Ultrasonic synthesis of magnetic covalent organic frameworks and application magnetic solid phase extraction for rapid adsorption of trace bisphenols in food samples

A simple ultrasonic synthesis strategy was developed for a novel magnetic covalent organic framework. Firstly, the Fe3O4 nanoparticles were encapsulated by imine-type COF, which generated by the Schiff reaction of 4,4',4''-(1,3,5-Triazine-2,4,6-triyl)-trianiline (TAPT) and tris(4-formylphenyl)-amine (TFPA) using ultrasonic synthesis method within 2 h. The synthesised nanocomposites showed a sizeable specific surface area, and high adsorption capacity. A fast, sensitive MSPE method with Fe3O4@TAPT-TFPA-COF as adsorbent for analysing bisphenol compounds was developed. This method's advantages were simple operation, short extraction time, and avoidance of the use of centrifugal equipment. The method validation indicate that this method exhibited superior linearity, and detection limits range between 0.33 and 0.60 μg L-1. The recoveries of BPs ranged from 74.7 % to 107.0 %, with relative standard deviations of less than 3.8 % in water, milk, vinegar, and soy sauce samples. The proposed method was successfully applied for extracting BPs in food samples.

Bioaerosolization behaviour of potential pathogenic microorganisms from wastewater treatment plants: Occurrence profile, social function and health risks

Wastewater treatment plants (WWTPs) are the leading sources of potential pathogenic bioaerosol that cause non-negligible health risks. However, bioaerosolization behaviour of potential pathogenic microorganisms (PPMs) migrating from wastewater to the atmosphere is still unclear. This study investigated the occurrence profile of PPMs in wastewater, sludge and bioaerosol, then analyzed bioaerosolization level, impact factors and social function. Staphylococcus aureus was selected as the target due to its pathogenicity, and the health risks of workers, engineers and researchers wearing various masks (N90, N95 and medical masks) were evaluated. The results showed that there were 38 and 64 PPMs in bioaerosol from plant A and B. Streptomyces in plant A (average bioaerosolization index, BI= 237.71) and Acinetobacter in plant B (average BI = 505.88) were more likely to migrate from wastewater to the atmosphere forming bioaerosol. Environmental factors (relative humidity, wind speed and temperature) affected both BI and microbial species of PPMs in different ways. PPMs related to fermentation, aerobic chemoheterotrophy, and chemoheterotrophy are the most abundant. Meanwhile microbial networks from plants A and B showed that PPMs were well-connected. Emission level of Staphylococcus aureus bioaerosol can reach 980 ± 309.19 CFU/m3 in plant A and 715.55 ± 44.17 CFU/m3 in plant B. For three exposure population, disease burden (DB) and annual probability infection (Py) of Staphylococcus aureus bioaerosol in two plants were both higher than the U.S.EPA benchmark (10-4 DALYs pppy). All three masks (N90,N95 and medical masks) can decrease Py and DB by at least one order of magnitude. This study illustrated the bioaerosolization behaviour of PPMs comprehensively, which provides a scientific basis for exposure risk prevention and control.

Biodegradation of microplastics derived from controlled release fertilizer coating: Selective microbial colonization and metabolism in plastisphere

Coated controlled-release fertilizers (CRFs) are widely used in agriculture, and the persistent presence of residual polymer coating has raised environmental concerns. This study investigates the underlying degradation dynamics of microplastics (MPs) derived from three typical materials used in CRFs, including polyethylene (PE), epoxy (EP), and polyurethane (PU), through a soil degradation test. The formation of surface biofilm, the succession process, and metabolic characteristics of microbial community are revealed by laser scanning confocal microscope, 16S rRNA sequencing, and non-targeted metabolomics analysis. The weight loss rates of PE, EP, and PU after 807 days of degradation were 16.70 %, 2.79 %, and 4.86 %, respectively. Significant secondary MPs were produced with tears and holes appeared in the coating cross sections and pyrolysis products were produced such as ethers, acids, and esters for PE; alkanes, olefins and their branched-chain derivatives for EP; and short-chain fatty acids and benzene molecules for PU. The coating surface selectively recruited the bacteria of Chujaibacter and Ralstonia and fungus of Fusarium and Penicillium, forming biofilm composed of lipids, proteins, and living cells. The metabolism of amino acids and polymers was enhanced to protect against MP-induced stress. The metabolites or intermediates of organic acids and derivatives, oxygen-contained organic compounds, and benzenoids on CRF surface increased significantly compared with soil, but there were no significant differences among different coating types. This study provides insights to the underlying mechanisms of biodegradation and microenvironmental changes of MPs in soil.

A colorimetric probe for the detection of hydrazine and its application

A colorimetric probe was developed to detect N2H4 content based on the colour change in natural light, and the recognition mechanism is the N2H4 cutting the ester bond of probe 1. As the N2H4 concentration increases, the Ultraviolet absorption ratio (A352nm/A505nm) of the probe solution was gradually increases, and the colour of the solution changed from colourless to pink under natural light. The detection limit of probe 1 for N2H4 was 0.1 μM. The probe can also be applied to test paper detection, and the test paper of probe was changed from colourless to fluorescent yellow under UV light as the concentration of N2H4 increased. There was a linear functional relationship between the RGB (Red, Green, Blue) values of the photos and the N2H4 concentration. Probe 1 is a rapid detection tool for N2H4 concentration using a smartphone. Furthermore, the probe can also be used to detect N2H4 in tap water, tea and apple juice.

Research progress in the synthesis of stable isotopes of food flavour compounds

Stable isotope dilution analysis (SIDA) is a quantitative method widely used in the determination of food flavour components because of its high efficiency and precision. However, many stable isotope reagents cannot be purchased through commercial channels. In this paper, the basic principle of stable isotope dilution analysis is introduced and its historical progress in food flavour analysis are examined. Then, the preparation methods of stable isotope analysis of food flavour compounds in recent years were compiled. In the literature reviewed, from 2012 to 2022, there were 185 stable isotopes of food flavour compounds used for food flavour analysis, of which 126 compounds can be purchased commercially and 59 compounds must be prepared in the laboratory. This review aims to present the methods used in the synthesis of stable isotopes to facilitate the development of food flavour analysis using stable isotope technology.

Phase II clinical trial of neoadjuvant anti-PD-1 (toripalimab) combined with axitinib in resectable mucosal melanoma

BACKGROUND

The outcome of patients with resectable mucosal melanoma is poor. Toripalimab combined with axitinib has shown impressive results in metastatic mucosal melanoma with an objective response rate of 48.3% and a median progression-free survival of 7.5 months in a phase Ib trial. It was hypothesized that this combination administered in the neoadjuvant setting might induce a pathologic response in resectable mucosal melanoma, so we conducted this trial.

PATIENTS AND METHODS

This single-arm phase II trial enrolled patients with resectable mucosal melanoma. Patients received toripalimab 3 mg/kg once every 2 weeks (Q2W) plus axitinib 5 mg two times a day (b.i.d.) for 8 weeks as neoadjuvant therapy, then surgery and adjuvant toripalimab 3 mg/kg Q2W starting 2 ± 1weeks after surgery for 44 weeks. The primary endpoint was the pathologic response rate according to the International Neoadjuvant Melanoma Consortium recommendations.

