risk prostate cancer population who received PSA screening and their quality of life and economy. The screening population comprised males aged over 50 years. All screening patients were tested for PSA. If the PSA value is unnormal, a further diagnosis based on magnetic resonance imagining (MRI) or a transrectal ultrasound-guided prostate biopsy were performed. The decision-tree and Markov model was used to simulate the process of disease development of high-risk prostate cancer patients who underwent screenings and those who did not, and the incremental cost-effectiveness ratio was also evaluated.

Results

A total of 13,726 men received a PSA screening. Of these, 1,062 men had abnormal PSA values, and 73 of these were diagnosed with prostate cancer. Of these 73 patients, 40, 21, and 12 had early stage, mid-stage, and late-stage prostate cancer, respectively. Compared to the patients unscreened, the 1,000 patients who received an early PSA screening increased their quality-adjusted life year (QALY) by 15.69 years; however, each QALY had an additional cost of 38,550 yuan, which was lower than the willingness to pay threshold of 72,447 yuan (per capita gross domestic product in 2020).

Conclusions

For high-risk prostate cancer patients, early screenings have a cost-effective advantage over no screenings. Thus, early screening should be vigorously promoted for high-risk prostate cancer patients.

[Pravelance and risk factors of frailty in community-dwelling Chinese elderly population]

OBJECTIVE

To investigate the incidence of frailty in community-dwelling Chinese elderly population and explore the risk factors and protective factors of frailty in the elderly.

METHODS

This study was conducted based on the 2011-2015 survey data provided by the China Health and Retirement Longitudinal Study (CHARLS). A research cohort was established consisting of non-debilitated elderly individuals aged 60 years and above at the 2011 baseline survey to assess the incidence of debilitation in the cohort population followed up till 2015. A nested case-control study was conducted to analyze the contributing factors to frailty in the elderly.

RESULTS

In this study, the cohort population was followed up for a total of 14351 person-years. A total of 248 individuals had newly developed frailty during the follow-up period, resulting in an incidence of 17.28/1000 person-years; the incidence was lower in elderly men than in elderly women (14.63/1000 vs 20.14/1000 person-years). The incidence of debilitation increased progressively with ageing: 8.90/1000 person-years in 60-64 years group, 16.77/ 1000 person-years in 65-69 years group, 24.04/1000 person-years in 70-74 years group, and 64.67/1000 person-years in 80 years or older group. Multivariate conditional logistic regression analysis showed that depressive symptoms (OR=2.534, 95% CI: 1.714-3.748), smoking (OR=1.713, 95% CI: 1.081-2.715) and self-care difficulties (OR=1.684, 95% CI: 1.155-2.456) were the risk factors contributing to frailty in the elderly; the marital status (unmarried, divorced and widowed) (OR=0.432, 95%CI: 0.278-0.673), a high cognitive function score (OR=0.919, 95% CI: 0.870-0.970), a primary school education (OR=0.453, 95% CI: 0.254- 0.806) and drinking (OR=0.520, 95%CI: 0.323-0.837) were the protective factors against frailty in the elderly.

CONCLUSIONS

The incidence of frailty in community-dwelling Chinese elderly population is lower than the average incidence globally. The incidence of frailty in the elderly differs with gender and age, and depressive symptoms, smoking, and self-care difficulties are the main risk factors for frailty in the community-dwelling elderly.