Development and validation of novel diagnostic nomogram for tuberculous pleurisy based on TB-IGRA results

OBJECTIVE: To establish the diagnostic nomogram for tuberculous pleurisy (TP) based on TB-interferon-gamma release assays (TB-IGRA), as well as clinical and peripheral blood characteristics.MATERIAL AND METHODS: Patients who underwent TB-IGRA tests during hospitalisation and were finally diagnosed, were retrospectively and continuously enrolled. TP was divided into confirmed TP (cTP) and presumptive TP (pTP), and corresponding diagnostic nomograms were established.RESULTS: A total of 1283 patients were enrolled (median age 49 years, range 14-96; males: 63.1%). The area under the curve (AUC) of TB-IGRA was 0.81 (95%CI 0.77-0.84) for cTP (n = 272) and 0.74 (95%CI 0.71-0.78) for pTP (n = 644). The false-positive and negative rates of TB-IGRA among non-TP and cTP were respectively 32.4% and 16.8%. Based on LASSO analysis, we then selected respectively 12 and 10 predictors from clinical and peripheral blood characteristics to establish cTP and pTP nomograms (TB-IGRA was selected). The cTP and pTP nomograms had an AUC of 0.93 (95%CI 0.90-0.95) and 0.92 (95%CI 0.90-0.94) in the training group, and 0.91 (95%CI 0.87-0.96) and 0.93 (95%CI 0.89-0.96) in the validation group, respectively, which were superior to TB-IGRA test alone.CONCLUSION: Novel predictive nomograms with less invasiveness were provided based on TB-IGRA test to assist differential diagnosis of TP and non-TP patients.

[Clinical effect evaluation of anodized and sandblasted, large-grit, acid-etched implants within 10 years: a meta-analysis]

Objective: To systematically evaluate the clinical effect of anodized implants and sandblasted, large-grit, acid-etched (SLA) implants in the recent 10 years, so as to provide a reference for the selection and evaluation of implants. Methods: The data from Pubmed, Cochrane Library, Embase, CNKI, and Wanfang Data database from January 2010 to April 2020 were searched, to find clinical studies on anodized and SLA implants. According to the inclusion and exclusion criteria, literature was strictly screened, and data was extracted. Included studies were evaluated by using the methodological index for non-randomized studies (MINORS) and were analyzed by Stata14.0. The outcome of interest was cumulative survival rate (CSR) and marginal bone loss (MBL). Heterogeneity and publication bias among included literature was evaluated comprehensively. Results: A total of 22 articles, including 6 276 anodized implants, were collected for the analysis of anodized implants. Meta-analysis of proportions showed that anodized implants CSR were 98% (95%CI: 97%-98%, P<0.05) in total, at 5 years were 98% (95%CI: 98%-99%, P<0.05), and at 10 years were 97% (95%CI: 96%-98%, P<0.05). MBL change was 1.02 mm (95%CI: 0.69-1.34, P<0.05) in total. A total of 17 articles, including 4 567 SLA implants, were collected for the analysis of SLA implants. Meta-analysis of proportions showed that SLA implants CSR were 99% (95%CI: 98%-100%, P<0.05) in total, 99% at 5 years (95%CI: 98%-100%, P<0.05), and 99% at 10 years (95%CI: 97%-100%, P<0.05). MBL change was 0.69 mm (95%CI: 0.44-0.95, P<0.05) in total. The results of the above two studies were tested for bias (P>0.05), indicating no significant publication bias. Conclusions: Meta-analysis suggested that SLA implants have higher CSR and lower MBL than anodized implants.

Epidemiology of and risk factors for mortality due to carbapenemase-producing organisms (CPO) in healthcare facilities

BACKGROUND

Carbapenemase-producing organisms (CPO) have been largely responsible for the extensive spread of carbapenem resistance, and their prevalence is increasing in many parts of the world.

AIM

To evaluate clinical and molecular epidemiology and mortality associated with CPO among patients.

METHODS

All CPO from clinical and long-term healthcare surveillance cultures across Scotland in 2003-2017 were reviewed retrospectively. Polymerase chain reaction was used to detect genes coding for carbapenemases. A generalized linear mixed model was used to identify risk factors for mortality.

