Value of long non-coding RNA HAS2-AS1 as a diagnostic and prognostic marker of glioma

BACKGROUND

Glioma presents high incidence and poor prognosis, and therefore more effective treatments are needed. Studies have confirmed that long non-coding RNAs (lncRNAs) basically regulate various human diseases including glioma. It has been theorized that HAS2-AS1 serves as an lncRNA to exert an oncogenic role in varying cancers. This study aimed to assess the value of lncRNA HAS2-AS1 as a diagnostic and prognostic marker for glioma.

METHODS

The miRNA expression data and clinical data of glioma were downloaded from the TCGA database for differential analysis and survival analysis. In addition, pathological specimens and specimens of adjacent normal tissue from 80 patients with glioma were used to observe the expression of HAS2-AS1. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic ability and prognostic value of HAS2-AS1 in glioma. Meanwhile, a Kaplan-Meier survival curve was plotted to evaluate the survival of glioma patients with different HAS2-AS1 expression levels.

RESULTS

HAS2-AS1 was significantly upregulated in glioma tissues compared with normal tissue. The survival curves showed that overexpression of HAS2-AS1 was associated with poor overall survival (OS) and progression-free survival (PFS). Several clinicopathological factors of glioma patients, including tumor size and WHO grade, were significantly correlated with HAS2-AS1 expression in tissues. The ROC curve showed an area under the curve (AUC) value of 0.863, indicating that HAS2-AS1 had good diagnostic value. The ROC curve for the predicted OS showed an AUC of 0.906, while the ROC curve for predicted PFS showed an AUC of 0.88. Both suggested that overexpression of HAS2-AS1 was associated with poor prognosis.

CONCLUSIONS

Normal tissues could be clearly distinguished from glioma tissues based on HAS2-AS1 expression. Moreover, overexpression of HAS2-AS1 indicated poor prognosis in glioma patients. Therefore, HAS2-AS1 could be used as a diagnostic and prognostic marker for glioma.

MD Anderson Phase III Randomized Preoperative Stereotactic Radiosurgery (SRS) vs. Postoperative SRS for Brain Metastases Trial

PURPOSE/OBJECTIVE(S)

Postoperative stereotactic radiation therapy/radiosurgery (SRT/SRS) is being evaluated in comparison to Preoperative SRT for brain metastases (mets) in a limited number of prospective clinical trials. Our objective is to address the significant knowledge gap concerning the logistics of preoperative SRT in comparison to postoperative SRT in a randomized controlled study.

MATERIALS/METHODS

Patients with brain mets with at least 1 surgically operable met were randomized (1:1) to Preop vs Postop SRT. In this abstract, we present non-primary endpoint data on the trial concept and logistics of treatment for this data safety monitoring board reviewed study. Patients enrolled had 1-2 lesions resected and <15 lesions treated at time of SRT to best reflect the standard population that receive SRT and surgery at our institution.

RESULTS

From 12/2018 to 12/2022, 99 patients with 1-2 operable brain mets were enrolled and randomized to Preop (n = 49) or Postop (n = 50) SRT. Males represented 56% of the cohort compared to females, and <25% were age 18-49 years, while 27%, 29, and 19% respectively were 50-59, 60-69, and > = 70. The most frequent histologies enrolled were lung (29%), renal cell (15%), melanoma (14%), and breast (11%) cancers. The majority of patients (83%) had 1-4 brain mets on their baseline MRI and 91% subsequently had a single lesion resected. Seventy-nine patients completed both SRT and surgery, while 9% received no therapy due to drop out before study therapy initiation. Among patients receiving both therapies in the combined cohort, 68% received a non-invasive stereotactic radiosurgery instrument to the randomized cavity lesion compared to 32% receiving LINAC based SRT. Treatment of the lesion or cavity with single fraction SRT was 51% in the Preop arm vs 31% in the Postop arm. Multi-fraction (3-5 SRT) was 67% in the Postop cohort in contrast to 47% in the Preop cohort. Time from randomization to RT was 5.6 days and 33.7 days in the Preop and Postop cohorts respectively, and for surgery was 10.2 days vs 12.9 days in the Postop vs Preop cohorts. The average time from RT to surgery was 7.3 days in the Preop arm and 23.5 days in the Postop arm (to allow for incisional healing time).

