Neural mechanisms distinguishing two types of cooperative problem-solving approaches: An fNIRS hyperscanning study

Collaborative cooperation (CC) and division of labor cooperation (DLC) are two prevalent forms of cooperative problem-solving approaches in daily life. Despite extensive research on the neural mechanisms underlying cooperative problem-solving approaches, a notable gap exists between the neural processes that support CC and DLC. The present study utilized a functional near-infrared spectroscopy (fNIRS) hyperscanning technique along with a classic cooperative tangram puzzle task to investigate the neural mechanisms engaged by both friends and stranger dyads during CC versus DLC. The key findings of this study were as follows: (1) Dyads exhibited superior behavioral performance in the DLC task than in the CC task. The CC task bolstered intra-brain functional connectivity and inter-brain synchrony (IBS) in regions linked to the mirror neuron system (MNS), spatial perception (SP) and cognitive control. (2) Friend dyads showed stronger IBS in brain regions associated with the MNS than stranger dyads. (3) Perspective-taking predicted not only dyads' behavioral performance in the CC task but also their IBS in brain regions associated with SP during the DLC task. Taken together, these findings elucidate the divergent behavioral performance and neural connection patterns between the two cooperative problem-solving approaches. This study provides novel insights into the various neurocognitive processes underlying flexible coordination strategies in real-world cooperative contexts.

[Analysis of the factors influencing the severity of coronavirus disease 2019 in patients with myeloproliferative neoplasms based on an online questionnaire]

Objective: To explore the variables associated with the severity of coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 omicron variant during the epidemic in patients with myeloproliferative neoplasms (MPN). Methods: A cross-sectional study. During the SARS-CoV-2 omicron variant pandemic from December 15, 2022, to March 15, 2023, COVID-19 related data for patients with MPN who were treated at Peking University People's Hospital were collected through an online questionnaire-based survey. All questionnaires and clinical data were checked by medical assistants. Logistic multivariate analysis was used to explore the prevalence and variables associated with the severity of COVID-19 in patients with MPN. Results: A total of 239 patients with MPN, including 90 (37.7%) presenting with essential thrombocythemia (ET), 50 (20.9%) with polycythemia vera (PV), and 99 (41.4%) with myelofibrosis (MF), were enrolled in the study. The 99 patients with MF included 87 (87.9%) with primary MF, 5 (5.1%) with post-PV MF, and 7 (7.1%) with post-ET MF. Overall, 239 (100%) patients reported that they experienced COVID-19 during the pandemic. Of these, 226 (94.6%) had mild disease, 4 (1.7%) had moderate disease, 7 (2.9%) had severe disease, and 2 (0.8%) had critical disease. Two (0.8%) patients with severe COVID-19 died, one of which suffered from MT and the other from PV. Multivariate analysis showed that older age (OR=2.36, 95%CI 1.24-4.49), MF (OR=10.22, 95%CI 1.13-92.80), or comorbidity (OR=5.25, 95%CI 1.25-22.03) were associated with a significantly higher risk of developing moderate, severe, or critical COVID-19. Among patients with MF, higher risk stratification reflected an increased risk of developing moderate, severe, or critical COVID-19 (P=0.034). Conclusion: During the omicron pandemic, older age, MF (especially higher-risk categories), and comorbidity were associated with a higher risk of developing moderate, severe, or critical COVID-19.

[Clinical and genetic characteristics of young patients with myeloproliferative neoplasms]

Objectives: To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN). Methods: In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients. Results: 1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion: Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

The state of the art in beyond 5G distributed massive multiple-input multiple-output communication system solutions

Beyond fifth generation (5G) communication systems aim towards data rates in the tera bits per second range, with improved and flexible coverage options, introducing many new technological challenges in the fields of network architecture, signal pro- cessing, and radio frequency front-ends. One option is to move towards cell-free, or distributed massive Multiple-Input Multiple-Output (MIMO) network architectures and highly integrated front-end solutions. This paper presents an outlook on be- yond 5G distributed massive MIMO communication systems, the signal processing, characterisation and simulation challenges, and an overview of the state of the art in millimetre wave antennas and electronics.

SARC-F at the Emergency Department: Diagnostic Performance for Frailty and Predictive Performance for Reattendances and Acute Hospitalizations

OBJECTIVES

Sarcopenia is associated with adverse health outcomes including mortality, functional loss, falls, and poorer quality of life. However, the value of screening sarcopenia at the Emergency Department (ED) remains unclear. We aimed to examine the SARC-F questionnaire for its (1) diagnostic ability in identifying frailty, and (2) predictive ability for adverse health outcomes.

DESIGN

A secondary analysis of a quasi-experimental study.

SETTING

An ED within a 1700-bed tertiary hospital.

PARTICIPANTS

ED patients aged ≥85 years (mean age 90.0 years) recruited into the Emergency Department Interventions of Frailty (EDIFY) study.

MEASUREMENTS

Data of demographics, premorbid function, frailty status [Frailty Index (FI), Clinical Frailty Scale (CFS), FRAIL], comorbidities, medications, and cognitive status were gathered. We also captured outcomes of mortality, acute hospitalization, and ED reattendance at 1-, 3-, and 6-month. We then compared area under the operating characteristic curves (AUCs) for the abovementioned measures against the FI (reference) for diagnosis of frailty. Lastly, we performed univariate analyses and logistic regression to compare SARC-F and other measures against the adverse outcomes of interest.

RESULTS

Amongst the various instruments, the SARC-F (AUC 0.92, 95% Confidence Interval (CI) 0.86-0.98, P<0.001; Sensitivity 79.0%, and Specificity 88.9%) performed best for frailty detection as defined by FI. Optimal cutoff was ≥3 (Sensitivity 91.4%, Specificity 83.3%, and Negative Predictive Value 68.2%). Only SARC-F was predictive of acute hospitalization [Adjusted Odds Ratio (OR) 4.00, 95% CI 1.47-10.94, P=0.007] and ED-reattendance [Adjusted OR 3.29, 95% CI 1.26-8.56, P=0.015] at 3-month.