FINDINGS

In total, 290 individuals with CPO were identified. The overall incidence increased over time (P<0.001) from 0.02 to 1.38 per 100,000 population between 2003 and 2017. A total of 243 distinct CPO isolates were obtained from 269 isolations in 214 individuals with available metadata. The majority of the isolates were Enterobacterales (206/243, 84.8%), and Klebsiella pneumoniae (65/206, 31.6%) and Enterobacter cloacae (52/206, 25.2%) were the most common species. VIM (75/243, 30.9%) and NDM (56/243, 23.0%) were the most common carbapenemases. The crude 30-day mortality rate was 11.8% (25/211), while the case fatality rate was 5.7% (12/211). Age >60 years [adjusted odds ratio (aOR) 3.36, 95% confidence interval (CI) 1.06-10.63; P=0.033], presence of non-fermenters (aOR 4.88, 95% CI 1.64-14.47; P=0.005), and systemic infection or organ failure (aOR 4.21, 95% CI 1.38-12.81; P=0.032) were independently associated with 30-day mortality.

CONCLUSION

The incidence of CPO in Scotland is low but increasing. Awareness is required that inpatients aged >60 years, patients with systemic infection or organ failure, and patients presenting with non-fermenters are at higher risk of death from CPO.

Early-life Exposures and Age at Breast Development in the Sister Study Cohort

Purpose: Early age at breast development (thelarche) has been associated with increased breast cancer risk. Average age at thelarche has declined over time, but there are few established risk factors for early thelarche. We examined associations between pre- and postnatal exposures and age at thelarche in a U.S. cohort of women born between 1928 and 1974. Methods: Breast cancer-free women ages 35–74 years who had a sister diagnosed with breast cancer were enrolled in the Sister Study from 2003–2009 (N = 50,884). At enrollment, participants reported their age at thelarche, which we categorized as early (≤10 years), average (11–13 years), and late (≥14 years), as well as information on early-life exposures. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for early and late thelarche relative to average age at thelarche using polytomous logistic regression for each early-life exposure, adjusted for birth cohort, race/ethnicity and family income level in childhood. We examined modification by birth cohort, race/ethnicity, family income, relative weight at age 10, and extent of breast cancer family history through stratification. Results: Early thelarche was more common in recent birth cohorts and among non-Hispanic Black and Hispanic women. Early thelarche (≤10 years) was associated with multiple prenatal exposures: gestational hypertensive disorder (OR = 1.25, 95% CI, 1.09–1.43), maternal diethylstilbestrol (DES) use (OR = 1.23, 95% CI, 1.04–1.45), maternal smoking during pregnancy (OR = 1.20, 95% CI, 1.13–1.27), and young maternal age (OR 1.30, 95% CI, 1.16–1.47 for &lt;20 vs 25–29 years). Being firstborn was also associated with early thelarche (OR = 1.25, 95% CI, 1.17–1.33). Low birthweight (&lt;2500 vs 2500–3999g) was suggestively associated with both early (OR = 1.06, 95% CI, 0.96–1.17) and late (OR = 1.15, 95% CI, 1.05–1.25) thelarche, as was use of soy formula in infancy (Early: OR = 1.10, 95% CI, 0.93–1.30; Late: OR = 1.07, 95% CI, 0.92–1.25). Patterns were generally similar across strata of modifiers of interest. Conclusion: Associations between pre- and postnatal exposures and age at thelarche suggest that the early-life environment may influence breast development and therefore may also affect breast cancer risk by altering the timing of pubertal breast development.

Antibiotics in marine aquaculture farms surrounding Laizhou Bay, Bohai Sea: Distribution characteristics considering various culture modes and organism species

