Multiparametric MRI-based radiomics nomogram for predicting the hormone receptor status of HER2-positive breast cancer

AIM

To investigate the value of multiparametric magnetic resonance imaging (MRI)-based radiomics nomograms for predicting the hormone receptor (HR) status of HER2-positive breast cancer.

MATERIALS AND METHODS

Patients with HER2-positive invasive breast cancer were divided randomly into training (68 patients) and validation (30 patients) sets. All were classified as either HR-positive (HR+) or negative (HR-) at histopathology. Two radiologists outlined the three-dimensional (3D) volumetric regions of interest (VOI) on the MRI images. Features (n=1,096) were extracted from the T2-weighted imaging (WI), apparent diffusion coefficient (ADC), and dynamic contrast-enhanced (DCE) images separately. Dimensionality was reduced using feature screening. Binary radiomics prediction models were established using a logistic regression classifier and were validated in the validation set. To construct a nomogram, independent predictors were identified using multivariate logistic regression analysis. The predictive efficacy of the model was assessed using the area under the receiver operating characteristic curve (AUC).

RESULTS

Ten radiomics features were obtained after feature dimensionality reduction based on the merged T2WI, ADC, and DCE images. The diagnostic efficacy of the radiomics signature using the three sequences was better than that of any single sequence (training set AUC: 0.797; validation set AUC: 0.75). Using multivariate logistic regression analysis, the independent predictors for identifying HR status were combined radiomics signature and peritumoural oedema. Nomograms constructed by combining the radiomics signature and peritumoural oedema showed good discrimination in both the training and validation sets (AUC: 0.815 and 0. 805, respectively).

CONCLUSION

A multiparametric MRI-based nomogram incorporating the radiomics signature and peritumoural oedema can assess the HR status of HER2-positive breast cancer. The resulting model can improve diagnostic accuracy, improving patient outcomes.

Enhanced arsenite removal from water using zirconium-ferrocene MOFs coupled with peroxymonosulfate:oxidation and multi-sites adsorption mechanism

The efficient removal of arsenite (As(III)) poses a significant challenge to traditional water treatment technologies due to its high toxicity and mobility. In this work, multifunctional Zirconium-Ferrocene Metal Organic Framework (ZrFc-MOF) fabricated with redox-active 1,1-ferrocene dicarboxylic acid ligands and Zr⁴⁺ precursors were elaborated to achieve remarkably enhanced As(III) removal via activation by peroxymonosulfate (PMS). The adsorption affinity coefficient increased from 0.097 to 2.035 L mg^-1 and the maximum adsorption capacity increased from 59.79 to 111.34 mg g^-1 compared with that without PMS. Besides the conventional homogeneous PMS oxidation and the following adsorption through Zr-O clusters of ZrFc-MOFs, the enhanced As(III) removal synergistic combines the oxidation mechanism of As(III) by reactive oxygen species (•OH, SO₄^•-, O₂^•- and ¹O₂) formed in Ferrocene (Fc) activating PMS process with the simultaneous formed extra adsorption sites of Ferrocenium (Fc⁺). PMS also help ZrFc-MOF to avoid destruction in harsh alkaline condition, making the effluent in this advanced treatment meet the World Health Organization (WHO) threshold of 10 μg L^-1 over a wide range of initial pH (2-11) with high selectivity and durability. These results indicate that this novel Fc-based MOFs activating PMS system has potential applicability for As(III) in oxidation and selectively capturing in the water environment.

[Mechanical ventilation strategy for acute respiratory distress syndrome patients supported by veno-venous extracorporeal membrane oxygenation]

The mortality of acute respiratory distress syndrome (ARDS) patients is very high, veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been proved to improve the prognosis of these patients, but the maximization of this benefit relies on the appropriate mechanical ventilation strategy; with the new research evidence arise, scholars have reached a certain consensus on how to implement mechanical ventilation in ARDS patients supported by VV-ECMO, but there are still many controversies. Based on the evidences of current researches and clinical experiences, this article analyzes the hot issues of mechanical ventilation strategy for these patients, including the implementation of early 'overprotective' ventilation strategy, whether spontaneous breathing allowed, prone ventilation and ventilator weaning.

Characterization of Staphylococcus aureus ST3320 clone causing fatal respiratory infection in rabbits

<em>Staphylococcus aureus</em> is a well-known pathogen that infects humans and animals. However, information on the fatal respiratory infection in rabbits caused by<em> S. aureus</em> is still limited. In the present study, a <em>S. aureus</em> isolate designated ND01 was recovered from lung samples of rabbits that died of fatal respiratory infection, and the ND01 was characterised by intranasal infection of rabbits, multi-locus sequencing typing, screening virulence genes and testing antimicrobial susceptibility. Clinical signs of matted forepaws and pathological lesions of haemorrhagic tracheitis and necrotising haemorrhagic pneumonia were observed in the ND01 infected rabbits, which were identical to those of naturally infected ones. The sequence type of the ND01 was defined as ST3320 and the ND01 was further grouped into the clonal complex 398. Notably, the ND01 was <em>pvl-positive</em> <em>S. aureus</em> and carried the human-associated scn gene. Moreover, the ND01 was methicillin-susceptible <em>S. aureus</em> and was susceptible to 6 of 10 tested antibiotics. This study described the characteristics of the ND01 causing fatal respiratory infection in rabbits. The results are helpful to further the understanding of the pathogenicity of S. aureus ST3320 clone in rabbits. The results also highlighted that operators must be on the alert for the colonisation of <em>pvl-positive</em> <em>S. aureus</em> in rabbits and potential transmission events between rabbits and humans.

