The association of bisphenol A exposure with premature ovarian insufficiency: a case-control study

BACKGROUND

A few epidemiological investigations and animal studies have demonstrated that bisphenol A (BPA) may affect female reproductive health. However, no epidemiologic study has investigated the relationship between BPA exposure and the risk of premature ovarian insufficiency (POI).

METHODS

In this case-control study, urinary concentrations of BPA and serum levels of reproductive hormone were measured. Associations between BPA concentrations and the risk of POI and POI-related hormone levels were estimated.

RESULTS

Among BPA quartiles, no obvious association was found between BPA levels and the risk of POI (p = 0.603). Although the adjusted odds ratio (OR) of POI was slightly increased for participants in the highest BPA concentration quartile, the association was not statistically significant (OR = 1.282, 95% confidence interval [CI] 0.615-2.049 for the highest vs. lowest quartile, p = 0.508). Although follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH) levels showed no tendency of an association with BPA (p = 0.941 and p = 0.876 for FSH and AMH, respectively), the highest quartile of luteinizing hormone was significantly positively associated with BPA levels (OR = 1.333, 95% CI 0.986-1.803, p = 0.042).

CONCLUSIONS

The urinary concentrations of BPA determined in this study were consistent with the range of exposure currently observed in Chinese women. However, BPA exposure at a relatively low level is not associated with POI in Chinese women. Further epidemiological studies are needed to confirm our findings.

Hyperglycaemia-related occipital lobe seizures

Recognition of the role of hyperglycaemia in seizures is vital, because they tend to refractory to antiepileptic drugs and respond to insulin therapy and hydration.

The long-term effectiveness of metabolic control on cardiovascular disease in patients with diabetes in a real-world health care setting - A prospective diabetes management study

AIMS

To determine the incidence rates of cardiovascular disease (CVD) and assess the effect of metabolic risk factor management on the development of CVD in patients with diabetes.

METHODS

We studied 733 patients with diabetes without prior CVD in the Shanghai Taopu community health service center. Success in managing CVD risk factors was evaluated as follows: (1) glucose control (haemoglobin A1c [HbA1c] <7.0% in patients aged <65years and <8.0% in patients aged ≥65years), (2) blood pressure control (<140/90mmHg), and (3) lipid control (high-density lipoprotein cholesterol ≥1.0mmol/L in men and ≥1.3mmol/L in women, and triglycerides <1.7mmol/L).

RESULTS

During a median 8.0-year follow-up, 206 CVD incident cases were identified. Each 1% increment in HbA1c, 10mmHg increment in systolic blood pressure (SBP), and 1mmol/L increment in triglycerides during follow-up significantly increased the risk of CVD by 17%, 37%, and 14%, respectively. Compared to those who did not, patients who met the blood pressure and glucose control goals during follow-up had a 64% and a 29% decreased risk of CVD, respectively. The multivariable-adjusted hazard ratios of CVD were 1.00, 1.78 (95% confidence interval [CI] 1.10-2.87), and 2.51 (95% CI 1.54-4.07) among patients who attained three, two, and one/none of the CVD factor control goals (HbA1c, blood pressure, and lipid) during follow-up, respectively.

CONCLUSIONS

Average levels of HbA1c, SBP, and triglycerides during follow-up were positively associated with the risk of CVD, and treatment targeting multiple factors can significantly reduce CVD risk.

THU0047 THE SYNOVIUM REWIRES AN IMMUNOLOGICAL RHEOSTAT THAT DEFINES TWO FUNCTIONALLY DISPARATE PATHOGENIC CD4+HLA-DR+ SUBSETS IN HUMAN ARTHRITIS

Background:

Despite advances in understanding how the adaptive T cell landscape is affected in human arthritis, specific T cell subset knowledge has yet to be utilised in clinical settings. We have previously discovered within active arthritic patients, a circulating pathogenic-like lymphocyte (CPLs; CD4+HLA-DR+) within the T-effector compartment, that is phenotypically similar to their synovial counterparts. CPLs are inflammatory, correlate with disease activity and overlap in synovial TCR repertoire. A similar inflammation-associated T-regulatory (iaTreg; CD4+HLA-DR+) subset, that is activated, poised to migrate to inflamed site and sharing synovial TCR overlap, suggest a common disease ontogeny that may exist between CPLs and iaTregs.

Objectives:

Here we seek to determine whether and how the synovial microenvironment plays a role in modulating these two functionally divergent (Teff/Treg compartments) yet pathogenically homologous subsets. This modulation, akin to an immunological rheostat, may be a feature of the disease process.

