Enzymatically produced acylglycerol and glycerin monostearate additives improved the characteristics of gelatin-stabilized omega-3 emulsions and microcapsules

The impacts of enzymatically produced acylglycerol and glycerin monostearate on the characteristics of gelatin-stabilized omega-3 emulsions and microcapsules were investigated. Tuna oil was enzymatically produced and the resulting acylglycerol was mixed with tuna oil at 12.5% (w/w) to prepare a novel oil phase. This oil phase was stabilized by gelatin to prepare oil-in-water emulsions and subsequent microcapsules via complex coacervation. The tuna oil with glycerin monostearate (GMS) at 1 and 2% (w/w) were used as controls. Results showed that both acylglycerol and GMS significantly reduced the emulsion droplet size and zeta potential, while increasing the viscoelasticity and stability. The diacylglycerol/monoacylglycerol were involved in the oil/water interfacial layer formation by lowering interfacial tension and increasing droplet surface hydrophobicity. Overall, the changed emulsion properties promoted the complex coacervation and contributed to the formation of microcapsules with improved oxidative stability. Therefore, enzymatically produced acylglycerol can develop high-quality stable omega-3 microencapsulated novel food ingredients.

Effect of MDA-mediated oxidation on the protein structure and digestive properties of golden pomfret

In this study, golden pomfret myofibrillar protein (MP) was used as the research object, and the oxidation system of malondialdehyde (MDA) as an inducer and the static digestion model in vitro was established for the analysis of the changes in protein structure and molecular morphology during oxidation and digestion. Subsequently, the effects of MDA-mediated oxidation on the structure and digestive properties of golden pomfret myofibrillar fibrillar protein were determined. The results showed that the hydrolysis degree and digestion rate of MP were inhibited with the increase in MDA concentration (0, 0.5, 1, 2, 5, 10 mmol/L), and the carbonyl group, surface hydrophobicity, irregular curling, and MDA content increased significantly (P < 0.05), whereas the total sulfhydryl groups, α-helices, free amino groups, hydrolysis degree, and MDA incorporation decreased significantly (P < 0.05), The molecular particle size was significantly reduced (P < 0.05), and the molecular morphology and molecular structure were analyzed (P >0.05). Finally, the molecular size and cross-linking degree gradually increased. In conclusion, MDA can alter the structure and morphology of proteins, resulting in a decrease in hydrolysis and digestion rate. This study can provide theoretical support and reference for the regulation of protein digestion.

Oxidized myoglobin: Revealing new perspectives and insights on factors affecting the water retention of myofibrillar proteins

The impact of oxidized myoglobin (Mb) on myofibrillar protein (MP) oxidation and water retention was investigated. Results showed that the oxidation of Mb increased with increasing concentration of oxidized linoleic acid (OLA). In the presence of 100 mmol/L OLA, hemin iron decreased by 62.07 % compared to the control group. Further investigation showed that mild oxidation of Mb (≤10 mmol/L OLA) increased the water retention and the absolute value of the zeta potential of MP, whereas excessive oxidation (>10 mmol/L OLA) decreased these properties. With the increase of Mb oxidation, the carbonyl content in MP increased, and α-helices changed to random helix. And the tertiary structure changed. Pearson correlation analysis suggested that oxidized Mb affected the water retention of MP, which was closely related to hemin iron and non-hemin iron. In conclusion, OLA induced Mb oxidation, further promoted MP oxidation and affected its water retention.

First Measurement of Discrimination between Helium and Electron Recoils in Liquid Xenon for Low-Mass Dark Matter Searches

We report the first measurement of discrimination between low-energy helium recoils and electron recoils in liquid xenon. This result is relevant to proposed low-mass dark matter searches which seek to dissolve light target nuclei in the active volume of liquid-xenon time projection chambers. Low-energy helium recoils were produced by degrading α particles from ^{210}Po with a gold foil situated on the cathode of a liquid xenon time-projection chamber. The resulting population of helium recoil events is well separated from electron recoils and is also offset from the expected position of xenon nuclear recoil events.