CONCLUSION

In one of the early initiated randomized prospective cohorts of Preop vs Postop SRT, we demonstrated logistical feasibility with an efficient clinical trial workflow for study treatment. Differences in Preop vs Postop logistics reflect clinical practice differences in time-to-treatment. Therapy with various modalities reflected real-world practice and possibly provider preferences in technique when addressing the nature of delineating cavities and changes in cavity volume with regard to fractionation. Independent of the primary outcomes, our data provides insights in the practical management of patients receiving these two modalities of therapy, and further data at the completion of trial will address relevant primary outcomes.

Comparison of landing kinematics and kinetics between experienced and novice volleyball players during block and spike jumps

BACKGROUND

The practice of volleyball requires many jumps. During landing, anterior cruciate ligament injuries may occur with high-risk lower limb kinematics and kinetics. Differences in landing strategies between experienced and novice volleyball players have not been fully explored. The purpose of the study was to compare lower limb kinematics and kinetics in experienced and novice volleyball players when performing volleyball specific jumps.

METHODS

A total of 30 healthy males, 15 experienced and 15 novice volleyball players, participated in the study. Participants performed block and spike jumps at a controlled jump height. Hip, knee and ankle joints angles at initial ground contact and ranges of motion in the sagittal plane, knee joint angles and moments in the frontal plane, vertical ground reaction force peak and loading rate were analyzed to investigate the expertise effect.

RESULTS

Experienced volleyball players landed with larger ankle dorsiflexion range of motion compared to novices. For the spike jump, experienced players landed with larger ankle plantarflexion angles at initial contact and larger ankle dorsiflexion ranges of motion, and for the block jump, they landed with larger knee flexion ranges of motion. Experienced players jumped significantly higher than novices. No difference was found in vertical ground reaction force peaks and loading rates.

CONCLUSIONS

Although the experienced group jumped higher than the novice group, no difference was found in ground reaction force parameters. These findings highlight that the experience of volleyball players acquired during regular trainings and competitions may play an important role in landing kinematics and kinetics to reduce the injury risk.

Time event ontology (TEO): to support semantic representation and reasoning of complex temporal relations of clinical events

OBJECTIVE

The goal of this study is to develop a robust Time Event Ontology (TEO), which can formally represent and reason both structured and unstructured temporal information.

MATERIALS AND METHODS

Using our previous Clinical Narrative Temporal Relation Ontology 1.0 and 2.0 as a starting point, we redesigned concept primitives (clinical events and temporal expressions) and enriched temporal relations. Specifically, 2 sets of temporal relations (Allen's interval algebra and a novel suite of basic time relations) were used to specify qualitative temporal order relations, and a Temporal Relation Statement was designed to formalize quantitative temporal relations. Moreover, a variety of data properties were defined to represent diversified temporal expressions in clinical narratives.

RESULTS

TEO has a rich set of classes and properties (object, data, and annotation). When evaluated with real electronic health record data from the Mayo Clinic, it could faithfully represent more than 95% of the temporal expressions. Its reasoning ability was further demonstrated on a sample drug adverse event report annotated with respect to TEO. The results showed that our Java-based TEO reasoner could answer a set of frequently asked time-related queries, demonstrating that TEO has a strong capability of reasoning complex temporal relations.

CONCLUSION

TEO can support flexible temporal relation representation and reasoning. Our next step will be to apply TEO to the natural language processing field to facilitate automated temporal information annotation, extraction, and timeline reasoning to better support time-based clinical decision-making.

A semantic relationship mining method among disorders, genes, and drugs from different biomedical datasets

BACKGROUND

Semantic web technology has been applied widely in the biomedical informatics field. Large numbers of biomedical datasets are available online in the resource description framework (RDF) format. Semantic relationship mining among genes, disorders, and drugs is widely used in, for example, precision medicine and drug repositioning. However, most of the existing studies focused on a single dataset. It is not easy to find the most current relationships among disorder-gene-drug relationships since the relationships are distributed in heterogeneous datasets. How to mine their semantic relationships from different biomedical datasets is an important issue.

