Backbone Engineering of Polymeric Catalysts for High-Performance CO2 Reduction in Bipolar Membrane Zero-Gap Electrolyzer

Bipolar membranes (BPMs) have emerged as a promising solution for mitigating CO2 losses, salt precipitation and high maintenance costs associated with the commonly used anion-exchange membrane electrode assembly for CO2 reduction reaction (CO2RR). However, the industrial implementation of BPM-based zero-gap electrolyzer is hampered by the poor CO2RR performance, largely attributed to the local acidic environment. Here, we report a backbone engineering strategy to improve the CO2RR performance of molecular catalysts in BPM-based zero-gap electrolyzers by covalently grafting cobalt tetraaminophthalocyanine onto a positively charged polyfluorene backbone (PF-CoTAPc). PF-CoTAPc shows a high acid tolerance in BPM electrode assembly (BPMEA), achieving a high FE of 82.6 % for CO at 100 mA/cm2 and a high CO2 utilization efficiency of 87.8 %. Notably, the CO2RR selectivity, carbon utilization efficiency and long-term stability of PF-CoTAPc in BPMEA outperform reported BPM systems. We attribute the enhancement to the stable cationic shield in the double layer and suppression of proton migration, ultimately inhibiting the undesired hydrogen evolution and improving the CO2RR selectivity. Techno-economic analysis shows the least energy consumption (957 kJ/mol) for the PF-CoTAPc catalyst in BPMEA. Our findings provide a viable strategy for designing efficient CO2RR catalysts in acidic environments.

Antenna Effect in Noble Metal-Free Dye-Sensitized Photocatalytic Systems Enhances CO2 -to-CO Conversion

Dye-sensitized photocatalytic systems (DSPs) have been extensively investigated for solar-driven hydrogen (H2 ) evolution. However, their application in carbon dioxide (CO2 ) reduction remains limited. Furthermore, current solar-driven CO2 -to-CO DSPs typically employ rhenium complexes as catalysts. In this study, we have developed DSPs that incorporate noble metal-free components, specifically a zinc-porphyrin as photosensitizer (PS) and a cobalt-quaterpyridine as catalyst (CAT). Taking a significant stride forward, we have achieved an antenna effect for the first time in CO2 -to-CO DSPs by introducing a Bodipy as an additional chromophore to enhance light harvesting efficiency. The energy transfer from Bodipy to zinc porphyrin resulted in remarkable stability (turn over number (TON)=759 vs. CAT), and high CO evolution activity (42 mmol g-1  h-1 vs. CAT).

Efficient Visible-Light-Driven Carbon Dioxide Reduction using a Bioinspired Nickel Molecular Catalyst

Inspired by natural enzymes, this study presents a nickel-based molecular catalyst, [Ni‖ (N2 S2 )]Cl2 (NiN2 S2 , N2 S2 =2,11-dithia[3,3](2,6)pyridinophane), for the photochemical catalytic reduction of CO2 under visible light. The catalyst was synthesized and characterized using various techniques, including liquid chromatography-high resolution mass spectrometry (LC-HRMS), UV-Visible spectroscopy, and X-ray crystallography. The crystallographic analysis revealed a slightly distorted octahedral coordination geometry with a mononuclear Ni2+ cation, two nitrogen atoms and two sulfur atoms. Photocatalytic CO2 reduction experiments were performed in homogeneous conditions using the catalyst in combination with [Ru(bpy)3 ]Cl2 (bpy=2,2'-bipyridine) as a photosensitizer and 1,3-dimethyl-2-phenyl-2,3-dihydro-1H-benzo[d]imidazole (BIH) as a sacrificial electron donor. The catalyst achieved a high selectivity of 89 % towards CO and a remarkable turnover number (TON) of 7991 during 8 h of visible light irradiation under CO2 in the presence of phenol as a co-substrate. The turnover frequency (TOF) in the initial 6 h was 1079 h-1 , with an apparent quantum yield (AQY) of 1.08 %. Controlled experiments confirmed the dependency on the catalyst, light, and sacrificial electron donor for the CO2 reduction process. These findings demonstrate this bioinspired nickel molecular catalyst could be effective for fast and efficient photochemical catalytic reduction of CO2 to CO.

Visible-Light-Driven CO2 Reduction with Homobimetallic Complexes. Cooperativity between Metals and Activation of Different Pathways

Visible-light-driven reduction of CO2 to both CO and formate (HCOO-) was achieved in acetonitrile solutions using a homobimetallic Cu bisquaterpyridine complex. In the presence of a weak acid (water) as coreactant, the reaction rate was enhanced, and a total of ca. 766 TON (turnover number) was reached for the CO2 reduction, with 60% selectivity for formate and 28% selectivity for CO, using Ru(phen)32+ as a sensitizer and amines as sacrificial electron donors. Mechanistic studies revealed that with the help of cooperativity between two Cu centers, a bridging hydride is generated in the presence of a proton source (water) and further reacts with CO2 to give HCOO-. A second product, CO, was also produced in a parallel competitive pathway upon direct coordination of CO2 to the reduced complex. Mechanistic studies further allowed comparison of the observed reactivity to the monometallic Cu quaterpyridine complex, which only produced CO, and to the related homobimetallic Co bisquaterpyridine complex, that has been previously shown to generate formate following a mechanism not involving the formation of an intermediate hydride species.