Methods:

We examined CD45+ immune cells from synovial and PBMCs (active JIA, inactive JIA, paediatric healthy) through mass cytometry (CyToF). CD4 T cells were sorted into CPLs, iaTregs, Teff and Treg through FACS Aria II, from active JIA PBMCs, paired JIA SFMCs and healthy paediatric PBMCs and examined through ngRNASEQ.

Results:

Mass cytometric analysis reveal a significant enrichment of synovium signatures in both circulatory CPLs and iaTregs subsets from active arthritic PBMCs, as compared with the conventional pool of Teff/Tregs. This immunological relationship between CPLs/iaTregs is reaffirmed by comparative differential gene expression (DEG) and phylogenetic tree analysis, which indicated transcriptomic convergence between circulatory pathogenic CPLs/iaTreg subsets and divergence from their respective conventional Teff/Treg pools. Circulatory CPLs/iaTregs exhibit (a) common pathway dysregulation in T cell signalling, (b) restriction in TCR oligoclonality and (c) common transcription factor drivers within the gene regulatory network, suggesting a common pathogenic mechanism acting on these two disparate compartments.

To understand how the microenvironment plays a role in modulating these two subsets, we compared the transcriptome of CPLs/iaTreg and conventional Teff/Treg subsets from (a) healthy PBMCs, (b) JIA PBMCs and (c) paired JIA SFMCs. The convergence between CPLs/iaTreg increases across the spatial/disease continuum, culminating in 7 key common dysregulated pathways within synovium CPLs/iaTregs. Importantly we detected higher clonotypic sharing of TCRs in CPLs/iaTregs across the spatial and disease continuum, suggesting a common precursor driven by antigenic selection.

Conclusion:

Our data suggest that CPLs/iaTregs are dichotomic components of a systemic immune rheostat, shape through the synovium environment, modulating autoimmunity in human arthritis. As iaTreg and CPL most likely have the capacity to morph into each other, the molecular crossroads which control this plasticity represent novel therapeutic targets.

Disclosure of Interests:

None declared

SAT0496 INTERROGATING THE CIRCULATORY IMMUNE ARCHITECTURE OF ENTHESITIS-RELATED ARTHRITIS

Background:

Enthesitis-related arthritis (ERA) is one of the most common subtype of juvenile idiopathic arthritis (JIA) in Asia1. It carries a poor prognosis, but limited knowledge of its pathogenesis hampers clinical diagnosis and treatment.

Objectives:

We hypothesise multiple aberrations from the healthy immunome culminating in an imbalance between the immune effector and regulatory cell subsets as key for driving ERA pathogenesis. Thus, we employed a comprehensive high-dimensional interrogative strategy using mass cytometry to assess the ERA immune architecture2.

Methods:

We examined peripheral blood mononuclear cells from 30 ERA patients (15 with active sacroilitis, 15 without active sacroilitis) within the first two years of disease and 30 healthy paediatric controls with mass cytometry, using two extensive antibody panels encompassing key lineage and functional markers. Dimensional reduction and unsupervised clustering were performed to identify immune cell subsets differentially present in ERA patients. Manual gating was performed to further describe observed differences in subset frequencies. These subsets were statistically evaluated with reference to the healthy cohort and their association with disease activity determined.

Results:

We identified broad differences in the ERA circulatory immune architecture that involved both innate and adaptive immune cell populations, notably with the enrichment of naive CD4+ T cells as well as depletion of cytolytic NK cells (CD56dimCD16+). The chemotactic profiles of their subsets also differed in ERA patients, which underscores their migratory capacity and hence potential effector role in the ERA arthritic microenvironment. In addition, there were some dissimilarities in the circulatory immunome of ERA patients with active sacroiliitis as compared to those without, which alludes to a possible mechanistic basis behind the disease complication.

Conclusion:

This is the first study, via deep parameterisation afforded by mass cytometry, to demonstrate a concomitant dysregulation of both innate and adaptive immune cell subsets in ERA patients. Further mechanistic studies of these immune cell subsets and their functional networks will inform the development of diagnostic and prognostic markers that can reliably predict clinical fate in ERA, thereby complementing clinical assessment in the care of ERA patients.

References:

[1]Arkachaisri et al. Paediatric rheumatology clinic in Southeast Asia: are we different?Rheumatology (Oxford). 2017.

[2]Tay et al. Immunomics in pediatric rheumatic diseases.Front Med (Lausanne). 2019.