METHODS

First, a variety of biomedical datasets were converted into RDF triple data; then, multisource biomedical datasets were integrated into a storage system using a data integration algorithm. Second, nine query patterns among genes, disorders, and drugs from different biomedical datasets were designed. Third, the gene-disorder-drug semantic relationship mining algorithm is presented. This algorithm can query the relationships among various entities from different datasets.

RESULTS AND CONCLUSIONS

We focused on mining the putative and the most current disorder-gene-drug relationships about Parkinson's disease (PD). The results demonstrate that our method has significant advantages in mining and integrating multisource heterogeneous biomedical datasets. Twenty-five new relationships among the genes, disorders, and drugs were mined from four different datasets. The query results showed that most of them came from different datasets. The precision of the method increased by 2.51% compared to that of the multisource linked open data fusion method presented in the 4th International Workshop on Semantics-Powered Data Mining and Analytics (SEPDA 2019). Moreover, the number of query results increased by 7.7%, and the number of correct queries increased by 9.5%.

Sentiment Analysis Methods for HPV VaccinesRelated Tweets Based on Transfer Learning

The widespread use of social media provides a large amount of data for public sentimentanalysis. Based on social media data, researchers can study public opinions on humanpapillomavirus (HPV) vaccines on social media using machine learning-based approaches that willhelp us understand the reasons behind the low vaccine coverage. However, social media data isusually unannotated, and data annotation is costly. The lack of an abundant annotated dataset limitsthe application of deep learning methods in effectively training models. To tackle this problem, wepropose three transfer learning approaches to analyze the public sentiment on HPV vaccines onTwitter. One was transferring static embeddings and embeddings from language models (ELMo)and then processing by bidirectional gated recurrent unit with attention (BiGRU-Att), called DWEBiGRU-Att. The others were fine-tuning pre-trained models with limited annotated data, called finetuninggenerative pre-training (GPT) and fine-tuning bidirectional encoder representations fromtransformers (BERT). The fine-tuned GPT model was built on the pre-trained generative pretraining(GPT) model. The fine-tuned BERT model was constructed with BERT model. Theexperimental results on the HPV dataset demonstrated the efficacy of the three methods in thesentiment analysis of the HPV vaccination task. The experimental results on the HPV datasetdemonstrated the efficacy of the methods in the sentiment analysis of the HPV vaccination task. Thefine-tuned BERT model outperforms all other methods. It can help to find strategies to improvevaccine uptake.

Society of pediatric liver transplantation: Current registry status 2011-2018

BACKGROUND

SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies.

OBJECTIVE

To report the outcomes of the SPLIT registry from 2011 to 2018.

METHODS

This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period.

RESULTS

A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.

Methanol outbreak in the district of Hulu Langat, 2018

INTRODUCTION

A methanol outbreak occurred in the district of Hulu Langat on 16 September 2018. The Hulu Langat District Health Office received 25 notifications of a suspected methanol poisoning from Kajang and Ampang Hospital. An outbreak investigation was done to determine the source followed by a preventive and control measure.

METHOD

Active case detection was done on cases living quarters and workplaces. Patients were interviewed, and their blood and urine samples were sent for methanol analysis. Samples of suspected alcoholic beverages were also sent for analysis. A suspected case was defined as any person presented with clinical symptoms with a history of consuming alcoholic beverages within five days before symptoms and high anion gap metabolic acidosis. A confirmed case was defined as a suspected case with positive blood and urine methanol.

RESULTS

In total, there were 25 suspected cases, of which 12 cases were confirmed. The calculated attack rate was 48%. There were six mortalities (50%) secondary to severe metabolic acidosis. The most common presenting symptom was vomiting (75%) and abdominal pain (41.7%). These cases were linked to consumption of illicitly produced alcohol. Samples of the alcoholic drinks were positive containing high level of methanol.

CONCLUSION

The methanol outbreak in the Hulu Langat was successfully managed. Appropriate control and prevention measures were taken, including health promotion and joint enforcement activities. Steps were taken successfully through collaborations with multiple agencies and cooperation with Selangor Health Departments and the Ministry of Health. Continuous surveillance on the product of liquor, and health promotion are essential to prevent a similar outbreak from happening again in future.