CONCLUSIONS

The SARC-F demonstrated excellent diagnostic ability for frailty detection and predictive validity for ED reattendance and acute hospitalization at 3 months. Lowering cutoff score to ≥3 may improve case-finding at the ED to facilitate early identification and management of sarcopenia. Further studies are required to validate the diagnostic and predictive performance of SARC-F at ED settings.

THU0295 LOW IMMUNOGENICITY IN PATIENTS WITH GIANT CELL ARTERITIS TREATED WITH TOCILIZUMAB: 3-YEAR RESULTS FROM THE RANDOMIZED CONTROLLED PORTION AND OPEN-LABEL FOLLOW-UP OF A PHASE 3 TRIAL

Background:

Tocilizumab (TCZ) has low immunogenicity in patients with rheumatoid arthritis.1The risk for immunogenicity remains to be determined in patients with giant cell arteritis (GCA) treated with TCZ. TCZ administered subcutaneously every week (QW) or every other week (Q2W) with 26-week prednisone tapering was superior to placebo (PBO) plus 26-week (PBO+26) or 52-week (PBO+52) prednisone tapering for the achievement of sustained remission in patients with GCA in the 52-week, double-blind part 1 of the GiACTA trial.2Part 2 was a 2-year open-label, long-term follow-up in which patients were treated at the investigators’ discretion; part 2 treatment could include initiation/termination of TCZ QW with or without glucocorticoids or methotrexate.

Objectives:

To investigate immunogenicity of TCZ QW and Q2W regimens in patients with GCA in combination with a 26-week prednisone taper regimen versus PBO+26 or PBO+52 over the course of the GiACTA study in the randomized controlled part 1 and long-term follow-up part 2.

Methods:

In parts 1 and 2 combined, anti–TCZ antibodies (ADA) and corresponding pharmacokinetic (PK) parameters were assessed in serum samples taken at scheduled times at weeks 0, 8, 24, 36, 52, 76, 100, 136, and 156 or at early withdrawal. Additional assessments were made for patients who interrupted blinded TCZ treatment for ≥4 weeks in part 1 and those who withdrew from the study because of anaphylaxis/hypersensitivity. All samples were tested by screening assay, and samples that were ADA positive were further analyzed by a confirmation assay to verify specificity. If the confirmation assay was positive, 2 additional tests were performed to characterize the detected ADA: a neutralizing assay to test the neutralizing potential of ADAs and an assay to determine whether the detected ADA were of the IgE isotype. Proportions of patients in whom ADA developed were summarized for the safety population.

Results:

Among evaluable patients (had baseline and ≥1 postbaseline ADA assessments and received ≥1 dose of study treatment) in part 1, ADA developed in 1 of 95 (1.1%) and 3 of 46 (6.5%) patients after TCZ QW and Q2W dosing, respectively. One of 49 (2.0%) and 1 of 47 (2.1%) in the PBO+26 and PBO+52 groups, respectively, tested positive for ADA but had not received TCZ and were considered false positives. In parts 1 and 2 combined, among 199 patients who received ≥1 dose of TCZ, 193 (97%) were evaluable (Table); TCZ-induced ADA developed in 13 of these patients (6.7%) postbaseline (4 during part 1, 9 during part 2). Of these 13 patients, 8 (4.1%) had ADA with neutralizing potential and 1 (0.5%) had IgE ADA. Most TCZ-induced ADA were transient. There was no clear impact of TCZ-induced ADA on TCZ PK (Figure). No patients with TCZ-induced ADA experienced anaphylaxis, hypersensitivity reactions, or injection site reactions, and none withdrew because of lack of efficacy

Conclusion:

In patients with GCA, treatment-induced ADA developed in a minority of patients and had no impact on TCZ PK, efficacy, or safety. The immunogenicity of subcutaneous TCZ treatment was low, consistent with that observed in patients with RA.

References:

[1]Burmester GR et al.Ann Rheum Dis2017;76:1078-85.

[2]Stone JH et al.N Engl J Med2017;377:317-28.

Table.

Immunogenicity in Patients Who Received TCZ (part 1 + part 2)

Patients Who Received TCZN = 199BaselineEvaluable patients194 (97.5)Positive screening assay12 (6.0)Positive confirmation assay6 (3.0)PostbaselineEvaluable patients193 (97.0)Treatment-induced ADA13 (6.7)Characterizaton of ADANeutralizing potential8 (4.1)IgE1 (0.5)

Data are number (%) of patients based on N at baseline and on number of evaluable patients postbaseline.

Disclosure of Interests:

Min Bao Shareholder of: Roche, Employee of: Genentech, Navita L. Mallalieu Shareholder of: Roche, Employee of: Roche, John H. Stone Grant/research support from: Roche, Consultant of: Roche

SAT0275 MAINTAINED BENEFIT IN HEALTH-RELATED QUALITY OF LIFE OF PATIENTS WITH GIANT CELL ARTERITIS TREATED WITH TOCILIZUMAB PLUS PREDNISONE TAPERING: RESULTS FROM THE OPEN-LABEL, LONG-TERM EXTENSION OF A PHASE 3 RANDOMIZED CONTROLLED TRIAL

Background:

In part 1 of the 52-week, double-blind GiACTA trial, patients with giant cell arteritis (GCA) who received weekly tocilizumab (TCZ) plus prednisone tapering reported improvement in the 36-item Short-Form Health Survey (SF-36) Mental Component Summary (MCS) and Physical Component Summary scores and FACIT-Fatigue scores that were statistically significant and clinically meaningful compared with patients who received prednisone alone.1

Objectives:

To analyze whether benefit in SF-36 MCS was maintained in patients originally assigned to TCZ compared with those originally assigned to placebo (PBO) plus a 26- or 52-week prednisone taper among patients who achieved clinical remission at week 52 and maintained treatment-free clinical remission in the 2-year, long-term extension of GiACTA.

