Integrated physiological, intestinal microbiota, and metabolomic responses of adult zebrafish (Danio rerio) to subacute exposure to antimony at environmentally relevant concentrations

The available information regarding the impact of antimony (Sb), a novel environmental pollutant, on the intestinal microbiota and host health is limited. In this study, we conducted physiological characterizations to investigate the response of adult zebrafish to different environmental concentrations (0, 30, 300, and 3000 µg/L) of Sb over a period of 14 days. Biochemical and pathological changes demonstrated that Sb effectively compromised the integrity of the intestinal physical barrier and induced inflammatory responses as well as oxidative stress. Analysis of both intestinal microbial community and metabolome revealed that exposure to 0 and 30 µg/L of Sb resulted in similar microbiota structures; however, exposure to 300 µg/L altered microbial communities' composition (e.g., a decline in genus Cetobacterium and an increase in Vibrio). Furthermore, exposure to 300 µg/L significantly decreased levels of bile acids and glycerophospholipids while triggering intestinal inflammation but activating self-protective mechanisms such as antibiotic presence. Notably, even exposure to 30 µg/L of Sb can trigger dysbiosis of intestinal microbiota and metabolites, potentially impacting fish health through the "microbiota-intestine-brain axis" and contributing to disease initiation. This study provides valuable insights into toxicity-related information concerning environmental impacts of Sb on aquatic organisms with significant implications for developing management strategies.

Pulsed light treatment enhances starch hydrolysis and improves starch physicochemical properties of germinated brown rice

BACKGROUND

Recently, germinated brown rice (GBR) has gained substantial attention as a functional food because of its nutritional attributes. Notably, pulsed light technology (PLT) has emerged as a promising tool for enhancing rice germination and, consequently, has improved the nutritional and functional qualities of GBR-derived products. However, further research is required to comprehensively understand the impact of PLT on GBR physicochemical properties. The present study aimed to investigate the stimulating effects of PLT on starch hydrolysis, starch structure and functional properties of GBR.

RESULTS

The PLT substantially boosted α-amylase activity during brown rice germination, leading to a 10.9% reduction in total starch content and a 17.3% increase in reducing sugar content, accompanied by elevated free water levels. Structural analysis indicated no changes in starch crystalline types, whereas gelatinization temperature slightly increased. Pasting properties exhibited a significant drop in peak viscosity. Scanning electron microscopy showed surface erosion of starch granules with microstructural changes. Furthermore, correlation analysis established positive links between α-amylase activity, reducing sugar accumulation, starch structure and functional properties in GBR.

CONCLUSION

The present study demonstrates that PLT enhanced the physicochemical properties of GBR starch, significantly improving the stability of GBR products, thereby contributing to expanded applicability of rice starch in the food industry. © 2023 Society of Chemical Industry.

A Universal Additive Design Strategy to Modulate Solvation Structure and Hydrogen Bond Network toward Highly Reversible Fe Anode for Low-Temperature All-Iron Flow Batteries

Aqueous all-iron redox flow batteries (RFBs) are promising competitors for next-generation grid-scale energy storage applications. However, the high-performance operation of all-iron RFBs in a wider temperature range is greatly hindered by inferior iron plating/stripping reaction and low solid-liquid transition temperature at Fe anode. Herein, a universal electrolyte additive design strategy for all-iron RFBs is reported, which realizes a highly reversible and dendrite-free Fe anode at low temperatures. Quantum chemistry calculations first screen several organic molecules with oxygen-containing functional groups and identify N,N-Dimethylacetmide (DMAc) as a potential candidate with low cost, high solubility, and strong interactions with Fe2+ and H2 O. Combined experimental characterizations and theoretical calculations subsequently demonstrate that adding DMAc into the FeCl2 solution effectively reshapes the primary solvation shell of Fe2+ via the Fe2+ -O (DMAc) bond and breaks hydrogen-bonding network of water through intensified H-bond interaction between DMAc and H2 O, thereby affording the Fe anode with enhanced Fe/Fe2+ reversibility and lower freezing point. Consequently, the assembled all-iron RFB achieves an excellent combination of high power density (25 mW cm-2 ), long charge-discharge cycling stability (95.59% capacity retention in 103 h), and preeminent battery efficiency at -20 °C (95% coulombic efficiency), which promise a future for wider temperature range operation of all-iron RFBs.

Choline induced cardiac dysfunction by inhibiting the production of endogenous hydrogen sulfide in spontaneously hypertensive rats

To investigate the exact effects of dietary choline on hypertensive heart disease (HHD) and explore the potential mechanisms, male spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) were randomly divided into five groups as follows: WKY group, WKY + Choline group, SHR group, SHR + Choline group, and SHR + Choline + NaHS group. In choline treatment groups, rats were fed with 1.3% (w/v) choline in the drinking water for 3 months. The rats in the SHR + Choline + NaHS group were intraperitoneally injected with NaHS (100 micromol/kg/day, a hydrogen sulfide (H2S) donor) for 3 months. After 3 months, left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), the indicators of cardiac function measured by echocardiography, were increased significantly in SHR as compared to WKY, although there was no significant difference in collagen volumes and Bax/Bcl-2 ratio between the two groups, indicating the early stage of cardiac hypertrophy. There was a significant decrease in LVEF and LVFS and an increase in collagen volumes and Bax/Bcl-2 ratio in SHR fed with choline, meanwhile, plasma H2S levels were significantly decreased significantly in SHR fed with choline accompanying by the decrease of cystathionine-gamma-lyase (CSE) activity. Three months of NaHS significantly increased plasma H2S levels, ameliorated cardiac dysfunction and inhibited cardiac fibrosis and apoptosis in SHR fed with choline. In conclusion, choline aggravated cardiac dysfunction in HHD through inhibiting the production of endogenous H2S, which was reversed by supplementation of exogenous H2S donor.