Dynamic Contrast-Enhanced MRI in Patients with Brain Metastases Undergoing Laser Interstitial Thermal Therapy: A Pilot Study

BACKGROUND AND PURPOSE

Tumor recurrence is difficult to predict in patients receiving laser ablation for intracranial malignancy. We assessed the efficacy of the initial area under the time-to-signal intensity curve at 60 seconds (iAUC₆₀) from dynamic contrast-enhanced MR imaging in predicting progression-free survival in patients with brain metastases following laser interstitial thermal therapy.

MATERIALS AND METHODS

The study population was a consecutive series of patients undergoing laser interstitial thermal therapy for brain metastases. Patient demographics including age, sex, tumor histology, and Karnofsky Performance Scale were collected prospectively. Preoperative, postoperative, and 1-month follow-up dynamic contrast-enhanced MRIs were analyzed. Values of iAUC₆₀ were computed using a trapezoidal rule applied to the time history of contrast uptake over the first 60 seconds postenhancement. The change in iAUC₆₀ (ΔiAUC₆₀) was calculated by taking the difference between the values of iAUC₆₀ from 2 time points. Pearson correlation coefficients were calculated between progression-free survival, defined as the time from laser interstitial thermal therapy to tumor recurrence, and iAUC₆₀ or ΔiAUC₆₀ values.

RESULTS

Thirty-three cases of laser interstitial thermal therapy for 32 brain metastases in a cohort of 27 patients were prospectively analyzed. A significant relationship was observed between the values of iAUC₆₀ from postoperative dynamic contrast-enhanced MR imaging and progression-free survival with Pearson correlation (P = .03) and Cox univariate analysis (P = .01). The relationship between preoperative and 1-month follow-up dynamic contrast-enhanced MR imaging was not significantly correlated with progression-free survival. Similarly, no statistically significant relationship was observed with ΔiAUC₆₀ and progression-free survival between any time points.

CONCLUSIONS

Progression-free survival is difficult to predict in patients undergoing laser interstitial thermal therapy for brain metastases due to confounding with posttreatment change. iAUC₆₀ extracted from postoperative dynamic contrast-enhanced MR imaging shows promise for accurately prognosticating patients following this operative therapy.

Ontological representation-oriented term normalization and standardization of the Research Domain Criteria

The Research Domain Criteria, launched by the National Institute of Mental Health, is a new dimensional and interdisciplinary research framework for mental disorders. The Research Domain Criteria matrix is its core part. Since an ontology has the strengths of supporting semantic inferencing and automatic data processing, we would like to transform the Research Domain Criteria matrix into an ontological structure. In terms of data normalization, which is the essential part of an ontology representation, the Research Domain Criteria elements (mainly in the Units of Analysis) have some limitations. In this article, we propose a series of solutions to improve data normalization of the Research Domain Criteria elements in the Units of Analysis, including leveraging standard terminologies (i.e. the Unified Medical Language System Metathesaurus), context-combining queries, and domain expertise. The evaluation results show the positive (Yes) percentage is more than 80 percent, indicating our work is favorably received by the mental health professionals, and we have formed a good data foundation for the Research Domain Criteria ontological representation in the future work.

The social location of harm from others' drinking in 10 societies

AIMS

Survey data from 10 diverse countries were used to analyse the social location of harms from others' drinking: which segments of the population are more likely to be adversely affected by such harm, and how does this differ between societies?

METHODS

General-population surveys in Australia, Chile, India, Laos, New Zealand, Nigeria, Sri Lanka, Thailand, United States and Vietnam, with a primary focus on the social location of the harmed person by gender, age groups, rural/urban residence and drinking status. Harms from known drinkers were analysed separately from harms from strangers.

RESULTS

In all sites, risky or moderate drinkers were more likely than abstainers to report harm from the drinking of known drinkers, with risky drinkers the most likely to report harm. This was also generally true for harm from strangers' drinking, although the patterns were more mixed in Vietnam and Thailand. Harm from strangers' drinking was more often reported by males, while gender disparity in harm from known drinkers varied between sites. Younger adults were more likely to experience harm both from known drinkers and from strangers in some, but not all, societies. Only a few sites showed significant urban/rural differences, with disparities varying in direction. In multivariate analyses, most relationships remained, although some were no longer significant.