Disclosure of Interests:

None declared

0063 Age Related Changes in Central Autonomic Couplings During Sleep

Introduction

Studies show coupling between central nervous system (CNS) and autonomic nervous system (ANS) activity during sleep. We reported on a novel central/autonomic coupling event (ACE) during non-rapid eye movement (NREM) sleep, in which bursts in heart rate (HRBs) coincide with increased slow-wave activity (SWA) 5 seconds prior to the HRB, followed by a surge in vagal high-frequency activity in the RR signal (HFRR) 5 seconds after the HRB. ACEs predicted sleep-related explicit memory improvement. Aging is characterized with impaired sleep and autonomic loss. We, therefore, investigated ACE activity in older adults.

Methods

We compared ACEs during a daytime nap between youngers (18-25yrs, N=49) and olders (60-75yrs, N=32). Subjects took an EEG-monitored, 90-minute nap. We measured SWA and HFRR in a 20-sec window around the HRB peak separately for Stage 2 and slow-wave sleep (SWS). EEG were binned into 5-sec intervals around the HRB: -10, -5, +5, +10 bins. For Stage 2 and SWS, repeated-measure ANOVAs with two factors (age and windows) were performed on SWA and HFRR. Corrections used Greenhouse-Geisser and Bonferroni methods.

Results

For SWA, we found an interaction between age and windows during Stage 2 (p&lt;.001), and SWS (p=.001). SWA during the -5bin was greater in youngers than olders during both Stage 2 and SWS (ps &lt; .001). The ACE profile in youngers showed highest SWA in the -5bin in Stage 2 and SWS (ps &lt; .001) and highest HFRR in the +5bin in Stage 2 (ps &lt; .001) The ACE profile in olders, however, showed no clear pattern for SWA in either sleep stage. Olders showed greater HFRR during the +5bin compared to the -10bin (p=.041) during Stage 2 but no HFRR modulations were found during SWS.

Conclusion

Our results replicated the ACE profile in daytime naps first reported by Naji et al (2018). In youngers, heart rate bursts were coupled with increased SWA and vagal activity. In contrast, olders demonstrated a lack of boost in SWA and HFRR, which provides implications in cognitive aging. Future research is needed to further understand the impact of decreased coupling between ANS/CNS activity on cognitive decline.

Support

 

[A survey on clinical characteristics and risk factors of severe asthma in China]

Objective: To investigate the clinical characteristics and risk factors of severe bronchial asthma in Chinese people over 14 years old. Methods: According to the multi-stage random cluster sampling methods, a total of 164 215 subjects were visited by a questionnaire in the epidemiology survey from eight provinces (Beijing, Shanghai, Guangdong, Liaoning, Henan, Shanxi, Jiangsu, Sichuan provinces) located in seven regions (north, northeast, east, central China, south, southwest and northwest) of China from February 2010 to August 2012. A total of 2 034 were diagnosed as asthma. The clinical characteristics and related risk factors of patients with severe asthma in China were analyzed. Results: Among all asthma patients, 560 were newly diagnosed, accounting for 27.5% (560/2 034) and the percentage of previously confirmed patients was 72.5% (1 474/2 034). A total of 145 were eligible for severe asthma, accounting for 9.8% (145/1 474) of previously confirmed asthmatics and 7.1% (145/2 034) of all asthmatics. 83.5% (121/145) severe asthmatics had at least one trigger factor. Correlation analysis showed that the risk factors of severe asthma were: smoking (OR=1.543, 95%CI: 1.250-1.814), obesity (OR=2.186, 95%CI: 1.972-2.354), petting (OR=2.135, 95%CI: 1.904-2.283), combined with allergic rhinitis (OR=3.456, 95%CI: 2.721-4.326), gastroesophageal reflux disease (OR=1.842, 95%CI: 1.682-2.140), bronchiectasis (OR=1.665, 95%CI: 1.347-1.912) or chronic obstructive pulmonary disease (OR=1.312, 95%CI: 1.171-1.694). Conclusions: The most common comorbidities in severe asthmatics in China are allergic rhinitis and gastroesophageal reflux disease. The risk factors of severe asthma include obesity, allergic rhinitis, gastroesophageal reflux disease, chronic obstructive pulmonary disease, bronchiectasis, smoking and petting.