A sight of self-assembly mechanism in fish oil oleogels: Phase transition, crystal structure and non-covalent interaction

Fish oils contain ω-3 polyunsaturated fatty acids (PUFAs), but easily cause quality deterioration due to the oxidation. Beeswax-based oleogels could wrap fish oils by beeswax self-assembly. The phase transition, crystal structure and non-covalent interaction were investigated to reveal the self-assembly mechanism from the perspective of beeswax and oil phase characteristics. The results indicated that high unsaturation degree, PUFAs and beeswax additions promoted phase transition, SFC and stable crystal networks. The changes of crystal structures were ascribed to the polymorphism and polymorphic transition. β-Polymorphs could form crystal networks, and β'-polymorphs could influence the size of crystal chains or clusters as well as crystalline domains. Crystalline domain sizes affected crystal morphologies and network structures, including plate-like structures and multi-layer porous structures. UFAs could involve the beeswax self-assembly to change structure characteristics by van der Waals forces and π-π stacking. The OBC remained 100%, when beeswax additions reached more than 6%. Hence, beeswax additions, PUFA contents and unsaturation degree all influenced the self-assembly mechanism and adjusted the macroscopic properties of oleogels.

Risk profiles and incidence of cardiovascular events across different cancer types

BACKGROUND

Cancer survivors are at increased risk for cardiovascular (CV) disease, although additional data are needed to better understand the incidence of CV events across different malignancies. This study sought to characterize the incidence of major adverse CV events [myocardial infarction, stroke, unstable angina (MACE), or heart failure (HF)] across multiple cancer types after cancer diagnosis.

PATIENTS AND METHODS

Patients were identified from a USA-based administrative claims database who had index cancer diagnoses of breast, lung, prostate, melanoma, myeloma, kidney, colorectal, leukemia, or lymphoma between 2011 and 2019, with continuous enrollment for ≥12 months before diagnosis. Baseline CV risk factors and incidence rates of CV events post-index were identified for each cancer. Multivariable Cox hazards models assessed the cumulative incidence of MACE, accounting for baseline risk factors.

RESULTS

Among 839 934 patients across nine cancer types, CV risk factors were prevalent. The cumulative incidence of MACE was highest in lung cancer and myeloma, and lowest in breast cancer, prostate cancer, and melanoma. MACE cumulative incidence for lung cancer was 26% by 4 years (2.7-fold higher relative to breast cancer). The incidence of stroke was especially pronounced in lung cancer, while HF was highest in myeloma and lung cancer.

CONCLUSIONS

CV events were especially increased following certain cancer diagnoses, even after accounting for baseline risk factors. Understanding the variable patient characteristics and associated CV events across different cancers can help target appropriate CV risk factor modification and develop strategies to minimize adverse CV events and improve patient outcomes.

First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment

The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9  GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36  GeV/c^{2}, rejecting cross sections above 9.2×10^{-48}  cm at the 90% confidence level.

Study on the Structure and Bioactivity of Ganoderma lucidum Polysaccharides under Cassava Stalk Stress

Various carbon sources affect the growth of the G. lucidum fruiting body, and the cassava stalk is considered a promising carbon source for G. lucidum. The composition, functional group characteristics, molecular weight distribution, antioxidant activity in vitro, and growth effect of L. rhamnosus LGG of G. lucidum polysaccharides (GLPs) under cassava stalk stress were investigated by gas chromatography-mass spectrometry, near-infrared spectroscopy, and gel chromatography. The results showed that GLPs consisted of D-glucose, D-galactose, and seven other monosaccharides. The end of the sugar chain had β-D-Glc and β-D-Gal configurations. The total sugar content in GLP1 was the highest (4.07%), and GLP1, GLP2, GLP3, and GLP5 had the β-D-Gal configuration, while GLP4 and GLP6 had the β-D-Glc configuration. The greater the proportion of cassava stalk, the greater the maximum molecular weight of GLPs. The total antioxidant capacities of GLPs obtained from different cassava stalks significantly varied, as well as their stimulating effects on the L. rhamnosus LGG growth. Higher concentrations of GLPs corresponded to the more intensive growth of L. rhamnosus LGG. This study provided essential data support for cassava stalk as a carbon source in G. lucidum cultivation.

[Multiple primary malignancies combined with SWI/SNF complex-deficient gastric cancer: a case report and literature review]

Multiple primary malignancies combined with SWI/SNF complex-deficient gastric cancer is a rare clinical entity and poorly documented. Herein we report a case of this disease in an 81-year-old male patient treated in our hospital. Before the established diagnosis of metachronous multiple primary malignancies, the patient received left lower lobectomy for a spaceoccupying mass in the left lung, which was confirmed by postoperative pathology as early stage lung cancer. SWI/SNF complex-deficiency gastric cancer with metastasis was subsequently detected by gastroscopy, and high-throughput sequencing identified ARID1A and TMB-H gene mutations in the tumor tissues. The patient received chemotherapy combined with immunotherapy but failed to respond to the treatment, and died 13 months later. We conducted a literature review and analyzed the occurrence, pathological and immunohistochemical characteristics, diagnosis, treatment and prognosis of this disease.