MYCT1 attenuates renal fibrosis and tubular injury in diabetic kidney disease

Tubulointerstitial abnormalities contribute to the progression of diabetic kidney disease (DKD). However, the underlying mechanism of the pathobiology of tubulointerstitial disease is largely unknown. Here, we showed that MYCT1 expression was downregulated in in vitro and in vivo DKD models. Adeno-associated virus (AAV)-Myct1 significantly attenuated renal dysfunction and tubulointerstitial fibrosis in diabetic db/db mice and downregulated Sp1 transcription and TGF-β1/SMAD3 pathway activation. In human proximal tubular epithelial cells, high glucose-induced high expression of SP1 and TGF-β1/SMAD3 pathway activation as well as overaccumulation of extracellular matrix (ECM) were abrogated by MYCT1 overexpression. Mechanistically, the binding of VDR to the MYCT1 promoter was predicted and confirmed using dual-luciferase reporter and ChIP analysis. VDR transcriptionally upregulates MYCT1. Our data reveal MYCT1 as a new and potential therapeutic target in treating DKD.

Adapting the investigation of patients on urgent suspected cancer pathway with lower gastrointestinal symptoms across Wales during COVID-19

INTRODUCTION

The COVID-19 pandemic necessitated the introduction of revised diagnostic pathways for assessing urgent suspected cancer (USC) referrals. Combinations of faecal immunochemical testing (FIT) and minimal preparation computed tomography (CT) scans (MPCT) were used to manage referrals and prioritise access to clinical services or invasive tests. The effectiveness of these pathways across Wales is evaluated in this study.

METHODS

All consecutive patients referred from primary care on the USC pathway between 15 March and 15 June 2020 were included to reflect the effect of full lockdown measures. Data collected included demographics, presenting symptom(s), investigations and timelines and patient outcomes up to 90 days following initial referral.

RESULTS

A total of 1,050 patients across eight sites in Wales were included. Of these 1,050 patients, 52.6% were female with median age 68 (21-97) years; 50.5% had first-line clinical review, of which 61.1% were virtual consultations; 49.5% had primary investigations; 26.7% of patients had FIT and 13.1% had MPCT. COVID-response pathways achieved a 29.9% reduction in use of colonoscopy as first-line investigation and 79% of patients avoided face-to-face consultations altogether during this first wave of the pandemic. Overall, 6.8% of USC referrals were diagnosed with colorectal cancer (CRC). Median timescale from diagnosis to treatment for CRC was 65 (4-175) days. The negative predictive value (NPV) for FIT in this cohort was 99.6%. MPCT as the first modality had a NPV of 99.2%.

CONCLUSION

A modified investigation pathway helped maintain cancer diagnosis rates during the pandemic with improved resource utilisation to that used prepandemic.

Factors influencing initial implementation of an online community-based exercise intervention with adults living with HIV: a systems approach

Introduction

Online community-based exercise (CBE) is a digital health intervention and rehabilitation strategy that promotes health among people living with HIV. Our aim was to describe the factors influencing initial implementation of a pilot online CBE intervention with adults living with HIV using a systems approach, as recommended by implementation science specialists.

Methods

We piloted the implementation of a 6-month online CBE intervention and 6-month independent exercise follow up, in partnership with the YMCA in Toronto, Canada. We recruited adults living with HIV who identified themselves as safe to engage in exercise. The intervention phase included personalized exercise sessions online with a personal trainer; exercise equipment; access to online exercise classes; and a wireless physical activity monitor. Two researchers documented implementation factors articulated by participants and the implementation team during early implementation, defined as recruitment, screening, equipment distribution, technology orientation, and baseline assessments. Data sources included communication with participants; daily team communication; weekly team discussions; and in-person meetings. We documented implementation factors in meeting minutes, recruitment screening notes, and email communication; and analyzed the data using a qualitative descriptive approach using a systems engineering method called Cognitive Work Analysis.

Results

Thirty-three adults living with HIV enrolled in the study (n = 33; median age: 52 years; cis-men: 22, cis-women: 10, non-binary: 1). Fifty-five factors influencing implementation, spanned five layers: (i) Natural, including weather and the COVID-19 virus; (ii) Societal, including COVID-19 impacts (e.g. public transit health risks impacting equipment pick-ups); (iii) Organizational, including information dissemination (e.g. tech support) and logistics (e.g. scheduling); (iv) Personal, including physical setting (e.g. space) and digital setting (e.g. device access); and (v) Human, including health (e.g. episodic illness) and disposition (e.g. motivation). The implementation team experienced heightened needs to respond rapidly; sustain engagement; and provide training and support. Additional organizational factors included a committed fitness training and research team with skills spanning administration and logistics, participant engagement, technology training, physical therapy, and research ethics.

Conclusion

Fifty-five factors spanning multiple layers illustrate the complexities of online CBE with adults living with HIV. Initial implementation required a dedicated, rehabilitation-centred, multi-skilled, multi-stakeholder team to address a diverse set of factors.

Adaptive optics pre-compensation for orbital angular momentum beams transmitting through simulated atmospheric turbulence

We propose an adaptive optics (AO) pre-compensation scheme to improve the transmission quality of orbital angular momentum (OAM) beams in atmospheric turbulence. The distortion wavefront caused by atmospheric turbulence is obtained with the Gaussian beacon from the receiver. The AO system imposes the conjugate distortion wavefront onto the outgoing OAM beams at the transmitter, tto achieve the pre-compensation. Using the scheme, we conducted transmission experiments with different OAM beams in the simulated atmospheric turbulence. The experimental results indicated that the AO pre-compensation scheme can improve the transmission quality of the OAM beams in the atmospheric turbulence in real-time. It is found that the turbulence-induced crosstalk effects on neighboring modes are reduced by an average of 6 dB, and the system power penalty is improved by an average of 12.6 dB after pre-compensation.