A CuICoII cryptate for the visible light-driven reduction of CO2

Among the rare bimetallic complexes known for the reduction of CO2, CoIICoII and ZnIICoII hexamine cryptates are described as efficient photocatalysts. In close relation to the active sites of natural, CO2-reducing enzymes, we recently reported the asymmetric cryptand {NSNN}m ({NSNN}m = N[(CH2)2SCH2(m-C6H4)CH2NH(CH2)2]3N) comprising distinct sulphur- and nitrogen-rich binding sites and the corresponding CuIMII (MII = CoII, NiII, CuII) complexes. To gain insight into the effect of metals in different oxidation states and sulphur-incorporation on the photocatalytic activity, we herein investigate the CuICoII complex of {NSNN}m as catalyst for the visible light-driven reduction of CO2. After 24 h irradiation with LED light of 450 nm, CuICoII-{NSNN}m shows a high efficiency for the photocatalytic CO2-to-CO conversion with 9.22 μmol corresponding to a turnover number of 2305 and a high selectivity of 98% over the competing H2 production despite working in an acetonitrile/water (4 : 1) mixture. Experiments with mononuclear counterparts and computational studies show that the high activity can be attributed to synergistic catalysis between Cu and Co. Furthermore, it was shown that an increase of the metal distance results in the loss of synergistic effects and rather single-sited Co catalysis is observed.

1D/2D interface engineering of a CoPc-C3N4 heterostructure for boosting the nitrogen reduction reaction to NH3

Herein, we demonstrate the construction of a 1D/2D heterostructure of cobalt phthalocyanine (CoPc)-carbon nitride (C3N4) for electrochemical N2 reduction to NH3. Improved performance originates from the higher exposure of active surface sites. The electrochemical NRR performance showed an NH3 formation rate of 423.8 μg h-1 mgcat-1, a high faradaic efficiency (FE) of 33%, and stability for 20 h. This study provides a new strategy for designing a highly efficient 1D/2D electrocatalytic system for ammonia synthesis.

Association between post-operative hPG80 (circulating progastrin) detectable level and worse prognosis in glioblastoma

BACKGROUND

Patients with glioblastomas have a dismal prognosis, and there is no circulating predictive or prognostic biomarker. Circulating progastrin, hPG80, is a tumor-promoting peptide present in the blood of patients with various cancers that has been shown to have prognostic value. We evaluated the prognostic value of plasma hPG80 in patients with isocitrate dehydrogenase-wild type glioblastoma after surgery.

PATIENTS AND METHODS

A multicentric retrospective study in glioblastoma patients treated with standard radio-chemotherapy was conducted. The hPG80 levels were measured in plasma EDTA samples collected after surgery with an ELISA DxPG80.lab kit (Biodena Care, Montpellier, France), which has a detection threshold of 1.2 pM. The relationship between post-operative hPG80 plasma levels, in combination with other known prognostic factors, and patients' progression-free survival (PFS) and overall survival (OS) was evaluated.

RESULTS

Sixty-nine patients were assessable. Plasma samples were collected after tumor biopsy (B), partial resection (PR), and complete resection (CR) for 22, 25, and 22 patients, respectively. At a median concentration of 5.37 pM (interquartile range 0.00-13.90 pM), hPG80 was detected in 48 (70%) patients (hPG80+). CR was associated with significant lower values of hPG80 levels: the median value was 0.7 versus 9.1 pM for PR (P = 0.02) and 8.3 pM for B (P = 0.004). The hPG80 detection rate was also significantly lower: 50% (CR) versus 72% (PR) versus 86% (B) (P = 0.005). The median follow-up was 39 months [22.4 months-not reached]. hPG80 post-operative detection was associated with numerically shorter PFS (6.4 versus 9.4 months, P = 0.13) and OS (14.5 versus 20.9 months, P = 0.11). In multivariate analysis, hPG80 was a prognostic factor for OS (P = 0.034).

CONCLUSIONS

Circulating hPG80 could serve as a new prognostic biomarker after surgery in patients with glioblastoma treated with radio-chemotherapy.

Inequality factors in access to early-phase clinical trials in oncology in France: results of the EGALICAN-2 study

BACKGROUND

Investigation of the disparities in the access to experimental treatment in early-phase clinical trials is lacking. The objective of the EGALICAN-2 study was to identify the factors underpinning such inequalities.

METHODS

A national prospective survey was conducted in 11 early-phase clinical trial centers (CLIP2) certified by the French National Cancer Institute. Sociodemographic, socioeconomic and medical data were collected. Univariate logistic regression models were carried out to estimate odds ratios and 90% confidence intervals associated with the effect of each study variable. A multivariate logistic regression model was built to explore the independent factors associated with the administration of the experimental treatment (C1D1). A post hoc analysis was carried out excluding female cancer patients.

RESULTS

Between 2015 and 2016, 1355 patients referred from 11 CLIP2 centers in France were included in the study. Eight hundred and forty-eight patients received C1D1 (73%) and 320 patients (27%) were screening failure. Median age was 58 years (range 17-97 years) and 667 patients (54%) were female. Most patients had a metastatic disease (n = 751, 87%). In the multivariate logistic regression analysis, the significant independent factors associated with C1D1 were male sex, initial care received in a hospital with an early-phase unit and living in wealthy metropolitan areas (P values <0.05). In the post hoc analysis, the sex factor was no longer significant [odds ratio = 1.21 (95% confidence interval 0.86-1.70), P value = 0.271].

CONCLUSIONS

This study investigated the factors producing social inequalities in the context of early-phase clinical trials in oncology. Our research highlights factors of sex, care pathway and geographic location. Gynecological cancer was found to impact C1D1 significantly, unlike breast cancer. The results of this study should contribute to improve patient access to early-phase clinical trials.

In-situ spectroscopic probe of the intrinsic structure feature of single-atom center in electrochemical CO/CO2 reduction to methanol

While exploring the process of CO/CO₂ electroreduction (CO_xRR) is of great significance to achieve carbon recycling, deciphering reaction mechanisms so as to further design catalytic systems able to overcome sluggish kinetics remains challenging. In this work, a model single-Co-atom catalyst with well-defined coordination structure is developed and employed as a platform to unravel the underlying reaction mechanism of CO_xRR. The as-prepared single-Co-atom catalyst exhibits a maximum methanol Faradaic efficiency as high as 65% at 30 mA/cm² in a membrane electrode assembly electrolyzer, while on the contrary, the reduction pathway of CO₂ to methanol is strongly decreased in CO₂RR. In-situ X-ray absorption and Fourier-transform infrared spectroscopies point to a different adsorption configuration of *CO intermediate in CORR as compared to that in CO₂RR, with a weaker stretching vibration of the C-O bond in the former case. Theoretical calculations further evidence the low energy barrier for the formation of a H-CoPc-CO^- species, which is a critical factor in promoting the electrochemical reduction of CO to methanol.