Analysis of Physicochemical Properties, Lipid Composition, and Oxidative Stability of Cashew Nut Kernel Oil

Cashew nut kernel oil (CNKO) is an important oil source from tropical crops. The lipid species, composition, and relative content of CNKO were revealed using ultra high performance liquid chromatography time-of-flight tandem mass spectrometry (UPLC-TOF-MS/MS), and the physicochemical properties, functional group structure, and oxidation stability of CNKO at different pressing temperatures were characterized using a near infrared analyzer and other methods. The results showed that CNKO mainly consisted of oleic acid (60.87 ± 0.06%), linoleic acid (17.33 ± 0.28%), stearic acid (10.93 ± 0.31%), and palmitic acid (9.85 ± 0.04%), and a highly unsaturated fatty acid (78.46 ± 0.35%). In addition, 141 lipids, including 102 glycerides and 39 phospholipids, were identified in CNKO. The pressing temperature had a significant effect on the physicochemical properties of cashew kernels, such as acid value, iodine value, and peroxide value, but the change in value was small. The increase in pressing temperature did not lead to changes in the functional group structure of CNKO, but decreased the induction time of CNKO, resulting in a decrease in their oxidative stability. It provided basic data support to guide subsequent cashew kernel processing, quality evaluation, and functional studies.

Acute thrombocytopenia during cesarean section

We report a case of a healthy 29-year-old parturient with a normal pre-operative platelet count who received combined spinal-epidural anesthesia for cesarean section, and who suffered the sudden intra-operative onset of severe thrombocytopenia (platelet count 3 × 10⁹/L). This event was likely due to cefoxitin administered for the prophylaxis of surgical infection.

Fire Needling Therapy of Different Frequencies versus External Diclofenac Diethylamine Emulgel for Knee Osteoarthritis: Study Protocol for a Pilot Randomized Controlled Trial

Purpose

Knee osteoarthritis (KOA) is regarded as one of the leading musculoskeletal diseases. Although the efficacy is under exploration, fire needling therapy is considered an effective alternative for KOA. This trial aims to investigate the effectiveness of different frequencies of fire needling therapy in attenuating pain and promoting function in KOA patients.

Methods

This is a study protocol for a pilot, three-arm, single-center, randomized controlled trial. A total of 90 participants with KOA will be recruited and randomly assigned to the high-frequency fire needling group (3 sessions per week, for 6 weeks), the low-frequency fire needling group (1 session per week, for 6 weeks) or the positive control group (Diclofenac Diethylamine Emulgel, 3 times per day, for 6 weeks) in a 1:1:1 ratio. Participants will accomplish the trial at Week 14 after a follow-up evaluation. The response rate will be set as the primary outcome that the proportion of participants obtaining a minimal clinically important difference, which is identified as ≥2 units on the numerical rating scale (NRS) and ≥6 units on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score at Week 6 compared with Week 0. Secondary outcomes are NRS, WOMAC, Brief Pain Inventory, Short-Form Health Survey-12, Timed Up and Go Test, and pain threshold.

Discussion

This is the first standardized protocol comparing fire needling therapy and positive control drugs. This trial may provide reliable evidence for the effectiveness of fire needling therapy and dose-effect property of it in KOA. Trial registration: The trial has been registered on Chinese Clinical Trial Registry (Registered number: ChiCTR2100043041), registered on 4 February 2021.

[Susceptibility and mechanism of sodium salicylate-induced tinnitus model in low estrogen rats]