RESULTS

Between August 2019 and October 2021, 29 patients were enrolled and received treatment, of whom 24 underwent resection. The median follow-up time was 34.2 months (95% confidence interval 20.4-48.0 months). The pathologic response rate was 33.3% (8/24; 4 pathological complete responses and 4 pathological partial responses). The median event-free survival for all patients was 11.1 months (95% confidence interval 5.3-16.9 months). The median overall survival was not reached. Neoadjuvant therapy was tolerable with 8 (27.5%) grade 3-4 treatment-related adverse events and no treatment-related deaths. Tissue samples of 17 patients at baseline and after surgery were collected (5 responders and 12 nonresponders). Multiplex immunohistochemistry demonstrated a significant increase in CD3+ (P = 0.0032) and CD3+CD8+ (P = 0.0038) tumor-infiltrating lymphocytes after neoadjuvant therapy, particularly in pathological responders.

CONCLUSIONS

Neoadjuvant toripalimab combined with axitinib in resectable mucosal melanoma demonstrated a promising pathologic response rate with significantly increased infiltrating CD3+ and CD3+CD8+ T cells after therapy.

[Immunotherapy advances for lung cancer combined with chronic obstructive pulmonary disease]

Lung cancer is a major public health problem worldwide, with high rates of morbidity and mortality. It often coexists with chronic obstructive pulmonary disease (COPD), the diagnosis and management of which often receives insufficient attention. In particular, the presence of COPD has significant implications for the clinical management of lung cancer patients. This review systematically assesses the influence of COPD on the efficacy of immunotherapy and the occurrence of immune-related adverse events in patients with lung cancer, identifies existing challenges and proposes avenues for future research in this field.

Determination of carboxylesterase by fluorescence probe to guide detection of carbamate pesticide

A carboxylesterase fluorescent probe (Probe 1) was developed for determination of carboxylesterase to guide detection of carbamate pesticide. The probe uses benzothiazole as fluorescence group and phenyldimethyl carbamate as recognition group. The solution of the fluorescent probe gradually changes from light blue to dark blue as the concentration of carbamate pesticides increases. The concentration of carbamate pesticides can be quickly calculated according to the colour of the probe solution through Get Color software on a smartphone. It showed that Probe 1 can be used as a rapid detection tool to achieve rapid detection of carbamate pesticides in juice samples without professional personnel and equipment. Furthermore, the probe has been successfully used to detect carbamate pesticides in fruit juice and vegetable juice.

A colorimetric fluorescent probe for the detection of carboxylesterase and carbamate pesticides

A colorimetric fluorescent probe (BTCNA) was developed for the determination of carboxylesterase and carbamate pesticides. The probe used naphthalene-benzothiazole as the fluorescent group and naphthyl acetate as the recognition group. The recognition mechanism of BTCNA for carboxylesterase was based on the enzymatic hydrolysis of naphthyl acetate by carboxylesterase (CES). The test paper of the BTCNA gradually changed from light blue to bright yellow with the increase of CES activity. The probe solution gradually changed from light blue to earth-yellow as the carbaryl concentration increased. There was a linear functional relationship between the R*G (red, green) value of the photo and the CES activity. And a linear functional relationship between the carbaryl concentration and the R*G value of the photo was found. Additionally, BTCNA was successfully used to detect the concentration of carbaryl in actual samples. BTCNA is a rapid detection tool for CES activity and carbamate pesticides using a smartphone.

Comparison of bioaerosol release characteristics between windrow and trough sludge composting plants: Concentration distribution, community evolution, bioaerosolization behaviour, and exposure risk

Windrow and trough composting are two mainstream composting methods, but the effect of composting methods on bioaerosol release from sludge composting plants is unclear. The study compared the bioaerosol release characteristics and exposure risks between the two composting methods. The results showed that the bacterial aerosol concentrations in the windrow composting plant ranged from 14,196 to 24,549 CFU/m3, while the fungal aerosol concentrations in the trough composting plant reached 5874 to 9284 CFU/m3; there were differences in the microbial community structures between the two sludge composting plants, and the composting method had a greater effect on bacterial community evolution than on fungal community evolution. The biochemical phase was the primary source of the bioaerosolization behaviour of the microbial bioaerosols. In the windrow and trough composting plants, the bacterial bioaerosolization index ranged from 1.00 to 999.28 and from 1.44 to 24.57, and the fungal bioaerosolization index ranged from 1.38 to 1.59 and from 0.34 to 7.72, respectively. Bacteria preferentially aerosolized mainly in the mesophilic stage, while the peak of the fungal bioaerosolization index appeared in the thermophilic stage. The total non-carcinogenic risks for bacterial aerosols were 3.4 and 2.4, while those for fungi were 1.0 and 3.2 in the trough and windrow sludge composting plants, respectively. Respiration is the main exposure pathway for bioaerosols. It is necessary to develop different bioaerosol protection measures for different sludge composting methods. The results of this study provided basic data and theoretical guidance for reducing the potential risk of bioaerosols in sludge composting plants.

A dual-function fluorescent probe for the detection of pH values and formaldehyde

A dual-function fluorescent probe (Probe 1) was developed in this work for the separate detection of pH value and formaldehyde (HCHO). Probe 1 could recognize HCHO and the pH value from the amino group. The colour of the probe solution was changed from grey blue to light blue with the increase in the pH value, and luminous intensity became larger with the increase in formaldehyde concentration. The curve function relationship between fluorescence intensity and the pH value was also determined. A smartphone containing a colour detector for imaging was used to record the values of the three primary colours (R value, G value, and B value) for the probe solution in formaldehyde. Importantly, there was a linear functional relationship between the B*R/G value with HCHO concentration. Therefore, the probe could be used as a rapid tool for the detection of formaldehyde. More importantly, Probe 1 was successfully used to detect formaldehyde in an actual distilled liquor sample.

The Chemical Composition and Health-Promoting Benefits of Vegetable Oils-A Review

With population and economic development increasing worldwide, the public is increasingly concerned with the health benefits and nutritional properties of vegetable oils (VOs). In this review, the chemical composition and health-promoting benefits of 39 kinds of VOs were selected and summarized using Web of Science TM as the main bibliographic databases. The characteristic chemical compositions were analyzed from fatty acid composition, tocols, phytosterols, squalene, carotenoids, phenolics, and phospholipids. Health benefits including antioxidant activity, prevention of cardiovascular disease (CVD), anti-inflammatory, anti-obesity, anti-cancer, diabetes treatment, and kidney and liver protection were examined according to the key components in representative VOs. Every type of vegetable oil has shown its own unique chemical composition with significant variation in each key component and thereby illustrated their own specific advantages and health effects. Therefore, different types of VOs can be selected to meet individual needs accordingly. For example, to prevent CVD, more unsaturated fatty acids and phytosterols should be supplied by consuming pomegranate seed oil, flaxseed oil, or rice bran oil, while coconut oil or perilla seed oil have higher contents of total phenolics and might be better choices for diabetics. Several oils such as olive oil, corn oil, cress oil, and rice bran oil were recommended for their abundant nutritional ingredients, but the intake of only one type of vegetable oil might have drawbacks. This review increases the comprehensive understanding of the correlation between health effects and the characteristic composition of VOs, and provides future trends towards their utilization for the general public's nutrition, balanced diet, and as a reference for disease prevention. Nevertheless, some VOs are in the early stages of research and lack enough reliable data and long-term or large consumption information of the effect on the human body, therefore further investigations will be needed for their health benefits.