Methods:

At the end of part 1, patients entered open-label part 2, in which GCA therapy (including initiation/termination of open-label TCZ and/or GCs) was given at the investigator’s discretion according to disease status. Change from baseline in SF-36 MCS score was compared for combined original TCZ (n = 33) and PBO (n = 17) patients who achieved clinical remission at week 52 and maintained treatment-free (no TCZ or GCs) clinical remission in part 2 using a repeated-measures model. The minimal clinically important difference (MCID) for SF-36 MCS is >2.5.2

Results:

During treatment, SF-36 MCS scores in all 50 patients who maintained treatment-free clinical remission in part 2 had diverged between the TCZ and PBO groups as early as 36 weeks after baseline, with greater improvements evident in the TCZ group (Figure). The difference in least square means (LSM) change between TCZ and PBO was statistically significant at week 52 (p= 0.016) and maintained at weeks 100 (p= 0.023) and 156 (p= 0.002). The LSM difference (95% CI) between TCZ and PBO at weeks 52, 100, and 156 was 5.6 (1.1-10.2), 6.5 (0.9-12.1), and 7.4 (2.9-11.9), respectively, exceeding the MCID.

Conclusion:

Among patients who maintained treatment-free clinical remission during part 2 of GiACTA, those originally assigned to receive TCZ plus a prednisone taper during part 1 maintained statistically significant and clinically meaningful improvements in SF-36 MCS up to week 156 compared with those originally assigned to receive PBO plus a prednisone taper in part 1. This was true even though neither of the patient groups received TCZ or GC treatment after they achieved clinical remission at week 52.

References:

[1]Strand V et al.Arthritis Res Ther2019;21:64.

[2]Lubeck DP.Pharmacoeconomics2004;22:27-38.

Disclosure of Interests:

John H. Stone Grant/research support from: Roche, Consultant of: Roche, Jian Han Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Sebastian Unizony Grant/research support from: Genentech, Inc., Martin Aringer Consultant of: Boehringer Ingelheim, Roche, Speakers bureau: Boehringer Ingelheim, Roche, Daniel Blockmans Consultant of: yes, Speakers bureau: yes, Elisabeth Brouwer Consultant of: Roche (consultancy fee 2017 and 2018 paid to the UMCG), Speakers bureau: Roche (2017 and 2018 paid to the UMCG), Maria C. Cid Speakers bureau: Roche, Bhaskar Dasgupta Grant/research support from: Roche, Consultant of: Roche, Sanofi, GSK, BMS, AbbVie, Speakers bureau: Roche, Jürgen Rech Consultant of: BMS, Celgene, Novartis, Roche, Chugai, Speakers bureau: AbbVie, Biogen, BMS, Celgene, MSD, Novartis, Roche, Chugai, Pfizer, Lilly, Carlo Salvarani: None declared, Robert Spiera Grant/research support from: Roche-Genetech, GSK, Boehringer Ingelheim, Chemocentryx, Corbus, Forbius, Sanofi, Inflarx, Consultant of: Roche-Genetech, GSK, CSL Behring, Sanofi, Janssen, Chemocentryx, Forbius, Mistubishi Tanabe, Min Bao Shareholder of: Roche, Employee of: Genentech

OP0027 TIME TO FLARE AND GLUCOCORTICOID EXPOSURE IN PATIENTS WITH NEW-ONSET VERSUS RELAPSING GIANT CELL ARTERITIS TREATED WITH TOCILIZUMAB OR PLACEBO PLUS PREDNISONE TAPERING: 3-YEAR RESULTS FROM A RANDOMIZED CONTROLLED PHASE 3 TRIAL

Background:

In part 1 of the 52-week, double-blind GiACTA trial, tocilizumab (TCZ) every week (QW) or every other week (Q2W) + prednisone tapering reduced the risk for flare versus placebo (PBO) + 26-week prednisone tapering among patients with new-onset giant cell arteritis (GCA) at baseline. Among patients with relapsing GCA, TCZ QW but not Q2W + prednisone reduced the risk for flare versus both PBO groups, and there was separation in the time to flare between the TCZ QW and Q2W groups.1

Objectives:

To report time to first flare and potential cumulative glucocorticoid (GC) sparing over 3 years of the GiACTA trial (part 1 + 2-year open-label part 2) among patients with new-onset or relapsing GCA.

Methods:

At the end of part 1, patients entered open-label part 2, in which GCA therapy (including initiation/termination of open-label TCZ and/or GCs) was given at the investigator’s discretion according to disease status. Time to first GCA flare during the 3-year study period was assessed using Kaplan-Meier analysis for patients in the intention-to-treat population according to disease onset status at baseline (new-onset/relapsing) based on their originally assigned treatment groups: TCZ QW, TCZ Q2W, or pooled PBO (PBO+26-week and PBO+52-week prednisone taper).

Results:

Among patients randomly assigned in part 1, 47 of 100 (47%) in the TCZ QW group, 26 of 49 (53%) in the TCZ Q2W group, and 46 of 101 (46%) in the pooled PBO group had new-onset GCA at baseline; the rest had relapsing GCA. Median time to first flare over 3 years was longer for patients assigned to TCZ treatment in part 1 than for patients assigned to PBO; Kaplan-Meier analysis showed a clear separation between the TCZ QW and the pooled PBO groups over 3 years for patients with new-onset and relapsing GCA (Figure 1A). Separation between the TCZ QW and TCZ Q2W groups was also observed over 3 years in patients with new-onset and relapsing GCA, although this was more evident in patients with relapsing GCA (Figure 1B). Higher proportions of patients in the TCZ QW group (new-onset, 49%; relapsing, 47%) than the pooled PBO group (new-onset, 28%; relapsing, 31%) and the TCZ Q2W group (new-onset, 27%; relapsing, 35%) remained flare-free during their entire treatment period. Cumulative prednisone dose over 3 years was lower for patients originally assigned to TCZ QW versus those originally assigned to PBO for patients with new-onset GCA and those with relapsing GCA at baseline (Figure 2).