CONCLUSION

The social location of harms from others' drinking, whether known or a stranger, varies considerably between societies. One near-commonality among the societies is that those who are themselves risky drinkers are more likely to suffer harm from others' drinking.

Reduced vitamin D levels in painful diabetic peripheral neuropathy

AIM

Recent studies have reported an association between low vitamin D levels and diabetic peripheral neuropathy. However, many of these did not differentiate between people with painful diabetic peripheral neuropathy and those with painless diabetic peripheral neuropathy, or assess major confounding factors including sunlight exposure and daily activity. Our study addressed these limitations and evaluated vitamin D levels in people with carefully phenotyped diabetic peripheral neuropathy and controls.

METHODS

Forty-five white Europeans with Type 2 diabetes and 14 healthy volunteers underwent clinical and neurophysiological assessments. People with Type 2 diabetes were then divided into three groups (17 with painful diabetic peripheral neuropathy, 14 with painless diabetic peripheral neuropathy and 14 with no diabetic peripheral neuropathy). All had seasonal sunlight exposure and daily activity measured, underwent a lower limb skin biopsy and had 25-hydroxyvitamin D measured during the summer months, July to September.

RESULTS

After adjusting for age, BMI, activity score and sunlight exposure, 25-hydroxyvitamin D levels (nmol/l) (se) were significantly lower in people with painful diabetic peripheral neuropathy [painful diabetic peripheral neuropathy 34.9 (5.8), healthy volunteers 62.05 (6.7), no diabetic peripheral neuropathy 49.6 (6.1), painless diabetic peripheral neuropathy 53.1 (6.2); ANCOVAP = 0.03]. Direct logistic regression was used to assess the impact of seven independent variables on painful diabetic peripheral neuropathy. Vitamin D was the only independent variable to make a statistically significant contribution to the model with an inverted odds ratio of 1.11. Lower 25-hydroxyvitamin D levels also correlated with lower cold detection thresholds (r = 0.39, P = 0.02) and subepidermal nerve fibre densities (r = 0.42, P = 0.01).

CONCLUSIONS

We have demonstrated a significant difference in 25-hydroxyvitamin D levels in well-characterized people with painful diabetic peripheral neuropathy, while accounting for the main confounding factors. This suggests a possible role for vitamin D in the pathogenesis of painful diabetic peripheral neuropathy. Further prospective and intervention trials are required to prove causality between low vitamin D levels and painful diabetic peripheral neuropathy.

Harms from a partner's drinking: an international study on adverse effects and reduced quality of life for women

BACKGROUND

Partners of heavy drinking individuals can be detrimentally affected as a result of their partner's drinking.

OBJECTIVES

The aim of this study was to identify the proportion of heterosexual intimate partner relationships with a heavy drinking male that resulted in reported alcohol-related harm and to investigate the impact of this on well-being in 9 countries.

METHODS

This study used survey data from the Gender and Alcohol's Harm to Others (GENAHTO) Project on Alcohol's Harm to Others in 9 countries (10,613 female respondents, 7,091 with intimate live-in partners). Respondents were asked if their partners drinking had negatively affected them as well as questions on depression, anxiety, and satisfaction with life.

RESULTS

The proportion of partnered respondents that reported having a harmful heavy drinking partner varied across countries, from 4% in Nigeria and the US to 33% in Vietnam. The most consistent correlate of experiencing harm was being oneself a heavy episodic drinker, most likely as a proxy measure for the acceptability of alcohol consumption in social circles. Women with a harmful heavy drinking partner reported significantly lower mean satisfaction with life than those with a partner that did not drink heavily.

CONCLUSIONS

Harms to women from heavy drinking intimate partners appear across a range of subgroups and impact on a wide range of women, at least demographically speaking. Women living with a heavy drinking spouse experience higher levels of anxiety and depression symptoms and lower satisfaction with life.