Bioaerosol-related studies in wastewater treatment plant with anaerobic-anoxic-oxic processes: Characterization, source analysis, control measures

Sewage in wastewater treatment plants (WWTPs) can produce fugitive bioaerosols that pose a health risk to employees and residents. This study aimed to fugitive bioaerosols from two WWTPs with anaerobic-anoxic-oxic (AAO) processes, and bioaerosols control measures were proposed based on the results of these studies. It was found that the bioaerosols were mainly composed of microorganisms from dominant genera such as Romboutsia, Rubellimicrobium, Sphingomonas, Acidea, Cryptotrichosporon and water-soluble ions dominated by SO₄^2-. Moreover, total suspended particulate (TSP), relative humidity (RH), wind speed (WS), Ca²⁺, NH₄⁺, Na⁺, Cl^-, NO₃^-, and K⁺ had positive effects on most dominant genera, while temperature (T) and SO₄^2- had negative effects on most dominant genera. The source analysis showed that the bioaerosols in the indoor treatment facility's fine screen room and sludge dewatering plant mainly originated from sewage or sludge, and those in the aeration tank of the outdoor treatment facility mainly originated from the background air of WWTPs . By combining the characteristics of bioaerosols and the results of source analysis, targeted control measures were proposed from three aspects: source reduction of bioaerosol fugitives, control of bioaerosol propagation, and collection and treatment systems. This study provides the theoretical basis and ideas for controlling bioaerosols in WWTPs with AAO processes.

Cross-media migration behavior of antibiotic resistance genes (ARGs) from municipal wastewater treatment systems (MWTSs): Fugitive characteristics, sharing mechanisms, and aerosolization behavior

The municipal wastewater treatment systems (MWTSs) are the leading enrichment site of antibiotic resistance genes (ARGs), the occurrence of which in sewage and sludge significantly influences the ARGs burden of aerosols. However, the migration behavior and impact factors of gas-liquid-solid phase ARGs in MWTSs are still unclear. In this study, we collected gas (aerosol), liquid (sewage), and solid (sludge) samples from MWTSs to explore the cross-media transport behavior of ARGs. The results showed that the main ARGs detected in the solid-gas-liquid phase of the three MWTSs were consistent, constituting the central antibiotic resistance system of MWTSs. Multidrug resistance genes were dominant in cross-media transmission (average relative abundance is 42.01 %). Aminocoumarin, fluoroquinolone, and aminoglycoside resistance genes (aerosolization index of 1.260, 1.329, and 1.609, respectively) were prone to migrating from the liquid to gas phase under aeration or mechanical action, resulting in long-distance transmission. Environmental factors (mainly temperature and wind speed), water quality index (mainly COD) and heavy metals may be the key factors to affecting the trans-media migration of ARGs between the liquid, gas, and solid phase based on regression analysis. Based on partial least squares path modeling (PLS-PM), the migration of ARGs in gas phase is primarily influenced by ARGs' aerosolization index in liquid phase and solid phase, while heavy metals indirectly influences almost all categories of ARGs. Impact factors aggravated the migration of ARGs in MWTSs through coselection pressure. This study clarified the key pathways and impact factors that form the cross-media migration behavior of ARGs, which can more specifically control ARGs pollution from different media.

Stress response and signalling of a low-temperature bioaugmentation system in decentralized wastewater treatment: Degradation characteristics, community structure, and bioaugmented mechanisms

Low temperatures present challenges for stable wastewater treatment operations in cold regions. Low-temperature effective microorganisms (LTEM) were added as a bioaugmentation strategy at a decentralized treatment facility to improve performance. The effects of a low-temperature bioaugmentation system (LTBS) with LTEM at low temperatures (4 °C) on organic pollutant performance, microbial community changes, and the metabolic pathways of functional genes and functional enzymes were studied. To explore the bioaugmentation mechanism of LTBS based on stress response and signalling. The results showed that the start-up time of the LTBS (S2) with LTEM was shorter (8 days) and that it removed COD and NH₄⁺-N at higher rates (87 % and 72 %, respectively) at 4 °C. LTEM effectively degraded complex macromolecular organics into small molecular organics, and decomposing sludge flocs and the changing the extracellular polymeric substances (EPS) structure removed more organics and nitrogen. LTEM and local microbial communities (nitrifying and denitrifying bacteria) improved the ability of organic matter degradation and denitrification of the LTBS and formed a core microbial community dominated by LTEM (Bacillus and Pseudomonas). Finally, based on the functional enzymes and metabolic pathways of the LTBS, a low-temperature strengthening mechanism consisting of 6 cold stress responses and signal pathways under low temperatures was formed. This study demonstrated that the LTEM-dominated LTBS could provide an engineering alternative for future decentralized wastewater treatment in cold regions.

A novel integrated industrial-scale biological reactor for odor control in a sewage sludge composting facility: Performance, pollutant transformation, and bioaerosol emission mechanism

In order to remove multiple pollutants in the sewage sludge (SS) composting facility, a novel integrated industrial-scale biological reactor based on biological trickling filtration and fungal biological filtration (BTF-FBF) was developed. This study examined bioaerosol emission, odour removal, pollutant transformation mechanism, and project investment. At an inlet flow rate of 7200 m³/h, the average removal efficiencies of hydrogen sulfide (H₂S), ammonia (NH₃), and volatile organic compounds (VOCs) during the steady stage were 97.2 %, 98.9 %, and 92.2 %. The BTF-FBF separates microbial phases (bacteria and fungi) of different modules. BTF removed most hydrophilic compounds, while FBF removed hydrophobic ones. Moreover, the reactor could effectively remove pathogens or opportunistic pathogens bioaerosols, such as Escherichia coli (61.9%), Salmonella sp. (85%), and Aspergillus fumigatus (82.1%). The pollutant transformation mechanism of BTF-FBF was proposed. BTF-FBF annualized costs were 324,783 CNY/year at 15 years. In conclusion, BTF-FBF provides new insights into composting facility bioaerosol, odour, and pathogen emission control.

[A combined regimen based on bortezomib and glucocorticoids for 6 patients with recurrent/refractory immune thrombotic thrombocytopenic purpura]

Objective: To observe the efficacy and adverse reactions of a combination therapy regimen based on bortezomib and glucocorticoids in recurrent/refractory immune thrombocytopenic purpura (iTTP) . Methods: Six patients with recurrent/refractory TTP were included and treated with a glucocorticoid and two courses of bortezomib-based regimen. The clinical remission status of patients, changes in ADAMTS13 activity/ADAMTS13 inhibitor, and the occurrence of treatment-related adverse reactions were observed. Results: Of the 6 patients, 2 were males and 4 were females, with a median age of 21.5 (18-68) years. Refractory TTP was found in 1 case and recurrent TTP in 5 cases. Glucocorticoids were administered with reference to prednisone at 1 mg·kg(-1)·d(-1), and gradually reduced in dosage after achieving clinical remission. Bortezomib is subcutaneously administered at 1.3 mg/m(2) on days 1, 4, 8, and 11 with a 28-day treatment course consisting of 2 courses. Six patients achieved clinical remission after receiving bortezomib as the main treatment. ADMATS13 activity returned to normal in all patients with TTP after treatment, and the ADAMTS13 inhibitor turned negative. Thrombocytopenia is the most common adverse reaction after treatment, with other adverse reactions, including peripheral neuritis and abdominal pain, but ultimately all patients returned to normal. In a median follow-up of 26 (9-41) months, 5 patients maintained sustained remission, and 1 patient relapsed after 16 months of bortezomib treatment. Conclusion: Combination therapy of bortezomib and glucocorticoids has a satisfactory therapeutic effect and controllable adverse reactions for recurrent/refractory iTTP.