Development and evaluation of automated synovial fluid total cell count on an Iris iQ® 200 for identifying patients at risk of septic arthritis

Septic arthritis is a diagnostic emergency. The white blood cell (WBC) count, in synovial fluid (SF), can guide the diagnosis. From November 2021 to November 2022, we included 350 SF. The WBC count was performed with the Iris iQ® 200 compared with the manual method. Automated and manual counts displayed good correlation. However, a Bland Altman plot demonstrates a higher percentage difference at higher WBC counts. The use of Iris iQ® 200 for SF analysis enables a rapid and accurate assessment for WBC count. Its implementation would advantageously replace the long and tedious optical analysis in daily routine.

Factors influencing bariatric surgery outcomes

The outcomes of bariatric surgery, while often impressive, are not universally satisfactory; they vary from patient to patient and from operation to operation. Between 20-30% of patients experience suboptimal weight loss or substantial weight regain early in their postoperative course. Confronted with this chronic disease, and given that failures are difficult to manage, it is essential to better characterize obesity preoperatively, considering other metrics beyond just the body mass index (BMI), to select the best candidates for surgery and optimize the benefit/risk ratio. Based on the data of the most recent studies on bariatric surgery, our objective is to identify the predictive factors of weight loss as well as the risk factors of failure. Our analysis indicates that the choice of the surgical technique, age, initial BMI, ethnic origin, the presence of eating disorders and metabolic factors all have an impact on weight-loss outcomes after bariatric surgery. Thus, it is of major importance to carefully select patients during a preoperative multidisciplinary discussion in order to optimize weight loss and metabolic outcomes.

Electrocatalytic CO2 Reduction with a Binuclear Bis-Terpyridine Pyrazole-Bridged Cobalt Complex

A pyrazole-based ligand substituted with terpyridine groups at the 3 and 5 positions has been synthesized to form the dinuclear cobalt complex 1, that electrocatalytically reduces carbon dioxide (CO₂ ) to carbon monoxide (CO) in the presence of Brønsted acids in DMF. Chemical, electrochemical and UV-vis spectro-electrochemical studies under inert atmosphere indicate pairwise reduction processes of complex 1. Infrared spectro-electrochemical studies under CO₂ and CO atmosphere are consistent with a reduced CO-containing dicobalt complex which results from the electroreduction of CO₂ . In the presence of trifluoroethanol (TFE), electrocatalytic studies revealed single-site mechanism with up to 94 % selectivity towards CO formation when 1.47 M TFE were present, at -1.35 V vs. Saturated Calomel Electrode in DMF (0.39 V overpotential). The low faradaic efficiencies obtained (<50 %) are attributed to the generation of CO-containing species formed during the electrocatalytic process, which inhibit the reduction of CO₂ .

Controlling the Hydrophilicity of the Electrochemical Interface to Modulate the Oxygen-Atom Transfer in Electrocatalytic Epoxidation Reactions

The electrocatalytic epoxidation of alkenes at heterogeneous catalysts using water as the sole oxygen source is a promising safe route toward the sustainable synthesis of epoxides, which are essential building blocks in organic chemistry. However, the physicochemical parameters governing the oxygen-atom transfer to the alkene and the impact of the electrolyte structure on the epoxidation reaction are yet to be understood. Here, we study the electrocatalytic epoxidation of cyclooctene at the surface of gold in hybrid organic/aqueous mixtures using acetonitrile (ACN) solvent. Gold was selected, as in ACN/water electrolytes gold oxide is formed by reactivity with water at potentials less anodic than the oxygen evolution reaction (OER). This unique property allows us to demonstrate that a sacrificial mechanism is responsible for cyclooctene epoxidation at metallic gold surfaces, proceeding through cyclooctene activation, while epoxidation at gold oxide shares similar reaction intermediates with the OER and proceeds via the activation of water. More importantly, we show that the hydrophilicity of the electrode/electrolyte interface can be tuned by changing the nature of the supporting salt cation, hence affecting the reaction selectivity. At low overpotential, hydrophilic interfaces formed using strong Lewis acid cations are found to favor gold passivation. Instead, hydrophobic interfaces created by the use of large organic cations favor the oxidation of cyclooctene and the formation of epoxide. Our study directly demonstrates how tuning the hydrophilicity of electrochemical interfaces can improve both the yield and selectivity of anodic reactions at the surface of heterogeneous catalysts.

Electrification of a Milstein-type catalyst for alcohol reformation

Novel energy and atom efficiency processes will be keys to develop the sustainable chemical industry of the future. Electrification could play an important role, by allowing to fine-tune energy input and using the ideal redox agent: the electron. Here we demonstrate that a commercially available Milstein ruthenium catalyst (1) can be used to promote the electrochemical oxidation of ethanol to ethyl acetate and acetate, thus demonstrating the four electron oxidation under preparative conditions. Cyclic voltammetry and DFT-calculations are used to devise a possible catalytic cycle based on a thermal chemical step generating the key hydride intermediate. Successful electrification of Milstein-type catalysts opens a pathway to use alcohols as a renewable feedstock for the generation of esters and other key building blocks in organic chemistry, thus contributing to increase energy efficiency in organic redox chemistry.

Which typical floor movements of men's artistic gymnastics result in the most extreme lumbar lordosis and ground reaction forces?