This study mainly investigated the distribution characteristics and risk assessment of 14 antibiotics in typical marine aquaculture farms surrounding the Bohai Sea. The effects of various culture modes (outdoor pond culture, recirculating water culture, greenhouse pond culture, raft culture, cage culture and bottom sowing culture), and diverse cultured organism species such as fish (grouper, bass, pike and turbot), mollusk (oyster, scallop, conch and mussel) and sea cucumber on the distribution of antibiotics in different mariculture pond matrices (seawater, sediment/biofilm and organism) were studied. In addition, antibiotic pollution levels in various matrices (water, sediment, organism and feed) from different mariculture areas surrounding the Bohai Sea and the Yellow Sea were compared. The biofilm on the inner wall of greenhouse pond was more capable of accumulating antibiotics than the biofilm attached to the rope for raft culture and net for cage culture, and other culture sediments. The antibiotic concentration level in the culture matrices (water, sediment/biofilm and organism) was the highest under greenhouse pond culture mode, and that under the industrial recirculating water culture mode was the lowest. Antibiotic concentration in culture matrices of fish ponds was higher than that of sea cucumber ponds and mollusk ponds. The levels of antibiotics in water and sediment from marine aquaculture farms in Laizhou (Bohai Sea coast) were higher than those in Haiyang and Jimo (Yellow Sea coast). Enrofloxacin in turbot might cause considerable harm to human health, and the risk of antibiotics in other seafood could be ignored. Antibiotic ecological risks and resistance risks were generally low in water. Fluoroquinolones posed medium to high ecological risks in the natural receiving water around the mariculture farm. Trimethoprim and enrofloxacin showed relatively high antibiotic resistance risks in mariculture water and natural water, which might exert selective pressure on the bacterial community in the environment.

Long noncoding RNA PVT1 promotes metastasis via miR-484 sponging in osteosarcoma cells

OBJECTIVE

Long noncoding RNAs (lncRNAs) are widely involved in various malignancies including osteosarcoma. In the current study, we aimed to illustrate the role of lncRNA plasmacytoma variant translocation 1 (PVT1) in osteosarcoma.

PATIENTS AND METHODS

Expression of PVT1 and microRNA-486 (miR-486) in osteosarcoma tissue specimens and cell lines were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) assays and in situ hybridizations (ISH) assay. Transwell migration/invasion assays were performed to determine the metastatic ability changes in osteosarcoma cells. Kaplan-Meier survival analysis was applied to analyze the overall survival (OS) of patients with osteosarcoma. Luciferase assays were used to evaluate the targeted binding effect between PVT1 and miR-486.

RESULTS

We illustrated that lncRNA plasmacytoma variant translocation 1 (PVT1) was upregulated in osteosarcoma, and it was correlated with poor prognosis of patients with osteosarcoma. Furthermore, we found that PVT1, via constructed loss of function and gain of function assays, promoted osteosarcoma cells migration and invasion. Meanwhile, we demonstrated that microRNA-486 (miR-486) was involved in PVT1-induced migration and invasion. We also uncovered that miR-486 was downregulated in osteosarcoma tissue specimens and cell lines. Functionally, we showed that upregulation of miR-486 reversed the facilitative effect of PVT1 on osteosarcoma cells migration and invasion, and vice versa. Mechanically, we illustrated that PVT1 interacted with miR-486 in a reciprocal suppressed manner. Moreover, we found that miR-486 could target to PVT1 via Luciferase assay. Lastly, we proved that PVT1 promoted osteosarcoma cells migration and invasion through miR-486 sponging.

CONCLUSIONS

We demonstrated that PVT1, functioning as an oncogene, promotes osteosarcoma cells metastasis via miR-486 sponging. PVT1/miR-486 axis might be a novel target in the molecular treatment of osteosarcoma.

A15 EFFICACY AND SAFETY OF FILGOTINIB AS INDUCTION THERAPY FOR PATIENTS WITH MODERATELY TO SEVERELY ACTIVE ULCERATIVE COLITIS: RESULTS FROM THE PHASE 2B/3 SELECTION STUDY

Aims

The SELECTION (NCT02914522) Induction Studies evaluated the efficacy/safety of filgotinib (FIL), a preferential JAK1 inhibitor, as induction therapy for patients (pts) with moderately to severely active ulcerative colitis (UC) who were biologic-naïve but failed conventional therapy (Induction Study A) or failed prior biologics (Induction Study B).

Methods

Pts were randomized 2:2:1 to once–daily FIL 200mg, FIL 100mg or placebo (PBO). The primary (clinical remission), key secondary (Mayo Clinic Score [MCS] remission, endoscopic remission, and histologic remission), and exploratory endpoints (MCS response and endoscopic improvement) were assessed at Week 10.