Valley-polarized and enhanced transmission in graphene with a smooth strain profile

We explore the influence of strain on the valley-polarized transmission of graphene by employing the wave-function matching and the non-equilibrium Green's function technique. When the transmission is along the armchair direction, we show that the valley polarization and transmission can be improved by increasing the width of the strained region and increasing (decreasing) the extensional strain in the armchair (zigzag) direction. It is noted that the shear strain does not affect transmission and valley polarization. Furthermore, when we consider the smooth strain barrier, the valley-polarized transmission can be enhanced by increasing the smoothness of the strain barrier. We hope that our finding can shed new light on constructing graphene-based valleytronic and quantum computing devices by solely employing strain.

Study of dental phobia, psychological resilience, and related factors in children aged 8-9 years in Weifang city

OBJECTIVES

To investigate the influencing factors of children's dental fear (CDF) and the relationship of CDF with resilience in children aged 8-9 years in Weifang city to provide evidence for the early prevention and intervention of CDF.

METHODS

Random cluster sampling method was applied. A total of 1 995 children aged 8-9 years from 10 primary schools in four districts of Weifang city were selected from June to October 2021 as the survey objects. General information questionnaire, the children's fear survey schedule-dental sub-scale, and adolescent resilience scale were used in the investigation.

RESULTS

The CDF detection rate was 31.78% (634 cases) in children aged 8-9 years in Weifang city, including 28.41% (296 cases) in boys and 35.47% (338 cases) in girls. Multivariate logistic analysis showed that female gender [odds ratio (OR)=1.329, 95% confidence interval (CI)=1.062-1.665], dental caries (OR=1.961, 95%CI=1.330-2.891), dental pain (OR=2.133, 95%CI=1.700-2.676), and dental treatment experience (OR=3.621, 95%CI=2.888-4.540) are risk factors for CDF. Parents with tertiary education or higher (OR=2.123, 95%CI=1.546-2.916; OR=3.304, 95%CI=2.368-4.612), high scores in the positive cognition factor of the psychological resilience-personal strength dimension (OR=1.520, 95%CI=1.141-2.025), high scores in the interpersonal assistance factor of the psychological resilience-support strength dimension (OR=3.819, 95%CI=2.743-5.318), and high scores in the family support factor (OR=5.634, 95%CI=4.047-7.844) were protective factors for CDF occurrence (P<0.05).

CONCLUSIONS

Children with high psychological resilience scores have low CDF incidence, and good parenting practices are beneficial in reducing CDF incidence.

[Clinical diagnosis and treatment of hereditary thrombocytopenia and purpura: a report of five cases and literature review]

Objective: To report the clinical manifestations and laboratory features of five patients with congenital thrombotic thrombocytopenic purpura (cTTP) and explore its standardized clinical diagnosis and treatment along with a review of literature. Methods: Clinical data of patients, such as age of onset, disease manifestation, personal history, family history, and misdiagnosed disease, were collected. Treatment outcomes, therapeutic effects of plasma infusion, and organ function evaluation were observed. The relationship among the clinical manifestations, treatment outcomes, and ADAMTS13 gene mutation of patients with cTTP was analyzed. Additionally, detection of ADAMTS13 activity and analysis of ADAMTS13 gene mutation were explored. Results: The age of onset of cTTP was either in childhood or adulthood except in one case, which was at the age of 1. The primary manifestations were obvious thrombocytopenia, anemia, and different degrees of nervous system involvement. Most of the patients were initially suspected of having immune thrombocytopenia. Acute cTTP was induced by pregnancy and infection in two and one case, respectively. ADAMTS13 gene mutation was detected in all cases, and there was an inherent relationship between the mutation site, clinical manifestations, and degree of organ injury. Therapeutic or prophylactic plasma transfusion was effective for treating cTTP. Conclusions: The clinical manifestations of cTTP vary among individuals, resulting in frequent misdiagnosis that delays treatment. ADAMTS13 activity detection in plasma and ADAMTS13 gene mutation analysis are important bases to diagnose cTTP. Prophylactic plasma transfusion is vital to prevent the onset of the disease.

[Kinetics of SARS-CoV-2-specific antibodies among inactivated COVID-19 vaccine recipients, SARS-CoV-2 natural infection cases, and breakthrough cases]

Between August and September, 2021, this study included 605 SARS-CoV-2 natural infection cases and 589 SARS-CoV-2 breakthrough cases from Nanjing and Yangzhou, as well as 690 inactivated COVID-19 vaccine recipients from Changzhou, China. In SARS-CoV-2 natural infection cases, the age range was 19-91 years (median age: 66 year), and the medians(Q₁,Q₃) of IgG titers were 0.19 (0.06-1.31), 3.70 (0.76-69.48), 15.31 (2.59-82.16), 4.41 (0.99-31.74), 2.31 (0.75-13.83), 2.28 (0.68-9.94) and 2.80 (1.00-9.53) at one to seven weeks after SARS-CoV-2 infection, respectively. In SARS-CoV-2 breakthrough cases, the age range was 18-76 years (median age: 45 year), and the medians(Q₁,Q₃)of IgG titers were 1.93 (0.34-26.67), 38.87 (7.90-121.0), 75.09 (11.85-123.70), 21.97 (5.20-95.58), 13.97 (3.47-46.82), 9.56 (2.48-33.38) and 4.38 (1.87-11.00) at one to seven weeks after SARS-CoV-2 infection, respectively. In inactivated COVID-19 vaccine recipients, the age range was 18-87 years (median age: 47 years), and the medians(Q₁,Q₃)of IgG titers were 16.22 (15.84-33.42), 5.35 (2.96-13.23), 3.30 (2.18-6.18), 3.14 (1.16-5.70), 2.77 (1.50-4.52), 2.72 (1.76-4.36), 2.01 (1.27-3.51) and 1.94 (1.35-3.09) at one to eight months after SARS-CoV-2 infection, respectively. The results suggested that IgG antibodies increased gradually within two weeks after SARS-CoV-2 infection, then declined gradually at three to seven weeks in SARS-CoV-2 natural infection cases. In SARS-CoV-2 breakthrough cases, IgG antibodies increased rapidly within two weeks, then declined gradually at three to seven weeks after SARS-CoV-2 infection. Additionally, IgG antibodies decreased rapidly within three months, then decreased gradually and remained at a low level within three months after immunization.

Performance on desulfurization and denitrification of one-step produced activated carbon for purification of sintering flue gas

An innovative one-step process for activated carbon production from low-rank coal is proposed in this research by applying oxidized pellets as activator. The new process can realize synchronous production of the activated carbon and direct reduction iron through combination of carbonization and activation of low-rank coal in one step while no solid wastes were discharged. The desulfurization and denitrification performance of the obtained activated carbon was also evaluated on the simulative sintering flue gas in comparison with one type of commercial activated carbon. The results indicated that a superior activated carbon with high specific surface area of 370.42 m² g^-1, iodine sorption value of 695.13 mg g^-1, compressive strength of 315 N·per^-1and abrasive resistance of 96.61%, can be prepared under suitable conditions of activation temperature at 850 °C for 140 min with C/Fe mass ratio of 2.5. Meanwhile, the direct reduction iron has a metallization ratio of 88.31%. The activated carbon has a preferable desulfurization performance with the breakthrough sulfur capacity of 5.463 mg/g and breakthrough time of 46.33 min, and single denitrification performance with the breakthrough nitric capacity of 1.935 mg/g and breakthrough time of 90.17 min at flue gas temperature of 80 °C, airspeed ratio of 8370 h^-1, gas flow of 1.8 m³/h, and oxygen concentration of 16%. The denitrification of activated carbon in the simultaneous desulfurization and denitrification process can be improved by catalytic reduction via the transformation from NO to N₂. The good results show that this process has a bright future with high technical and economic feasibility.