Conclusion:

In this 3-year analysis of GiACTA parts 1 and 2, time to first flare favored TCZ QW over TCZ Q2W in patients with new-onset and relapsing GCA. TCZ QW delayed time to first flare and resulted in lower cumulative GC exposure compared with PBO in patients with new-onset and relapsing GCA, supporting TCZ QW dosing in patients with GCA regardless of disease onset.

References:

[1]Stone JH et al. N Engl J Med 2017;377:317-28.

Disclosure of Interests:

John H. Stone Grant/research support from: Roche, Consultant of: Roche, Helen Spotswood Shareholder of: Roche Products Ltd, Employee of: Roche Products Ltd, Sebastian Unizony Grant/research support from: Genentech, Inc., Martin Aringer Consultant of: Boehringer Ingelheim, Roche, Speakers bureau: Boehringer Ingelheim, Roche, Daniel Blockmans Consultant of: yes, Speakers bureau: yes, Elisabeth Brouwer Consultant of: Roche (consultancy fee 2017 and 2018 paid to the UMCG), Speakers bureau: Roche (2017 and 2018 paid to the UMCG), Maria C. Cid Speakers bureau: Roche, Bhaskar Dasgupta Grant/research support from: Roche, Consultant of: Roche, Sanofi, GSK, BMS, AbbVie, Speakers bureau: Roche, Jürgen Rech Consultant of: BMS, Celgene, Novartis, Roche, Chugai, Speakers bureau: AbbVie, Biogen, BMS, Celgene, MSD, Novartis, Roche, Chugai, Pfizer, Lilly, Carlo Salvarani: None declared, Robert Spiera Grant/research support from: Roche-Genetech, GSK, Boehringer Ingelheim, Chemocentryx, Corbus, Forbius, Sanofi, Inflarx, Consultant of: Roche-Genetech, GSK, CSL Behring, Sanofi, Janssen, Chemocentryx, Forbius, Mistubishi Tanabe, Min Bao Shareholder of: Roche, Employee of: Genentech

Identification and characterisation of a novel FT orthologous gene in London plane with a distinct expression response to environmental stimuli compared to PaFT

FLOWERING LOCUS T (FT) is a key integrator of environmental signals and internal cues, and codes for florigen-like activity which regulates the transition from vegetative to reproductive growth in flowering plants. Unlike annual plants, perennial tree species undergo several years of vegetative growth prior to the transition to the reproductive stage, as characterised by the ability to form flower buds. Thereafter, trees in temperate regions typically display an annual growth cycle involving distinct vegetative growth, flowering and dormancy stages. In London plane (Platanus acerifolia Willd.), a FT-like gene has previously been identified. Here, we report the isolation of a novel FT orthologous gene, PaFTL, and investigate the functions of PaFT and PaFTL through the analysis of expression profiles and transgenic phenotypes. PaFT displayed the highest levels of expression during tree dormancy, and similarly elevated expression levels were seen under conditions of low temperature and short days (LT/SD). In contrast, PaFTL transcripts were up-regulated during the floral transition phase, the early stages of inflorescence development and throughout the main flowering period, whereas expression levels were low and variable during dormancy and in response to LT/SD treatments. Ectopic expression of 35s::PaFTL in tobacco produced a phenotype similar to that with PaFT, namely, advanced floral initiation. Overall, the results suggest that PaFT and PaFTL have both conserved and diverse functions in floral initiation, floral development and dormancy regulation.

P3567Genetic screening for monogenic hypertension in hypertensive individuals in a clinical setting

Objectives

Monogenic hypertension describes a series of hypertension syndromes inherited by Mendelian law and present with complex phenotypes.

Methods

1179 cases with monogenic hypertension potential were evaluated by sequencing 37 causative genes. Pathogenic variants were classified by using American College of Medical Genetics guidelines. Additionally, 49 variants of unknown significance were selected to receive functional analysis. The yield of combined genetic and functional analysis was evaluated.

Results

21 deleterious variants were identified in 33 of 1179 (2.80%). Functional analysis for 49 unknown significant variants showed 32 variants harbored by 61 individuals led to abnormally expressed protein levels. Overall, combining genetic screening with functional analysis promoted diagnostic yield to 8.73%. The main etiology established was primary aldosteronism, with CACNA1H harboring the greatest mutation burden. Logistic regression analysis showed hypertension complicated with special manifestations had the strongest correlation with disease causing variants detection (p=0.03).

Sequencing Results Summary Number of variants Number of individuals* Percentage† Individuals with no variant 0 524 44.44% Individuals with variants identified 592 655 55.56% Individuals with single contributing variant 297 480 40.71% Individuals with two or multiple contributing variants 295 175 14.84% Number of variants identified   Pathogenic and likely pathogenic variants 21 33 2.80%   Variants of unknown significance 570 634 53.77%   Benign or likely benign variants 1 1 0.08% Type of variant   Frameshift deletion 8 15 1.27%   Frameshift insertion 5 5 0.42%   Nonframeshift deletion 10 10 0.85%   Nonframeshift insertion 6 12 1.02%   Nonsynonymous SNV 546 607 51.48%   Stopgain SNV 18 30 2.54% WES, whole-exome sequencing. *The statistics in this table was based on 1179 individuals. †The percentage was calculated by the number of individuals in each category.

A flow chart of this study.

Conclusion

Our findings demonstrate an enhanced diagnostic ability by combining genetic analysis with functional evaluation and enables targeted treatment and prevention of hypertension.

Acknowledgement/Funding

This work was supported by National Basic Research Program of China (973 Program, 2014CB542300, 2014CB542302).

Predicted final spinal height in patients with adolescent idiopathic scoliosis can be achieved by surgery regardless of maturity status

AIMS

The aim of this study was to investigate the impact of maturity status at the time of surgery on final spinal height in patients with an adolescent idiopathic scoliosis (AIS) using the spine-pelvic index (SPI). The SPI is a self-control ratio that is independent of age and maturity status.

