IA comparison of two minimally invasive procedures for intra-articular displaced calcaneal fractures in older children

The purpose of this study was to compare the clinical outcomes of displaced intra-articular calcaneal fractures in older children treated with poking reduction and cannulated screws fixation or with plate fixation using a sinus tarsi approach. From June 2008 to May 2012, fifty patients were randomised to operative stabilisation either by poking reduction and cannulated screws fixation (Group A, 28) or by plates fixation using a sinus tarsi approach (Group B, 22). The two groups were comparable with respect to age, gender, BMI, the affected side, cause of injury, fracture type, time from injury to surgery and follow-up time. We collected data on operative time and radiation time, length of hospitalization, hospital costs, union time, full weight-bearing time, full physical activity time and complications and measured joint function using the American Orthopaedic Foot and Ankle surgery (AOFAS) score. The average follow-up time of Group A was 36.5±9.3 months and 40.2±10.6 months in Group B. No significant difference between these two groups was found in radiation time, average length of hospitalization, union time, full weight-bearing time, full physical activity time and the average AOFAS score. However, the patients of Group B had longer operation time (38.0±10.6 min vs. 66.5±9.4 min, P<0.05) and more hospital costs (6200±800 RMB vs. 15000±2000 RMB, P<0.05). The average Bohler's angle and Gissane's angle preoperative were 10.9±5.3 and 141.3±12.1 in Group A, and became 31.2±5.1 and 128.5±5.4 after operation. The average Bohler's angle and Gissane's angle preoperative in Group B were 11.7±4.0 and 138.8±16.2, respectively, and they became 30.9±5.2 and 124.6±6.8 after operation. Bohler's angle and Gissane's angle were significantly restored after surgery (P<0.05). Postoperative incision pain was more frequent in Group B than in Group A (P<0.05). Our results indicated that both cannulated screws and plates were efficient methods for intra-articular calcaneal fractures in older children. However, poking reduction and cannulated screws fixation had the advantages of a shorter operative time, fewer hospital costs and less incision pain.

Development of Precision Small-Molecule Proneurotrophic Therapies for Neurodegenerative Diseases

Age-related neurodegenerative diseases, such as Alzheimer's disease, will represent one of the largest future burdens on worldwide healthcare systems due to the increasing proportion of elderly in our society. As deficiencies in neurotrophins are implicated in the pathogenesis of many age-related neurodegenerative disorders, it is reasonable to consider that global neurotrophin resistance may also become a major healthcare threat. Central nervous system networks are effectively maintained through aging by neuroprotective and neuroplasticity signaling mechanisms which are predominantly controlled by neurotrophin receptor signaling. Neurotrophin receptors are single pass receptor tyrosine kinases that form dimeric structures upon ligand binding to initiate cellular signaling events that control many protective and plasticity-related pathways. Declining functionality of the neurotrophin ligand-receptor system is considered one of the hallmarks of neuropathological aging. Therefore, it is imperative to develop effective therapeutic strategies to contend with this significant issue. While the therapeutic applications of cognate ligands for neurotrophin receptors are limited, the development of nonpeptidergic, small-molecule ligands can overcome these limitations, and productively regulate this important receptor system with beneficial effects. Using our advanced knowledge of the high-dimensionality complexity of receptor systems, the future generation of precision medicines targeting these systems will be an attainable goal.

Observation of Orbital Order in the Half-Filled 4f Gd Compound

Half-filled electron systems, even with the maximized spin angular moment, have been given little attention because of their zero-orbital angular moment according to Hund's rule. Nevertheless, there are several measurements that show evidence of a nonzero orbital moment as well as spin-orbit coupling. Here we report for the first time the orbital order in a half-filled 4f-electron system GdB_{4}, using the resonant soft x-ray scattering at Gd M_{4,5}-edges. Furthermore, we discovered that the development of this orbital order is strongly coupled with the antiferromagnetic spin order. These results clearly demonstrate that even in half-filled electron systems the orbital angular moment can be an important parameter to describe material properties, and may provide significant opportunities for tailoring new correlated electron systems.