DNA methylation and waist-to-hip ratio: an epigenome-wide association study in Chinese monozygotic twins

PURPOSE

Epigenetic signatures such as DNA methylation may be associated with specific obesity traits. We performed an epigenome-wide association study (EWAS) by combining with the waist-to-hip ratio (WHR)-discordant monozygotic (MZ) twin design in an attempt to identify genetically independent DNA methylation marks associated with abdominal obesity in Northern Han Chinese and to determine the causation underlying.

METHODS

A total of 60 WHR discordant MZ twin pairs were selected from the Qingdao Twin Registry, China. Generalized estimated equation (GEE) model was used to regress the methylation level of CpG sites on WHR. The Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) was used to assess the temporal relationship between methylation and WHR. Gene expression analysis was conducted to validate the results of differentially methylated analyses.

RESULTS

EWAS identified 92 CpG sites with the level of P < 10^- 4 which were annotated to 32 genes, especially CADPS2, TUSC5, ZCCHC14, CORO7, COL23A1, CACNA1C, CYP26B1, and BCAT1. ICE FALCON showed significant causality between DNA methylation of several genes and WHR (P < 0.05). In region-based analysis, 14 differentially methylated regions (DMRs) located at 15 genes (slk-corrected P < 0.05) were detected. The gene expression analysis identified the significant correlation between expression levels of 5 differentially methylated genes and WHR (P < 0.05).

CONCLUSIONS

Our study identifies the associations between specific epigenetic variations and WHR in Northern Han Chinese. These DNA methylation signatures may have value as diagnostic biomarkers and provide novel insights into the molecular mechanisms of pathogenesis.

[Diagnostic value of rapid antigen testing for the detection of SARS-CoV-2 infection]

Objective: To investigate the diagnostic value of rapid antigen test based on colloidal gold immunochromatographic assay for the detection of SARS-CoV-2 infection in symptomatic patients. Methods: From May 20 to June 5 2022, 76 hospitalized children and their 55 accompanying family members with confirmed SARS-CoV-2 infection in the COVID-19 isolation unit of the Children's Hospital of Fudan University (designated referral hospital for SARS-CoV-2 infection in Shanghai) enrolled. Their nasopharyngeal swab specimens were consecutively collected. The samples were tested for SARS-CoV-2 nucleic acid by real-time quantitative. SARS-CoV-2 antigen was tested by immunochromatography. The correlation between the antigen detection results and the change of the cycle threshold (Ct) values were evaluated, as well as the sensitivity and specificity of SARS-CoV-2 antigen detection at different periods after the onset of the disease. Kappa consistency test was conducted to investigate the consistency between the 2 diagnostic methods. Results: Of the enrolled SARS-CoV-2 symptomatic infections, 76 were children, including 41 males and 35 females, with an age of 5 (2, 9) years; 55 were accompanying families, including 8 males and 47 females, with an age of 38 (32, 41) years. All 478 samples were simultaneously tested for SARS-CoV-2 antigen and nucleic acid. In any period from disease onset to negative conversion of viral nucleic acid, the overall sensitivity of the rapid antigen test was 48.2% (119/247), the specificity was 98.3% (227/231), and antigen test and nucleic acid test showed moderate consistency (κ=0.46, P<0.05). The sensitivity of antigen test was 100% (82/82) when the Ct value was ≤25. And the sensitivity of antigen test was 8/10, 4/15 and 8.3% (3/36) when the Ct value was 26, 30 and 35, respectively. All antigen tests were negative when Ct value was >35. During the period of 1-2 days, 3-5 days, 6-7 days, 8-10 days and >10 days after onset, the sensitivity and specificity of SARS-CoV-2 antigen test were 5/8 and 5/5, 90.2% (37/41) and 5/5, 88.9% (24/27) and 2/5, 45.0% (36/80) and 94.1% (32/34), 18.7% (17/91) and 98.9% (183/185) respectively. The Ct values of nasopharyngeal swabs were<26 during 2 to 7 days after onset, 28.7±5.0 on day 8, 34.5±2.9 on day 13 and > 35 after 14 days, respectively. Conclusion: SARS-CoV-2 antigen test in the patients with SARS-CoV-2 infection shows acceptable sensitivity and specificity within 7 days after onset of disease, and the sensitivity was positively correlated with viral load and negatively correlated with onset time.

[ABC prognostic classification and MELD 3.0 and COSSH-ACLF Ⅱ prognostic evaluation in acute-on-chronic liver failure]

Objective: To investigate the ABC prognostic classification and the updated version of Model for End-stage Liver Disease (MELD) score 3.0 and Chinese Group on the Study of Severe Hepatitis B ACLF Ⅱ score (COSSH-ACLF Ⅱ score) to evaluate the prognostic value in acute-on-chronic liver failure (ACLF). Methods: ABC classification was performed on a 1 409 follow-up cohorts. The area under the receiver operating characteristic curve (AUROC) was used to analyze MELD, MELD 3.0, COSSH-Ⅱ and COSSH-Ⅱ score after 3 days of hospitalization (COSSH-Ⅱ-3d). The prognostic predictive ability of patients were evaluated for 360 days, and the prediction differences of different classifications and different etiologies on the prognosis of ACLF were compared. Results: The survival curve of 1 409 cases with ACLF showed that the difference between class A, B, and C was statistically significant, Log Rank (Mantel-Cox) χ²=80.133, P<0.01. Compared with class A and C, χ²=76.198, P<0.01, the difference between class B and C, was not statistically significant χ²=3.717, P>0.05. AUROC [95% confidence interval (CI)] analyzed MELD, MELD 3.0, COSSH-Ⅱ and COSSH-Ⅱ-3d were 0.644, 0.655, 0.817 and 0.839, respectively (P<0.01). COSSH-Ⅱ had better prognostic predictive ability with class A ACLF and HBV-related ACLF (HBV-ACLF) for 360-days, and AUROC (95% CI) were 0.877 and 0.881, respectively (P<0.01), while MELD 3.0 prognostic predictive value was not better than MELD. Conclusion: ACLF prognosis is closely related to ABC classification. COSSH-Ⅱ score has a high predictive value for the prognostic evaluation of class A ACLF and HBV-ACLF. COSSH-Ⅱ score has a better prognostic evaluation value after 3 days of hospitalization, suggesting that attention should be paid to the treatment of ACLF in the early stage of admission.