PATIENTS AND METHODS

The study recruited 152 female patients with a Lenke 1 AIS. The additional inclusion criteria were a thoracic Cobb angle between 45° and 70°, Risser 0 to 1 or 3 to 4 at the time of surgery, and follow-up until 18 years of age or Risser stage 5. The patients were stratified into four groups: Risser 0 to 1 and selective fusion surgery (Group 1), Risser 0 to 1 and non-selective fusion (Group 2), Risser 3 to 4 and selective fusion surgery (Group 3), and Risser 3 to 4 and non-selective fusion (Group 4). The height of spine at follow-up (HOS_f) and height of pelvis at follow-up (HOP_f) were measured and the predicted HOS (pHOS) was calculated as 2.22 (SPI) × HOP_f. One-way analysis of variance (ANOVA) was performed for statistical analysis.

RESULTS

Of the 152 patients, there were 32 patients in Group 1, 27 patients in Group 2, 48 patients in Group 3, and 45 patients in Group 4. Significantly greater HOS_f was observed in Group 3 compared with Group 1 (p = 0.03) and in Group 4 compared with Group 2 (p = 0.02), with similar HOP_f (p = 0.75 and p = 0.83, respectively), suggesting that patients who undergo surgery at Risser grade of 0 to 1 have a shorter spinal height at follow-up than those who have surgery at Risser 4 to 5. HOS_f was similar to pHOS in both Group 1 and Group 2 (p = 0.62 and p = 0.45, respectively), indicating that undergoing surgery at Risser 0 to 1 does not necessarily affect final spinal height.

CONCLUSION

This study shows that fusion surgery at Risser 0 may result in growth restriction unlike fusion surgery at Risser 3 to 4. Despite such growth restriction, AIS patients could reach their predicted or 'normal' spinal height after surgery regardless of baseline maturity status due to the longer baseline spinal length in AIS patients and the remaining growth potential at the non-fusion levels. Cite this article: Bone Joint J 2018;100-B:1372-6.

Effect of serum 25-hydroxyvitamin D3 on insulin resistance and β-cell function in newly diagnosed type 2 diabetes patients

Aims/Introduction

To evaluate serum 25‐hydroxyvitamin D₃ (25(OH)D₃) in newly diagnosed type 2 diabetes patients and to explore the associations of 25(OH)D₃ with insulin resistance and β‐cell function.

Materials and Methods

A total of 97 newly diagnosed type 2 diabetes patients and 69 healthy controls were recruited. Serum 25(OH)D₃ was determined using high‐pressure liquid chromatography. Insulin resistance was measured using a homeostasis model assessment of insulin resistance (HOMA‐IR). β‐Cell function was determined using the HOMA β‐cell function index (HOMA‐β), early‐phase insulin secretion index (ΔI30/ΔG30) and area under the insulin curve (AUCins). Correlation analysis was carried out using Pearson's correlation and multiple stepwise regression analysis.

Results

Serum 25(OH)D₃ was much lower in patients with newly diagnosed type 2 diabetes (t = −13.00, P < 0.01), and the prevalence of hypovitaminosis 25(OH)D₃ was 62.9% (61/97) in diabetic patients. Among the diabetic patients, patients with hypovitaminosis 25(OH)D₃ showed higher glycosylated hemoglobin and AUCglu (P < 0.01) as well as lower HOMA‐β, ΔI30/ΔG30 and AUCins. Serum 25(OH)D₃ was independently positively correlated with ΔI30/ΔG30 and AUCins (P < 0.05), but was not significantly correlated with either HOMA‐IR or HOMA‐β. Only triglycerides, glycosylated hemoglobin and ΔI30/ΔG30 emerged as independent factors associated with serum 25(OH)D₃ in both diabetes patients and the health control group.

Conclusions

The present results further showed a low serum 25(OH)D₃ concentration in patients with newly diagnosed type 2 diabetes. 25(OH)D₃ deficiency is associated with disturbances in glucose metabolism and lipid metabolism. Serum 25(OH)D₃ is not correlated with basal insulin resistance or β‐cell function, but is significantly positively correlated with glucose‐stimulated insulin secretion and β‐cell function.

Anisakis infection in allis shad, Alosa alosa (Linnaeus, 1758), and twaite shad, Alosa fallax (Lacépède, 1803), from Western Iberian Peninsula Rivers: zoonotic and ecological implications

Spawning individuals of allis shad, Alosa alosa (Linnaeus, 1758), and twaite shad, Alosa fallax (Lacépède, 1803), were sampled from three rivers on the Atlantic coast of the Iberian Peninsula (Ulla, Minho, Mondego) during 2008 to 2013 to assess the presence of the zoonotic marine parasite Anisakis spp. larvae. The results revealed that both shad species were infected by third-larval stage Anisakis simplex s.s. and Anisakis pegreffii. The latter is reported in mixed infections in both shad species of Western Iberian Peninsula for the first time. In A. alosa, the prevalence of Anisakis infection can reach 100%, while in A. fallax, prevalence was up to 83%. Infected individuals of the former species also often contain much higher number of parasites in theirs internal organs and flesh: from 1 to 1138 Anisakis spp. larvae as compared to 1 to 121 larvae, respectively. In general, numbers of A. pegreffii were higher than those of A. simplex s.s. Our results suggest that in the marine environment of the Western Iberian Peninsula, both anadromous shad species act as paratenic hosts for A. simplex s.s. and A. pegreffii, thus widening the distribution of the infective nematode larvae from the marine to the freshwater ecosystem. This finding is of great epidemiological relevance for wildlife managers and consumers, considering the zoonotic and gastroallergic threats posed of these parasites.

