Succession and assembly mechanisms of seawater prokaryotic communities along an extremely wide salinity gradient

Salinity is an important environmental factor in microbial ecology for affecting the microbial communities in diverse environments. Understanding the salinity adaptation mechanisms of a microbial community is a significant issue, while most previous studies only covered a narrow salinity range. Here, variations in seawater prokaryotic communities during the whole salt drying progression (salinity from 3% to 25%) were investigated. According to high-throughput sequencing results, the diversity, composition, and function of seawater prokaryotic communities varied significantly along the salinity gradient, expressing as decreased diversity, enrichment of some halophilic archaea, and powerful nitrate reduction in samples with high salt concentrations. More importantly, a sudden and dramatic alteration of prokaryotic communities was observed when salinity reached 16%, which was recognized as the change point. Combined with the results of network analysis, we found the increasing of complexity but decreasing of stability in prokaryotic communities when salinity exceeded the change point. Moreover, prokaryotic communities became more deterministic when salinity exceeded the change point due to the niche adaptation of halophilic species. Our study showed that substantial variations in seawater prokaryotic communities along an extremely wide salinity gradient, and also explored the underlying mechanisms regulating these changes.

[Detection of microbes adherent to particles in a closed environment]

OBJECTIVE

In order to provide reference for controlling and monitoring the environmental contamination in the spacecraft, the species and amount of microbes, which adhere to the suspended particles with different size in a closed environment were detected.

METHOD

According to USA EPA IP-10, particles were continuously sampled by an impactor in a closed environment. The particles were divided into three grades by their aerodynamic diameters (AD): 100 micrometers > or = AD > 10 micrometers, 10 micrometers > or = AD>2 micrometers and AD < or = 2 micrometers. Clean outdoor air was collected as control by the same way. The collected particles were precisely weighed. The microbes that adhere to the particles were cultivated, counted and identified.

RESULT

By calculating total suspended particles (TSP) and inhalant particles (IP) of the closed environment, counting, clarifying and identifying the microbes, 6 kinds of bacteria, 2 genus of actinomyces and 6 kinds of fungi that adhere to the particles were detected.

CONCLUSION

The particles in a closed environment may have some effect on human health and instruments.

[Efficacy and safety of paclitaxel liposomes compared to paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma: a Meta-analysis]

Objective: To explore the efficacy and safety of paclitaxel liposomes compared to paclitaxel with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma. Methods: SinoMed, CNKI, WanFang MED ONLINE, VIP, PubMed, MEDLINE, Cochrane Library, Embase and ClinicalTrials.gov were searched to collect the papers or clinical studies of paclitaxel liposomes and paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma from the inception to January 15th 2021 in Chinese and English. Two independent reviewers screened the literatures, extracted the data and assessed the bias of the included studies. Meta-analysis was performed using RevMan 5.4 and R software. Results: Totally 9 papers involving 666 patients with unresectable cervical carcinoma were included. The results of meta-analysis indicated that compared to paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma, paclitaxel liposomes combined with platinum exhibited superiority in near-term efficacy (complete response + partial response) [81.4%(272/334) vs 68.7%(228/332), RR=1.19; 95% CI: 1.09, 1.29, P=0.000 1]; substantially decreased the incidence rates of blood system disorders [myelosuppressio, 50.3%(168/334)vs 65.1%(216/332)], gastrointestinal disorders [34.4%(115/334) vs 55.1%(183/332)], alopecia [42.2%(94/223)vs 63.3%(140/221)], allergic reaction [11.6% (23/198)vs 27.6%(54/196), P≤0.000 1], peripheral neuritis [43.0%(52/121) vs 54.9%(67/122)], or joint and muscle pain [20.3%(16/79) vs 34.6%(28/81), P<0.050 0]. Conclusion: Compared to paclitaxel combined with platinum in concurrent chemoradiotherapy for unresectable cervical carcinoma, paclitaxel liposomes is superior in near-term efficacy, and exhibits better safety.