Optical vortex convolution generator and quasi-Talbot effect

In this Letter, a simple optical vortex convolution generator is proposed where a microlens array (MLA) is utilized as an optical convolution device, and a focusing lens (FL) is employed to obtain the far field, which can convert a single optical vortex into a vortex array. Further, the optical field distribution on the focal plane of the FL is theoretically analyzed and experimentally verified using three MLAs of different sizes. Moreover, in the experiments, behind the FL, the self-imaging Talbot effect of the vortex array is also observed. Meanwhile, the generation of the high-order vortex array is also investigated. This method, with a simple structure and high optical power efficiency, can generate high spatial frequency vortex arrays using devices with low spatial frequency and has excellent application prospects in the field of optical tweezers, optical communication, optical processing, etc.

Advances in the development of antivirals for rotavirus infection

Rotavirus (RV) causes 200,000 deaths per year and imposes a serious burden to public health and livestock farming worldwide. Currently, rehydration (oral and intravenous) remains the main strategy for the treatment of rotavirus gastroenteritis (RVGE), and no specific drugs are available. This review discusses the viral replication cycle in detail and outlines possible therapeutic approaches including immunotherapy, probiotic-assisted therapy, anti-enteric secretory drugs, Chinese medicine, and natural compounds. We present the latest advances in the field of rotavirus antivirals and highlights the potential use of Chinese medicine and natural compounds as therapeutic agents. This review provides an important reference for rotavirus prevention and treatment.

A16 UNMET HEALTHCARE NEEDS AMONG PEOPLE WITH INFLAMMATORY BOWEL DISEASE: A NATIONAL CROSS-SECTIONAL POPULATION-REPRESENTATIVE STUDY

Background

Inflammatory bowel disease (IBD) is a chronic inflammatory disease primarily affecting the gastrointestinal tract. Despite treatment with the current standards of care, many IBD patients experience relapsing, remitting, and disabling bowel symptoms and significant disease complications. Ensuring patients have adequate access to high quality multidisciplinary healthcare is vital for the short- and long-term wellbeing of IBD patients.

Purpose

(1) Compare unmet healthcare needs of people with and without IBD. (2) Determine whether accessing regular medical care mediates the association between IBD and unmet healthcare needs. (3) Describe the reasons for unmet healthcare needs among people with and without IBD.

Method

We used the 2014 Canadian Community Health Survey, a population-representative national cross-sectional survey conducted by Statistics Canada. Respondents with a non-IBD bowel disorder or aged 18 or younger were excluded. Survey weights were used for descriptive statistics. We used multilevel logistic regression to compare perceived unmet healthcare needs among individuals with and without IBD, clustering by health region and controlling for age, immigration status, race, home ownership, marital status, annual household income, education level, and number of chronic conditions (0, 1, 2+). In a second model, we additionally controlled for having a regular family doctor, having consulted a specialist, and having consulted a psychologist to assess if regularly accessing medical care mediated the association between IBD and unmet healthcare needs. Individuals reporting unmet healthcare needs were asked about the reasons for their unmet healthcare needs. Responses are summarized with weighted percentages, plotted in a bar graph.

Result(s)

Among the 690 IBD and 62,832 non-IBD eligible survey respondents, 16.7% of people with IBD had an unmet healthcare need within the past 12 months, compared with 10.3% of those without IBD (OR 1.39, 95% CI 1.12 to 1.74). Additionally adjusting for regular access to medical care slightly attenuated the association between IBD and unmet healthcare needs (OR 1.29, 95% CI 1.03 to 1.62). Reasons for unmet healthcare needs differed among those with and without IBD (Figure). Specifically, doctors believing that care was unnecessary and the cost of care were more likely to be the reason people with IBD had an unmet healthcare need.

Image

Conclusion(s)

People with IBD are more likely to have an unmet healthcare need that was partially mediated by access to healthcare professionals. Our work highlights the need for further research into the types of unmet healthcare needs experienced by people living with IBD. This underscores the need for multidisciplinary healthcare teams to address the increased burden of unmet healthcare needs in the IBD population.

Please acknowledge all funding agencies by checking the applicable boxes below

None

Disclosure of Interest

G. Postill: None Declared, E. Benchimol Consultant of: Hoffman La-Roche Limited and Peabody & Arnold LLP for matters unrelated to medications used to treat inflammatory bowel disease. Dr. Benchimol has also acted as a consultant for McKesson Canada and the Dairy Farmers of Ontario for matters unrelated to medications used to treat inflammatory bowel disease., J. Im: None Declared, A. Tang: None Declared, E. Kuenzig: None Declared

A177 RISK OF VENOUS THROMBOEMBOLISM IN COVID-19 PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED MATCHED COHORT STUDY

Background

Venous thromboembolism (VTE), is associated with significant morbidity and mortality. Inflammation increases the risk of VTE, and it is a well-recognised complication of both inflammatory bowel disease (IBD) and COVID-19.

Purpose

To compare the risk of VTE among individuals with and without IBD following a positive COVID-19 test.

Method

Using health administrative data from Ontario, Canada we conducted a retrospective matched cohort study.All Ontario residents with a positive SARS-CoV-2 PCR test between January 1,2020 and December 30,2021 who had been diagnosed with IBD prior to their COVID-19 infection (identified using a validated algorithm) were matched to 5 individuals without IBD based on year of birth, sex, mean neighbourhood income quintile, date of positive COVID-19 test, and rural/urban residence. Individuals with a cancer diagnosis in the 5 years prior to their first COVID-19 positive test were excluded. Individuals were followed from positive COVID-19 PCR test until VTE event, death, migration out of Ontario or March 31, 2022.VTEs were identified from emergency department or hospitalization data using ICD-10 codes. Incidence rate of VTEs among individuals with IBD were assessed at 1, 6 and 12 months. Proportional cause-specific hazards models compared the risk of VTEs in people with and without IBD, treating death as a competing risk and controlling for vaccination status (2^nd dose ≥14 days prior to positive COVID-19 test) and a history of VTE (VTE in the 5 years prior to infection).