Activation of p38 MAPK in the rostral ventromedial medulla by visceral noxious inputs transmitted via the dorsal columns may contribute to pelvic organ cross-sensitization in rats with endometriosis

Whether visceral organ cross-sensitization is involved in endometriosis-associated pain remains elusive. Previous studies have shown that visceral noxious stimuli may trigger a cascade of signal transductions in the rostral ventromedial medulla (RVM) via the spinal dorsal column (DC) pathway and the RVM plays a critical role in the descending control of visceral nociception. In the current study, we hypothesized that the p38 mitogen-activated protein kinase (MAPK) activation in the RVM by noxious visceral inputs from ectopic growths via the DC was involved in the development of pelvic organ cross-sensitization in established endometriosis. A rat model of experimental endometriosis was established. To examine ectopic growths-to-colon cross-sensitization, graded colorectal distention (CRD) was performed and abdominal withdrawal reflex (AWR) scores were recorded in female rats at 8weeks after the uterine or fat (control) auto-transplantation. Western blot study was carried out to examine the phosphorylated form and the total level of p38 MAPK protein in the RVM. Our results showed that lesions of bilateral DCs immediately following uterine or fat auto-transplantation in female rats significantly attenuated the later development of ectopic growths-to-colon cross-sensitization and the increased p38 MAPK activation in the RVM, as compared to sham DC lesions. Furthermore, intra-RVM microinjection of a p38 MAPK inhibitor (SB 203580), but not vehicle, in female rats with established endometriosis significantly attenuated ectopic growths-to-colon cross-sensitization and the increased activation of p38 MAPK in the RVM. These findings suggest that the noxious inputs from ectopic growths may activate p38 MAPK in the RVM via the DC, which may contribute to the development of ectopic growths-to-colon cross-sensitization in established endometriosis.

The diagnosis of diabetic acute complications using the glucose-ketone meter in outpatients at endocrinology department

OBJECTIVE

To determine urine ketone and blood β-hydroxybutyrate acid (β-HBA) in outpatients of endocrinology department and to investigate the association between urine ketone or blood β-HBA and diabetic ketosis (DK) or diabetic ketoacidosis (DKA).

METHODS

Urine ketone, blood β-HBA, body mass index (BMI) and glycosylated hemoglobin (HbA1c) were determined in 134 patients with blood glucose ≥ 13.9 mmol/L.

RESULTS

In 134 patients with severe hyperglycemia, there were 30 patients (22.4%) with acute complications of diabetes, including 24 patients (17.9%) diagnosed with DK and 6 patients (4.5%) diagnosed with DKA. Among them, 6 patients (20%) were withdrawal, 2 (6.7%) were infected, and 19 (63.3%) were not treated. When there was a negative urine ketone, 10% patients would have had blood β-HBA ≥ 0.3 mmol/L. When there was a positive urine ketone (+ to +++), 22.62% patients would have had blood β-HBA < 0.3 mmol/L.

CONCLUSIONS

Blood β-HBA had a positive correlation with blood glucose (r = 0.34, P < 0.001). Complications of severe hyperglycemia could be diagnosed quickly and accurately by analyzing blood β-HBA using the glucose-ketone meter.

Kinetics of serological responses in influenza A(H7N9)-infected patients correlate with clinical outcome in China, 2013

The novel avian influenza A(H7N9) infection has recently emerged to cause severe respiratory illness in China. The objectives of this study were to define the kinetics of the antibody responses in patients with influenza A(H7N9) disease and to correlate these kinetics with clinical outcome. Serial serum samples were obtained at intervals of three to four days from 18 patients with virologically confirmed A(H7N9) disease in Shanghai. We determined the kinetics of the haemagglutination inhibition (HI) and A(H7H9) pseudotype neutralisation antibody (Nab) responses and correlated these with clinical outcomes. Most patients had robust serological responses by both HI and Nab tests. Taking into account censoring due to time of testing and death, the median time from onset of illness to Nab titre ≥1:40 was 14 days (95% confidence interval (CI): 11–18 days) in the fatal cases and 10.5 days (95% CI: 7–12) in the survivors (p=0.003). The two groups did not differ in initial Nab titres, but the rate of increase in Nab titres was significantly faster for survivors by approximately 10-fold per 15 days (p=0.007). Early and rapid induction of Nab was correlated significantly with better clinical outcome.

Shortening tobacco life cycle accelerates functional gene identification in genomic research

Definitive allocation of function requires the introduction of genetic mutations and analysis of their phenotypic consequences. Novel, rapid and convenient techniques or materials are very important and useful to accelerate gene identification in functional genomics research. Here, over-expression of PmFT (Prunus mume), a novel FT orthologue, and PtFT (Populus tremula) lead to shortening of the tobacco life cycle. A series of novel short life cycle stable tobacco lines (30-50 days) were developed through repeated self-crossing selection breeding. Based on the second transformation via a gusA reporter gene, the promoter from BpFULL1 in silver birch (Betula pendula) and the gene (CPC) from Arabidopsis thaliana were effectively tested using short life cycle tobacco lines. Comparative analysis among wild type, short life cycle tobacco and Arabidopsis transformation system verified that it is optional to accelerate functional gene studies by shortening host plant material life cycle, at least in these short life cycle tobacco lines. The results verified that the novel short life cycle transgenic tobacco lines not only combine the advantages of economic nursery requirements and a simple transformation system, but also provide a robust, effective and stable host system to accelerate gene analysis. Thus, shortening tobacco life cycle strategy is feasible to accelerate heterologous or homologous functional gene identification in genomic research.

The FLOWERING LOCUS T orthologous gene of Platanus acerifolia is expressed as alternatively spliced forms with distinct spatial and temporal patterns

The FLOWERING LOCUS T (FT) protein is a likely component of the 'florigen' signal that plays a crucial role in regulating the transition from vegetative to reproductive growth. Here, we report the isolation of full-length cDNAs and the corresponding genomic clones encoding orthologous FT proteins (PaFT) of London plane (Platanus acerifolia Willd). Two genes with high sequence identity were isolated (PaFT1-2), but 34 different transcript products were identified, comprising 21 splice forms produced by alternative splicing of the PaFT pre-mRNAs. Expression of the alternative splicing forms of PaFT varied according to tissue type and developmental stage. PaFT transcripts were detected throughout adult trees, whereas in juvenile trees they were only detected in dormant sub-petiolar buds. In adult trees, levels of the various alternative splicing PaFT forms were related to flower development stage and tree dormancy. Ectopic expression of the archetypal splice form of PaFT-A in tobacco and Arabidopsis developed multiple altered phenotypes, notably early flowering and attenuation of apical dominance. The evidence in this study indicates that complex alternative processing of PaFT transcripts in P. acerifolia may be associated with multiple regulatory roles, including initiation of flowering, flower development, apical dominance, tree dormancy and dormancy release.