Objective: The susceptibility of tinnitus rats with low estrogen level induced by sodium salicylate and the changes of tumor necrosis factor α (TNF-α) in serum were observed to investigate the relationship between tinnitus occurrence and estrogen level. Methods: Forty-two healthy female Wistar rats were randomly divided into control group(n=6), normal group(n=6), sham operation group(n=6) and ovariectomized group(n=24). Control group was intraperitoneally injected with normal saline 200 mg/kg for 14 consecutive days. Normal group, sham operation group and ovariectomized group were intraperitoneally injected with sodium salicylate 200 mg/kg for 14 consecutive days. Before and after sodium salicylate induction, the tinnitus behavior of rats in each group was detected by prepulse inhibition (PPI) and gap pre-pulse inhibition of the acoustic startle (GPIAS) test. Before and after sodium salicylate induction, blood samples were collected from eyeballs of rats in each group, and serum levels of estradiol and TNF-α were detected by ELISA. SPSS 25.0 software was used to analyze the data. Results: (1) Following 14 days of sodium salicylate intervention, there was no significant difference in PPI inhibition rate between groups or within groups(all P>0.05). (2)There was no significant difference in the inhibition rate of GPIAS in the four groups before sodium salicylate injection(F=0.217, P>0.05). With sodium salicylate injected for 14 days, the inhibition rate of GPIAS in ovariectomized group (30.88%±15.40%) was significantly lower than that in the other three groups (44.11%±21.06%, 38.27%±10.92%, 51.59%±11.34%), and the difference was statistically significant(F=3.533, P<0.05). The inhibition rate of GPIAS in ovariectomized group with sodium salicylate injected for 14 days was significantly lower than that before injection, and the difference was statistically significant(t=2.977, P<0.05).There was no significant difference in GPIAS inhibition rate between the other three groups before and after sodium salicylate injection(P>0.05). (3)The level of TNF-α in ovariectomized rats was significantly higher than that in the other three groups, the difference was statistically significant(all P<0.05). With sodium salicylate injection for 14 days, TNF-α level in the ovariectomized group increased more significantly than that in the other three groups, the difference was statistically significant(F=8.045, P<0.05). TNF-α levels increased following salicylate injection in normal group, sham operation group and ovariectomized group, and the differences were statistically significant(t value was -4.843, -4.932 and -5.965 respectively, each P<0.05). There was no significant difference in TNF-α levels before and after normal saline injection in control group(all P>0.05). Conclusion: Low estrogen levels increase susceptibility to sodium salicylate-induced tinnitus. Decreased estrogen levels may increase susceptibility to tinnitus through the increased expression of pro-inflammatory factor TNF-α.

Gelation Process Optimization of Shrimp Surimi Induced by Dense Phase Carbon Dioxide and Quality Evaluation of Gel

Dense phase carbon dioxide (DPCD) is a new non-thermal method to induce surimi gel. However, the gel quality is affected by many factors, such as DPCD treatment time, temperature, and pressure, which makes it complicated to determine its operating parameters. Box-Behnken and backward linear regression were used to optimize the conditions (temperature, pressure, and treatment time) of DPCD-induced shrimp surimi gel formation, and a model between shrimp surimi gel strength and treatment conditions was developed and validated in the present study. Meanwhile, the heat-induced method was used as a control to analyze the effect of DPCD on the quality of shrimp surimi gel in the present study. The results showed that DPCD treatment affected the strength of shrimp surimi gel significantly, and the pressure of DPCD had the greatest influence on the gel strength of shrimp surimi, followed by time and temperature. When the processing pressure was 30 MPa, the temperature was 55 °C, and the treatment time was 60 min, the gel strength of the shrimp surimi was as high as 197.35 N·mm, which was not significantly different from the simulated value of 198.28 N mm (p > 0.05). The results of the gel quality properties showed that, compared with the heat-induced method, DPCD reduced the nutrient and quality loss of the shrimp surimi gel, and increased the gel strength and gel water-holding capacity. The results of low-field nuclear magnet resonance showed that DPCD increased the binding capacity of shrimp surimi to bound water and immobilized water, and reduced their losses. Gel microstructure further demonstrated that DPCD could improve shrimp surimi gelation properties, characterized by a finer and uniformly dense gel network structure. In summary, DPCD is a potential method for inducing shrimp surimi to form a suitable gel. The prediction model established in this study between DPCD treatment temperature, pressure, time, and gel strength can provide a reference for the production of shrimp surimi by DPCD.