A Novel Diazomethane-Mediated Synthesis of Azetidine-Embedded Tetracyclic Ketal Systems

Herein, the first diazomethane-mediated synthesis of azetidine-embedded tetracyclic ketal systems is reported. Reactions of norbornyl hemiaminal acetals with diazomethane afford azetidine-embedded tetracyclic ketals in good to excellent yields. The bridgehead-bromo-substituted hemiaminal acetals give higher yields compared to the corresponding bridgehead-chloro-substituted hemiaminal acetals. The hemiaminal acetals are prepared stereoselectively via nucleophilic addition of various amines to norbornyl α-diketones from the exo face.

Compression of a giant pseudomeningocele causing transient anoxic seizures-a case report

Transient anoxic seizure upon application of pressure on a giant pseudomeningocele has never been reported in the literature; such abrupt changes in intracranial pressure due to large volume of cerebrospinal fluid (CSF) translocation, if left untreated may lead to permanent cerebral hypoxic injury and death. Here we describe a case of a 26-year-old woman who had undergone lumbar disc surgery in another unit few months ago and developed a large lump around her back. Any pressure on the lump resulted in headaches and at times episodes of seizures. Clinical examination revealed a very large fluid-filled lump consistent with a giant pseudomeningocele, confirmed by an MRI. A video EEG while applying pressure on the lump was recorded. The patient developed a typical seizure attack with a characteristic pattern of cerebral anoxia, and a paired ECG showed irregular rhythm with junctional and ventricular ectopic beats during the latter part of the attack, raising a suspicion of asystole. Upon relieving the pressure off the lump, the patient gradually regained consciousness with no permanent neurological deficit. We then discuss the pathophysiology of anoxic seizures and highlight the need to be vigilant in managing patients with such lesions in order to prevent permanent cerebral hypoxic injury and death.

Abstract P6-03-04: Central nervous system miliary metastasis in breast cancer patients

Background: Little is known regarding central nervous system (CNS) miliary metastasis (MiM), which was first described as “carcinomatous encephalitis” by Madow and Alpers in 1951. The majority of reported cases arise from primary lung and gastrointestinal adenocarcinomas, with occasional melanoma primaries and one reported case in breast cancer. Moreover, clinicopathologic correlates, disease outcomes and prognostic factors in these patients are poorly understood. Although identified most frequently on neuroimaging, radiographic criteria to objectively diagnose MiM do not exist. In this analysis of patients with brain metastasis from primary breast cancer, we propose objective, stringent radiographic criteria for CNS MiM diagnosis and identify clinicopathologic factors contributing to disease outcomes.

Methods: Using a prospectively maintained electronic database, 1,002 female patients diagnosed with brain metastasis from primary breast cancer between 2000 and 2015 were identified. Only patients with neuroimaging available for direct review (CT or MRI) were included. Our radiographic criteria for MiM diagnosis were: 1) ≥20 metastatic lesions per image slice on ≥2 noncontiguous image slices by MRI, or 2) ≥10 lesions per image slice on ≥2 noncontiguous image slices by CT, and 3) MiM lesions were required to be present bilaterally and in both the supra- and infratentorial compartments. These criteria were established upon direct review of all neuroimaging by a neuroradiologist. Number and anatomic distribution of metastatic lesions were the patterns best observed to identify cases of CNS MiM on case review; lesion size was not a reliable pattern for MiM identification. Log rank tests were used for statistical analyses.

Results: Using stringent criteria, 486 patients were included in this analysis. Twenty patients with MiM were identified (4.1%). Ten patients were diagnosed with MiM at initial brain metastasis presentation; 10 developed MiM after known brain metastasis. Biomarker based subtype distribution was as follows: HR-/HER2- (TNBC) (n=8), HR+/HER2+ (n=3), HR+/HER2- (n=4), HR-/HER2+ (n=4), unknown (n=1).

Table 1: Disease Outcomes Based on Biomarker SubtypeBiomarker SubtypeMedian Time to MiM (months) (p=0.104)Median Survival after MiM (months) (p=0.008)TNBC (n=8)32.3 (12.1-132.5)1.8 (0.5-4.0)HR+/HER2+ (n=3)44.2 (33.2-71.5)10.8 (10.2-13.3)HR+/HER2- (n=4)110.2 (23.0-156.0)4.8 (0.8-9.8)HR-/HER2+ (n=4)27.1 (3.7-39.4)4.0 (1.8-5.0)All* (n=20)37.4 (3.7-156.0)3.7 (0.4-12.3)Key: BM: Brain metastasis; * Includes 1 patient with unknown subtype.