Integrated Two-Analyte Population Pharmacokinetic Model for Antibody-Drug Conjugates in Patients: Implications for Reducing Pharmacokinetic Sampling

An integrated pharmacokinetics (PK) model that simultaneously describes concentrations of total antibody (Tab) and antibody‐conjugated monomethyl auristatin E (acMMAE) following administration of monomethyl auristatin E (MMAE)‐containing antibody–drug conjugates (ADCs) was developed based on phase I PK data with extensive sampling for two ADCs. Two linear two‐compartment models that shared all parameters were used to describe the PK of Tab and acMMAE, except that the deconjugation rate was an additional clearance pathway included in the acMMAE PK model compared to Tab. Further, the model demonstrated its ability to predict Tab concentrations and PK parameters based on observed acMMAE PK and various reduced or eliminated Tab PK sampling schemes of phase II data. Thus, this integrated model allows for the reduction of Tab PK sampling in late‐phase clinical development without compromising Tab PK characterization.

A comparison of double Endobutton and triple Endobutton techniques for acute acromioclavicular joint dislocation

PURPOSE OF THE STUDY

The purpose of this study was to evaluate the results of patients treated with either double Endobutton device or triple Endobutton device for acute acromioclavicular joint dislocations.

PATIENTS AND METHODS

Eighty patients were randomized to operative stabilization either by double Endobutton device (group A, 40) or by triple Endobutton device (group B, 40). Preoperative variables included the patients' age, sex, the affected side, cause of injury, Rockwood classification and time from injury to surgery. Peri-operative variables were incision length, blood loss, the operative time and the radiation time, length of hospitalization and hospital costs. Postoperative variables were complications, the Constant and VAS scores and the ability to return to previous work. The coracoclavicular (CC) distance of the affected shoulder was assessed on a standard radiograph and compared with the contralateral normal one.

RESULTS

The average follow-up time of group A was 26.5±7.3months and group B was 24.2±6.6months. The overall complication rate was similar in both groups (26/40 vs. 24/40, P=0.644). There were no significant differences in the mean incision length, blood loss, the operative and radiation time, length of hospitalization, the Constant and VAS scores, and the ability to return to previous work between the two groups. However, the patients of group B had more hospital costs (3802.5±258.5 vs. 2433.6±182.5 USD, P=0.000). The radiological assessment revealed no significant difference in the CC distance between the two groups (P=0.625).

DISCUSSIONS

Triple Endobutton technique did not show significant clinical advantages over double Endobutton technique.

LEVEL OF EVIDENCE

Level II prospective randomized study.

Synchronized 4 × 12 GHz hybrid harmonically mode-locked semiconductor laser based on AWG

We report a monolithically integrated synchronized four wavelength channel mode-locked semiconductor laser chip based on arrayed waveguide grating and fabricated in the InP material system. Device fabrication was completed in a multiproject wafer foundry run on the Joint European Platform for Photonic Integration of Components and Circuits. The integrated photonic chip demonstrated 5th harmonic electrical hybrid mode-locking operation with four 400 GHz spacing wavelength channels and synchronized to a 12.7 GHz RF clock, for nearly transform-limited optical pulse trains from a single output waveguide. A low timing jitter of 0.349 ps, and RF frequency locking range of ~50 MHz were also achieved.

Vascular risk factors aggravate cognitive impairment in first-ever young ischaemic stroke patients

BACKGROUND AND PURPOSE

Young ischaemic stroke patients often suffer from cognitive impairment after stroke. However, the risk factors of cognitive impairment are still unclear. This study examined the impact of vascular risk factors (VRFs) on cognitive impairment in first-ever young ischaemic stroke patients.

METHODS

Subjects were divided into low (0-1 VRF, n = 27), medium (2-3 VRFs, n = 45) and high-risk (≥4 VRFs, n = 12) groups according to their number of VRFs. The following VRFs were collected: hypertension, diabetes mellitus, dyslipidaemia, atrial fibrillation, obesity, smoking, excess alcohol consumption, coronary heart disease and hyperhomocysteinaemia. A battery of cognitive assessments was executed 2 weeks after stroke. Differences of cognitive performances between groups were compared. The correlation between VRFs and cognitive function was investigated with an emphasis on discovering the main VRFs.