[A multicenter cross-sectional study of quality of life and nonsurgical treatment in patients with knee osteoarthritis]

Objective: To explore the influencing factors of health-related quality of life (HRQoL) in patients with knee osteoarthritis, and to analyze the non-surgical treatment of knee osteoarthritis. Methods: Demographic variables, treatment modalities, imaging data, and 12-item short form health survey (SF-12) scores of patients with knee osteoarthritis in orthopedic outpatient departments of five hospitals in Beijing from December 2017 to November 2018 were collected to analyze influencing factors of HRQoL and non-surgical treatment. Results: A total of 2 034 patients were included. There were 530 males (26.1%) and 1 504 females (73.9%), with a mean age of (59.17±10.22) years. In terms of physical quality of life, female patients with knee osteoarthritis had lower physical components summary (PCS) compared with male patients (β=-0.521, P=0.036); patients aged ≥64 years had lower PCS than those aged<55 years (β=-0.636, P=0.026). Patients with an education of more than 12 years had higher PCS than those with less than 10 years (β=1.063, P<0.001). Compared to patients with mild clinical symptoms, the PCS of patients with moderate clinical symptoms was lower (β=-0.860, P=0.002), while the PCS of those with severe clinical symptoms was much lower (β=-1.126, P<0.001). Patients treated with combination therapy had higher PCS than untreated patients (β=0.731, P=0.005). In terms of mental quality of life, compared to patients engaged in sedentary work, the mental components summary (MCS) of patients engaged in mild manual labor jobs was lower (β=-0.712, P=0.015); Compared to patients with a Charson comorbidity index of 0, patients with a Charlson comorbidity index ≥ 2 had lower MCS (β=-1.183, P=0.007). In the past 12 months, 648 (31.9%), 143 (7.0%), 406 (20.0%), 680 (33.4%), 343 (16.9%), 681 (33.5%), 170 (8.4%) patients had used non-steroid anti-inflammatory drugs (NSAIDs), acetaminophen, glucosamine/chondroitin formulations, physical therapy, articular cavity puncture injection, traditional Chinese medicine treatment and exercise therapy, respectively. Total of 451 patients (22.2%) received monotherapy and 889 patients (43.7%) received combination therapy. Conclusions: The major non-surgical treatment methods for patients with knee osteoarthritis in Beijing are NSAIDs, physiotherapy and traditional Chinese medicine. Combination therapy is used more frequently than monotherapy. Physical quality of life is related to gender, age, education, severity of symptoms and treatment, while mental quality of life is related to occupational labor and comorbidities.

[Evidence-based research and prognosis of novel coagulation factor Ⅺ inhibitors in venous thromboembolism]

Thrombosis is the main cause of the development and progression of venous thromboembolism(VTE). Anticoagulant therapy is the cornerstone for the prophylaxis and treatment of VTE, and it has evolved mainly through indirect thrombin inhibitors, direct thrombin inhibitors, vitamin K antagonists and new oral anticoagulants. Although safety is improving, the risk of bleeding remains a non-negligible side effect of current anticoagulation therapy, especially in patients with higher bleeding risk. Studies of the coagulation pathway have found that FXI is not involved in the initiation of hemostasis, but promotes thrombus growth and stabilization primarily through feedback activation of FⅪ by thrombin. Further studies have found that inhibition of FⅪ significantly inhibits thrombus formation and only affects hemostasis slightly. Recent studies have confirmed the efficacy and safety of FⅪ inhibitors in the prevention of VTE in patients after knee replacement. In addition, the safety of FⅪ inhibitors has been further confirmed by the studies of FⅪ inhibitors in people with higher bleeding risk. FⅪ inhibitors may be the most promising anticoagulant drugs in the next decade.

A Robust Visual Tracking Method Based on Reconstruction Patch Transformer Tracking

Recently, the transformer model has progressed from the field of visual classification to target tracking. Its primary method replaces the cross-correlation operation in the Siamese tracker. The backbone of the network is still a convolutional neural network (CNN). However, the existing transformer-based tracker simply deforms the features extracted by the CNN into patches and feeds them into the transformer encoder. Each patch contains a single element of the spatial dimension of the extracted features and inputs into the transformer structure to use cross-attention instead of cross-correlation operations. This paper proposes a reconstruction patch strategy which combines the extracted features with multiple elements of the spatial dimension into a new patch. The reconstruction operation has the following advantages: (1) the correlation between adjacent elements combines well, and the features extracted by the CNN are usable for classification and regression; (2) using the performer operation reduces the amount of network computation and the dimension of the patch sent to the transformer, thereby sharply reducing the network parameters and improving the model-tracking speed.

A colourimetric fluorescent probe for the sensitive detection of total iron in wine

As the iron content of wine affects the wine quality, a highly selective and simple detection method is needed to detect the iron content in wine. A colourimetric fluorescent probe (BTBAP probe) for the detection of total iron in wine was developed. The quantitative range of Fe^2+/3+ content detected with the probe was 0 to 200 μM with a limit of detection (LOD) of 1.16 μM. After 10 min of Fe^2+/3+ addition, the luminescence intensity of the BTBAP probe solution gradually decreased with increasing Fe^2+/3+ concentration. Moreover, the B and G values of the luminescence photos were linearly related to the concentration of Fe^2+/3+ (0-200 μM). BTBAP probe was successfully applied for rapid determination of the Fe^2+/3+ concentration of wine. This work demonstrates that BTBAP probe is an excellent tool for rapid determination of the total iron content of wine using only a smartphone and no other professional equipment.

[Sacubitril/valsartan attenuates left ventricular remodeling and improve cardiac function by upregulating apelin/APJ pathway in rats with heart failure]

Objective: To investigate the effect and mechanism of sacubitril/valsartan on left ventricular remodeling and cardiac function in rats with heart failure. Methods: A total of 46 SPF-grade male Wistar rats weighed 300-350 g were acclimatized to the laboratory for 7 days. Rats were then divided into 4 groups: the heart failure group (n=12, intraperitoneal injection of adriamycin hydrochloride 2.5 mg/kg once a week for 6 consecutive weeks, establishing a model of heart failure); heart failure+sacubitril/valsartan group (treatment group, n=12, intragastric administration with sacubitril/valsartan 1 week before the first injection of adriamycin, at a dose of 60 mg·kg^-1·d^-1 for 7 weeks); heart failure+sacubitril/valsartan+APJ antagonist F13A group (F13A group, n=12, adriamycin and sacubitril/valsartan, intraperitoneal injection of 100 μg·kg^-1·d^-1 APJ antagonist F13A for 7 weeks) and control group (n=10, intraperitoneal injection of equal volume of normal saline). One week after the last injection of adriamycin or saline, transthoracic echocardiography was performed to detect the cardiac structure and function, and then the rats were executed, blood and left ventricular specimens were obtained for further analysis. Hematoxylin-eosin staining and Masson trichrome staining were performed to analyze the left ventricular pathological change and myocardial fibrosis. TUNEL staining was performed to detect cardiomyocyte apoptosis. mRNA expression of left ventricular myocardial apelin and APJ was detected by RT-qRCR. ELISA was performed to detect plasma apelin-12 concentration. The protein expression of left ventricular myocardial apelin and APJ was detected by Western blot. Results: Seven rats survived in the heart failure group, 10 in the treatment group, and 8 in the F13A group. Echocardiography showed that the left ventricular end-diastolic diameter (LVEDD) and the left ventricular end-systolic diameter (LVESD) were higher (both P<0.05), while the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were lower in the heart failure group than in the control group (both P<0.05). Compared with the heart failure group, rats in the treatment group were featured with lower LVEDD and LVESD (both P<0.05), higher LVEF and LVFS (both P<0.05), these beneficial effects were reversed in rats assigned to F13A group (all P<0.05 vs. treatment group). The results of HE staining showed that the cardiomyocytes of rats in the control group were arranged neatly and densely structured, the cardiomyocytes in the heart failure group were arranged in disorder, distorted and the gap between cells was increased, the cardiomyocytes in the treatment group were slightly neat and dense, and cardiomyocytes in the F13A group were featured similarly as the heart failure group. Masson staining showed that there were small amount of collagen fibers in the left ventricular myocardial interstitium of the control group, while left ventricular myocardial fibrosis was significantly increased, and collagen volume fraction (CVF) was significantly higher in the heart failure group than that of the control group (P<0.05). Compared with the heart failure group, the left ventricular myocardial fibrosis and the CVF were reduced in the treatment group (both P<0.05), these effects were reversed in the F13A group (all P<0.05 vs. treatment group). TUNEL staining showed that the apoptosis index (AI) of cardiomyocytes in rats was higher in the heart failure group compared with the control group (P<0.05), which was reduced in the treatment group (P<0.05 vs. heart failure group), this effect again was reversed in the F13A group (P<0.05 vs. treatment group). The results of RT-qPCR and Western blot showed that the mRNA and protein levels of apelin and APJ in left ventricular myocardial tissue of rats were downregulated in heart failure group (all P<0.05) compared with the control group. Compared with the heart failure group, the mRNA and protein levels of apelin and APJ were upregulated in the treatment group (all P<0.05), these effects were reversed in the F13A group (all P<0.05 vs. treatment group). ELISA test showed that the plasma apelin concentration of rats was lower in the heart failure group compared with the control group (P<0.05); compared with the heart failure group, the plasma apelin concentration of rats was higher in the treatment group (P<0.05), this effect was reversed in the F13A group (P<0.05 vs. treatment group). Conclusion: Sacubitril/valsartan can partially reverse left ventricular remodeling and improve cardiac function in rats with heart failure through modulating Apelin/APJ pathways.