Result(s)

There were 4293 people with IBD (44% Crohn’s disease, mean age ±SD 46.1±17.2 y) matched to 20,207 with out IBD (mean age 45.3±16.8 y) with a positive SARS-CoV-2 PCR test. Within 1 month of a positive COVID-19 test, the crude incidence rate of VTE in individuals with IBD was 4.77(95%CI, 4.75-4.80) per 100,000 person-days compared to 8.25(95%CI, 8.20-8.30) per 100,000 among people without IBD.Within 6 months, these rates were 1.86(95%CI, 1.86-1.87) and 2.12(95%CI, 2.11-2.12) per 100,000 person-days among people with and without IBD, respectivley. Within 12 months, these rates were 1.59(95% CI, 1.58-1.59) and 1.42(95% CI, 1.42-1.42) per 100,000 person-days among people with and without IBD, respectively.After adjusting for vaccination status and history of VTE there was no difference in the risk of VTE for people with and without IBD (HR 1.08, 95%CI, 0.64 to 1.83).

Conclusion(s)

IBD patients with COVID-19 were not more likely to experience a VTE infection compared with the general popluation. The risk of VTE was highest soon after COVID-19 and declined thereafter.

Please acknowledge all funding agencies by checking the applicable boxes below

None

Disclosure of Interest

None Declared

Antibiotic use for respiratory tract infections among older adults living in long-term care facilities: a systematic review and meta-analysis

BACKGROUND

Antibiotics are commonly prescribed for respiratory tract infections (RTIs) among older adults in long-term care facilities (LTCFs), and this contributes to the emergence of antimicrobial resistance. The objective of this study was to determine the antibiotic prescribing rate for RTIs among LTCF residents, and to analyse the antibiotic consumption patterns with the AwaRe monitoring tool, developed by the World Health Organization.

METHODS

MEDLINE, EMBASE and CINAHL were searched from inception to March 2022. Original articles reporting antibiotic use for RTIs in LTCFs were included in this review. Study quality was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Data. A random-effects meta-analysis was employed to calculate the pooled estimates. Subgroup analysis was conducted by type of RTI, country, and study start year.

RESULTS

In total, 47 articles consisting of 50 studies were included. The antibiotic prescribing rate ranged from 21.5% to 100% (pooled estimate 69.8%, 95% confidence interval 55.2-82.6%). The antibiotic prescribing rate for lower respiratory tract infections (LRTIs) was higher than the rates for viral and general RTIs. Compared with Italy, France and the USA, the Netherlands had lower antibiotic use for LRTIs. A proportion of viral RTIs were treated with antibiotics, and all the antibiotics were from the Watch group. Use of antibiotics in the Access group was higher in the Netherlands, Norway, Switzerland and Slovenia compared with the USA and Australia.

CONCLUSION

The antibiotic prescribing rate for RTIs in LTCFs was high, and AWaRe antibiotic use patterns varied by type of RTI and country. Improving antibiotic use may require coordination efforts.

Nomogram Based on Clinical and Radiomics Data for Predicting Radiation-induced Temporal Lobe Injury in Patients with Non-metastatic Stage T4 Nasopharyngeal Carcinoma

AIMS

To use pre-treatment magnetic resonance imaging-based radiomics data with clinical data to predict radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients with stage T4/N0-3/M0 within 5 years after radiotherapy.

MATERIALS AND METHODS

This study retrospectively examined 98 patients (198 temporal lobes) with stage T4/N0-3/M0 NPC. Participants were enrolled into a training cohort or a validation cohort in a ratio of 7:3. Radiomics features were extracted from pre-treatment magnetic resonance imaging that were T1-and T2-weighted. Spearman rank correlation, the t-test and the least absolute shrinkage and selection operator (LASSO) algorithm were used to select significant radiomics features; machine-learning models were used to generate radiomics signatures (Rad-Scores). Rad-Scores and clinical factors were integrated into a nomogram for prediction of RTLI. Nomogram discrimination was evaluated using receiver operating characteristic analysis and clinical benefits were evaluated using decision curve analysis.

RESULTS

Participants were enrolled into a training cohort (n = 139) or a validation cohort (n = 59). In total, 3568 radiomics features were initially extracted from T1-and T2-weighted images. Age, D_max, D_1cc and 16 stable radiomics features (six from T1-weighted and 10 from T2-weighted images) were identified as independent predictive factors. A greater Rad-Score was associated with a greater risk of RTLI. The nomogram showed good discrimination, with a C-index of 0.85 (95% confidence interval 0.79-0.92) in the training cohort and 0.82 (95% confidence interval 0.71-0.92) in the validation cohort.

CONCLUSION

We developed models for the prediction of RTLI in patients with stage T4/N0-3/M0 NPC using pre-treatment radiomics data and clinical data. Nomograms from these pre-treatment data improved the prediction of RTLI. These results may allow the selection of patients for earlier clinical interventions.

Simultaneous Regulation of Solvation Shell and Oriented Deposition toward a Highly Reversible Fe Anode for All-Iron Flow Batteries

Developing low-cost all-iron hybrid redox flow batteries (RFBs) presents a practical alternative to the high-cost all-vanadium RFBs and is deemed vital for grid-scale energy storage applications. However, the intrinsically poor Fe anode reversibility associated with the deposition and dissolution of metallic iron greatly limits the cycling performance and long-term stability of all-iron hybrid RFBs. Herein, a highly reversible and dendrite-free Fe anode is reported for all-iron RFBs through regulation of polar solvent dimethyl sulfoxide (DMSO) on FeCl₂ anolyte, which simultaneously reshapes Fe²⁺ solvation structure and induces controllable oriented Fe deposition. Combining both experimental and theoretical analyses, the polar DMSO additives prove effective in replacing H₂ O molecule from the primary solvation shell of Fe²⁺ cation via the Fe²⁺ -O (DMSO) bond and meanwhile induces a fine-grained Fe nucleation on the preferred Fe (110) plane, which are responsible for the minimized hydrogen evolution and dendrite-free Fe deposition that significantly enhance Fe anode reversibility. The all-iron RFB based on the proposed FeCl₂ -DMSO anolyte demonstrates an excellent combination of peak power density of 134 mW cm^-2 , high energy efficiency of 75% at 30 mA cm^-2 , and high capacity retention of 98.6% over 200 cycles, which presents the best performance of all-iron RFBs among previously reported research.