RESULTS

Eighty-four patients were enrolled in this study eventually. Compared with the low-risk group, the high-risk group had significantly worse performance in most of the cognitive domains. VRFs had a correlation with general cognition, executive function, attention and verbal fluency. After adjusting the covariates, VRFs showed a linear correlation with global cognitive function (R = 0.640, P = 0.000), verbal fluency (R = 0.372, P = 0.000), delayed memory (R = 0.327, P = 0.002), visual attention (R = 0.290, P = 0.007) and executive function (R = 0.266, P = 0.015). Amongst all the VRFs, hypertension, hyperlipidaemia, smoking and hyperhomocysteinaemia were the main influencing VRFs.

CONCLUSION

Vascular risk factors aggravate cognitive impairment after young ischaemic stroke. Effective management of VRFs in young adults is urgent and this may reduce the cognitive impairment.

Abstract P4-13-05: Safety results of the US expanded access program (EAP) of palbociclib in combination with letrozole as treatment of post-menopausal women with hormone-receptor-positive (HR+), HER2-negative (HER2-) advanced breast cancer (ABC) for whom letrozole therapy is deemed appropriate

Background: In the Phase I/II PALOMA-1 trial, a study in women with estrogen receptor (ER) positive advanced breast cancer (ABC) receiving initial therapy for their metastatic disease, combination of the CDK4/6 inhibitor palbociclib with letrozole improved progression free survival compared to letrozole. The aim of this open-label, single-arm EAP was to provide appropriate patients (pts) with ABC access to palbociclib pending marketing approval in the United States.

Methods: In the EAP, a total of 242 pts with HR+/HER2- ABC were treated at 42 sites in the US. Pts received palbociclib 125 mg/d (3 weeks on, 1 week off) in combination with letrozole 2.5 mg/d (continuous daily dosing) until disease progression, intolerable adverse event (AE), or commercial availability. AEs and serious AEs (SAEs) were assessed every cycle. Complete blood counts were assessed on day 1 and day 14 of the first two cycles and then at the beginning of each cycle thereafter. Tumor assessments were collected by investigators as per routine clinical practice.

Results: In this early analysis, we describe an initial cohort of 97 pts, with data collected during the first 3 months of study. Median duration of therapy was 31 days. Mean age was 62 yr (range 29-89). Baseline ECOG PS was 0, 1 or 2 in 36%, 49%, and 14% of pts, respectively. Common prior treatments (≥40% in any setting) included fulvestrant (59%), anastrozole (50%), paclitaxel (50%), exemestane (48%), cyclophosphamide (46%), tamoxifen (45%), doxorubicin (44%), and capecitabine (40%). Treatment-emergent AEs (TEAE; all grades) that occurred in greater than 10% of patients included neutropenia (28%), fatigue (19%), neutrophil count decreased (12%). Other hematologic TEAE rates included: anemia 9%, white blood cell count decreased 9% and thrombocytopenia 5%. All causality SAEs occurred in 6% of pts at the rate of 1 patient each for ankle fracture, constipation, disease progression, febrile neutropenia, lung infection, and pancytopenia. The rate of palbociclib dose reduction due to a TEAE was 4%. The rate of temporary delay of palbociclib due to TEAE was 36%. TEAEs leading to permanent discontinuation occurred in 1% of pts (Grade 3 nausea & vomiting). Grade 3 or 4 TEAEs were reported in 42% of pts, including neutropenia (Grade 3: 24%, Grade 4: 2%). There were no fatal outcomes due to TEAEs. This early data will be updated for final conference presentation to include the complete patient cohort and updated duration of therapy on study drug.

Conclusions: In this population of pts with HR+/HER2- ABC, palbociclib in combination with letrozole was well tolerated. Analysis of this early cohort indicates that the safety profile was consistent with that seen in the PALOMA-1 trial.

Clinical trial information: NCT02142868

Funding Source: Pfizer.

Citation Format: Stearns V, Smith II JW, Patel R, Lu D, Perkins JJ, Cotter MJ, Brufsky AM. Safety results of the US expanded access program (EAP) of palbociclib in combination with letrozole as treatment of post-menopausal women with hormone-receptor-positive (HR+), HER2-negative (HER2-) advanced breast cancer (ABC) for whom letrozole therapy is deemed appropriate. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-05.