20-Hydroxyecdysone receptor-activated Bombyx mori CCAAT/enhancer-binding protein gamma regulates the expression of BmCBP and subsequent histone H3 lysine 27 acetylation in Bo. mori

Cyclic adenosine monophosphate (cAMP) response element binding protein (CREB)-binding protein (CBP or CREBBP) plays important roles in regulating gene transcription and animal development. However, the process by which CBP is up-regulated to impact insect development is unknown. In this study, the regulatory mechanism of Bombyx mori CBP (BmCBP) expression induced by 20-hydroxyecdysone (20E) was investigated. In the Bo. mori cell line, DZNU-Bm-12, 20E enhanced BmCBP transcription and histone H3K27 acetylation. BmCBP RNA interference (RNAi) resulted in decreased histone H3K27 acetylation. Additionally, the luciferase activity analysis revealed that the transcription factor, Bo. mori CCAAT/enhancer-binding protein gamma (BmC/EBPg), activated BmCBP transcription, which was suppressed by BmC/EBPg RNAi and promoted by BmC/EBPg overexpression. Electrophoretic mobility shift assay and chromatin immunoprecipitation results demonstrated that BmC/EBPg could bind to the C/EBP cis-regulatory elements in two positions of the BmCBP promoter. Moreover, BmC/EBPg transcription was enhanced by the 20E receptor (BmEcR), which bound to the BmC/EBPg promoter. BmEcR RNAi significantly inhibited the transcriptional levels of BmC/EBPg and BmCBP in the presence of 20E. Furthermore, the BmEcR-BmC/EBPg pathway regulated the acetylation levels of histone H3K27. Altogether, these results indicate that BmEcR enhances the expression of BmC/EBPg, which binds to the BmCBP promoter, activates BmCBP expression and leads to histone H3K27 acetylation.

[Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia]

Objective: To investigate the clinical characteristics of medical staff with novel coronavirus pneumonia(NCP). Methods: 30 patients infected with novel coronavirus referred to jianghan university hospital between January 11, 2020 and January 3, 2020 were studied. The data reviewed included those of clinical manifestations, laboratory investigation and Radiographic features. Results: The patients consisted of 10 men and 20 women, including 22 doctors and 8 nurses,aged 21~59 years(mean 35±8 years).They were divided to 26 common type and 4 severe cases, all of whom had close(within 1m) contact with patients infected of novel coronavirus pneumonia. The average contact times were 12 (7,16) and the average cumulative contact time was 2 (1.5,2.7) h.Clinical symptoms of these patients were fever in 23 patients (76.67%) , headache in 16 petients (53.33%) , fatigue or myalgia in 21patients (70%) , nausea, vomiting or diarrhea in 9 petients (30%) , cough in 25 petients (83.33%) , and dyspnea in 14 petients (46.67%) .Routine blood test revealed WBC<4.0×10(9)/L in 8 petients (26.67%) , (4-10) ×10(9)/L in 22 petients (73.33%) , and WBC>4.0×10(9)/L in 4 petients (13.33%) during the disease.Lymphocyte count<1.0×10(9)/L occurred in 12 petients (40%),abnormal liver function in 7 petients (23.33%) ,myocardial damage in 5 petients(16.67%), elevated D-dimer (>0.5mg/l) in 5 patients (16.67%). Compared with normal patients, the average exposure times, cumulative exposure time, BMI, Fever time, white blood cell count, liver enzyme, LDH, myoenzyme and D-dimer were significantly increased in severe patients, while the lymphocyte count and albumin levels in peripheral blood were significantly decreased.Chest CT mainly showed patchy shadows and interstitial changes.According to imaging examination, 11 patients (36.67%) showed Unilateral pneumonia and 19 patients (63.33%) showed bilateral pneumonia,4 patients (13.33%) showed bilateral multiple mottling and ground-glass opacity.Compared with the patients infected in the protected period, the proportion of severe infection and bilateral pneumonia were both increased in the patients infected in unprotected period. Conclusion: Medical staffs are at higher risk of infection.Infection rates are associated with contact time, the amount of suction virus. Severe patients had BMI increased, heating time prolonged, white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage.Strict protection measures is important to prevent infection for medical workers.

Functioning Mechanism of the Secondary Aqueous Zn-β-MnO2 Battery

Rechargeable aqueous Zn-MnO₂ batteries are a promising candidate for large-scale energy storage systems due to their outstanding advantages, such as high energy density, high safety, low cost, and environmental friendliness. Considering the controversies surrounding the mechanism of this battery containing a mildly acidic electrolyte, the electrochemical behavior of this type of battery using β-MnO₂ as the cathode is systematically investigated. The results indicate that the reversible intercalation of Zn²⁺ ions into MnO₂ is not likely to take place in the aqueous system. We conclude that it is the existence of the water molecule and its participation in the electrochemical reactions, for instance, the reversible insertion of proton into MnO₂ and the electrolysis of water, that makes the mechanism of aqueous Zn-MnO₂ batteries complicated. Besides, the capacity fading of this mildly acidic Zn-MnO₂ battery is assigned to the generation of the inert layer of Zn₄SO₄(OH)₆·nH₂O and the ZnMn₂O₄ on the cathode via electrochemical conversion reactions, the dissolution of the active material during discharging, and the release of gases. When Mn²⁺ ions are available in the electrolyte, they will be electrodeposited on the cathode during charging, and the kinetics of the electrochemical reactions of the electrode is improved, leading to the higher electrochemical performance of the battery.