Conclusions: Reports of MiM consist overwhelmingly of lung and gastrointestinal adenocarcinoma primaries. This retrospective, observational study is the first to establish that CNS MiM occurs in breast cancer with an incidence of roughly 4%. Review of an additional 1,600 patient charts is underway, but this preliminary study is the first to identify clinicopathologic correlates and determine disease outcomes in patients with MiM; it is also the first to propose stringent radiographic criteria for the diagnosis of CNS MiM, and further updated data will be presented at the meeting.

Citation Format: Bashour SI, Ibrahim NK, Schomer DF, Colen RR, Sawaya R, Suki D, Rao G, Murthy RK, Moulder SL, Abugabal Y, Hess KR, Fuller GN. Central nervous system miliary metastasis in breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-03-04.

PROSE

The study of paraconsistent reasoning with ontologies is especially important for the Semantic Web since knowledge is not always perfect within it. However, classical OWL reasoners cannot support reasoning with inconsistent ontologies. In this article, the authors present a plugin-based framework called prose to provide rich paraconsistent reasoning services for OWL ontologies, whose architecture contains the three following parts: a classical OWL reasoner, a multi-valued transformer, and an OWL API connecting with them. Within the proposed framework prose, they implement different multi-valued paraconsistent reasoning in the OWL. Moreover, they select three popular classical OWL reasoners and two typical kinds of reasoning services for users. As the authors excepted, prose does exactly enable current classical OWL reasoners to tolerate inconsistency in a simple and convenient way. Finally, they evaluate the three reasoners in a united framework (prose) and, as a result, those results can amend the analysis of the three reasoners on inconsistent ontologies.

Glioblastoma stem cells exploit the αvβ8 integrin-TGFβ1 signaling axis to drive tumor initiation and progression

Glioblastoma (GBM) is a primary brain cancer that contains populations of stem-like cancer cells (GSCs) that home to specialized perivascular niches. GSC interactions with their niche influence self-renewal, differentiation and drug resistance, although the pathways underlying these events remain largely unknown. Here, we report that the integrin αvβ8 and its latent transforming growth factor β1 (TGFβ1) protein ligand have central roles in promoting niche co-option and GBM initiation. αvβ8 integrin is highly expressed in GSCs and is essential for self-renewal and lineage commitment in vitro. Fractionation of β8^high cells from freshly resected human GBM samples also reveals a requirement for this integrin in tumorigenesis in vivo. Whole-transcriptome sequencing reveals that αvβ8 integrin regulates tumor development, in part, by driving TGFβ1-induced DNA replication and mitotic checkpoint progression. Collectively, these data identify the αvβ8 integrin-TGFβ1 signaling axis as crucial for exploitation of the perivascular niche and identify potential therapeutic targets for inhibiting tumor growth and progression in patients with GBM.

Accelerated magnetic resonance thermometry in the presence of uncertainties

A model-based information theoretic approach is presented to perform the task of magnetic resonance (MR) thermal image reconstruction from a limited number of observed samples on k-space. The key idea of the proposed approach is to optimally detect samples of k-space that are information-rich with respect to a model of the thermal data acquisition. These highly informative k-space samples can then be used to refine the mathematical model and efficiently reconstruct the image. The information theoretic reconstruction was demonstrated retrospectively in data acquired during MR-guided laser induced thermal therapy (MRgLITT) procedures. The approach demonstrates that locations with high-information content with respect to a model-based reconstruction of MR thermometry may be quantitatively identified. These information-rich k-space locations are demonstrated to be useful as a guide for k-space undersampling techniques. The effect of interactively increasing the predicted number of data points used in the subsampled model-based reconstruction was quantified using the L2-norm of the distance between the subsampled and fully sampled reconstruction. Performance of the proposed approach was also compared with uniform rectilinear subsampling and variable-density Poisson disk subsampling techniques. The proposed subsampling scheme resulted in accurate reconstructions using a small fraction of k-space points, suggesting that the reconstruction technique may be useful in improving the efficiency of thermometry data temporal resolution.