Comparative Lipidomics Profiling of Acylglycerol from Tuna Oil Selectively Hydrolyzed by Thermomyces Lanuginosus Lipase and Candida Antarctica Lipase A

Lipase hydrolysis is an effective method to develop different functional types of lipids. In this study, tuna oil was partially hydrolyzed at 30% and 60% by Thermomyces lanuginosus lipase (TL 100 L) and Candida Antarctica lipase A (ADL), respectively, to obtain lipid-modified acylglycerols. The lipidomic profiling of the acylglycerols was investigated by UPLC-Q-TOF-MS and GC-MS to clarify the lipid modification effect of these two lipases on tuna oil. The results showed that 247 kinds of acylglycerols and 23 kinds of fatty acids were identified in the five samples. In the ADL group, the content of triacylglycerols (TAG) and diacylglycerols (DAG) increased by 4.93% and 114.38%, respectively, with an increase in the hydrolysis degree (HD), while there was a decreasing trend in the TL 100 L group. TL 100 L had a better enrichment effect on DHA, while ADL was more inclined to enrich EPA and hydrolyze saturated fatty acids. Cluster analysis showed that the lipids obtained by the hydrolysis of TL 100 L and ADL were significantly different in the cluster analysis of TAG, DAG, and monoacylglycerols (MAG). TL 100 L has strong TAG selectivity and a strong ability to hydrolyze acylglycerols, while ADL has the potential to synthesize functional lipids containing omega-3 PUFAs, especially DAG.

Research Progress on Nutritional Value, Preservation and Processing of Fish-A Review

The global population has rapidly expanded in the last few decades and is continuing to increase at a rapid pace. To meet this growing food demand fish is considered a balanced food source due to their high nutritious value and low cost. Fish are rich in well-balanced nutrients, a good source of polyunsaturated fatty acids and impose various health benefits. Furthermore, the most commonly used preservation technologies including cooling, freezing, super-chilling and chemical preservatives are discussed, which could prolong the shelf life. Non-thermal technologies such as pulsed electric field (PEF), fluorescence spectroscopy, hyperspectral imaging technique (HSI) and high-pressure processing (HPP) are used over thermal techniques in marine food industries for processing of most economical fish products in such a way as to meet consumer demands with minimal quality damage. Many by-products are produced as a result of processing techniques, which have caused serious environmental pollution. Therefore, highly advanced technologies to utilize these by-products for high-value-added product preparation for various applications are required. This review provides updated information on the nutritional value of fish, focusing on their preservation technologies to inhibit spoilage, improve shelf life, retard microbial and oxidative degradation while extending the new applications of non-thermal technologies, as well as reconsidering the values of by-products to obtain bioactive compounds that can be used as functional ingredients in pharmaceutical, cosmetics and food processing industries.

Physicochemical parameters and nutritional profile of back and abdomen muscle of fresh golden pompano (Trachinotus ovatus) and hybrid grouper (Epinephelus lanceolatus × Epinephelus fuscoguttatus)

Golden pompano (Trachinotus ovatus) and hybrid grouper (Epinephelus lanceolatus × Epinephelus fuscoguttatus) has widely been distributed in China and Southeast Asian countries with great commercial importance. In this study, the nutritional profiles, chemical and physical parameters of back and abdomen muscles were determined. Significantly different (p < .05) proximate compositions were found in two fish muscles. The contents of water-soluble protein, salt-soluble protein, and non-nitrogenous protein were higher in the golden pompano while salt-insoluble proteins were higher in the hybrid grouper. The main minerals found were K (3700.56-4495.57 μg/g) followed by P > Na > Mg > and Ca, respectively. Fatty acids contents consisted of polyunsaturated fatty acids ranging from 29.40% to 43.09% and saturated fatty acids 28.33% to 39.61%. The muscles were rich in n-3 PUFAs with n-6/n-3 ratio of 1.36%-2.96% in the back and abdomen. On the other hand, total amino acid and non-essential amino acid contents were found higher in the hybrid grouper while essential amino acid and delicious amino acid contents were higher in the golden pompano. Glutamic acid was the most predominant amino acid. The amino acid scores (AAS) of six amino acids were close to 1.00, whereas lysine showed the highest AAS while tryptophan was the most limited essential amino acid in all muscles, respectively. These results indicated golden pompano and hybrid grouper exhibited a varied nutritional composition and offered a good nutritional profile.

AB0883 Real-World Treatment Patterns In Patients With Psoriatic Arthritis

Background

Psoriatic arthritis (PsA) is a complex inflammatory disease with manifestations that play an important role in treatment selection.1 Treatments include oral agents, biologic therapies (inhibitors of tumor necrosis factor [TNFi], interleukin [IL-17Ai, IL-12/23i], cytotoxic T lymphocyte–associated antigen 4 inhibitor [CTLA-4i]), and new targeted oral agents (inhibitors of phosphodiesterase-4 [PDE-4i] and Janus kinase [JAKi]).1 Few studies have examined real-world treatment patterns of recently approved therapies.