Toripalimab (anti-PD-1) versus High-Dose Interferon-α2b as Adjuvant Therapy in Resected Mucosal Melanoma: A Phase II Randomized Trial

BACKGROUND

No standard of care for mucosal melanoma (MM) in the adjuvant setting has been established. Meanwhile, relapse-free survival (RFS) is only about five months after surgery alone. This phase II trial aimed to compare toripalimab vs. high-dose interferon-α2b (HDI) as an adjuvant therapy for resected MM.

PATIENTS AND METHODS

From July 2017 to May 2019, 145 patients with resected MM were randomized (1:1) to receive HDI (N = 72) or toripalimab (N = 73) for one year until disease relapse/distant metastasis, unacceptable toxicity, or withdrawal of consent. The primary endpoint was RFS. The secondary endpoints included distant metastasis-free survival (DMFS), overall survival (OS), and safety.

RESULTS

After a median follow-up of 26.3 months, the numbers of RFS, OS, and DMFS events were 51 vs. 46, 33 vs. 29, and 49 vs. 44 in the toripalimab arm and the HDI arm, respectively. The median RFS were 13.6 (95%CI: 8.31-19.02) months and 13.9 (95%CI: 8.28-19.61) months in the toripalimab arm and HDI arm, respectively. The DMFS was not significantly different between the two arms (HR: 1.00, 95%CI: 0.65-1.54). The median OS was 35.1 months (95%CI: 27.93-NR) in the toripalimab arm, with no significant difference in all-cause death (HR: 1.11, 95% CI: 0.66-1.84) for the two arms. The median sums of the patients' actual infusion doses were 3672 mg and 1054.5 MIU in the toripalimab arm and HDI arm, respectively. The incidence of treatment-emergent adverse events with a grade ≥ 3 was much higher in the HDI arm than in the toripalimab arm (87.5% vs. 27.4%).

CONCLUSION

Toripalimab showed a similar RFS and a more favorable safety profile than HDI, both better than historical data, suggesting that toripalimab might be the better treatment option. However, additional translational studies and better treatment regimens are still warranted to improve the clinical outcome of MM.

Secondary Flow Effect on Supercritical Kerosene Oxidation Deposition and Heat Transfer in a Coiled Tube

Deposition in fuel cooling systems remains a challenge to the development of active cooling technologies for air-breathing engines. We experimentally and numerically investigated the influence of the secondary flow and heat-transfer characteristics of supercritical kerosene in a coiled tube on oxidation deposition. A coiled heated tube reactor (3000 mm long, 23 cycles) under constant heat flux and flow rate was applied to simulate the conditions of the fuel side in the heat exchanger of an aero-engine cooling system. The coupling characteristics of coking distribution with the development of secondary flow were studied along the whole pipe. The dynamic pressure, temperature, and velocity were analyzed in two specific circular cross sections located in the bend of the tube. The secondary flows induced in the coiled tube greatly enhance the heat transfer and slightly decrease the deposition rate, resulting in linear wall temperature profiles and a uniform coking distribution along the tube compared to the long straight tube. There is no obvious heat-transfer enhancement or deterioration in the whole coiled tube. The modified heat-transfer correlation of the supercritical RP-3 in the coiled tube was fitted at different flow rates and heat fluxes with an error of ±10%.

A novel fluorescence probe for the detection of water content in organic solvents and the distinction between deuterated and nondeuterated reagents

A novel D-π-A type fluorescent probe (probe 1) was developed for water content detection in organic solvents. By analyzing the relationship between fluorescence and water content, the probe was successfully applied to determine trace water content in tetrahydrofuran, ethyl acetate, 2-butanone, acetone, dimethylformamide, and acetonitrile. High water content in THF and ethyl acetate was associated with a gradual colour change from yellowish green to earthy yellow. The red/green value had a linear relationship with the water content in THF and ethyl acetate. There was a linear relationship between the red/blue value and water content in 2-butanone and acetone. Furthermore, probe 1 could be used for human serum albumin detection. Unexpectedly, probe 1 had a different colour response in deuterated and nondeuterated solvents, and had different fluorescence intensity and fluorescence emission wavelength. Probe 1 is rare tool that can distinguish between deuterated and nondeuterated reagents.

Abstract CT209: A first-in-human phase 1 trial of IO-108, an antagonist antibody targeting LILRB2 (ILT4), as monotherapy and in combination with pembrolizumab in adult patients with advanced relapsed or refractory solid tumors (NCT05054348)

Cancer immunotherapy has entered the mainstream with approval of T-cell checkpoint inhibitors. However, most patients with advanced solid tumors do not derive benefits, or relapse after T-cell checkpoint blockade. Myeloid checkpoint inhibition is a new approach to cancer immunotherapy. LILRB2 is primarily expressed by myeloid cells and its expression in tumors is associated with high macrophage infiltration. Several LILRB2 ligands (HLA-G, ANGPTL2, and SEMA4A) are known to contribute to the immune suppressive microenvironment of solid tumors. Blockade of the LILRB2 pathway has the potential to reactivate or enhance anti-tumor T cell immune responses. IO-108 is a IgG4 monoclonal antibody that specifically binds LILRB2 to block ligands interaction and activation of LILRB2. In vitro, IO-108 treatment of primary immune cells results increased pro-inflammatory responses and an enhanced antigen presenting cell phenotypes. A Good Laboratory Practice repeat-dose, 15-day toxicology study in Cynomolgus monkeys at 0 (control), 1, 10, or 100 mg/kg/dose administered intravenously once weekly for a total of 3 doses showed that IO-108 was well-tolerated at all dose levels, with only non-statistically significant reduction of thyroid glands weight. No-observed-adverse-effect-level (NOAEL) of 100 mg/kg provides a sufficient safety margin for the IO-108 starting dose of 60 mg, which was derived using a MABEL (minimum anticipated biological effect level) approach. This clinical trial is a first-in-human, Phase 1, multicenter, open-label, dose-escalation, safety, pharmacokinetic (PK), and pharmacodynamic evaluation of intravenously administered IO-108, both as monotherapy and in combination with pembrolizumab, in adult patients with solid tumors that have failed standard of care therapies (NCT05054348). It is estimated that up to 36 patients will be enrolled in the study. IO-108 will be administered every 21 days, with a dose-limiting toxicity (DLT) evaluation period of 21 days. Patients will be enrolled into sequential cohorts and treated with increasing doses of IO-108 using mTPI (modified Toxicity Probability Interval) method. Safety, PK, and clinical activity will be evaluated on an ongoing basis. The primary objective of the study is to assess safety and tolerability at increasing dose levels of IO-108 in successive cohorts of adult patients (treated with or without with pembrolizumab) with advanced relapsed or refractory solid tumors, to estimate the maximal tolerated dose (MTD) or maximum administered dose (MAD) and select the recommended phase 2 dose (RP2D). Secondary objectives include characterizing PK, immunogenicity, and preliminary anti-tumor activity. Biomarker evaluation will include changes in myeloid cell markers and T-cells, LILRB2 expression level and receptor occupancy. Statistical analyses will be primarily descriptive in nature. Tabulations will be produced for appropriate disposition, demographic, baseline disease characteristics, safety, PK, pharmacodynamic, and clinical activity parameters. Response to treatment as assessed by RECIST v1.1 will be tabulated. To date, five patients have been dosed without DLT.