Back pain is prevalent among gymnast populations and extreme flexion or extension of the lumbar spine along with high ground reaction forces (GRFs) are known to increase intervertebral stress. The aim of this study was to determine which postures and dynamic conditions among common floor movements provide the greatest risk of injury in men's artistic gymnastics (MAG). For this purpose, lumbar spine curvatures, obtained through a full-body subject-specific kinematic model fed by motion capture data, and GRFs on feet and hands were compared between typical floor movements of MAG (pike jump, round off back handspring, front handspring, forward and backward tucked somersaults) performed by six adolescent gymnasts. The round off back handspring and the pike jump resulted respectively in the largest lumbar extension and flexion, and the forward tucked somersault take-off in the highest GRF. At ground impacts, the largest lumbar flexion was during the backward tucked somersault landing and only the back handspring hands ground contact phase led to lumbar extension. Such identification of high-risk conditions should enable better back pain management in gymnastics through more tailored training adaptations, particularly in case of pathologies or musculoskeletal specificities.

Sleep decreases neuronal activity control of microglial dynamics in mice

Microglia, the brain-resident immune cells, are highly ramified with dynamic processes transiently contacting synapses. These contacts have been reported to be activity-dependent, but this has not been thoroughly studied yet, especially in physiological conditions. Here we investigate neuron-microglia contacts and microglia morphodynamics in mice in an activity-dependent context such as the vigilance states. We report that microglial morphodynamics and microglia-spine contacts are regulated by spontaneous and evoked neuronal activity. We also found that sleep modulates microglial morphodynamics through Cx3cr1 signaling. At the synaptic level, microglial processes are attracted towards active spines during wake, and this relationship is hindered during sleep. Finally, microglial contact increases spine activity, mainly during NREM sleep. Altogether, these results indicate that microglial function at synapses is dependent on neuronal activity and the vigilance states, providing evidence that microglia could be important for synaptic homeostasis and plasticity.

Molecular Electrochemical Reductive Splitting of Dinitrogen with a Molybdenum Complex

Nitrogen reduction under mild conditions (room T and atmospheric P), using a non-fossil source of hydrogen remains a challenge. Molecular metal complexes, notably Mo based, have recently been shown to be active for such nitrogen fixation. We report electrochemical N₂ splitting with a Mo^III triphosphino complex [(PPP)MoI₃ ], at room temperature and a moderately negative potential. A Mo^IV nitride species was generated, which is confirmed by electrochemistry and NMR studies. The reaction goes through two successive one electron reductions of the starting Mo species, coordination of a N₂ molecule, and further splitting to a Mo^IV nitride complex. Preliminary DFT studies support the formation of a bridging Mo^I N₂ Mo^I dinitrogen dimer evolving to the Mo nitride via a low energy transition state. This example joins a short list of molecular complexes for N₂ electrochemical reductive cleavage. It opens a door to electrochemical proton-coupled electron transfer (PCET) conversion studies of N₂ to NH₃ .

Impact of myocardial injury on regional left ventricular function in the course of acute myocarditis with preserved ejection fraction: insights from segmental feature tracking strain analysis using cine cardiac MRI

The aim of this study was to provide insights into myocardial adaptation over time in myocyte injury caused by acute myocarditis with preserved ejection fraction. The effect of myocardial injury, as defined by the presence of late gadolinium enhancement (LGE), on the change of left ventricular (LV) segmental strain parameters was evaluated in a longitudinal analysis. Patients with a first episode of acute myocarditis were enrolled retrospectively. Peak radial (PRS), longitudinal (PLS) and circumferential (PCS) LV segmental strain values at baseline and at follow-up were computed using feature tracking cine cardiac magnetic resonance imaging. The change of segmental strain values in LGE positive (LGE+) and LGE negative (LGE-) segments was compared over a course of 89 ± 20 days. In 24 patients, 100 LGE+ segments and 284 LGE- segments were analysed. Between LGE+ and LGE- segments, significant differences were found for the change of segmental PCS (p < 0.001) and segmental PRS (p = 0.006). LGE + segments showed an increase in contractility, indicating recovery, and LGE- segments showed a decrease in contractility, indicating normalisation after a hypercontractile state or impairment of an initially normal contracting segment. No significant difference between LGE+ and LGE- segments was found for the change in segmental PLS. In the course of acute myocarditis with preserved ejection fraction, regional myocardial function adapts inversely in segments with and without LGE. As these effects seem to counterbalance each other, global functional parameters might be of limited use in monitoring functional recovery of these patients.

[National protocol for diagnosis and care of congenital aniridia: Summary for the attending physician]

Congenital aniridia is a rare panocular disease defined by a national diagnostic and care protocol (PNDS) validated by the HAS. In most cases, it is due to an abnormality in the PAX6 gene, located at 11p13. Aniridia is a potentially blinding autosomal dominant disease with high penetrance. The prevalence varies from 1/40,000 births to 1/96,000 births. Approximately one third of cases are sporadic. Ocular involvement includes complete or partial absence of iris tissue, corneal opacification with neovascularization, glaucoma, cataract, foveal hypoplasia, optic disc hypoplasia and ptosis. These ocular disorders coexist to varying degrees and progress with age. Congenital aniridia manifests in the first months of life as nystagmus, visual impairment and photophobia. A syndromic form such as WAGR syndrome, WAGRO syndrome (due to the risk of renal Wilms tumor) or Gillespie syndrome (cerebellar ataxia) must be ruled out. Systemic associations may include diabetes, due to expression of the PAX6 gene in the pancreas, as well as other extraocular manifestations. Initial assessment is best carried out in a referral center specialized in rare ophthalmologic diseases, with annual follow-up. The management of progressive ocular involvement must be both proactive and responsive, with medical and surgical management. Visual impairment and photophobia result in disability, leading to difficulties in mobility, movement, communication, learning, fine motor skills, and autonomy, with consequences in personal, school, professional, socio-cultural and athletic life. Medico-socio-educational care involves a multidisciplinary team. Disability rehabilitation must be implemented to prevent and limit situations of handicap in activities of daily living, relying on the Commission for the Rights and Autonomy of People with Disabilities (CDAPH) within the Departmental House of People with Disabilities (MDPH). The general practitioner coordinates multidisciplinary medical and paramedical care.