Results

In both studies, baseline demographics and disease characteristics were similar across treatment groups. In Study A, 659 pts were randomized and treated. Baseline mean MCS was 8.6 and 56% had a Mayo endoscopic subscore (ES)=3. A significantly higher proportion of biologic-naïve pts on FIL 200mg achieved clinical remission vs PBO and all key secondary endpoints (Table). In Study B, 689 pts were randomized and treated. Baseline mean MCS was 9.3 and 78% had ES=3. Prior treatment failures were: anti-TNF (86%), vedolizumab (52%) and both (dual-refractory; 43%). A significantly higher proportion of biologic-experienced pts on FIL 200mg achieved clinical remission vs PBO. In Studies A and B, a greater proportion of pts on FIL 200 mg achieved an MCS response and endoscopic improvement vs PBO.

The rates of AEs, serious AEs and discontinuations due to AEs were similar across FIL and PBO groups during induction. In the PBO, FIL 100mg and FIL 200mg groups, serious infections occurred in 0.7%, 0.7% and 0.4% pts in Study A and 1.4%, 1.4% and 0.8% pts in Study B; H Zoster occurred in &lt;1% in both groups for both cohorts.

Conclusions

SELECTION included a high proportion of dual-refractory pts, and pts with severe endoscopic disease. Both doses of FIL were well tolerated. Filgotinib 200mg was effective induction therapy for both biologic-naïve/-experienced pts with moderately to severely active UC.

Funding Agencies

None

Primary and Secondary Metabolite Profiles of Lodgepole Pine Trees Change with Elevation, but Not with Latitude

Climate change has a large influence on plant functional and phenotypic traits including plant primary and secondary metabolites. One well-established approach to investigating the variation in plant metabolites involves studying plant populations along elevation and latitude gradients. We considered how two space-for-time climate change gradients (elevation and latitude) influence carbohydrate reserves (soluble sugars, starches) and secondary metabolites (monoterpenes, diterpene resin acids) of lodgepole pine trees in western Canada. We were particularly interested in the relationship of terpenes and carbohydrates with a wide range of tree, site, and climatic factors. We found that only elevation had a strong influence on the expression of both terpenes and carbohydrates of trees. Specifically, as elevation increased, concentrations of monoterpenes and diterpenes generally increased and soluble sugars (glucose, sucrose, total sugars) decreased. In contrast, latitude had no impact on either of terpenes or carbohydrates. Furthermore, we found a positive relationship between concentrations of starch and total terpenes and diterpenes in the elevation study; whereas neither starches nor sugars were correlated to terpenes in the latitude study. Similarly, both terpenes and carbohydrates had a much greater number of significant correlations to site characteristics such as slope, basal area index, and sand basal area, in the elevational than in the latitude study. Overall, these results support the conclusion that both biotic and abiotic factors likely drive the patterns of primary and secondary metabolite profiles of lodgepole pine along geographical gradients. Also, presence of a positive relationship between terpenes and starches suggests an interaction between primary ad secondary metabolites of lodgepole pine trees.

Keel-bone fractures are associated with bone quality differences in laying hens

This study aimed to investigate the relationship between bone quality in terms of metabolism, homeostasis of elements, bone mineral density (BMD), and microstructure and keel-bone fractures in laying hens (Gallusgallusdomesticus). One hundred and twenty 17 week old Lohmann White laying hens with normal keel bones were individually housed in furnished cages for 25 weeks. Birds were then euthanased and dissected to assess keel-bone status at 42 weeks. Serum and keel-bone samples from normal keel (NK) and fractured keel (FK) hens were collected to determine the previously mentioned bone quality parameters. The results showed FK hens to have higher levels of the components of osteocalcin, greater alkaline phosphatase activity in serum and keel bones, and greater tartrate-resistant acid phosphatase (TRAP) activity in keel bones, compared to NK hens. Additionally, FK hens also had higher concentrations of Li, B, K, Cu, As, Se, Sn, Hg, and Pb, but lower concentrations of Na, P, and Ca. Moreover, FK hens showed decreased bone microstructural parameters including bone volume/tissue volume, trabecular number, degree of anisotropy, connectivity density, and BMD, but increased trabecular separation. Meanwhile, no differences were detected in serum TRAP activity, trabecular thickness, bone surface, or bone surface/bone volume. Results showed laying hens with keel-bone fractures to have differences in bone metabolism, elements of homeostasis, bone microstructure parameters, and BMD. These results suggest that keel-bone fractures may be associated with bone quality.