Synthesis and characterization of imidazolium poly(azolyl)borate ionic liquids and their potential application in SO2 absorption

New imidazolium poly(azolyl)borate ionic liquids (ILs) were synthesized by salt metathesis, and they can absorb SO₂ through multi-site interactions at 20 °C, 0.1 MPa SO₂ with the highest SO₂ capacity of 5.8 mol mol⁻¹ of IL and 1.05 g g⁻¹ of IL.

The relationship between radiographic parameters and clinical outcome of distal radius fractures in elderly patients

PURPOSE OF THE STUDY

Treatment of distal radius fractures in elderly patients is controversial. This study explored the relationship between radiographic parameters and clinical outcomes of patients with distal radius fractures following conservative treatment. The study was done using radiographic measurements of distal radius fractures in elderly patients.

PATIENTS AND METHODS

Ninety-two active, healthy patients with conservatively managed distal radius fractures were included in the study. Functional and radiographic assessments were made 1 year after injury. Fifty patients who underwent corrective osteotomy comprised the control group. Radiographic parameters and clinical outcomes were compared between the two groups. The correlation coefficients of the radiographic parameters were analysed using multiple regression.

RESULT

Radius height (RH), volar tilt (VT) and Mayo wrist and Disabilities of the Arm, Shoulder and Hand (DASH) scores in the experimental group were significantly superior to those of the control group. There was no significant group difference in radial inclination. Multiple regression analysis revealed that the most important factor affecting functional outcome was RH, followed by VT.

DISCUSSION

RH and VT were significantly correlated with the clinical outcomes of conservative treatment of distal radius fractures. RH should be given foremost consideration in elderly patients. Preoperatively, surgeons should evaluate this parameter carefully and be prepared to treat injuries accordingly.

LEVEL OF EVIDENCE

Level IV retrospective study.

Genome-wide association study of myelosuppression in non-small-cell lung cancer patients with platinum-based chemotherapy

Platinum-induced myelosuppression severely impedes successful chemotherapy in non-small-cell lung cancer (NSCLC) patients. Hence, it is clinically important to identify the patients who are at high risk for severe toxicity to certain chemotherapy. We first carried out a genome-wide scan of 906 703 single-nucleotide polymorphisms (SNPs) to identify genetic variants associated with platinum-induced myelosuppression risk in 333 NSCLC patients with chemotherapy. Then, we replicated 24 SNPs that had P<1 × 10(-4) in another independent cohort of 876 NSCLC patients. With P<0.05 as the criterion of statistical significance, we found that rs13014982 at 2q24.3 and rs9909179 at 17p12 exhibited consistently significant associations with myelosuppression risk in both the genome-wide association studies (GWAS) scan and the replication stage (rs13014982: odds ratio (OR)=0.55, 95% confidence intervals (CIs): 0.41-0.74, P=7.29 × 10(-5) for GWAS scan and OR=0.77, 95% CI: 0.65-0.93, P=0.006 for replication stage; rs9909179: OR=0.51, 95% CI: 0.37-0.70, P=4.60 × 10(-5) for GWAS scan and OR=0.82, 95% CI: 0.68-0.99, P=0.040 for replication stage; both in additive model). In combined samples of genome-wide scan and replication samples, the minor alleles of rs13014982 and rs9909179 remained significant associations with the decreased risk of myelosuppression (rs13014982: OR=0.71, 95% CI: 0.61-0.83, P =1.36 × 10(-5); rs9909179: OR=0.76, 95% CI: 0.65-0.89, P=0.001). Rs13014982 at 2q24.3 and rs9909179 at 17p12 might be independent susceptibility markers for platinum-induced myelosuppression risk in NSCLC patients.

Class IIa HDAC inhibition enhances ER stress-mediated cell death in multiple myeloma