Designing Smart Microcapsules with Natural Polyelectrolytes to Improve Self-Healing Performance for Water-Based Polyurethane Coatings

Active anticorrosive organic coatings adopting microcapsules (MCs) have lately attracted extensive attention as they were proven to be effective to minimize metal corrosions and offer a long-lasting protection performance. Herein, a novel environmental-friendly active corrosion protection system was designed for aluminum alloy 2024 (AA2024) based on water-based polyurethane coatings with the addition of water and alkaline pH-responsive smart MCs, which is fabricated by utilizing 2-mercaptobenzothiazole (2-MBT) as an inhibitor, halloysite clay nanotubes (HNTs) as an inhibitor carrier, and the natural polyelectrolytes ε-poly-l-lysine (ε-PLL) and sodium alginate (SA) as layer-by-layer (LBL) encapsulation polyelectrolytes. Salt spray tests and electrochemical measurements prove that the scratched coatings with embedded MCs possess an excellent self-healing performance by forming an adsorption layer of released 2-MBT on the AA2024 surface, thereby providing over 90% inhibition efficiency within 6 days' immersion. The UV-vis spectrophotometer results further showed that the release of 2-MBT is a three-stage long-term process sensitive to water and alkaline pH value, while the outward release rate is both regulated by the solubility of 2-MBT and the SA layer. The fabricated MCs not only offer a great promise to provide an excellent self-healing performance but also shed light on the future design of advanced MCs on demand based on the LBL technique.

Distorted wavefront detection of orbital angular momentum beams based on a Shack-Hartmann wavefront sensor

The vortex beams carried Orbital Angular Momentum (OAM) have recently generated considerable interest due to their potential used in communication systems to increase transmission capacity and spectral efficiency. In this paper, the distorted wavefront detection based on Shack-Hartmann wavefront sensor (HWS) for the vortex beams is investigated. The detection slope of the helical phase sub-spot pattern is used as the calibrated slope zero point, and then the distortion phase of the vortex beam is detected by the HWS. Simulation and experimental results demonstrate that this method can detect the distortion phase of vortex beam with high precision and high frame rate, which is expected to accelerate the application of optical communication systems with vortex beams.

Completely revealing the amplitude properties of Laguerre-Gaussian vortex beams

In this paper, the amplitude properties of the Laguerre-Gaussian (LG) vortex beams are analyzed theoretically and demonstrated experimentally. Firstly, the ring width of the LG vortex beam is almost a constant, which can be considered to be independent of the topological charge (l) and only determined by the waist radius ω(z), and its general expression is derived via investigating Lambert W function. On this basis, concise expressions for inner and outer ring radii, ratio of inner and outer ring radius, ring area and beam divergence are also given out. Moreover, modification functions are added to obtain more accurate expressions. In the experiment, a spatial light modulator is employed to generate the LG vortex beams with l = 1∼20 at ω₀= 0.3mm and ω₀=0.4mm, and the LG vortex beams with l=10 at different propagation distances. The experimental results are in good agreement with the theoretical values. This work may help researchers to better understand the LG vortex beam and provide a useful guideline for its further applications.

Experimental research on a multi-aperture phase modulation technique based on a corner-cube reflector array

In this paper, a novel phase modulation technique based on a corner-cube reflector (CCR) array is proposed and demonstrated experimentally. The piezoceramics are linked behind each CCR. When the beams irradiate on the CCR array, the phase modulation can be realized by applying a voltage to piezoceramics to control the spatial location of each CCR. The piston phase errors of the device itself are compensated by employing the stochastic parallel gradient descent (SPGD) algorithm. Then, the piezoceramics are loaded with preset voltages to obtain the expected phase, and the anticipative optical field is generated. In the experiment, the piston phase errors of the 7-way and 19-way CCR array are corrected well. In order to further verify the phase control capability of the device, a vortex beam carrying orbital angular momentum (OAM) of 1 is generated by utilizing the 6-way CCR array. The experimental results confirm the feasibility of the concept.

High Rate Capability Achieved by Reducing the Miscibility Gap of Na4-xMnV(PO4)3

NASICON structured Na4MnV(PO4)3 has attracted great interest as a promising cathode for sodium ion batteries due to its high theoretical capacity and working potential. However, it suffers from poor cycling...

Insight into biosorption of heavy metals by extracellular polymer substances and the improvement of the efficacy: a review

Heavy metals are continuously released into aquatic environments in which they accumulate. This phenomenon endangers public health because heavy metals accumulate along the food chain. However, conventional remediation methods are inefficient, expensive and yield toxic intermediate products, which adversely affect the environment. The discovery of green bio-adsorbents such as microbial extracellular polymer substance (EPS) has quickly attracted considerable worldwide attention because of their low cost, high removal efficiency of heavy metals and industrial availability. Hence, this review considers the sources, hazards and treatment methods of heavy metals pollution, particularly the biosorption mechanism of EPS to heavy metals and the influencing factors of the bio-adsorption process, which are significant in the efficient removal of heavy metals-containing wastewater treatment. This review also focuses on strengthening the process of EPS adsorption of heavy metals, which can further contribute to heavy metals removal. Finally, it has been proposed that improving the yield, stability, selectivity and recoverability of EPS is the key direction of further research.

Phase I/II trial of palbociclib, pembrolizumab and letrozole in patients with hormone receptor-positive metastatic breast cancer

BACKGROUND

CDK4/6 inhibitors modulate immune response in breast cancer. This phase I/II trial was designed to test the safety and efficacy of palbociclib, pembrolizumab and letrozole in women with hormone receptor positive (HR⁺) human epidermal growth factor receptor 2 negative (HER2^-) metastatic breast cancer (MBC).