[Analysis of the characteristics of retracted scientific papers in the field of global liver diseases published by Chinese scholars]

Objective: To analyze the characteristics of scientific papers in the field of global liver diseases published by Chinese scholars that were retracted for diverse reasons from the Retraction Watch database, so as to provide a reference to publishing-related papers. Methods: The Retraction Watch database was retrieved for retracted papers in the field of global liver disease published by Chinese scholars from March 1, 2008 to January 28, 2021. The regional distribution, source journals, reasons for retraction, publication and retraction times, and others were analyzed. Results: A total of 101 retracted papers that were distributed across 21 provinces/cities were retrieved. Zhejiang area (n = 17) had the most retracted papers, followed by Shanghai (n = 14), and Beijing (n = 11). The vast majority were research papers (n = 95). The journal PLoS One had the highest number of retracted papers. In terms of time distribution, 2019 (n = 36) had the most retracted papers. 23 papers, accounting for 8.3% of all retractions, were retracted owing to journal or publisher concerns. Liver cancer (34%), liver transplantation (16%), hepatitis (14%), and others were the main areas of retracted papers. Conclusion: Chinese scholars have a large number of retracted articles in the field of global liver diseases. A journal or publisher chooses to retract a manuscript after investigating and discovering more flawed problems, which, however, require further support, revision, and supervision from the editorial and academic circles.

[Study on the difference of binocular accommodative response between atients with intermittent exotropia under different viewing condition]

Objective: To evaluate the accommodative response of patients with intermittent exotropia (IXT) objectively, and study the changes of accommodative response of intermittent exotropia patients when maintaining binocular fusion. Methods: The prospective cohort study was used in this study. Twenty-four patients diagnosed with basic intermittent exotropia who visited the eye hospital of Wenzhou Medical University during October 2016 through January 2017 together with 24 normal volunteers were included, the 48 participants aged from 10 to 27 years old. The participants were divided into the case group and the control group. There were 11 males and 13 females in the case group, and 7 males and 17 females in the control group. The Open-filed autorefractor WAM-5500 (Grand Seiko, Japan) was used to measure the accommodative response of each eye under binocular and monocular viewing conditions at 5 m and 40 cm respectively. During the measurement, patients wore full correction spectacles to achieve distant best-corrected visual acuity of both eyes. The accommodative responses of each eye under binocular and monocular viewing conditions at distance or near between fellow eyes and groups were compared. Results: Under near fixation (40cm) binocular viewing conditions, the accommodative response of the fixating eye (-1.915±0.301)D was different from the deviating eye -1.649(-2.020, -0.304)D in the case group (Z=-3.714, P<0.001). Under near fixation monocular viewing conditions, the accommodative response of the fixating eye (-1.653±0.271)D was also different from the deviating eye -1.565 (-2.031, -0.667)D in the case group (Z=-2.971, P=0.003). During binocular viewing, the asymmetric value of the accommodative response between both eyes of the case group was 0.389(0.102, 1.458)D which was more significant than the normal controls' 0.155(0.009, 0.573)D (Z=-3.505, P<0.001), but during monocular viewing, there was no significant difference between the groups (Z=-1.908, P=0.056). Under near viewing conditions, the variation value of the fixating eyes of the case group was -0.228(-0.796, 0.382)D, which was greater than the variation value -0.086(-0.606, 0.628)D of the right eye of the normal controls, such difference is of statistical significance (Z=-2.279, P=0.023). Under distance viewing conditions, there was no significant difference in the accommodative response between fixating eyes and deviating eyes in case group neither during monocular viewing nor binocular viewing (t=-1.525, -1.729, P>0.05). Besides, the asymmetric values of accommodative response between groups were not significantly different (Z=-1.433, P=0.152. Z=-0.938, P=0.348). Under distance viewing conditions, the changes in accommodative response of each eye during both monocular viewing and binocular viewing were not significantly different between case group and normal controls (Z=-0.041, P=0.967. Z=-1.433, P=0.152). Conclusions: The accommodative responses of the fixating eye and deviating eye of patients with intermittent exotropia were asymmetric under near fixation binocular viewing conditions, and the accommodative response of the deviating eye tends to decrease. Besides, the change of accommodative response of the patients with intermittent exotropia when maintaining binocular fusion is more significant than that of the normal controls. (Chin J Ophthalmol, 2018, 54: 55-61).