Access to early-phase clinical trials in older patients with cancer in France: the EGALICAN-2 study

Background

Patients and methods

Results

Conclusions

•

Older patients are underrepresented in early-phase clinical trials (17.7%) compared with the number of new cases (50%).

•

The rate of signed informed consent was similar across age groups (92.7% in younger patients versus 90.6% in older patients).

•

The rate of screening failure was consistent across all age groups (28.5% in younger patients versus 24.3% in older patients).

•

In older patients the initial care received in the center having a phase I unit was associated with study drug administration.

POS0490 USEFULNESS OF MHC-II IMMUNO-STAINING ON MUSCLE BIOPSIES IN IDIOPATHIC INFLAMMATORY MYOPATHIES

Background

Idiopathic inflammatory myopathies (IIMs) constitute a group of acquired muscular diseases that occur during childhood and adulthood, exhibit a variety of phenotypes and are potentially life-threatening. IIM diagnosis considers clinical, serological, and histological data. Muscle pathological analysis of IIM patients gives relevant elements for the diagnosis (immune cell infiltrate, vascular and connective tissues, as well as myofiber morphology). Immunochemistry (IHC) labeling for major histocompatibility complex class I (MHC-I), and C5b9, that are negative in normal muscle, appeared of interest in IIM diagnosis and the understanding of IIM pathogenesis. In normal muscle, myofibers are negative for MHC-II IHC. Its interest in the neuropathological exam of IIM muscle remains to be better characterized.

Objectives

This study aims to analyze the pattern of MHC-II expression in various IIMs.

Methods

A historical cohort was designed using the MYOLYON register (IIM patients diagnosed between 2016 and 2020 at the University Hospital of Lyon, France). Inclusion criteria were IIM diagnosis that was established histologically and available frozen muscle samples for additional analyses. Exclusion criterium was any treatment before muscle biopsy. Demographical data and final diagnosis were collected retrospectively from medical records. A centralized, standardized, and blind analysis of muscle MHC-II immuno-staining was conducted to define the various patterns of MHC-II by myofibers and by capillaries. The study complied with ethical requirements.

Results

Seventy-three patients were included: 23 dermatomyositis (DM), 13 anti-synthetase syndrome (ASS), 13 immune-mediated necrotizing myopathies (IMNM), 13 inclusion body myositis (IBM), and 11 overlap myositis (OM). MHC-II immuno-staining of myofibers or capillaries was abnormal for 91.8% of the analyzed biopsies (Figure 1). The analysis of MHC-II myofiber immuno-staining revealed distinguishable patterns according to IIM subtype: the labeling was diffuse in IBM (69.2%, n=9/13), perifascicular in ASS (61.5%, n=8/13), and variable in OM (patchy for 27.3% n=3/11 or clustered for 36.4%, n=4/11). MHC-II immuno-staining was negative in IMNM (84.6%, n=11/13) and in DM (47.8%, n=11/23). DM exhibiting positive MHC-II myofibers (n=12) were associated with the presence of anti-TIF1γ, anti-NXP2 and anti-SAE auto antibodies (n=5, n=3 and n=2, respectively). Among the 12 patients, there were juvenile cases (n=5, 41.7%) or DM associated with ongoing neoplasia (n=4, 33.3%). Three main architectures were described for capillaries: giant, leaky and capillary dropout. Patterns of MHC-II positive capillaries were the following: DM was characterized by capillary dropout (68.2%), IMNM showed leaky capillaries (75.0%), IBM giant capillaries (66.7%), ASS exhibited both giant (61.5%) and/or leaky (58.3%) capillaries, while OM showed giant (63.6%) or/and leaky (80.0%) capillaries and capillaries dropout (60.0%).

Conclusion

The present work establishes the usefulness of MHC-II immuno-staining for IIM diagnosis, and gives additional elements on the impairment of myofibers and capillaries in the various IIM subgroups. MHC-II expression is known to be induced by inflammatory cytokine such as interferon type II. This could be linked to myofiber and/or capillary impairment in some IIMs, such as IBM, ASS and OM. These results also support the implication of vasculopathy in IIM pathogenesis, with various structural and cellular consequences regarding the different subgroups. Finally, MHC-II immuno-staining in IIM muscle biopsies enables a foremost analysis of myofibers and capillaries, and represents an additional biomarker to distinguish IIM subgroups.

References

[1]De Bleecker, J.L. et al. 205th ENMC International Workshop: Pathology diagnosis of idiopathic inflammatory myopathies part II 28-30 March 2014, Naarden, The Netherlands. Neuromuscul Disord 2015, 25, 268-272.

Disclosure of Interests

None declared.

AB0143 CHARACTERIZATION OF CELLULAR INFILTRATE IN TEMPORAL ARTERITIS USING IMAGING MASS CYTOMETRY IN GIANT CELL ARTERITIS

Background

Imaging mass cytometry (IMC) is a high-plex imaging technique that incorporates flow cytometry principles while preserving the histological and architectural components of the tissue sample. Characterizing the entire cellular component of temporal artery (TA) in patients with giant cell arteritis (GCA) may provide clues towards novel diagnostic and therapeutic approaches.

Objectives

We aimed at a comprehensive summary of the immune cells and pathways involved GCA by using IMC approach.

Methods

TA samples from biopsy-proven GCA patients (n=2) and controls (CTLs, n=2) were analyzed using IMC with a panel of 15 staining antibodies.