PATIENTS AND METHODS

Women with stage IV HR⁺ HER2^- MBC were enrolled and treated with palbociclib, pembrolizumab and letrozole. Primary end-points were safety, tolerability and efficacy.

RESULTS

Between November 2016 and July 2020, 23 patients were enrolled with 20 evaluable for response, including 4 patients in cohort 1 and 16 patients in cohort 2. Cohort 1 median age was 48 years (33-70) and cohort 2 median age was 55 (37-75). Cohort 1 closed early due to limited accrual. Grade III-IV adverse events were neutropenia (83%), leucopaenia (65%), thrombocytopenia (17%) and elevated liver enzymes (17%). In cohort 1, 50% achieved a partial response (PR) and 50% had stable disease (SD). In cohort 2, 31% achieved complete response (CR), 25% had PR and 31% had SD by Response Evaluation Criteria in Solid Tumours version 1.1. Median progression-free survival was 25.2 months (95% confidence interval [CI] 5.3, not reached) and median overall survival was 36.9 months (95% CI 36.9, not reached) in cohort 2 with a median follow-up of 24.8 months (95% CI 17.1, not reached). A correlative immune biomarker analysis was published separately.

CONCLUSION

The combination of palbociclib, pembrolizumab and letrozole is well tolerated, and a complete response rate of 31% was identified in HR⁺ MBC patients who received this combination as front-line therapy. Confirmatory trials are required to better understand the immune-priming effects of CDK4/6 inhibitors.

Preparation and antioxidant activity of phosphorylated polysaccharide from purple sweet potato

Purple sweet potato polysaccharide was extracted via hot water, and it was chemically modified by phosphorus oxychloride-pyridine to obtain phosphorylated polysaccharide from purple sweet potato (P-PPSP) with certain degrees of substitution. Furthermore, the structure and antioxidant activity in vitro of PPSP and phosphorylated derivative were compared. The result indicated that the phosphorylation modification product of polysaccharide from purple sweet potato could improve the scavenging effect on hydroxyl radical and superoxide anion of PPSP, significantly. It also could improve the anti-lipid peroxidation ability while fail to improve the reducing ability of PPSP.

Injectable keratin hydrogels as hemostatic and wound dressing materials

Injectable hydrogels hold promise in biomedical applications due to their noninvasive administration procedure and capacity enabling the filling of irregularly shaped defects. Protein-based hydrogels provide features including good biocompatibility and inherent biofunction. However, challenges still remain to develop a protein-based injectable hydrogel in a convenient way due to the limited active groups in proteins. Keratins are a group of cysteine-rich structural proteins found abundantly in skin and skin appendages. In this work, we utilized keratin and the Au(iii) salt to develop an injectable hydrogel based on the dynamic exchange between disulfide bonds (S-S) and gold(i)-thiolates (Au-S). Such a hydrogel could be prepared at the physiological pH and applied as an injectable hydrogel for biomedical applications including hemostatic and wound dressing materials. Our findings demonstrated that this keratin injectable hydrogel showed a good hemostatic effect in both tail amputation and liver injury models. Moreover, it was proved efficient as a drug loading carrier, and the deferoxamine-loaded hydrogel showed a desirable wound healing effect in a full-thickness excision wound model.

Structure and Gas Barrier Properties of Polyimide Containing a Rigid Planar Fluorene Moiety and an Amide Group: Insights from Molecular Simulations

A novel diamine (FAPDA) bearing rigid planar fluorene and amide groups was successfully synthesized. Using such diamine and pyromellitic dianhydride (PMDA), a high-barrier polyimide (FAPPI) was obtained. FAPPI exhibits an outstanding gas barrier. Its water vapor transmission rate (WVTR) and oxygen transmission rate (OTR) are as low as 0.51 g·m^-2·day^-1 and 0.43 cm³·m^-2·day^-1, respectively. Additionally, FAPPI shows excellent thermal stability with a coefficient of thermal expansion (CTE) of 5.8 ppm·K^-1 and a glass transition temperature (T _g) of 416 °C. Molecular simulations, positron annihilation, and X-ray diffraction were utilized to gain insight on the microstructures for the enhanced barrier properties. Introducing fluorene moieties and amide groups improves the regularity and rigidity of molecular chains and increases interchain interaction of PI, resulting in low free volumes and decreased movement capacity of the chain. The low free volumes of FAPPI restrain the gas diffusivity and solubility. Meanwhile, the decreased chain movement reduces the diffusivity of gases. Consequently, barrier performances of FAPPI are improved. The polyimide possesses widespread application in the microelectronics packaging fields.

Nutrition and Physical Activity Clinical Practice Guidelines for Older Adults Living with Frailty

Background: We developed clinical practice guidelines to provide health care providers with evidence-based recommendations for decisions related to the effective management of frailty and pre-frailty using nutrition and physical activity interventions. Methods: We based the recommendations on two systematic reviews with meta-analyses. Nutrition, physical activity, and combined nutrition and physical activity interventions for adults ≥65y were considered if study populations were identified as frail using a frailty tool or assessment. Risk of bias and certainty of evidence were evaluated. We included physical outcomes, mobility, frailty, cognitive function, activities of daily living, falls, quality of life, diet quality, energy/fatigue levels, health services use, and caregiver outcomes. Results: Overall, mobility improvements were moderate with nutritional strategies that optimize dietary intake, various types of physical activity interventions, and interventions that combine nutrition and physical activity. Physical outcomes, such as body mass and muscle strength, improved moderately with nutritional strategies and interventions that combined nutrition with physical activity. Frailty status improved with multi-component physical activity interventions. Strong recommendations include optimizing dietary intake, performing physical activity, and adopting interventions that combine nutrition and physical activity. We strongly recommend various types of physical activity including muscle strengthening activities, mobilization or rehabilitation exercises, and multi-component physical activity interventions. Interpretation: Tailored nutrition and physical activity interventions based on individual goals and health status are associated with improved clinical and physical outcomes. While the recommendations facilitate shared decision-making, we identified sparse application of validated frailty assessments and lack of standardized research outcomes as critical gaps in knowledge.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Lognormal Distribution of Local Strain: A Universal Law of Plastic Deformation in Material