[Advances on molecular typing methods and evolution of human parainfluenza virus]

Human parainfluenza viruses (HPIVs) is one of the main causes of acute respiratory tract infections in children. HPIVs have been grouped into four serotypes (HPIV1~HPIV4) according to serological and genetic variation. Different serotypes of HPIVs have diverse clinical disease spectrum, epidemic characteristics and disease burden. Based on the nucleotide variation in structural protein genes, HPIVs can be further divided into distinct genotypes and subtypes with diverse temporal and spatial distribution features. The standard molecular typing methods are helpful to clarify the gene evolution and transmission patterns of HPIVs in the process of population transmission. However, the development of molecular epidemiology of HPIVs has been hindered by the lack of a standardized molecular typing method worldwide. Therefore, this study reviewed the viral characteristics, genome structure, existing genotyping methods and evolution of HPIVs, and screened the reference strains for molecular typing, so as to improve the understanding of gene characteristics and molecular typing of HPIVs, and provide an important scientific basis for the monitoring and research of molecular epidemiology of HPIVs in China.

[Expression and diagnostic value of macrophage inflammatory protein-3α in patients with hepatitis B-related acute-on-chronic liver failure]

Objective: To screen serum protein markers and evaluate their diagnostic application value in hepatitis B-related acute-on-chronic liver failure (HBV-ACLF). Methods: Serum samples of patients with HBV-ACLF, chronic hepatitis B (CHB) and normal healthy volunteers (n = 5/group) were determined by cytokine antibody chip in line with the Chinese Diagnostic Standards Study for HBV-ACLF (COSSH-ACLF) cohort. The differentially expressed proteins significance were identified by microarray analysis and prediction. The preliminary serological markers of HBV-ACLF were screened for diagnosis. The potential markers were determined by enzyme-linked immunosorbent assay (ELISA), area under the receiver operating characteristic curve (AUROC) analysis and liver tissue immunohistochemistry for the diagnosis of HBV-ACLF. Student t-test or Mann-Whitney U test were used to compare the continuous measurement data between the two groups, and analysis of variance and Kruskal-Wallis test were used to compare the continuous measurement data between multiple groups. Results: Cytokine antibody chip preliminary screening results showed that the expression levels of these six cytokines, namely, macrophage inflammatory protein 3α (MIP-3α), hepatocyte growth factor, E-selectin, osteopontin, growth differentiation factor 15 and carcinoembryonic antigen-related cellular adhesion molecule 1 were significantly increased in the HBV-ACLF group. Among them, the expression level of MIP-3α was significantly higher in the HBV-ACLF group (99.6 times higher than CHB group and 146.9 times higher than healthy volunteers' group, respectively, P < 0.0001) as validated by serum ELISA in 132 HBV-ACLF cases, 91 CHB cases and 72 healthy volunteers. AUROC analysis showed that the high expression of MIP-3α could be used as a marker to distinguish patients with HBV-ACLF from CHB. The AUROC was 0.995 (95% CI: 0.990 ~ 1.000), with sensitivity and specificity of 95.5% and. 98.9%, respectively. Immunohistochemistry showed that MIP-3α was positively expressed in HBV-ACLF-derived liver tissues, and negatively expressed in CHB-derived liver and normal liver tissues. Conclusion: Serum MIP-3α level is closely related to the pathological characteristics of HBV-ACLF. Therefore, it may be used as a potential serological marker for the diagnosis of HBV-ACLF.

Effect of clay supplementation on growth performance of broiler chickens: a systematic review and meta-analysis