Results

Eleven cell populations were identified in arterial wall from GCA patients including both immune (CD20+ B cells, CD8+ T cells, CD4+ T cells, FOXP3+ Tregs, CD66b+ granulocytes, CD11b+ myeloid cells, CD14+ monocytes, CD68+ macrophages) and non-immune (aSMA+ smooth muscle cells, CD31+ endothelial cells, Vimentin+ fibroblasts) cells (Figure 1). The 3 layers (intima, media and adventitia) of the arterial wall was enriched by all the immune cell subsets in GCA except for granulocytes and myeloid cells. CD8+, CD4+ and FOXP3+ regulatory T cells were significantly increased in any layer of the TA. The proportion of B cells was also enhanced in both intima and adventitia and displayed a high level of Ki67 expression.

Figure 1.

Unbiased clustering of cellular infiltrate in temporal arteritis using Imaging Mass Cytometry.

Heatmap of different cell type markers expressed by the 11 cell populations identified in the arterial wall of GCA patients: CD20+ B cells, CD8+ T cells, CD4+ T cells, FOXP3+ Tregs, CD66b+ granulocytes, CD11b+ myeloid cells, CD14+ monocytes, CD68+ macrophages, Vimentin+ fibroblasts, aSMA+ smooth muscle cells and CD31+ endothelial cells. A population of unidentified cells is also represented (A). Donut chart representing the relative composition of immune cells in the arterial wall of GCA patients (B). tSNE dimensional plots of the different cell clusters identified in the arterial wall of CTL and GCA patients (C). Percent and Heatmap of immune cells identified in the arterial wall of each patient (D).

GCA: giant cell arteritis, CTL: controls, Tregs: regulatory T cells.

Conclusion

Our study provides an exhaustive overview of the distinct cell lineages involved in GCA and supports IMC approach to further characterize the immune networks active in GCA.

Disclosure of Interests

None declared

POS0862 INAUGURAL DROPPED HEAD SYNDROME AND CAMPTOCORMIA IN INFLAMMATORY MYOPATHIES

Background

The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of diseases that can affect the muscles, skin, lungs, heart, and joints. Increase knowledge about histopathological findings, clinical manifestations and auto-antibodies have allowed further novel classification of IIMs. Today, the main IMs subgroups are: dermatomyositis (DM), inclusion body myositis (IBM), immune-mediated necrotizing myopathies (IMNM), overlap myositis (OM) and immune-checkpoint inhibitor-related myositis (ICIrm). Axial muscle involvement results either in a “Dropped Head Syndrome (DHS)”, with a marked weakness of the neck extensors, or in a camptocormia (CC), with a weakness of the thoracolumbar paraspinal muscles. This atypical presentation is poorly described in the course of IMs while it may results in a major disability, and may lead to myositis diagnosis delay.

Objectives

This study aimed to describe IMs revealed by DHS and/or CC. Secondary outcomes were to define subgroups of patients according to clinical, biological and histopathological characteristics. Then, the effects of treatments used were analyzed.

Methods

A historical cohort was designed using the register MYOLYON which includes all IMs followed at the University Hospital of Lyon (France) between 2000 and 2021. All patients with IM revealed by DHS and/or CC and having an histologically proven IMs were included, after exclusion of alternative (e.g., myasthenia gravis, motoneuron disease). Clinical, biological, immunological, histopathological data as well as outcome and care were collected through a standardized form. Agreement for the study was obtained from the French Ministry of the Research and the study was approved by the Local Research Ethics Committee.

Results

Twenty-two patients were fully characterized: DM (n=4), IBM (n=7), OM (n=8), ICIrm (n=2) and one myositis with anti-Hu antibodies. Two groups of patients were identified according to the age at first symptoms and to the type of muscle axial involvement (e.g, DHS and/or CC). Before the age of 70 (n=13/22), the two most common diagnoses (n=11/13) were DM (n=4/4) and OM (n=7/8). Axial muscle involvement was diffuse (DHS and CC) in 10/13 patients. After 70 years old (n=9/22), there were a majority of IBM (n=6/9) and all cases of ICIrm (n=2). Axial involvement was restricted to one group of muscles (DHS or CC) in 5/9 patients. Finally, 77% (17/22) of patients had refractory disease and required a second line treatment (e.g, immunoglobulins). All of these results are summarized in the Figure 1.

Figure 1.

Conclusion

While IM diagnosis is challenging in the presence of inaugural axial involvement, these results highlight the subset of IM to be considered according to the age at first symptoms and the type of axial involvement (e.g., DHS and/or CC).

References

[1]Mariampillai, K. et al. Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies. JAMA Neurol75, 1528-1537 (2018).

[2]Landon-Cardinal, O. et al. Recognising the spectrum of scleromyositis: HEp-2 ANA patterns allow identification of a novel clinical subset with anti-SMN autoantibodies. RMD Open6 (2020).

[3]Suarez, G.A. & Kelly, J.J., Jr. The dropped head syndrome. Neurology42, 1625-1627 (1992).

[4]Oerlemans, W.G. & de Visser, M. Dropped head syndrome and bent spine syndrome: two separate clinical entities or different manifestations of axial myopathy? J Neurol Neurosurg Psychiatry65, 258-259 (1998).

Disclosure of Interests

None declared

POS1325 CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS (CRMO): NEW INSIGHTS INTO EXTRA-OSSEOUS MANIFESTATIONS

Background

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory disease of the skeleton characterized by chronic and recurrent episodes of osteo-articular inflammation. The median age of onset is 10 years old. Clinical manifestations include musculoskeletal symptoms that are well described (pain, tenderness, swelling). Sometimes, skin lesions or digestive manifestations occur. Whole body magnetic resonance imaging (MRI) is the gold standard for assessing the multifocal pattern of the CRMO. Treatment is still empirical and mainly relies on non-steroidal anti-inflammatory drugs (NSAIDs). Bisphosphonates and biologics are used as second-line treatments. To date, the focus has been set on bone involvement and very few data are available on extra-osseous manifestations in CRMO.

Objectives

This study aims to further describe these extra-osseous clinical manifestations in CRMO.