Objectives

Evaluate real-world treatment patterns for branded systemic therapy in patients with PsA.

Methods

In this retrospective study, medical and pharmacy claims from the US IBM MarketScan Commercial and Medicare databases (1/1/2012–12/31/2019) were used to identify patients with PsA who initiated treatment with a TNFi (adalimumab, etanercept, infliximab, golimumab, or certolizumab), IL-17Ai (secukinumab, ixekizumab), IL-12/23p40i (ustekinumab), IL-23p19i (guselkumab), CTLA-4i (abatacept), JAKi (tofacitinib), or PDE-4i (apremilast). Patients (≥18 years) with ≥1 prescription, ≥2 PsA claims separated by ≥1 day on or before the index date (first prescription date [1/1/13–12/31/2018]), and 1-year continuous enrollment before and after the index date were eligible. Treatment patterns were grouped into continuers, discontinuers, and patients with treatment modification (switchers [without a treatment gap], reinitiators [same drug with a treatment gap], and restarters [different drug with a treatment gap]) (Table 1). Patients were followed for 1 year or until treatment modification, whichever came first. Descriptive statistics were used.

Table 1.

Terminology

CohortDefinitionn/N (%)ContinuersOn index treatment during 1-year follow-up with no treatment gaps*1910/6455 (29.6)DiscontinuersNo prescription claims for any therapy during 1-year follow-up1614/6455 (25.0)Patients with treatment modificationsAll patients with a change in treatment during 1-year follow-up2908/6455 (45.1)SwitchersPrescription claims for treatments different than index therapy before permissible treatment gaps*794/6455 (12.3)ReinitiatorsPrescription claims for treatments SAME as index therapy AFTER treatment gaps*1686/6455 (26.1)RestartersPrescription claims for DIFFERENT therapy AFTER treatment gap*428/6455 (6.6)

Note: All terminology applies to cohorts within the first year of treatment.

*Treatment gap: gap of 200% of recommended dosing schedule from end of previous prescription’s days’ supply.

Results

A total of 6455 patients were included (mean age, 50.5 years; 55.5% female; mean Charlson Comorbidity Index score, 0.54). At baseline, the most commonly used therapies were immunosuppressants (58.5%), corticosteroids (52.2%), and nonsteroidal anti-inflammatory drugs (45.9%). Treatments most used at index were TNFi (72.5%; including adalimumab [41.6%] and etanercept [23.8%]) and the PDE-4i apremilast (21.1%). During the 1-year study period, 29.6% of patients maintained their index therapy and 25.0% discontinued. Treatment modification was observed in 45.1% of patients; 12.3% switched to a new therapy without a treatment gap, 26.1% restarted their index therapy, and 6.6% started a new therapy after a treatment gap.

Conclusion

Among patients with PsA, there is substantial variability, including high rates of discontinuation within the first year and after index therapy. Further studies are warranted to understand reasons for these treatment patterns.

References

[1]Ogdie A et al. Treatment guidelines in psoriatic arthritis. Rheumatology (Oxford). 2020;59(Suppl 1):i37-i46.

Acknowledgements

This study was sponsored by Bristol Myers Squibb. Statistical analysis support was provided by Arindom Borkakoti, formerly of Mu Sigma. Professional medical writing assistance was provided by LeeAnn Braun, MPH, MEd, of Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, USA, and funded by Bristol Myers Squibb.

Disclosure of Interests

Jiyoon Choi Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Antoine Sreih Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Thomas Lehman Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Manasi Suryavanshi Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Qian Xia Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Miroslawa Nowak Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb

Quality and volatile compound analysis of shrimp heads during different temperature storage

This study aimed to investigate volatile compounds and quality traits of shrimp heads stored at 20 °C, 4 °C, -3 °C, and -18 °C. With increased storage time, sensory scores gradually decreased, while pH and TVB-N content showed a gradually increase trend. L* showed a decreasing and then increasing tendency. The radar chart and principal component analysis showed variation changes. Three compounds including 2-decanone, dimethyl disulphide and dimethyl tetrasulphide, four compounds including 2-pentanone, 3-methyl-1-butanol, 2-methylbutyric acid, and 2,3,5-trimethylpyrazine, and 3-methylbutyraldehyde were the characteristic volatiles for the samples stored at 20 °C, 4 °C, and -3 °C, respectively. Twenty-five volatile compounds were key volatile compounds, among which nine were potential classification compounds with high variable importance in projection values. Trimethylamine and 2-nonanol were selected as potential markers of spoilage. The study provides the theoretical basis for quality and volatile compound investigations for shrimp heads with further high-quality utilization.