Given the infinite diversity of microstructural inhomogeneity, the variation in spatial distribution of local strain could be infinite. However, this study finds that the statistical distribution of local strain universally follows a lognormal distribution irrespective of phase content and deformation mechanism. Moreover, this universal law is proved conditional upon the macroscopic homogeneity of deformation on the statistical window scale, equivalent to the equality between the macrostrain calculated from the displacements at the window corners and the average of the local strain. The discovery of a lognormal distribution law suggests the existence of a minimum statistical representative window (MSRW) size that is characteristic for each material. Explorations on the dependence of MSRW size on the microstructure, deformation mechanism, and strain magnitude are expected to add new dimensions to understanding of the relationship between microstructure and mechanical properties.

Pelvic floor muscle training: mechanisms of action for the improvement of genitourinary syndrome of menopause

Objective: This study aims to investigate the mechanism of action of pelvic floor muscle training (PFMT) for the improvement of the signs and symptoms of genitourinary syndrome of menopause (GSM) in postmenopausal women with GSM and urinary incontinence (UI).Methods: Twenty-nine women were included in the secondary analysis of a single-arm feasibility study. Using color Doppler ultrasound, the peak systolic velocity, time-averaged maximum velocity, and pulsatility index of the internal pudendal and dorsal clitoral arteries were measured at rest and after a pelvic floor muscle (PFM) contraction task. PFM function was assessed by dynamometry, and vulvovaginal tissue elasticity was measured using the Vaginal Atrophy Index.Results: PFMT significantly improved blood flow parameters in both arteries (p < 0.05) and significantly increased the speed of PFM relaxation after a contraction (p = 0.003). After the intervention, a marginally significant decrease in PFM tone was observed, as well as an increase in PFM strength (p = 0.060 and p = 0.051, respectively). Finally, improvements in skin elasticity and introitus width were observed as measured by the Vaginal Atrophy Index (p < 0.007).Conclusion: Our findings suggest that PFMT improves blood flow in vulvovaginal tissues, PFM relaxation capacity, and vulvovaginal tissue elasticity in postmenopausal women with GSM and UI.

Very high rate of false positive biochemical results when screening for pheochromocytoma in a large, undifferentiated population with variable indications for testing

OBJECTIVE

Pheochromocytoma/Paraganglioma (PPGL) is a rare tumor with non-specific presentations overlapping common entities like anxiety, hypertension, acute illness and episodic "spells." Assessment of urine normetanephrine or metanephrine (UNM-UMN) in real-life, where PPGL is very rare and PPGL mimics extremely common, may show overlap in results with loss of specificity depending on the reference range. We determined the extent to which UNM-UMN are high in people undergoing screening for PPGL.

DESIGN AND METHODS

Retrospective review of all UNM-UMN performed in a central lab serving Southern Alberta over 8 years.

RESULTS

After excluding pediatric ages and patients with CKD, there were 12,572 unique patients with 14,383 measures of UNM-UMN. 85 patients (0.7%) had markedly high UNM-UMN compatible with likely PPGL. Depending on the age category (in decades), 10-22% of all UNM results were above the upper reference limit(URL), particularly between ages of 40-60. Less than 3% had elevations in both UNM and UMN. Of those with high UNM, 99% were less than 3-fold the URL. Based on the population data, a potential new reference range for UNM is suggested, which may be more appropriate to the types of patient who undergo this form of testing.

CONCLUSIONS

There is an extraordinarily high prevalence of high UNM seen in real-life use of the test. However, the vast majority of high UNM are unlikely to be PPGL given the disease rarity and the massive number of tests ordered. This suggests the current laboratory URL may be too low (poor specificity) and/or the reference range may not be appropriate to the type of patient being screened for PPGL. Depending on the frequency of use of any screening test in a population, if the disease is rare and the specificity of the test is poor, a high rate of false positive results will be expected.

How Well Can You Tailor the Charge of Lipid Vesicles?

Knowledge and control of surface charge or potential is important for tailoring colloidal interactions. In this work, we compare widely used zeta potential (ζ) measurements of charged lipid vesicle surface potential to direct measurements using the surface force apparatus (SFA). Our measurements show good agreement between the two techniques. On varying the fraction of anionic lipids dimyristoylphosphatidylserine (DMPS) or dimyristoylphosphatidylglycerol (DMPG) mixed with zwitterionic dimyristoylphosphatidylcholine (DMPC) from 0 to 100 mol % we observed a near-linear increase in membrane surface charge or potential up to 20-30 mol % charged lipids beyond which charge saturation occurred in physiological (high) salt conditions. Similarly, in low salt concentrations, a linear increase in charge/potential was found but only up to ∼5-10 mol % charged lipids beyond which the surface charge or potential leveled off. While a lower degree of ionization is expected due to the lower dielectric constant (ε ∼ 4) of the lipid acyl chain environment, increasing intramembrane electrostatic repulsion between neighboring charged lipid head groups at higher charge loading contributes to charge suppression. Measured potentials in physiological salt solutions were consistent with predictions using the Gouy-Chapman-Stern-Grahame (GCSG) model of the electrical double layer with Langmuir binding of counterions, but in low salt conditions, the model significantly overestimated the surface charge/potential. The much lower ionization in low salt (maximum ∼1-2% of total lipids ionized) instead was consistent with counterion condensation at the bilayer surface which limited the charge that could be obtained. The strong interplay between membrane composition, lipid headgroup ionization, electrolyte concentration, and solution pH complicates exact prediction and tuning of membrane surface charge for applications. However, the theoretical frameworks used here can provide guidelines to understand this interplay and establish a range of achievable potentials for a system and predict the response to triggers like pH and salt concentration changes.