[Short-term efficacy evaluation of laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision for advanced proximal gastric cancer based on mesangial anatomy]

Objective: To investigate short-term efficacy of laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision for advanced proximal gastric cancer based on mesangial anatomy. Methods: A case series study was carried out. Case inclusion criteria: (1) patient was confirmed as gastric adenocarcinoma by gastroscopic biopsy before operation; (2) locally advanced gastric cancer was confirmed by abdominal CT before operation; (3) no distant metastases such as liver, lung, and posterior peritoneal lymph nodes, and no tumor directly invading the pancreas, spleen, liver, and colon were verified by superficial lymph node ultrasound, chest and abdominal CT before operation;(4) total gastrectomy or proximal gastrectomy plus D2 lymphadenectomy were performed, and R0 resection was confirmed by postoperative pathology. Exclusion criteria: (1) intraperitoneal dissemination or distant metastasis was found during laparoscopic exploration; (2) No.10 lymph nodes were significantly enlarged or fused into clusters; (3) pathological diagnostic data were incomplete. According to above criteria, the clinicopathological data of 36 patients who underwent laparoscopic spleen-preserving No.10 lymphadenectomy and left epigastrium mesogastric excision based on interspace anatomy for advanced proximal gastric cancer in The First Affiliated Hospital of Zhengzhou University from June 2017 to March 2018 were retrospectively collected and analyzed. The intraoperative conditions, postoperative recovery and complications of patients were analyzed. Results: In 36 patients, the mean age was (59.8±8.0) years, the mean BMI was (23.9±3.5) kg/m(2), and 8 cases (22.2%) received preoperative chemotherapy. All the patients underwent successfully the laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision. In the examination of postoperative resected specimens, it was found that the mesangial boundary of the upper and posterior part of the stomach was smooth, indicating the efficiency of complete mesangial resection. No case was converted to open operation. The mean time of lymph node dissection and mesangial resection was (34.2±11.4) minutes. The mean blood loss during operation was (44.8±21.3) ml. The mean number of lymph node dissection per patient was 45.6±17.6. The mean number of No. 11p+11d lymph node dissection was 3.1± 2.8 per patient, and 7 patients were pathologically positive with metastasis rate of 19.4% (7/36). The mean number of No.10 lymph node dissection was 2.9±2.5 per patient, and 2 patients were pathologically positive with metastasis rate of 5.6% (2/36). The time to postoperative flatus was (3.8±0.6) days, time to removal of nasogastric was (1.9±0.7) days, time to the first intake of fluid was (3.0±0.4) days, time to removal of drainage tube was (6.0±1.2) days. Postoperative mean hospital stay was (12.8±4.0) days. One case (2.7%) developed pulmonary embolism and 1 case (2.7%) developed gastroplegia after operation. The morbidity of postoperative complication was 5.6% (2/36). No operative site infection, postoperative bleeding and death within postoperative 30-day were observed. All the 36 patients were followed up and the median follow-up was 18 months (12-28 months). Seven patients died of tumor relapse and metastasis (3 cases died within postoperative 1 year) and another 1 case developed colonic cancer 17 months after operation. Conclusion: Laparoscopic spleen-preserving splenic hilus lymphadenectomy and left epigastrium mesogastric excision for advanced proximal gastric cancer based on mesangial anatomy is safe and feasible.

[Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia]