1. This review assessed the effect of dietary clay supplementation as a drug and toxin adsorbent on broiler growth performance as a meta-analysis.2. A total of 33 eligible studies were included in the present study after identification and evaluation from online databases. Standardised mean differences (SMD) with corresponding 95% confidence intervals were computed with a fixed-effects model.3. The results indicated that clay supplementation significantly improved broiler daily gain (P < 0.001) and feed conversion ratio (P < 0.001), but did not affect feed intake (P = 0.954). Results of subgroup analysis showed that zeolite clay had the most stable medium improvement effect on FCR, while kaolin had a large effect. In addition, male broilers and Cobb or Ross broilers were more sensitive to the addition of clay, and the best supplemental levels, in general, were 10 g/kg to 30 g/kg.4. Meta-regression analysis showed that clay supplemental level and sex of broilers may be important factors in the effect of clay on ADG and FCR of broilers, respectively. The sensitivity analysis showed high stability of the results and no significant publication bias was found with funnel plot analysis and Egger's or Begg's test (P > 0.05).5. In conclusion, an appropriate addition level is a prerequisite for effective clay application. Kaolin and zeolite clays seem to be more suitable for enhancing broiler growth performance, and the value of clay is amplified in specific broiler breeds.

Protocol for the derivation and culture of murine trophoblast organoids for CRISPR-Cas9 screening

Murine trophoblast organoids present a more balanced array of trophoblast subtypes, rendering them a suitable platform for CRISPR-Cas9-based screening. Here, we present a protocol for the derivation and culture of murine trophoblast organoids from trophoblast stem cells or placentae. We describe steps for establishing and differentiating murine trophoblast organoids, the characterization of trophoblast organoids in both conditions, the generation of focused single guide RNA (sgRNA) libraries, and the subsequent screening using those libraries in murine trophoblast organoids. For complete details on the use and execution of this protocol, please refer to Mao et al.1.

[A cohort study on the epidemiological characteristics of HBeAg sero-clearance in HBeAg positive chronic hepatitis B patients in Jiangsu province from 2012 to 2014]

Objective: To understand the epidemiological characteristics and influencing factors related to HBeAg sero-clearance in chronic hepatitis B patients so as to provide evidence for regular management on chronic HBV patients. Methods: From 2012 to 2014, a cohort study was conducted among HBeAg positive chronic HBV patients in Jiangsu province. Association between the characteristics and incidence of HBeAg sero-clearance was analyzed by Cox regression method. The changing trend on HBV DNA between patients with HBeAg sero-clearance and those with persistent HBeAg positive status was compared by repeated measure data variance analysis method. Results: In 2012, there were 721 HBeAg positive hepatitis B patients aged (45.2 ± 14.2) years enrolled in this study. By 2014, the follow-up observation period was 1 058 person-years, and 393 cases had lost their HBeAg status, with the rate as 37.2/100 person-years. The HBeAg sero-clearance rate was 32.4/100 person-years in hepatitis B patients who received antiviral treatment. The probability of HBeAg clearance in HBeAg positive hepatitis B patients aged ≥60 year (62.0/100 person-years) was higher than those of aged <20 year (7.0/100 person-years). The rate of HBeAg sero-clearance in HBeAg positive patients with HBV DNA <20 000 IU/ml (75.8/100 person-years) was higher than those whose HBV DNA were ≥200 000 IU/ml (16.1/100 person-years). By Cox regression analysis, the HBV DNA level was an important influencing factor on the progress of HBeAg sero-clearance. Patients with HBV DNA levle as ≥200 000 IU/ml, had a lower HBeAg clearance rate (HR=0.18, 95%CI: 0.13-0.23, P<0.001). Compared to the persistent HBeAg positive group, HBV DNA showed a more dramatic fall in the HBeAg-lost group (P<0.001). Conclusion: The rate of HBeAg sero-clearance among HBeAg positive hepatitis B patients was correlated with age and HBV DNA status of the patients that called for comprehensive management and intervention programs to develop for the HBeAg positive hepatitis B patients with different characteristics.

[Progress in cohort study of children and adolescents health]

Cohort study of children and adolescents health is an ideal method to explore health-related problems from childhood to adulthood, to which more attention has been paid. This paper summarizes the progress in cohort study of children and adolescents health conducted both at home and abroad by introducing the study design, main contents. Emphasizing the international exchange and cohort integration, continuously expanding cohort research field, and using multi-source data for high-quality follow-up have become the trend of cohort study of children and adolescents health.