An ICT-based fluorescent probe with a large Stokes shift for measuring hydrazine in biological and water samples

As a strong reductant and highly active alkali, hydrazine (N₂H₄) has been widely used in chemical industry, pharmaceutical manufacturing and agricultural production. However, its high acute toxicity poses a threat to ecosystem and human health. In the present study, a ratiometric fluorescent probe for the detection of N₂H₄ was designed, utilizing dicyanoisophorone as the fluorescent group and 4-bromobutyryl moiety as the recognition site. 4-(2-(3-(dicyanomethylene)-5,5-dimethylcyclohex-1-enyl) phenyl 4-brobutanoate (DDPB) was readily synthesized and could specially sense N₂H₄ via an intramolecular charge transfer (ICT) pathway. The cyclization cleavage reaction of N₂H₄ with a 4-bromobutyryl group released phenolic hydroxyl group and reversed the ICT process between hydroxy group and fluorophore, turning on the fluorescence in the DDPB-N₂H₄ complexes. DDPB exhibits a low cytotoxicity, reasonable cell permeability, a large Stokes shift (186 nm) and a low detection limit (86.3 nM). The quantitative determination of environmental water systems and the visualization fluorescence of DDPB test strips provides a strong evidence for the applications of DDPB. In addition, DDPB is suitable for the fluorescence imaging of exogenous N₂H₄ in HeLa cells and zebrafish.

A novel and effective benzo[d]thiazole-based fluorescent probe with dual recognition factors for highly sensitive and selective imaging of cysteine in vitro and in vivo

Double recognition groups significantly improved the selectivity of a fluorescent probe to Cys in living cells.

The E2F1-3 transcription factors are essential for cellular proliferation

The retinoblastoma tumour suppressor (Rb) pathway is believed to have a critical role in the control of cellular proliferation by regulating E2F activities. E2F1, E2F2 and E2F3 belong to a subclass of E2F factors thought to act as transcriptional activators important for progression through the G1/S transition. Here we show, by taking a conditional gene targeting approach, that the combined loss of these three E2F factors severely affects E2F target expression and completely abolishes the ability of mouse embryonic fibroblasts to enter S phase, progress through mitosis and proliferate. Loss of E2F function results in an elevation of p21Cip1 protein, leading to a decrease in cyclin-dependent kinase activity and Rb phosphorylation. These findings suggest a function for this subclass of E2F transcriptional activators in a positive feedback loop, through down-modulation of p21Cip1, that leads to the inactivation of Rb-dependent repression and S phase entry. By targeting the entire subclass of E2F transcriptional activators we provide direct genetic evidence for their essential role in cell cycle progression, proliferation and development.

S-Phase progression mediates activation of a silenced gene in synthetic nuclei

Aberrant expression of developmentally silenced genes, characteristic of tumor cells and regenerating tissue, is highly correlated with increased cell proliferation. By modeling this process in vitro in synthetic nuclei, we find that DNA replication leads to deregulation of established developmental expression patterns. Chromatin assembly in the presence of adult mouse liver nuclear extract mediates developmental stage-specific silencing of the tumor marker gene alpha-fetoprotein (AFP). Replication of silenced AFP chromatin in synthetic nuclei depletes sequence-specific transcription repressors, thereby disrupting developmentally regulated repression. Hepatoma-derived factors can target partial derepression of AFP, but full transcription activation requires DNA replication. Thus, unscheduled entry into S phase directly mediates activation of a developmentally silenced gene by (i) depleting developmental stage-specific transcription repressors and (ii) facilitating binding of transactivators.

Hepatocyte nuclear factor 3 relieves chromatin-mediated repression of the alpha-fetoprotein gene

The alpha-fetoprotein gene (AFP) is tightly regulated at the tissue-specific level, with expression confined to endoderm-derived cells. We have reconstituted AFP transcription on chromatin-assembled DNA templates in vitro. Our studies show that chromatin assembly is essential for hepatic-specific expression of the AFP gene. While nucleosome-free AFP DNA is robustly transcribed in vitro by both cervical (HeLa) and hepatocellular (HepG2) carcinoma extracts, the general transcription factors and transactivators present in HeLa extract cannot relieve chromatin-mediated repression of AFP. In contrast, preincubation with either HepG2 extract or HeLa extract supplemented with recombinant hepatocyte nuclear factor 3 alpha (HNF3alpha), a hepatic-enriched factor expressed very early during liver development, is sufficient to confer transcriptional activation on a chromatin-repressed AFP template. Transient transfection studies illustrate that HNF3alpha can activate AFP expression in a non-liver cellular environment, confirming a pivotal role for HNF3alpha in establishing hepatic-specific gene expression. Restriction enzyme accessibility assays reveal that HNF3alpha promotes the assembly of an open chromatin structure at the AFP promoter. Combined, these functional and structural data suggest that chromatin assembly establishes a barrier to block inappropriate expression of AFP in non-hepatic tissues and that tissue-specific factors, such as HNF3alpha, are required to alleviate the chromatin-mediated repression.