Objective: To investigate the clinical characteristics of medical staff with novel coronavirus pneumonia(NCP). Methods: 30 patients infected with novel coronavirus referred to jianghan university hospital between January 11, 2020 and January 3, 2020 were studied. The data reviewed included those of clinical manifestations, laboratory investigation and Radiographic features. Results: The patients consisted of 10 men and 20 women, including 22 doctors and 8 nurses,aged 21~59 years(mean 35±8 years).They were divided to 26 common type and 4 severe cases, all of whom had close(within 1m) contact with patients infected of novel coronavirus pneumonia. The average contact times were 12 (7,16) and the average cumulative contact time was 2 (1.5,2.7) h.Clinical symptoms of these patients were fever in 23 patients (76.67%) , headache in 16 petients (53.33%) , fatigue or myalgia in 21patients (70%) , nausea, vomiting or diarrhea in 9 petients (30%) , cough in 25 petients (83.33%) , and dyspnea in 14 petients (46.67%) .Routine blood test revealed WBC <4.0×10(9)/L in 8 petients (26.67%) , (4-10) ×10(9)/L in 22 petients (73.33%) , and WBC>4.0×10(9)/L in 4 petients (13.33%) during the disease.Lymphocyte count <1.0×10(9)/L occurred in 12 petients (40%),abnormal liver function in 7 petients (23.33%) ,myocardial damage in 5 petients(16.67%), elevated D-dimer (>0.5mg/l) in 5 patients (16.67%). Compared with normal patients, the average exposure times, cumulative exposure time, BMI, Fever time, white blood cell count, liver enzyme, LDH, myoenzyme and D-dimer were significantly increased in severe patients, while the lymphocyte count and albumin levels in peripheral blood were significantly decreased.Chest CT mainly showed patchy shadows and interstitial changes.According to imaging examination, 11 patients (36.67%) showed Unilateral pneumonia and 19 patients (63.33%) showed bilateral pneumonia,4 patients (13.33%) showed bilateral multiple mottling and ground-glass opacity.Compared with the patients infected in the protected period, the proportion of severe infection and bilateral pneumonia were both increased in the patients infected in unprotected period. Conclusion: Medical staffs are at higher risk of infection.Infection rates are associated with contact time, the amount of suction virus. Severe patients had BMI increased, heating time prolonged , white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage.Strict protection measures is important to prevent infection for medical workers.

Two-dimensional grating coupler on silicon with a high coupling efficiency and a low polarization-dependent loss

Two-dimensional grating couplers are important components for silicon photonic circuits to achieve light coupling from/to a fiber for both polarizations. A two-dimensional grating coupler structure with a high coupling efficiency and a low polarization dependent loss is demonstrated. Using two crossing ellipses as the grating scatter and a diamond-like grating lattice, the polarization dependent loss of the grating coupler can be reduced. The coupling loss is further decreased with a metal mirror, which reaches -1.73 dB theoretically at 1310 nm wavelength. Experimentally, -2.37 dB coupling loss is achieved with an 1 dB coupling bandwidth of 29 nm. The corresponding PDL was measured lower than 0.2 dB in a wavelength range of 78 nm. The proposed configuration for the metal mirror also facilitates a robust wafer-scale post-processing as well as an easy fiber alignment.

Non-canonical Wnt signalling regulates scarring in biliary disease via the planar cell polarity receptors

The number of patients diagnosed with chronic bile duct disease is increasing and in most cases these diseases result in chronic ductular scarring, necessitating liver transplantation. The formation of ductular scaring affects liver function; however, scar-generating portal fibroblasts also provide important instructive signals to promote the proliferation and differentiation of biliary epithelial cells. Therefore, understanding whether we can reduce scar formation while maintaining a pro-regenerative microenvironment will be essential in developing treatments for biliary disease. Here, we describe how regenerating biliary epithelial cells express Wnt-Planar Cell Polarity signalling components following bile duct injury and promote the formation of ductular scars by upregulating pro-fibrogenic cytokines and positively regulating collagen-deposition. Inhibiting the production of Wnt-ligands reduces the amount of scar formed around the bile duct, without reducing the development of the pro-regenerative microenvironment required for ductular regeneration, demonstrating that scarring and regeneration can be uncoupled in adult biliary disease and regeneration.

[Research progress on the relationship between electrode position and electrode impedance of artificial cochlea]

Summary Since the first cochlear implant was developed and used in clinical practice, many patients with profound deafness have returned to the world of sound, with the development of modern large-scale integrated circuits and the in-depth study of the anatomical pathophysiology of cochlea, deaf patients have been continuously benefited from it. Electrode is one of the core parts of cochlea implants, the design of the electrode and the placement of the electrode are important factors for patients to benefit from cochlea implantation. Postoperative starting up and debugging are also crucial. Through debugging, the electric stimulation level of each channel can be optimized, which is of great significance for postoperative rehabilitation effect, the magnitude of electrode impedance plays an important role in starting up and debugging. At present, there is no unified conclusion about the relationship between the electrode position and the electrode impedance value. Only when the implanted position and the electrode impedance are normal, can the implanted electrode function be better played.