Mechanical force drives the initial mesenchymal-epithelial interaction during skin organoid development

Rationale: Stem cells self-organize to form organoids that generate mini-organs that resemble the physiologically-developed ones. The mechanism by which the stem cells acquire the initial potential for generating mini-organs remains elusive. Here we used skin organoids as an example to study how mechanical force drives initial epidermal-dermal interaction which potentiates skin organoids to regenerate hair follicles. Methods: Live imaging analysis, single-cell RNA-sequencing analysis, and immunofluorescence were used to analyze the contractile force of dermal cells in skin organoids. Bulk RNA-sequencing analysis, calcium probe detection, and functional perturbations were used to verify that calcium signaling pathways respond to the contractile force of dermal cells. In vitro mechanical loading experiment was used to prove that the stretching force triggers the epidermal Piezo1 expression which negatively regulates dermal cell attachment. Transplantation assay was used to test the regenerative ability of skin organoids. Results: We found that dermal cell-derived contraction force drives the movement of dermal cells surrounding the epidermal aggregates to trigger initial mesenchymal-epithelial interaction (MEI). In response to dermal cell contraction force, the arrangement of the dermal cytoskeleton was negatively regulated by the calcium signaling pathway which further influences dermal-epidermal attachment. The native contraction force generated from the dermal cell movement exerts a stretching force on the adjacent epidermal cells, activating the stretching force sensor Piezo1 in the epidermal basal cells during organoid culture. Epidermal Piezo1 in turn drives strong MEI to negatively regulate dermal cell attachment. Proper initial MEI by mechanical-chemical coupling during organoid culture is required for hair regeneration upon transplantation of the skin organoids into the back of the nude mice. Conclusion: Our study demonstrated that mechanical-chemical cascade drives the initial event of MEI during skin organoid development, which is fundamental to the organoid, developmental, and regenerative biology fields.

Co-expression of immune checkpoints in glioblastoma revealed by single-nucleus RNA sequencing and spatial transcriptomics

Glioblastoma (GBM) is one of the most malignant tumors of the central nervous system. The pattern of immune checkpoint expression in GBM remains largely unknown. We performed snRNA-Seq and spatial transcriptomic (ST) analyses on untreated GBM samples. 8 major cell types were found in both tumor and adjacent normal tissues, with variations in infiltration grade. Neoplastic cells_6 was identified in malignant cells with high expression of invasion and proliferator-related genes, and analyzed its interactions with microglia, MDM cells and T cells. Significant alterations in ligand-receptor interactions were observed, particularly between Neoplastic cells_6 and microglia, and found prominent expression of VISTA/VSIG3, suggesting a potential mechanism for evading immune system attacks. High expression of TIM-3, VISTA, PSGL-1 and VSIG-3 with similar expression patterns in GBM, may have potential as therapeutic targets. The prognostic value of VISTA expression was cross-validated in 180 glioma patients, and it was observed that patients with high VISTA expression had a poorer prognosis. In addition, multimodal cross analysis integrated SnRNA-seq and ST, revealing complex intracellular communication and mapping the GBM tumor microenvironment. This study reveals novel molecular characteristics of GBM, co-expression of immune checkpoints, and potential therapeutic targets, contributing to improving the understanding and treatment of GBM.

Synthesis and characterization of low-dimensional N-heterocyclic carbene lattices

The covalent interaction of N-heterocyclic carbenes (NHCs) with transition metal atoms gives rise to distinctive frontier molecular orbitals (FMOs). These emergent electronic states have spurred the widespread adoption of NHC ligands in chemical catalysis and functional materials. Although formation of carbene-metal complexes in self-assembled monolayers on surfaces has been explored, design and electronic structure characterization of extended low-dimensional NHC-metal lattices remains elusive. Here we demonstrate a modular approach to engineering one-dimensional (1D) metal-organic chains and two-dimensional (2D) Kagome lattices using the FMOs of NHC-Au-NHC junctions to create low-dimensional molecular networks exhibiting intrinsic metallicity. Scanning tunneling spectroscopy and first-principles density functional theory reveal the contribution of C-Au-C π-bonding states to dispersive bands that imbue 1D- and 2D-NHC lattices with exceptionally small work functions.