Methods

A historical cohort was designed using 61 CRMO patients at the Pediatric Rheumatology Department in a tertiary university hospital in Paris (Hôpital Bicêtre, France). All patients underwent a MRI that confirmed the diagnosis according to the criteria of Jansson. Skeletal involvement was characterized with 1/axial, 2/ peripheral, 3/ axial and peripheral lesions. Extra-osseous manifestations were divided into 1/ skin lesions, 2/ gastro-intestinal manifestations, 3/ enthesitis and 4/ others. Pain was evaluated thanks to the Visual Analog Scale (VAS, from 0 to 10). Treatments used were recorded. The study complied with ethical requirements.

Results

Forty one patients were included in the study, with 31 females (75.6%). The mean ± SD age at onset was 79.1 ± 59.8 months, with a delay at diagnosis beyond six months (6.71 ± 6.96). Twenty-one patients had a familial history of inflammatory diseases (51.2%), with a majority of psoriasis or ankylosing spondylitis (n=13/21, 61.9%). At diagnosis, the level of pain was 5.71 ± 3.24. Eleven patients (42.3%) had blood inflammation. Bone lesions were reviewed thanks to whole body MRI: four patients had isolated axial involvement (10.0%), nine had peripheral involvement (22.5%) and 27 patients harbored both types of lesions (67.5%). The mean number of lesions was 6.65 ± 4.23. After 12 months of follow-up, all parameters regarding disease’s activity decreased (pain, blood inflammation, number of lesions). Regarding extra-osseous symptoms, fever occurred in seven patients (17.1%). Twenty-four patients had skin manifestations (58.5%) with palmoplantar lesions (n=3, 12.5%), acne (n=6, 25.0%), psoriasis (n=5, 20.8%) and aphthous (n=10, 41.7%). Four patients (9.76%) had gastro-intestinal symptoms and seven (17.1%) had enthesitis. One patient had uveitis. Almost all patients received NSAIDs (n=39/41, 95.1%) and half of the cohort were treated with bisphosphonates (n=21/41, 51.2%). Nine patients (22.0%) received biologics with a majority of TNF inhibitors. All patients that received TNF inhibitors had either a cutaneous involvement or digestive symptoms or enthesitis (Figure 1).

Conclusion

Extra-osseous manifestations have to be carefully searched in CRMO, especially in the presence of familial history of inflammatory diseases. While the severity of bone involvement can lead to use bisphosphonates, the introduction of biologics seems to rely on extra-osseous symptoms. These conclusions are drawn on a retrospective study and need to be confirmed in larger cohort.

References

[1]Wipff J, et al. A large national cohort of French patients with chronic recurrent multifocal osteitis. Arthritis Rheumatol 67, 1128-1137 (2015).

[2]Jansson A, et al. Classification of Non-Bacterial Osteitis: Retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology 46, 154-160 (2006).

Disclosure of Interests

None declared

Obstacles affecting the management innovation process through different actors during the covid-19 crisis: a longitudinal study of Industry 4.0

Industry 4.0 represents the most advanced stage of organization of industrial companies, allowing them to respond to an uncertain and changing environment, particularly as accentuated by the recent crisis resulting from COVID-19. Management innovation (MI) contributes to this process of permanent adaptation. The MI implementation phase is a critical step in MI generation that can generate many potential obstacles. This study focuses on these obstacles while considering the different activities (or subprocesses) embedded in this phase and the different actors involved in this complex process. We conducted a longitudinal case study in real time to investigate the implementation of MI internally generated by a multinational industrial company. Our results show that the obstacles encountered during the MI implementation phase may differ depending on the different activities and actors of this phase, thus leading us to question current implementation frameworks. This paper contributes by refining the theoretical model of MI generation and providing a better understanding of the obstacles that occur during the MI implementation phase. From a managerial perspective, this paper highlights key management principles to overcome the obstacles identified.

Highly Efficient Photocatalytic Reduction of CO2 to CO by In Situ Formation of a Hybrid Catalytic System Based on Molecular Iron Quaterpyridine Covalently Linked to Carbon Nitride

Efficient and selective photocatalytic CO₂ reduction was obtained within a hybrid system that is formed in situ via a Schiff base condensation between a molecular iron quaterpyridine complex bearing an aldehyde function and carbon nitride. Irradiation (blue LED) of an CH₃ CN solution containing 1,3-dimethyl-2-phenyl-2,3-dihydro-1H-benzo[d]imidazole (BIH), triethylamine (TEA), Feqpy-BA (qpy-BA=4-([2,2':6',2'':6'',2'''-quaterpyridin]-4-yl)benzaldehyde) and C₃ N₄ resulted in CO evolution with a turnover number of 2554 and 95 % selectivity. This hybrid catalytic system unlocks covalent linkage of molecular catalysts with semiconductor photosensitizers via Schiff base reaction for high-efficiency photocatalytic reduction of CO₂ , opening a pathway for diverse photocatalysis.

Les traits psychologiques positifs sont associés aux changements de comportement alimentaire liés au confinement du COVID-19 dans la cohorte NutriNet-Santé

Introduction et but de l’étude

La propagation du coronavirus (COVID-19) a eue pour conséquence la mise en place de mesures strictes de confinement, ayant entraîné des changements dans les comportements alimentaires. Les traits psychologiques sont des déterminants bien connus du comportement alimentaire. L’objectif de cette étude était donc d’étudier les associations entre les traits psychologiques positifs et les changements dans le grignotage et la consommation de groupes alimentaires pendant la période du confinement.

Méthodes

En 2016, les niveaux d’optimisme, de résilience, d’estime de soi, de satisfaction de la vie, de pleine conscience et de maîtrise ont été mesurés chez 33 766 adultes de la cohorte NutriNet-Santé. Le grignotage et la consommation de groupes d’aliments ont été évalués en avril–mai 2020. L’association entre les traits psychologiques et les changements dans le grignotage et la consommation de groupes alimentaires a été évaluée à l’aide de régressions logistiques, ajustées sur les caractéristiques sociodémographiques et le mode de vie, l’anxiété et la symptomatologie dépressive.