Improving timing performance of double-ended readout in TOF-PET detectors

Scintillation crystals of 20mm length or longer are needed for clinical time-of-flight positron emission tomography (TOF-PET) to ensure effective detection efficiency for gamma photons. However, the use of long crystals would deteriorate the key performance of TOF-PET detectors, time and spatial resolution, because of the variations in the travel times of the photons in crystals and the effects of parallax errors. In this work, we studied double-ended readout TOF-PET detectors based on coupling a long scintillation crystal to SiPMs at both ends for correcting the depth-dependent effects to improve the coincidence time resolution (CTR). In particular, we focused our attention to analyze timing performance using different correction methods, including trigger times of the individual photodetectors at both ends of the crystal, the simple average of the trigger times, and the weighted average based on the inverse variances of the depth-dependent corrected trigger times. For a 3 mm × 3 mm × 25mm unpolished lutetium fine silicate (LFS) crystal with double-ended readout and practical head-on irradiation, a CTR of 246ps FWHM can be achieved using depth-dependent timing-correction and weighted average time method compared to 280ps FWHM using the conventional simple average time method and 393ps FWHM using the conventional single-ended readout. The results show that the depth-dependent timing-correction and weighted average time method in double-ended readout can effectively correct for the trigger time variations in TOF-PET detector utilizing long unpolished crystals, resulting in an improvement in the CTR of as much as 37% compared to single-ended readout.

69 Phosphorylation of mechanistic target of rapamycin in porcine blastocyst-stage embryos is dependent on the concentration of glutamine in the medium

Supplementation of glutamine to porcine embryo culture medium improves blastocyst development, increases leucine consumption, and enhances mitochondrial activity. In cancer cells, glutamine has been implicated in the phosphorylation and activation of mechanistic target of rapamycin (MTOR) to support rapid cellular proliferation. The objective of this study was to determine if phosphorylation of MTOR in porcine blastocysts was dependent upon the concentration of glutamine in the medium and presence of leucine, another activator of MTOR. Presumptive zygotes (n=732 per treatment across 6 replicates) were split into four groups and cultured in 0, 1, 3.75, or 10mM GlutaMAX, an L-glutamine alternative, with or without 0.2mM leucine. On Day 6, percentages of embryos developed to the blastocyst stage were recorded. Blastocyst-stage embryos (n=100 per treatment) were collected for immunoblotting to detect total MTOR and phosphorylated (Ser2448) MTOR (pMTOR) with 3 replicates per target. To assess MTOR and lysosomal colocalization as another indicator of MTOR activation, blastocyst-stage embryos (n=15 per treatment) were fixed, probed with antibodies against MTOR and lysosomal associated membrane protein 1 (LAMP1), and imaged on a confocal microscope. Data were analysed by using the GLM procedure in SAS 9.4 (SAS Institute Inc.), and differences between means were detected by using one-way ANOVA followed by a least significant difference test with P&lt;0.05 declared significant. Compared with the other treatments, culture in 0mM GlutaMAX resulted in decreased blastocyst development with (26.2±4.8%) or without (23.2±3.0%) leucine. Embryos cultured in 3.75mM GlutaMAX had increased development to the blastocyst stage (+Leu: 49.7±4.2%; −Leu: 46.2±2.6%) compared with culture in 1mM (+Leu: 39.5±3.5%; −Leu: 37.8±2.1%). In the presence of leucine, culture in 0mM GlutaMAX resulted in decreased pMTOR abundance compared with 3.75 or 10mM GlutaMAX. In the absence of leucine, embryos cultured in 0mM GlutaMAX had decreased abundance of total MTOR compared with all other groups, and pMTOR abundance was decreased in embryos cultured in 0 or 1mM compared with 3.75 or 10mM GlutaMAX. Furthermore, embryos cultured in 0mM GlutaMAX had decreased colocalization of MTOR and LAMP1 compared with those cultured in 3.75 or 10mM GlutaMAX. Therefore, glutamine supplementation is sufficient to prompt MTOR phosphorylation in porcine embryos. Further analyses are examining the phosphorylation status of MTOR downstream targets and effects of inhibiting enzymes involved in glutaminolysis. Funding was provided by the United States Department of Agriculture, National Institute of Food and Agriculture (2019-67011-29543) and Food for the 21st Century at the University of Missouri.