Sea Cucumber Viscera Processed by Protease Hydrolysis Combined with Cordyceps militaris Fermentation Protect Caco-2 Cells against Oxidative Damage via Enhancing Antioxidant Capacity, Activating Nrf2/HO-1 Pathway and Improving Cell Metabolism

Excessive reactive oxygen species (ROS) may lead to oxidative damage and metabolic disorder. The pathogenesis of human bowel inflammation is closely related to oxidative damage of intestinal epithelial cells caused by ROS. This study aimed to explore the high-value utilization of the byproducts of sea cucumber in antioxidant food for colitis prevention. The technology of protease hydrolysis combined with Cordyceps militaris fermentation was used to obtain fermented sea cucumber viscera protease hydrolysates (FSVHs). The results revealed that FSVH could enhance antioxidant capacity and alleviate oxidative damage and apoptosis by activating the Nrf2/HO-1 pathway and triggering the self-protection immune mechanisms. Moreover, the FSVH supplementation could upregulate antioxidant-related metabolic pathways of Caco-2 cells such as glutathione metabolism, confirming the enhanced antioxidant capacity of damaged cells. In summary, FSVH could exert protective effects on Caco-2 cells in response to oxidative damage, providing a promising prospect for sea cucumber resource utilization and colitis prevention.

Inhibition Effects and Mechanism Study of rAj-HRP30, a Recombinant Histidine-Rich Peptide from Apostichopus japonicus, on the Viability of Pancreatic Ductal Adenocarcinoma Cells Panc01 and Panc02

rAj-HRP30 is a recombinant peptide derived from the wild-type rAj-HRP of Apostichopus japonicus through a gene-shortening mutation. It has a high histidine content (53.3% in its primary structure) and a molecular weight of 3.919 kDa, classifying it as a histidine-rich peptide. The literature reports indicate that human histidine-rich peptides exhibit antitumor activity. Previous research by our group demonstrated similar properties in rAj-HRP, the precursor of rAj-HRP30. Therefore, this study used Panc01 (human) and Panc02 (mouse) cells-highly malignant models with limited targeted therapies-to investigate the antitumor activity and mechanisms of rAj-HRP30 and evaluate its potential for pancreatic cancer treatment. This study designed a gene-shortening strategy for rAj-HRP and artificially synthesized the gene sequence of rAj-HRP30. The cDNA sequence of rAj-HRP30 was cloned into the pET23b vector, and the recombinant plasmid pET23b-HRP30 was transformed into E. coli BL21 for expression. Following IPTG induction, the recombinant peptide was purified using nickel ion affinity chromatography, yielding rAj-HRP30 with a purity exceeding 95%. rAj-HRP30 markedly inhibited the adhesion, migration, and invasion of Panc01 and Panc02 cells. It also disrupted cellular morphology and cytoskeletal structure while inducing apoptosis. These effects were dose-dependent. After confirming the in vitro anticancer activity of rAj-HRP30, this study employed Panc02 cells as a model to investigate its inhibitory mechanisms using Western blot analysis. The results revealed that rAj-HRP30 reduced FGFR1 expression in Panc02 cells and inhibited the downstream FYN and FAK signaling pathways, subsequently blocking the PI3K/AKT signaling and apoptosis pathways. In the apoptotic pathway, rAj-HRP30 was able to downregulate the expression of Bcl-2, Caspase-9, Caspase-3, Caspase-7, and PARP1 and upregulate the expression of Bax, cleaved Caspase-9, cleaved Caspase-3, cleaved Caspase-7, and cleaved-PARP1 to induce apoptosis in Panc02 cells. Furthermore, rAj-HRP30 also downregulated the expression of MMP2 and MMP9, thereby inhibiting the migration and invasion of Panc02 cells. Conclusion: rAj-HRP30 exhibits significant inhibitory effects on pancreatic ductal adenocarcinoma Panc01 and Panc02 cells in vitro. Its mechanism involves FGFR1-related signaling and apoptosis pathways. rAj-HRP30 shows promise as a therapeutic agent targeting FGFR for pancreatic cancer.

Time at home among nonvalvular atrial fibrillation patients treated with non-vitamin K antagonist oral anticoagulants versus warfarin

Background

Clinical trials and real-world database studies have shown the benefits of non-vitamin K antagonist oral anticoagulants (NOACs) compared to warfarin; however, measures of functional outcomes are critical in evaluating a patient's quality of life. Previous measures of time spent out of hospital in a home setting and time spent receiving disease-related care among non-valvular atrial fibrillation (NVAF) patients are lacking in the current literature.