Defects and plasticity in ultrastrong supercrystalline nanocomposites

Supercrystalline nanocomposites are nanoarchitected materials with a growing range of applications but unexplored in their structural behavior. They typically consist of organically functionalized inorganic nanoparticles arranged into periodic structures analogous to crystalline lattices, including superlattice imperfections induced by processing or mechanical loading. Although featuring a variety of promising functional properties, their lack of mechanical robustness and unknown deformation mechanisms hamper their implementation into devices. We show that supercrystalline materials react to indentation with the same deformation patterns encountered in single crystals. Supercrystals accommodate plastic deformation in the form of pile-ups, dislocations, and slip bands. These phenomena occur, at least partially, also after cross-linking of the organic ligands, which leads to a multifold strengthening of the nanocomposites. The classic shear theories of crystalline materials are found to describe well the behavior of supercrystalline nanocomposites, which result to feature an elastoplastic behavior, accompanied by compaction.

Exposure and tiered ecological risk assessment of phthalate esters in the surface water of Poyang Lake, China

Phthalate esters (PAEs) are a class of endocrine disruptors that are produced and used extensively in China. Given its presence in various products, a great quantity of PAEs flows into different aquatic systems each year. Hence, it is important to study the pollution levels and ecological risk of PAEs. This study investigated the distribution and seasonal variation of six priority PAEs in the surface water of Poyang Lake, the largest freshwater lake in China. In the wet season, the mean concentration of the total PAEs was 0.544 ± 0.173 μg/L, while the dry season concentration (1.003 ± 0.451 μg/L) nearly doubled. The most abundant PAE congeners were di-n-butyl phthalate (DBP), followed by bis (2-ethylhexyl) phthalate (DEHP). To evaluate the ecological risks in Poyang Lake, the predicted no-effect concentrations (PNECs) of four PAEs based on non-lethal effects were derived. For diethyl phthalate (DEP), butyl benzyl phthalate (BBP), DBP, and DEHP, the PNECs were 31.6, 3.30, 2.31, and 0.0210 μg/L, respectively. The tiered ecological risk assessment showed that DEP and BBP posed no risk in Poyang Lake. Meanwhile, DBP posed a potential risk in Poyang Lake, but the risk of DEHP was unacceptable and requires more actions. Specifically, the probabilities of exceeding the threshold for the protection of 95% of the aquatic organisms (HC₅) were 3.30% and 4.43% for DEHP in the wet and dry season, respectively. This study provides an appropriate reference for the surface water management of PAE pollution in China.

Effects of phytase supplementation on production performance, egg and bone quality, plasma biochemistry and mineral excretion of layers fed varying levels of phosphorus

Excessive fecal excretion of phosphorus (P) has increasingly become an environmental issue due to oversupply of P in layer rations, and thus it is imperative to minimize safety margins for P to ensure the sustainability of the egg industry. In this study, a 12-week feeding trial (22 to 34 weeks of age) was conducted to evaluate the effects of phytase supplementation on production performance, plasma biochemistry, egg and bone quality and P excretion of laying hens fed various levels of non-phytate P (NPP). Forty-eight Lohmann white laying hens were randomly allocated to one of six corn-soybean meal-oat-based diets: diets containing 2.0, 2.5 or 3.0 g/kg NPP without phytase, and diets containing 1.0, 1.5 or 2.0 g/kg NPP with phytase (1 000 U/kg diet) where phytase inclusion was expected to provide 1.0 g/kg NPP to laying hens, thus making the phytase-unsupplemented treatment served as a control for the phytase-supplemented treatment accordingly. Productive performance was recorded during the experimental period. Blood and egg samples were collected, and digestibility studies were conducted at weeks 6 and 12 of the experiment. Bone mineralization was evaluated at the end of the experiment. Egg weight and egg production, feed consumption, BW and feed conversion ratio of laying hens fed lower NPP diets supplemented with phytase were comparable to those of hens fed high NPP phytase-unsupplemented controls. Eggshell thickness, specific gravity, Haugh units, tibia bone mineral density, tibia ash percent, plasma P and other biochemical parameters were not significantly different among dietary treatments. Total P intake, excretion and retention were affected by diet (P < 0.001), but its deposition in eggs was not significantly different. Contrast analysis further showed that total P excretion of phytase present vs phytase absent was averagely reduced by 40.4 mg/hen per day (P < 0.01). Moreover, total P excretion was linearly (P < 0.01) reduced with lowering dietary NPP, and this relationship was similar regardless of whether phytase was supplemented or not. The results from this study indicated that NPP levels in laying hen diets could be reduced to 1.0 g/kg (excluding the portion of NPP released by phytase) with the inclusion of phytase, without negative effects on production performance and health of the hens, thereby diminishing P excretion into environment.