Texture Feature Ratios from Relative CBV Maps of Perfusion MRI Are Associated with Patient Survival in Glioblastoma

BACKGROUND AND PURPOSE

Texture analysis has been applied to medical images to assist in tumor tissue classification and characterization. In this study, we obtained textural features from parametric (relative CBV) maps of dynamic susceptibility contrast-enhanced MR images in glioblastoma and assessed their relationship with patient survival.

MATERIALS AND METHODS

MR perfusion data of 24 patients with glioblastoma from The Cancer Genome Atlas were analyzed in this study. One- and 2D texture feature ratios and kinetic textural features based on relative CBV values in the contrast-enhancing and nonenhancing lesions of the tumor were obtained. Receiver operating characteristic, Kaplan-Meier, and multivariate Cox proportional hazards regression analyses were used to assess the relationship between texture feature ratios and overall survival.

RESULTS

Several feature ratios are capable of stratifying survival in a statistically significant manner. These feature ratios correspond to homogeneity (P = .008, based on the log-rank test), angular second moment (P = .003), inverse difference moment (P = .013), and entropy (P = .008). Multivariate Cox proportional hazards regression analysis showed that homogeneity, angular second moment, inverse difference moment, and entropy from the contrast-enhancing lesion were significantly associated with overall survival. For the nonenhancing lesion, skewness and variance ratios of relative CBV texture were associated with overall survival in a statistically significant manner. For the kinetic texture analysis, the Haralick correlation feature showed a P value close to .05.

CONCLUSIONS

Our study revealed that texture feature ratios from contrast-enhancing and nonenhancing lesions and kinetic texture analysis obtained from perfusion parametric maps provide useful information for predicting survival in patients with glioblastoma.

A rate-based transcutaneous CO2 sensor for noninvasive respiration monitoring

The pain and risk of infection associated with invasive blood sampling for blood gas measurements necessitate the search for reliable noninvasive techniques. In this work we developed a novel rate-based noninvasive method for a safe and fast assessment of respiratory status. A small sampler was built to collect the gases diffusing out of the skin. It was connected to a CO2 sensor through gas-impermeable tubing. During a measurement, the CO2 initially present in the sampler was first removed by purging it with nitrogen. The gases in the system were then recirculated between the sampler and the CO2 sensor, and the CO2 diffusion rate into the sampler was measured. Because the measurement is based on the initial transcutaneous diffusion rate, reaching mass transfer equilibrium and heating the skin is no longer required, thus, making it much faster and safer than traditional method. A series of designed experiments were performed to analyze the effect of the measurement parameters such as sampler size, measurement location, subject positions, and movement. After the factor analysis tests, the prototype was sent to a level IV NICU for clinical trial. The results show that the measured initial rate of increase in CO2 partial pressure is linearly correlated with the corresponding arterial blood gas measurements. The new approach can be used as a trending tool, making frequent blood sampling unnecessary for respiratory status monitoring.

LAMC2 enhances the metastatic potential of lung adenocarcinoma

Lung cancer is the number one cancer killer, and metastasis is the main cause of high mortality in lung cancer patients. However, mechanisms underlying the development of lung cancer metastasis remain unknown. Using genome-wide transcriptional analysis in an experimental metastasis model, we identified laminin γ2 (LAMC2), an epithelial basement membrane protein, to be significantly upregulated in lung adenocarcinoma metastatic cells. Elevated LAMC2 increased traction force, migration, and invasion of lung adenocarcinoma cells accompanied by the induction of epithelial-mesenchymal transition (EMT). LAMC2 knockdown decreased traction force, migration, and invasion accompanied by EMT reduction in vitro, and attenuated metastasis in mice. LAMC2 promoted migration and invasion via EMT that was integrin β1- and ZEB1-dependent. High LAMC2 was significantly correlated with the mesenchymal marker vimentin expression in lung adenocarcinomas, and with higher risk of recurrence or death in patients with lung adenocarcinoma. We suggest that LAMC2 promotes metastasis in lung adenocarcinoma via EMT and may be a potential therapeutic target.