Histone deacetylase (HDAC) inhibitors have been extensively investigated as therapeutic agents in cancer. However, the biological role of class IIa HDACs (HDAC4, 5, 7 and 9) in cancer cells, including multiple myeloma (MM), remains unclear. Recent studies show HDAC4 interacts with activating transcription factor 4 (ATF4) and inhibits activation of endoplasmic reticulum (ER) stress-associated proapoptotic transcription factor C/EBP homologous protein (CHOP). In this study, we hypothesized that HDAC4 knockdown and/or inhibition could enhance apoptosis in MM cells under ER stress condition by upregulating ATF4, followed by CHOP. HDAC4 knockdown showed modest cell growth inhibition; however, it markedly enhanced cytotoxicity induced by either tunicamycin or carfilzomib (CFZ), associated with upregulating ATF4 and CHOP. For pharmacological inhibition of HDAC4, we employed a novel and selective class IIa HDAC inhibitor TMP269, alone and in combination with CFZ. As with HDAC4 knockdown, TMP269 significantly enhanced cytotoxicity induced by CFZ in MM cell lines, upregulating ATF4 and CHOP and inducing apoptosis. Conversely, enhanced cytotoxicity was abrogated by ATF4 knockdown, confirming that ATF4 has a pivotal role mediating cytotoxicity in this setting. These results provide the rationale for novel treatment strategies combining class IIa HDAC inhibitors with ER stressors, including proteasome inhibitors, to improve patient outcome in MM.

A genetic variant in SLC6A20 is associated with Type 2 diabetes in white-European and Chinese populations

AIMS

To investigate whether polymorphisms in SLC6A20 are associated with susceptibility to Type 2 diabetes.

METHODS

In the Rotterdam Study, a prospective, population-based cohort (n = 5974), 22 tagging polymorphisms with minor allele frequencies>0.05 across SLC6A20 were studied. Replication studies were performed in an independent Dutch case-control study (DiaGene-Rotterdam Study 2 n = 3133), and in a Chinese Han case-control population (n = 2279). A meta-analysis of the results was performed.

RESULTS

In the Rotterdam study, the minor alleles of rs13062383, rs10461016 and rs2286489 increased the risk of Type 2 diabetes (hazard ratio 1.37, 95% CI 1.15-1.63, hazard ratio 1.30 95% CI 1.09-1.54 and hazard ratio 1.20, 95% CI 1.07-1.35, respectively). In the DiaGene/Rotterdam Study 2, the A allele of rs13062383 increased the risk of Type 2 diabetes (odds ratio 1.45, 95% CI 1.19-1.76). In the Chinese Han study, the rs13062383 A allele also increased the risk of Type 2 diabetes (odds ratio 1.21, 95% CI 1.03-1.42). Meta-analysis showed a highly significant association of rs13062383 with Type 2 diabetes (odds ratio 1.35, 95% CI 1.21-1.47; P = 3.3 × 10⁻⁸).

CONCLUSIONS

In conclusion, rs13062383 in SLC6A20 increased the susceptibility to Type 2 diabetes in populations with different genetic backgrounds.

Upgrade of the electron beam ion trap in Shanghai

Over the last few years the Shanghai electron beam ion trap (EBIT) has been successfully redesigned and rebuilt. The original machine, developed under collaboration with the Shanghai Institute of Applied Physics, first produced an electron beam in 2005. It could be tuned with electron energies between 1 and 130 keV and beam current up to 160 mA. After several years of operation, it was found that several modifications for improvements were necessary to reach the goals of better electron optics, higher photon detection, and ion injection efficiencies, and more economical running costs. The upgraded Shanghai-EBIT is made almost entirely from Ti instead of stainless steel and achieves a vacuum of less than 10(-10) Torr, which helps to minimize the loss of highly changed ions through charge exchange. Meanwhile, a more compact structure and efficient cryogenic system, and excellent optical alignment have been of satisfactory. The magnetic field in the central trap region can reach up till 4.8 T with a uniformity of 2.77 × 10(-4). So far the upgraded Shanghai-EBIT has been operated up to an electron energy of 151 keV and a beam current of up to 218 mA, although promotion to even higher energy is still in progress. Radiation from ions as highly charged as Xe(53+, 54+) has been produced and the characterization of current density is estimated from the measured electron beam width.