Free-base nicotine in tobacco products. Part I. Determination of free-base nicotine in the particulate phase of mainstream cigarette smoke and the relevance of these findings to product design parameters

The free-base nicotine (FBN) content of mainstream cigarette smoke (MSS) has been discussed in the peer-reviewed literature and popular press. It has been alleged that manufacturers adjust product design features to increase the percentage of total nicotine (TN) in the MSS gas-vapor phase that is unprotonated [P(g)(,nic)(%)] and/or the fraction of nicotine in the MSS total particulate matter (TPM) that is unprotonated (FBN/TN). Our research showed the Health Canada Intensive smoking conditions negated the effects of blend and cigarette design features reported to raise the pH of TPM collected under ISO or US FTC conditions. Our research also showed that when additive-free Canadian cigarettes were smoked under ISO conditions, the FBN/TN ratio increased as the tar/nicotine ratio decreased. Our findings are in line with other studies that have questioned allegations of a relationship between use of ammonia and its compounds as tobacco additives and amounts of unprotonated nicotine in MSS. In addition, the experimental work demonstrated how use of solid-phase microextraction to estimate FBN can yield erroneously high results due to improper conditioning and/or smoking of the cigarettes. Our research showed that there is no longer any scientific support for regulators to require smoke pH and FBN determinations on cigarette products.

Association study of genetic variants in eight genes/loci with type 2 diabetes in a Han Chinese population

BACKGROUND

At least twenty genes/loci were shown to be associated with type 2diabetes in European original populations. Five of these genes were shown to be associated with type 2 diabetes (T2D) in Chinese populations. The purpose of this study was to replicate the association of genetic vairants in the eight diabetes-related genes/loci with type 2 diabetes in a Han Chinese cohort from western part of China. Nineteen single nucleotide polymorphisms (SNPs) from the eight genes/loci including TCF7L2, HHEX, CDKAL1, SLC30A8, PPARG, IGF2BP2, KCNJ11, and CDKN2A/CDKN2B were genotyped in 1,529 cases and 1,439 controls in a Han Chinese population using the ABI SNaPshot method. The meta-analysis of the association between rs7903146 in TCF7L2 gene and T2D in the Han Chinese was performed.

RESULTS

Among the eight genes/loci examined, we found that four were significantly associated with T2D. Although previous studies showed that the association between the SNP rs7903146 in the TCF7L2 gene and T2D was controversial within the Han Chinese population, we have confirmed the significant association between the SNP rs7903146 in the TCF7L2 gene and T2D in both this study and the meta-analysis in the population. In addition, we also confirmed that three SNPs (rs1111875, rs7923837 and rs5015480) in HHEX , one SNP (rs10946398) in CDKAL1, and three SNPs (rs13266634, rs3802177 and rs11558471) in SLC30A8 were significantly associated with T2D in the population being studied.

CONCLUSIONS

We demonstrated that the variants in TCF7L2, CDKAL1, HHEX, and SLC30A8 genes are associated with T2D in a Han Chinese population.

Pulping cardoon (Cynara cardunculus) with peroxyformic acid (MILOX) in one single stage

In this work, depithed cardoon stalk (Cynara cardunculus) has been used with the objective of obtaining bleachable pulps. The material, once properly prepared, was subjected to one-step peroxyformic acid delignification. In order to study the process, a face-centred second order factorial design was developed which allowed the determination of the influences of four variables: concentrations of formic acid and hydrogen peroxide in the cooking liquor and the time and temperature of the treatment. Empirical mathematical models have been obtained which predict the yield, kappa index, residual lignin content, and viscosity of the pulps. These models demonstrate that in general the delignification was extensive, producing pulps with kappa indexes less than 25 in the majority of cases, with good yields in the range of 45-60%. However, the pulps seem to have been degraded in the reaction media, as can be deduced from the low viscosity values found: 260-520 mL/g.

IGF-I but not insulin inhibits apoptosis at a low concentration in vascular smooth muscle cells

Apoptosis of vascular smooth muscle cells (VSMCs) is of importance in the development of diabetic angiopathy. Our aim was to evaluate the effect of insulin and IGF-I on apoptosis in VSMCs. Rat aortic VSMCs were used and apoptosis was induced by serum starvation. As apoptotic markers we measured caspase-3 activity, histone-associated DNA fragments by ELISA and nuclear morphology by DAPI (4',6-diamidino-2-phenylindole) staining. Phosphorylation of IGF-I receptors was evaluated by Western blot. Serum starvation had increased caspase-3 activity even after 3 h. The highest activity was found after 3-12 h. IGF-I 10(-9 )M inhibited serum starvation-induced caspase-3 activity with a maximal effect after 12 h. When studied after starvation for 12 h, significant inhibitory effects on caspase-3 were found at IGF-I concentrations of 10(-8)-10(-7) M (P<0.01) and at an insulin concentration of 10(-6 )M (P<0.01). DNA fragmentation was detected by ELISA after 24 h and chromatin condensation and nuclear fragmentation by DAPI staining after 24 and 48 h respectively. IGF-I dose-dependently reduced apoptosis evaluated by ELISA, reaching a maximal effect at 10(-9) M. Insulin reduced apoptosis but the effect was weaker and a higher concentration was needed. IGF-I (10(-8 )M) and insulin at a very high concentration (10(-6) M) phosphorylated IGF-I receptors. Taken together, IGF-I and insulin have antiapoptotic effects on VSMCs but the effect of insulin is only found at high unphysiological concentration.