Insight into muscle quality of golden pompano (Trachinotus ovatus) frozen with liquid nitrogen at different temperatures

The effects of different liquid nitrogen freezing (LNF) temperatures (-35, -55, -75, -95, and -115 °C) on the freezing rate, physicochemical properties, and microstructure of golden pompano (Trachinotus ovatus) were evaluated in the present study. The results showed that the total freezing time of golden pompano was significantly shortened using LNF (P < 0.05). Compared with other freezing methods, the cooking loss and L* values (lightness) of -95 °C LNF golden pompano were significantly lower, the false-colour image was much redder and brighter, the loss and mobility of water in fish muscle were inhibited, the water holding capacity and hardness were higher, and the muscle microstructure was comparatively intact. Therefore, -95 °C LNF effectively shortened the freezing time and improved the muscle qualities of frozen golden pompano.

LF-NMR as a tool for predicting the 3D printability of surimi-starch systems

In this study, surimi from golden pompanos was mixed with starch to form a surimi-starch system. The water properties, rheological properties, and three-dimensional (3D) printability of the surimi-starch were measured. Cluster analysis results showed that the 3D printability was closely related to the type and addition content of starch, and the water and rheological properties. The low-field nuclear magnetic resonance (LF-NMR) parameters were used to predict 3D printability using polynomial regression models. The correlation coefficients (R²) for 3D printing accuracy and stability were 0.88 and 0.93, and the root mean square error (RMSE) values were 0.20% and 4.59%, respectively. In the verification test, the R² for the two models were 0.85 and 0.89, and the RMSE values were 0.20% and 1.06%, respectively. The nonlinear surface regression fitting exhibited superior predictive performance. Therefore, LF-NMR is a good non-destructive tool for quickly and accurately predicting the 3D printability of the surimi-starch systems.

Visible Light and Glutathione Dually Responsive Delivery of a Polymer-Conjugated Temozolomide Intermediate for Glioblastoma Chemotherapy

Temozolomide (TMZ) is a prodrug of 5-(3-methyltriazene-1-yl)imidazole-4-carboxamide (MTIC, short-lived) and used as a first-line therapy drug for glioblastoma multiforme (GBM). However, little progress has been made in regulating the kinetics of TMZ to MTIC degradation to improve the therapeutic effect, particularly in the case of TMZ-resistant GBM. In this work, we introduced a strategy to cage MTIC by N-acylation of the triazene moiety to boost the MTIC stability, designed a diblock copolymer-based MTIC prodrug installed with a disulfide linkage, and achieved self-assembled polymer micelles without the concern of MTIC leakage under physiological conditions. Polymer micelles could be induced to disassemble by stimuli factors such as glutathione (GSH) and visible light irradiation through thiol/sulfide exchange and homolytic sulfide scission mechanisms, which contributed to MTIC release in GSH-dependent and GSH-independent pathways. The in vitro results demonstrated that microenvironment-responsive polymeric micelles benefited the suppression of both TMZ-sensitive and TMZ-resistant GBM cells. The chemistry of polymer-MTIC prodrug provided a new option for TMZ-based glioma treatment.

Comparison of the Proximate Composition and Nutritional Profile of Byproducts and Edible Parts of Five Species of Shrimp

The nutritional components of different parts (meat, head, shell and tail) of Litopenaeus vannamei (L.v), Macrobrachium rosenbergii (M.r), Penaeus monodon (P.m), Fenneropenaeus chinensis (F.c), and Penaeus japonicus (P.j) were analyzed and their nutritional values were evaluated. For the five species of shrimp, the meat yield was 37.47–55.94%, and the byproduct yield was 44.06–62.53%. The meat yields of L.v and F.c were the highest (55.94 and 55.92%, respectively), and the meat yield of M.r was the lowest (37.47%). The shrimp contain high amounts of crude protein, and the values of the amino acid score (AAS), chemical score (CS), and essential amino index (EAAI) were greater than or close to 1.00, indicating that shrimp protein had higher nutritional value. The shrimp head was rich in polyunsaturated fatty acids and the ratio of n-6 to n-3 PUFAs was from 0.37 to 1.68, indicating that the shrimp head is rich in n-3 PUFAs and is a good source of n-3 PUFAs. The five species of shrimp were rich in macro- and micro-minerals, especially in shrimp byproducts. The shrimp byproducts were also rich in other bioactive ingredients (astaxanthin), which are also very valuable for developing biological resources. Therefore, shrimp have many nutritional benefits, and their byproducts can also be used to develop natural nutraceuticals, which are considered to be one of the healthiest foods.