Purpose

This analysis was based on the previously published ARISTOPHANES study, and used multiple data sources to evaluate the amount of time spent at a patient's home among NVAF patients who were prescribed NOACs versus warfarin.

Methods

This retrospective observational study used US data from CMS Medicare and four commercial databases to select adult NVAF patients who initiated apixaban, dabigatran, rivaroxaban, or warfarin (01JAN2013–30SEP2015). Time at home and time at home without external AF-related care were measured during the 180 days after the index date (OAC prescription). Time at home was defined as days from index date without any of the following: an inpatient, skilled nursing facility or nursing facility, hospice, or inpatient rehabilitation facility admission. Time at home and without external AF-related care was defined as days away from home and days with a claim for bleeding, stroke/systemic embolism, AF, or an INR test. Each day a claim was observed was counted as one day. In each database, three 1:1 NOAC-warfarin propensity-score-matched (PSM) cohorts were created before pooling the results. After PSM, a subgroup of patients who were alive and had ≥180 days of follow-up was created. Poisson regression was conducted in each NOAC-warfarin matched cohort to compare time at home and time at home without external AF-related care.

Results

After matching, a total of 100,977 apixaban-warfarin, 36,990 dabigatran-warfarin, and 125,068 rivaroxaban-warfarin patient pairs were selected. Of those patients, 38–46% had 180 days of follow-up available. Across treatment cohorts, approximately 75% of patients were at home for the 180-day follow-up. Apixaban, dabigatran, and rivaroxaban patients had 1.3, 0.9, and 0.8 more days at home, respectively, compared to warfarin patients. Patients treated with apixaban had 13.4 more days at home without AF-related care compared to warfarin, while dabigatran and rivaroxaban had 11.6 and 11.7 more days at home without AF-related care compared to warfarin. A greater proportion of warfarin patients than NOAC patients had an INR test (81–82% vs 14–21%), and days with INR testing were the main driver for external AF-related care for warfarin patients.

Conclusion

Among NVAF patients treated with OACs, NOACs were associated with a longer time at home and time at home without external AF-related care compared to warfarin. These results can help inform healthcare providers and patients regarding the impact of NOAC treatment in NVAF patients.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Bristol-Myers Squibb Company and Pfizer Inc.

Overall Survival Of Extraosseous Plasmacytoma: An Updated Analysis Of National Cancer Institute Database

Introduction/Objective

Plasma cell neoplasms arising outside of bone are known as extraosseous/extramedullary plasmacytoma. Although they constitute about 1% of all plasma cell neoplasms, updated epidemiological data are lacking in the current literature. Here, we have analyzed the incidence provided by the national cancer institute (SEER database) from 1975 – 2016 to shed light on the incidence, demographics, and survival of extraosseous plasma cell neoplasms.

Methods

We selected all cases of plasma cell neoplasms from the data provided by the national cancer institute (SEER database) from 1975 – 2016. We excluded all cases designated with the primary site as bone or bone marrow. We analyzed the data using SPSS statistics 20. We compared overall survival among different demographic groups and performed the log-rank test to see differences in overall survival.

Results

A total of 731 cases were found with extraosseous plasmacytoma in the United States with a male: female ratio of 1.85:1. The age range was from 9 to 92 years with a median age of 61. Younger age of diagnosis was associated with better overall survival. Overall survival was not significantly different between males and females (p = 0.4). The majority of the patients were Caucasian and overall survival was significantly better in this group (p = 0.028). Consistent with the current literature, the primary sites of the majority of cases were head and neck (44.5%) and soft tissue (15.7%). Overall survival was significantly different between different primary sites (p &lt; 0.05) with primary sites of soft tissue, thorax (including lung, mediastinum, and pleura), and CNS showing particularly poor survival.

Conclusion

Our results suggest that the prognosis of extraosseous plasma cell neoplasm is site-specific and a better understanding of tumor microenvironment in plasmacytoma arising in different primary sites is warranted.