Adventitious shoot regeneration from in vitro cultured leaves of London plane tree (Platanus acerifolia Willd.)

Adventitious shoots were successfully regenerated from leaf explants of in vitro cultures of Platanus acerifolia Willd. The leaves of three clones (genotypes), designated as PH1, PH2 and PC, respectively, were wounded by three to four transverse cuts through the midvein and cultured on 26 media based on Murashige and Skoog (MS) basal medium, containing different concentrations of 6-benzylaminopurine (BAP) in combination with different concentrations of indole-3-butyric acid (IBA). The highest regeneration rate (>90%) and the largest number of shoot clumps per regenerating leaf (>4 shoot clumps/explant) were obtained with leaves of genotype PH2 cultured on MS basal medium supplemented with 17.76 microM BAP and 4.92 microM IBA. The other two genotypes, PH1 and PC, showed very low capability of shoot regeneration (<10%) on all the media tested. Shoots on leaf explants originated mainly from callus that developed around the cut end of petioles and along the cuts across the midvein. The regenerated shoots were micropropagated, rooted and transplanted to the soil successfully.

Lack of association between methylenetetrahydrofolate reductase (MTHFR) C677T and ischaemic heart disease (IHD): family-based association study in a Spanish population

The effect of the C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene, traditionally associated with ischaemic heart disease (IHD), was assessed in a Spanish population. The transmission disequilibrium test (TDT) was used to determine a possible association in a sample of 101 trios of IHD patients. The distribution of MTHFR genotypes was similar in the IHD subjects and the parental group; the TT genotype was present in 14.9% of IHD patients, as compared to 15.2% in the parents. The frequency of the T allele was also similar in IHD cases and parents (39.6% vs. 42.4%; p = 0.649). The TDT confirmed that the observed transmission of the T allele did not deviate significantly from the expected one (chi2 = 0.743; p > 0.4). Our TDT analysis clearly demonstrates a lack of association between the T allele of the C677T mutation in MTHFR and cardiovascular artery disease, both for the general group and for different risk subgroups (smokers, hypertension, male sex, overweight and type A behaviour pattern) in the Spanish population.

Infrared Spectra of Phthalocyanine and Naphthalocyanine in Sandwich-Type (Na)phthalocyaninato and Porphyrinato Rare-Earth Complexes. II. The Effects of Rare-Earth Ionic Size on the IR Characteristics of Naphthalocyaninein Bis(naphthalocyaninato) Rare-Earth Complexes

The infra-red (IR) spectroscopic data for a series of 28 homoleptic substituted bis(naphthalocyaninato) rare-earth complexes M(2,3-Nc*)2 [M = Y, La–Lu except Pm; H2Nc* = 3(4),12(13),21(22),30(31)-tetra(tert-butyl)-2,3- naphthalocyanine (H2TBNc) and 3,4,12,13,21,22,30,31-octa(dodecylthio)-2,3-naphthalocyanine (H2ODTNc)] have been collected with a resolution of 2 cm–1. These neutral sandwich complexes are radicals due to their composition (Nc*)2–MIII(Nc*)–, wherein the unpaired electron is delocalized over both macrocycles on the vibrational time scale. Compared to spectra obtained with low resolution, such as 4 cm–1, a larger number of vibrational modes could be distinguished. The IR spectra for M(ODTNc)2 are much simpler than those of M(TBNc)2, revealing the relatively higher symmetry of the former molecules. By analogy with bis(phthalocyaninato) rare-earth counterparts, the pyrrole stretching absorptions at 1314–1317 and 1323–1330�cm–1 for M(TBNc)2 and at 1316–1327 cm–1 for M(ODTNc)2 are assigned to the IR marker bands of the respective naphthalocyanine mono-anion radicals. These marker bands, together with those at 746–753 cm–1 assigned to C–H wagging, 1350–1355 cm–1 attributed to pyrrole stretchings, and 1389–1394 cm–1 due to naphthalene stretchings, have been found to shift slightly to higher energy along with the rare-earth contraction, clearly demonstrating the effect of rare-earth ionic radius.

Intrinsic defects in the T-cell lineage results in natural killer T-cell deficiency and the development of diabetes in the nonobese diabetic mouse

T-cell-mediated autoimmune diabetes in nonobese diabetic (NOD) mice is closely associated with natural killer T (NKT)-cell deficiency. To determine whether intrinsic defects of the T-cell lineage contribute to the pathogenesis of the disease and NKT cell deficiency, we reconstituted the T-cell compartment in NOD.scid or BALB.scid mice with T-cells from NOD, nonobese diabetes-resistant (NOR), or AKR thymic precursor cells and examined the development of the NKT cell population. NKT cells developed well from AKR thymic precursor cells but not from other precursor cells in both recipient strains. Insulitis and diabetes developed only in the NOD.scid recipients of NOD or NOR precursor cells. When thymic precursor cells of beta2-microglobulin gene-deficient AKR mice, which have a deficient NKT population, were introduced into NOD.scid recipients, both CD4(+) and CD8(+) T-cell populations developed and the recipient mice developed insulitis and diabetes. We conclude that NKT cells originate from a T-cell-committed thymic precursor population and that the deficiency in the NKT cell population in NOD mice results from intrinsic defects within the T-cell lineage and plays a major role in the development of autoimmune diabetes in the presence of both the NOD thymus and antigen-presenting cells.

Integrin tyrosine phosphorylation in platelet signaling

The beta 3 integrin cytoplasmic tyrosine (ICY) motif of alpha IIb beta 3 becomes tyrosine phosphorylated during platelet aggregation, causing Shc and myosin to interact with the beta-integrin cytoplasmic domain. Platelets from mice lacking beta 3 ICY motif tyrosines formed defective aggregates and poorly retracted clots, establishing integrin tyrosine phosphorylation as a key mediator of beta 3-integrin signals.