136 Effects of the homology direct repair enhancer RS-1 on pig embryo culture

Advances in genome editing technologies, such as the CRISPR/Cas9 system, have facilitated gene manipulation and the generation of pigs resistant to disease, models for studying human diseases and for xenotransplantation. However, double-strand breaks generated by the CRISPR/Cas9 system are preferentially repaired by the non-homologous end joining (NHEJ) pathway compared with high-fidelity homology-directed repair (HDR). All reports of pigs created by zygote injection of the CRISPR/Cas9 system result from NHEJ rather than HDR. The molecule known as RS-1 was found to stimulate RAD51 and thus enhance HDR. Thus, our goals are to understand this pathway by evaluating the response, as well as dosage and temporal effects, of RS-1 on porcine embryo development, and to determine a safe concentration to achieve high HDR rates without affecting embryo development. As RS-1 was added to culture medium from a 7.5mM stock solution in DMSO, we also evaluated whether RS-1 in solution could have affinity and migrate to the mineral oil overlay placed in the media during embryo culture. After IVF, embryos were cultured without RS-1 (control groups) or in the presence of RS-1 at 7.5 and 15 µM. At 7.5 µM, RS-1 improved HDR in rabbits created by zygote injection of the CRISPR/Cas9. Based on that, we designed five experimental groups to evaluate short- (A, 20h) and long-term (B, 144 h) effects of RS-1: two groups in the presence of RS-1 at 7.5 µM (7.5 µM A and 7.5 µM B), two control groups (control A and control B), and a group in the presence of RS-1 at 15 µM A for short-term exposure only. First, embryos in the groups containing (7.5 µM A, 7.5 µM B, and 15 µM A) and without RS-1 (control A and control B) were cultured for 20h without the mineral oil overlay. Then, embryos from control A, 7.5 µM A, and 15 µM A groups were washed and cultured without RS-1 until Day 6 in the presence of the mineral oil overlay. To evaluate long-term effects of RS-1, embryos from control B and 7.5 µM B groups were washed and transferred to medium without or with RS-1 at 7.5 µM, respectively, and cultured until Day 6 with no mineral oil overlay. We report the mean values for each set of data±s.e.m., and the degree of statistical significance in all analyses was defined at P&lt;0.05. We observed that the presence of RS-1 at 15 µM decreased cleavage rates (control A 79.1±2.7%; 7.5 µM A 83.6±1.6%; 15 µM 70.9±4.4%; control B 80.8±1.4%; 7.5 µM B 80.0±2.8%), and long-term exposure to RS-1 decreased development to the blastocyst stage (control A 46.5±3.0%; 7.5 µM A 42.7±3.4%; 15 µM 41.8±4.7%; control B 44.9±3.3%; 7.5 µM B 28.8±4.9%). In addition, RS-1 exposure decreased the total cell number compared with the controls (control A 61.4±2.8; 7.5 µM A 49.2±3.0; 15 µM 48.5±2.3; control B 59.9±3.4; 7.5 µM B 41.5±2.5), however no differences in apoptosis rates were observed between the treatments. Our work will serve as a basis to understand the effects of RS-1 and RAD51 during embryonic development and to improve the applicability of customizable nucleases for the production of genetically modified pigs.

P98 Distal myopathy induced the onset of arrhythmogenic right ventricular cardiomyopathy in a pedigree carrying novel DSG2 null variant

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disease predominantly caused by variants in desmosome genes. Variants in human Desmoglein-2 (DSG2) gene can cause ARVC with incomplete penetrance. However, it remains unknown whether ARVC would penetrate by distal myopathy.

Methods

We performed targeted next-generation sequencing using a cardiomyopathy/ion channelopathy panel in a Chinese ARVC pedigree. Plasmids of DSG2 were constructed, and pathogenicity of the DSG2 variant was investigated by real-time PCR, western blots, Immunofluorescence, and electron microscope.

Results

We identified a novel nonsense variant in DSG2 (c.710T &gt; A, p.Leu237Ter) and a reported pathogenic missense variant of distal myopathy in MYH7 (c. 1322C &gt; T, p.Thr441Met) in the proband of an ARVC pedigree. The functional analyses suggested that the nonsense variant could affect the expression and cell location of DSG2, and the number and shape of desmosomes were affected as well, indicating that the variant was implicated in the pathogenesis of ARVC. We found only patients carrying the distal myopathy pathogenic variant would manifested early-onset severe ARVC phenotype, which suggested that MYH7-p.Thr441Met variant could induced the onset of ARVC in the DSG2-p.Leu237Ter variant carriers.

Conclusions

Our study identified a novel null variant in DSG2 gene (c.710T &gt; A, p.Leu237Ter) in an ARVC pedigree with incomplete penetrance. Only patients who carried a distal myopathy associated variant in MYH7 (c. 1322C &gt; T, p.Thr441Met) would induce the onset of ARVC with early-onset and severe symptoms.