First Report of Leaf Spot Caused by Cladosporium oxysporum on Greenhouse Eggplant in China

Eggplant (Solanum melongena L.) is an important vegetable crop that has significant economic value in northern regions of China, especially in Liaoning Province. In April 2013, a leaf spot was discovered on the eggplant cultivar 706 in ten 1-ha commercial greenhouses in Huludao, Liaoning Province, with 30% of the eggplants infected, resulting in reduced eggplant yield and quality. By July 2013, disease incidence was 35%. Spots were found mainly on the leaves. At the early stage of infection, small, chlorotic spots appeared on leaves and gradually expanded into brown, irregular spots with a diameter of 1 to 7 mm. Dark green mold developed in the spots on both sides of the leaves at high humidity, and the spots led to leaf yellowing and defoliation. Conidiophores in the lesions were straight or slightly flexuous with 1 to 7 septa, brown and smooth, with typical swellings at the junction of septa, and 45 to 670 × 3.0 to 5.3 μm. Conidia were oval or obpyriform with a smooth surface, brown or dark brown, with 0 to 2 septa and 5.5 to 14.8 × 2.5 to 4.0 μm. The pathogen was consistent morphologically with Cladosporium oxysporum (1). To identify the pathogen, leaf pieces (3 to 5 mm²) taken from the edge of lesions so that each leaf section included both infected and healthy leaf tissue, were surface-disinfested in 75% ethanol for 30 s, then transferred to a 0.1% aqueous mercuric chloride solution for 30 to 60 s, and rinsed with sterilized water three times. The sections were cultured on potato dextrose agar (PDA) at 25°C in the dark for 7 days. Three pure cultures were obtained from single spores. The conidia on PDA were oval or obpyriform, and 5.4 to 14.7 × 2.4 to 4.2 μm with 0 to 1 septa, and were smaller than the conidia examined directly from infected eggplant leaves. Two isolates were grown on synthetic nutrient agar (SNA) in slide cultures. The conidiophores on SNA were straight or slightly flexuous with swellings at the junctions of septa. On the grounds of these morphological characteristics, the pathogen was identified as C. oxysporum (1,3). For DNA extraction, cultures were grown in potato dextrose broth and the internal transcribed spacer (ITS) region of ribosomal DNA (rNDA) was amplified using primers ITS1 and ITS4 (2). Sequence analysis showed that the ITS sequences of the two isolates were 99% identical to that of C. oxysporum (GenBank Accession No. EF029816). Two isolates were tested for pathogenicity on eggplant using 1 × 10⁷ conidia/ml in sterilized water atomized onto each of six 7-week-old plants of the cultivar Xi'an Green Eggplant. Sterilized water was applied similarly to another six plants as the control treatment. The plants were incubated at 25°C with 85% relative humidity for 8 to 10 days. After 10 days, light brown, irregular spots were found on inoculated leaves, whereas no symptoms were observed on control plants. The pathogen was re-isolated from lesions on inoculated plants but not from control plants. The re-isolates were confirmed to be C. oxysporum based on morphological characteristics. The pathogenicity test was repeated and the same results obtained. Therefore, the pathogen causing leaf spot on eggplant in these greenhouses was identified as C. oxysporum. This is the first report of C. oxysporum causing leaf spot on greenhouse eggplant in China. C. oxysporum is a known pathogen of pepper and tomato. Additional studies are needed to provide management recommendations for this pathogen on Solanaceae crops. References: (1) K. Bensch et al. Stud. Mycol. 67:1, 2010. (2) Q. Li and G. Wang. Microbiol. Res. 164:233, 2009. (3) W. T. H. Peregrine and K. B. Ahmad. Phytopathol. Pap. 27:1, 1982.

Fragmentation mechanisms for methane induced by 55 eV, 75 eV, and 100 eV electron impact

The fragmentation of CH4 (2+) dications following 55 eV, 75 eV, and 100 eV electron impact double ionization of methane was studied using a cold target recoil-ion momentum spectroscopy. From the measured momentum of each recoil ion, the momentum of the neutral particles has been deduced and the kinetic energy release distribution for the different fragmentation channels has been obtained. The doubly charged molecular ions break up into three or more fragments in one or two-step processes, resulting in different signatures in the data. We observed the fragmentation of CH4 (2+) dications through different mechanisms according to the momentum of the neutral particles. For example, our result shows that there are three reaction channels to form CH2 (+), H(+), and H, one synchronous concerted reaction channel and two two-step reaction channels. For even more complicated fragmentation processes of CH4 (2+) dications, the fragmentation mechanism can still be identified in the present measurements. The slopes of the peak in the ion-ion coincidence spectra were also estimated here, as they are also related to the fragmentation mechanism.