Résultats

Les participants présentant des niveaux plus élevés d’optimisme, de résilience, d’estime de soi, de satisfaction de la vie, de pleine conscience ou de maîtrise étaient moins susceptibles d’avoir des changements dans leur comportement de grignotage et leur consommation de divers groupes alimentaires.

Conclusion

Les personnes présentant des niveaux de traits psychologiques plus élevés ont été moins affectées par le confinement en termes de comportement alimentaire, alors que les personnes ayant des niveaux plus faibles ont montré des changements favorables et défavorables dans leur comportement alimentaire global.

Heterogenization of molecular cobalt catalysts in robust metal–organic frameworks for efficient photocatalytic CO2 reduction

Efficient, selective and recyclable heterogeneous catalysts for photocatalytic CO2 reduction to CO under visible light irradiation are readily prepared by immobilization of cobalt molecular catalysts into Zr(iv)-based MOFs.

[Importance of cognitive disorders in internal medicine: Pathophysiology, diagnosis, management. The example of systemic lupus erythematosus]

Systemic diseases, which are in France mainly monitored in internal medicine, affect multiple organs or tissues. While cutaneous or articular manifestations are the most common, neurological involvement is often associated with severity. Diagnosis of peripheral (e.g, neuropathies) or central (e.g, myelitis) nervous disorders is quite easy through clinical examination and dedicated complementary tests. However, neuropsychological manifestations that affect cognition, including memory, attention, executive functions or reasoning, are difficult to diagnose, sometimes trivialized by practitioners. Their causes are often numerous and interrelated. Nevertheless, these cognitive manifestations are closely related to patients' quality of life, affecting their social life, family dynamics and professional integration but also the treatment adherence. The purpose of this review, focused on the example of systemic lupus erythematosus, is to raise awareness of cognitive dysfunction in systemic diseases including their management from diagnosis to treatments. The final aim is to go further into setting up research groups and care programs for patients with cognitive impairment followed in internal medicine.

P04.15 Radiomics features in prediction of pseudo-progression and response to hypofractionated stereotactic radiotherapy and anti-PDL1 Durvalumab combination in recurrent glioblastoma from STERIMGLI phase I trial

BACKGROUND

Due to the risk of pseudo-progression, evaluating the response of such combined treatment with anti-PDL1 immunotherapy and hypofractionated stereotactic radiotherapy (hFSRT) in patients with recurrent glioblastoma (GBM) is difficult even with iRANO criteria. We aim to analyze multi-modal MRI radiomic features in recurrent GBM patients included in the phase I STERIMGLI (NCT02866747) clinical trial.

MATERIAL AND METHODS

In phase I trial STERIMGLI, six patients received hFSRT 24 Gy in 3 fractions of 8 Gy prescribed to the 80% covering isodose in combination with Durvalumab IV 1500mg the same day following the third fraction of radiation then every 4 weeks for a maximum of 12 months. All patients underwent multi-modal MRI acquisitions. Contrast-enhancement on post-gadolinium T1 MRI (Gd-T1) and hyper-T2 signal on FLAIR MRI were manually segmented as volume-of-interest (VOIs) from baseline at week 0 (W0) and every eight weeks until weeks sixteen (W16). For patient 05, segmentation was performed until progression (W40). First order radiomics were extracted and normalized from these longitudinal VOIs in a total of 42 MRI: volume (in cm3), mean and median intensity, entropy, skewness and kurtosis were computed for each VOI. In total 504 (2 x 42 x 6) features were extracted.

RESULTS

Two patients underwent pseudoprogression (patients 04 and 05).

All patients but one (patient 05) presented an early relapse with an increase of FLAIR and Gd-T1 volumes and respective entropies from the first evaluation without decrease during follow up (until W16).

Patient 05 presented a Dose Limiting Toxicities and had the longest time to progression after Durvalumab and hFSRT. Contrary to the other patients, his FLAIR radiomics features presented a decrease of volume, intensity and entropy between W0 and W16 then, interestingly an increase between W24 and W40, date of progression. Moreover, patient 05 presented the lowest tumor volume and the lowest Gd-T1entropy. The intensity of the Gd-T1 followed the same trend as the hyper intense signal on the FLAIR in all patients, in particular for patient 05.

CONCLUSION

In our study, entropy and tumor volume for both FLAIR and Gd-T1, and FLAIR intensity seems to be the most interesting parameters to access the response of combined treatment. FLAIR signal may be more specific to the tumor microenvironment.

First order radiomics allowed us to follow tumor heterogeneity and identify the patient with the longest time to progression.

Taming Electron Transfers: From Breaking Bonds to Creating Molecules

The electron is the ultimate redox reagent to build and reshape molecular structures. Understanding and controlling the parameters underlying dissociative electron transfer (DET) reactivity and its coupling with proton transfer is crucial for combining selectivity, kinetics and energy efficiency in molecular chemistry. Reactivity understanding and mechanistic elements in DET processes are traced back and key examples of current research efforts are presented, demonstrating a large variety of applications. The involvement of DET pathways indeed encompasses a broad range of processes such as photoredox catalysis, CO₂ reduction and alcohol oxidation. Interplay between these experimental examples and fundamental mechanistic study provides a powerful path to the understanding of driving force-rate relationships, which is crucial for the development of future generations of energy efficient catalytic schemes in redox organic chemistry.

Electrocatalytic and Photocatalytic Reduction of Carbon Dioxide by Earth-abundant Bimetallic Molecular Catalysts

Converting CO₂ into useful resources by electrocatalysis and photocatalysis is a promising strategy for recycling of the gas and electrification of industries. Numerous studies have shown that multinuclear metal catalysts have higher selectivity and catalytic activity than monometallic catalysts due to the synergistic effects between the metal sites. In this review, we summarize some of the recent progress on the electrocatalytic and photocatalytic reduction of CO₂ by earth-abundant bimetallic molecular catalysts.