SNHG16 promotes the progression of osteoarthritis through activating microRNA-93-5p/CCND1 axis

OBJECTIVE

This study aims to investigate whether SNHG16 (small nucleolar RNA host gene 16) can promote the progression of osteoarthritis (OA) by regulating the microRNA-93-5p/Cyclin D1 (CCND1) axis, thereby finding new therapeutic targets for the treatment of OA.

PATIENTS AND METHODS

A total of 23 OA patients and 23 patients undergoing lower extremity amputation were enrolled in this study. We collected their cartilage tissues from knee joint for isolating chondrocytes. The relative levels of SNHG16, CCND1 and microRNA-93-5p in cartilage tissues of OA patients and controls were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The regulatory effect of SNHG16 on proliferative potential of chondrocytes was evaluated by Cell Counting Kit-8 (CCK-8) and colony formation assay, respectively. Cell cycle progression was examined using flow cytometry. Dual-Luciferase reporter gene assay was conducted to verify the binding between SNHG16 with microRNA-93-5p and microRNA-93-5p with CCND1. Rescue experiments were performed to elucidate whether SNHG16 regulated CCND1 expression by targeting microRNA-93-5p.

RESULTS

The expressions of SNHG16 and CCND1 upregulated, while microRNA-93-5p downregulated in cartilage tissues of OA patients relative to controls. Correlation regression analyses showed a negative expression correlation between SNHG16 and microRNA-93-5p, as well as CCND1 and microRNA-93-5p in OA patients. On the contrary, SNHG16 expression was positively correlated to CCND1 expression in OA. The knockdown of SNHG16 suppressed viability, cloning ability and cell cycle progression, but induced apoptosis in chondrocytes. Dual-Luciferase reporter gene assay showed that SNHG16 could bind to microRNA-93-5p. SNHG16 knockdown markedly upregulated the expression of microRNA-93-5p. Moreover, the knockdown of microRNA-93-5p reversed the inhibited viability due to SNHG16 knockdown. Transfection of microRNA-93-5p mimics markedly inhibited CCND1 expression. Importantly, CCND1 overexpression reversed the inhibitory effect of SNHG16 knockdown on chondrocyte viability.

CONCLUSIONS

SNHG16 promotes the development of OA by regulating microRNA-93-5p/CCND1 axis.

Planktonic and sediment bacterial communities in an integrated mariculture system

An integrated multi-trophic aquaculture (IMTA) system, with one fish cage model surrounded by an island and shellfish rafts, was used in the current study. Planktonic and sediment bacterial communities in the IMTA system were monitored over four seasons in 2019. In both plankton and sediment samples, the most dominant phyla were Proteobacteria and Bacteroidota. Sediment bacterial samples were more similar and had higher levels of biodiversity than planktonic bacterial samples. Obvious seasonal variations were found in plankton samples, but not in sediment samples. No obvious inter-site variations in planktonic and sediment bacteria (fish cages, shellfish rafts and control sites) were found and the results suggested that no obvious impact of feeding operations in fish culture cage model on bacterial communities in the IMTA system was observed in this study. Based on the sequence data, some faecal indicator bacteria and potentially pathogenic bacterial species were detected. According to the results, the bacterial water quality in the IMTA system was acceptable. PICRUSt (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) analysis revealed that the primary difference in potential functional roles of planktonic and sediment bacteria was amino acid transport and metabolism, which was active in different seasons.