Development and validation of a nomogram to predict the risk of occult cervical lymph node metastases in cN0 squamous cell carcinoma of the tongue

We have explored the relations between clinicopathological features and cervical lymph node metastases (LNM) in patients with cN0 squamous cell carcinoma (SCC) of the tongue, and developed and validated a nomogram for predicting the risk of their development. Clinical data on 230 patients with cN0 SCC of the tongue who had had primary extended excision and lymph node dissection of the neck were collected retrospectively. They were divided into a development cohort and a validation cohort in a 4:1 ratio. Logistic regression analysis was used to assess the risk factors of cervical LNM in patients in the development cohort, and a nomogram was established to predict the risk of such nodes. In the validation cohort, the predictive performance and compliance of the model were evaluated using the consistency index (C-index) and calibration curve, and the clinical value was evaluated by decision curve analysis. Of the 230 patients, 60 had cervical LNM, of which 60 were invaded (26%). Analysis of the development cohort showed that the site of the primary lesion, depth of invasion, size of the tumour, and histopathological grade were included in the prediction model, which was validated in the validation cohort. Consistency was high (C-index=0.846), calibration good, and it was clinically valuable. The nomogram could be used to predict the probability of occult cervical LNM before operation in patients with stage cN0 SCC of the tongue. It could also be used as a reference tool for dissection of cervical nodes and a communication tool between the doctor and the patient.

Packet Clustering Introduced by Routers

In this article, we investigate a router’s inherent variation on packet processing time and its effect on interpacket delay and packet clustering. We propose a simple pipeline model incorporating the inherent variation, and two metrics—one to measure packet clustering and one to quantify inherent variation. To isolate the effect of the inherent variation, we begin our analysis with no cross traffic and step through setups where the input streams have different data rates, packet size, and go through a different number of hops. We show that a homogeneous input stream with a sufficiently large interpacket gap will emerge at the router’s output with interpacket delays that are negative correlated with adjacent values and have symmetrical distributions. We show that for smaller interpacket gaps, the change in packet clustering is smaller. It is also shown that the degree of packet clustering could in fact decrease for a clustered input. We generalize our results by adding cross traffic. All the results predicted by the model are validated with experiments with real routers. We also investigated several factors that can affect the inherent variation as well as some potential applications of this study.

Abstract P6-18-18: Phase I trial of eribulin and everolimus in patients with metastatic triple negative breast cancer

Background: Alteration of PI3K/Akt/mTOR pathway is the most common genomic abnormality detected in triple negative breast cancer (TNBC). Everolimus acts synergistically with eribulin in inducing apoptosis in TNBC cell lines and xenografts in our preclinical study. This phase I trial was designed to test the safety and tolerability of combining eribulin and everolimus in patients (pts) with metastatic TNBC.

Methods: The overall objective of this study was to describe the safety and toxicities of the combination. The secondary objective was to assess activity based on response rate (RR) and progression free survival (PFS). Eligibility criteria included pts with metastatic TNBC, ECOG 0-2, 0-3 lines of prior chemotherapy in metastatic setting, and prior treatment with anthracycline and/or taxane therapy. The study utilized the toxicity equivalence range (TEQR) design with a target equivalence range for dose-limiting toxicities (DLTs) of 0.20-0.35. The recommended phase 2 dose (RP2D) will be the dose closest to the target of 0.25 below 0.51 based on isotonic regression.Three dosing levels of the combinations were tested: level A1 (everolimus 5mg daily; eribulin 1.4 mg/m2 days 1, 8 every 3 weeks), level A2 (everolimus 7.5mg daily; eribulin 1.4 mg/m2, days 1, 8 every 3 weeks), level B1(everolimus 5mg daily; eribulin 1.1 mg/m2 days 1, 8 every 3 weeks). Nanostring RNA analysis and genomic mutation analysis were conducted in 16 pts with available tumor tissue.

Results: A total of 27 pts were enrolled. Median age was 55 years (range 36-76). Two pts were ineligible due to HER2+ on repeat biopsy and were only included in the toxicity analysis. Dose level B1 (everolimus 5mg daily and eribulin 1.1 mg/m2 days 1, 8 every 3 weeks) was determined to be the RP2D doses. The DLTs were neutropenia, stomatitis and hyperglycemia. Across all cycles, 59% (16/27) had a ≥ Gr3 toxicity attributed to treatment at the possible or above level. 44% (12/27) had Gr3 heme-toxicities. The most common toxicities were ≥ Gr3 neutropenia (10 pts), Gr3 lymphopenia (6 pts) and ≥ Gr3 leukopenia (7 pts). 33% (9/27) had Gr3 non-heme toxicities. The most common were Gr3 stomatitis (3 pts), Gr3 hyperglycemia (3 pts) and Gr3 fatigue (5 pts). The median number of cycles completed was 4 (0-8). 68% (17/25) had a dose modification or hold, 14 of 25 (56%) were for eribulin and 15 of 25 (60%) were for everolimus. Of 25 eligible pts, 8 (32%) achieved a best response as partial response, 11 (44%) had stable disease and 6 (24%) had progression. 80% (20/25) experienced progression by RECIST or showed clinical progression, and the median time to progression was 2.7 mo (95% CI (2.2, 4.6)). At the time of this analysis, 16 participants had died, median OS was 6.3 mo (95% CI (5.3, undefined)). Two pts are still being followed on treatment. PI3K-Akt-mTOR pathway genes and mutations profiles were studied.

Conclusion: Eribulin 1.1 mg/m2 days 1, 8 and everolimus 5mg daily was defined as the RP2D. Genomic analysis is currently underway to understand the molecular mechanisms of resistance.

Citation Format: Yuan Y, Yost S, Blanchard S, Yin H, Li M, Robinson K, Tang A, Martinez N, Leong L, Somlo G, Tank Patel N, Waisman J, Portnow J, Hurria A, Luu T-H, Mortimer J. Phase I trial of eribulin and everolimus in patients with metastatic triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-18.