Citation Format: John Powderly, Manish Patel, Paul Woodard, Luke Chung, Hongyu Tian, Elizabeth Wieland, Kyu Hong, Maria Jose Costa, X. Charlene Liao, Matthew Taylor. A first-in-human phase 1 trial of IO-108, an antagonist antibody targeting LILRB2 (ILT4), as monotherapy and in combination with pembrolizumab in adult patients with advanced relapsed or refractory solid tumors (NCT05054348) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT209.

Abstract 601: IO-108, A fully human therapeutic antibody blocking the myeloid checkpoint LILRB2/ILT4, promotes innate and adaptive anti-cancer immunity in preclinical studies

Tumor-associated myeloid cells inhibit anti-cancer immune responses systemically and in the tumor microenvironment (TME), thereby limiting the efficacy of T cell checkpoint inhibitors. However, the plasticity of myeloid cells may enable therapeutic intervention. The immune inhibitory receptor LILRB2 (also known as ILT4) is expressed primarily by myeloid cells (monocytes, macrophages, dendritic cells and neutrophils), and has emerged as a key myeloid checkpoint contributing to the tolerogenic activity of myeloid cells associated with cancer. LILRB2 has several ligands (classical and non-classical MHC-I, ANGPTL2/5, SEMA4A and CD1) and most of these are known to contribute to immune suppression in the TME. Using computational biology approaches, we found that high LILRB2 expression is associated with macrophage infiltration in many solid tumor types from TCGA. Therefore, LILRB2 is a compelling target to overcome immune suppressive activity of cancer-associated myeloid cells. IO-108 is a fully human IgG4 therapeutic antibody that binds to LILRB2 with high affinity and specificity. IO-108 binds to all myeloid cells in the solid TME and periphery. In vitro studies support that blockade of LILRB2 interaction with its various ligands is the anticipated mechanism of action of IO-108. The LILRB2 antagonist activity of IO-108 produces the desired pro-inflammatory (re)polarization of myeloid cells. IO-108 treatment results in increased pro-inflammatory responses and an enhanced antigen-presenting cell (APC) phenotype to multiple stimuli (e.g., T cell activators, STING and TLR agonists) in ex vivo assays. In addition, IO-108 precludes the anti-inflammatory myeloid cell phenotype resulting from “tumor conditioning” and promotes the differentiation of monocytes and immature dendritic cells (DC) into pro-inflammatory DC. IO-108 enhances the effect of PD-1 blocking antibodies in allogeneic mixed leukocyte reactions of CD4+ T cells and macrophages. Moreover, IO-108 polarized primary myeloid cells isolated from solid tumor patient blood and ovarian cancer-associated ascites towards a proinflammatory phenotype and attenuated their suppressive effect on autologous T cell proliferation and production of proinflammatory cytokines. In vivo, IO-108 inhibits tumor growth in mouse models, which is associated with immune cell activation. Importantly, IO-108 presents a favorable pharmacokinetic and safety profile in preclinical models. Collectively, the preclinical characterization of IO-108 enabled a comprehensive clinical biomarker plan and lends rationale to the clinical study (NCT05054348) of IO-108 as a novel immunotherapy for multiple solid tumor types, including those relapsed/refractory to standard of care therapies.

Citation Format: Jing-Tyan Ma, Xiaoye Liu, Ryan Stafford, Krista McCutcheon, Heyu Chen, Tao Huang, Hongyu Tian, Kyu Hong, ChengCheng Zhang, Luke Chung, An Song, Paul Woodard, XCharlene Liao, MariaJose Costa. IO-108, A fully human therapeutic antibody blocking the myeloid checkpoint LILRB2/ILT4, promotes innate and adaptive anti-cancer immunity in preclinical studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 601.

[Characteristics of SARS-CoV-2 Omicron infection in children imported from Hong Kong]

Objective: To understand the clinical characteristics of children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region. Methods: This retrospective study was conducted to collect the data including clinical manifestations, outcomes and vaccination of 107 children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region to be admitted to the designated referral hospital in Shanghai from February to March 2022. According to the occurrence of clinical symptoms, the cases were divided into asymptomatic group and symptomatic group. According to the age of diagnosis, the cases were divided into <3 years group, 3-<6 years group and 6-<18 years group, and the clinical manifestations in different age group were analyzed with t-test and Mann-Whitney rank-sum test. Besides, to analyze the effectiveness of vaccination against SARS-CoV-2 Omicron infection in different age group, the cases aged 3-<18 years were also subdivided into unvaccinated group, 1-dose group and 2-dose group, and the relative risk (RR) was used to demonstrate the effectiveness. Results: Among the 107 cases, 66 were male and 41 were female, with infection age of 10 (5, 14) years. There were 29 cases in the asymptomatic group, and 78 cases in the symptomatic group, and no significant difference in the age of infection was observed between the 2 groups (11 (6, 14) vs. 10 (5, 14) years, Z=0.49, P>0.05). And there were no severe cases in symptomatic group. The length of hospitalization was (18±6) days, and was longer in symptomatic group than that in asymptomatic group ((19±6) vs. (16±7) d, t=0.17, P=0.030). Eight-two cases (76.6%) had a history of epidemiological exposure and, among whom, 81 cases (75.7%) were associated with household transmission. Among symptomatic group, 57 cases (73.1%) had fever and 20 cases (25.6%) had cough. Of the 74 cases undergoing chest CT examination, 17 cases (23.0%) showed mild abnormalities. Of the 83 cases who received the lab tests, 23 cases (27.7%) had white blood cell counts<4×10⁹/L, 3 cases (3.6%) had C-reaction protein >8.0 mg/L, and 6 cases (7.2%) had slightly elevated aspartate transaminase and alanine aminotransferase. Among the 92 children aged 3-<18 years, 31 cases were unvaccinated, 34 cases received 1 dose, and 27 cases received 2 doses. The interval between the last vaccination and infection was 2.2 (0.6, 6.0) months; the interval between the last vaccination and infection in the 2-dose group was longer than that in 1-dose group (6.0 (4.5, 7.3) vs. 0.7 (0.3,2.0) months, Z=3.59, P<0.001).The risk of symptomatic infection was reduced by 45% (RR=0.55, 95% CI 0.35-0.87) with two-dose vaccination compared to non-vaccination in cases aged 3-<18 years. All these cases recovered completely. Conclusions: Children infected with SARS-CoV-2 Omicron are usually mild or asymptomatic. Household transmission is the main pattern of infection with SARS-CoV-2 Omicron in children. Two-dose SARS-CoV-2 vaccination in children aged 3-<18 years can provide partial protection against disease caused by SARS-CoV-2 Omicron.