Insight into the correlations among rheological behaviour, protein molecular structure and 3D printability during the processing of surimi from golden pompano (Trachinotus ovatus)

To investigate the 3D printability of surimi from golden pompano, the rheological properties, protein molecular structure, and 3D printability of food inks from every step of surimi processing were measured, and their correlations were analysed. The results showed that surimi from chopping (surimi-C), chopping with salt (surimi-CS) and setting (surimi-S) were suitable for 3D printing, among which surimi-CS had the best shape fidelity. The clustering analysis of variables revealed that the yield stress and A_F could be used as indexes to characterize extrusion and deposition behaviour of surimi, respectively. The accuracy of 3D printing was affected by the extrusion property of the food ink, which was controlled by the ionic bond content. The stability of 3D printing was affected by the self-supporting capacity of the food ink, which was controlled by the hydrogen bond and hydrophobic interaction contents. The results provided theoretical guidance for developing 3D printing of surimi ingredients.

[Application of DNA origami in nanobiomedicine]

The development of DNA nanotechnology make it possible to artificially generate complex nucleic acid nanostructures with controllable sizes and shapes. DNA origami emerges as an effective and versatile approach to construct two- and three-dimensional programmable nanostructures, and represents a milestone in the development of structural DNA nanotechnology. Due to its high degree of controllable geometry, spatial addressability, easy chemical modification and good biocompatibility, DNA origami has great potentials for applications in many fields. In this review, we briefly summarize the applications of DNA origami in antigen-antibody interaction, targeted drug delivery and the synthesis of biomaterials.

The relationship between rheological and textural properties of shrimp surimi adding starch and 3D printability based on principal component analysis

The three-dimensional (3D) printing properties of pure shrimp surimi are poor and require improvement via the addition of other materials. The effects of the different amounts of potato starch, corn starch, tapioca starch, and cross-linked starch (CLS) (0%, 3%, 6%, or 9%, respectively) on the 3D printing properties and material properties of white shrimp (Litopenaeus vannamei) surimi were evaluated in the present study. The results showed that the apparent viscosity, G', and G'' of the samples were increased by adding 6% CLS, making it easy to extrude the sample from the nozzle and resulting in an improvement in the printing accuracy. In addition, after adding 6% CLS, the hardness, adhesiveness, and springiness of the sample were increased, which assist with maintaining the shape of the printed material and improve the printing stability of the sample. Moreover, the water holding capacity of shrimp surimi increased as a result of the addition of 6% CLS. In summary, 6% CLS can improve the material properties of shrimp surimi and make it more suitable for 3D printing.

Investigation on the correlation between changes in water and texture properties during the processing of surimi from golden pompano (Trachinotus ovatus)

Water and texture properties are important indicators for evaluating surimi and surimi seafood quality. The present study assessed the impact of surimi processing on the water and texture properties and analyzed their correlations. The results showed that the moisture content exhibited significant positive correlations with T₂₂ and A₂₂ (P < 0.05). However, water-holding capacity (WHC) revealed significant negative correlation with T₂₁ and A₂₂ (P < 0.05). Moreover, correlations between water and texture properties were observed. Moisture content and A₂₂ displayed significant negative correlation with hardness (P < 0.05). WHC exhibited significant positive correlations with cohesiveness, springiness, and chewiness (P < 0.05), whereas T₂₁ exhibited significant negative correlation with those properties (P < 0.05). Springiness is an important indicator for texture properties of surimi gel. T₂₁ and WHC exhibited significant correlations with springiness (P < 0.05). We used two equations to assess the relationship between springiness and T₂₁ (y = 9.64 × x² - 33.79 × x + 29.62, R² = 0.995, P < 0.05) and between springiness and WHC (y = 0.57 + 9.05/{1+e^{[-29.29 × ( x - 83.90)]} }^0.01 , R² = 0.999, P < 0.05), respectively. Verification experiments proved that these two regression equations could be used to predict the change law among feature indicators during the processing of surimi seafood. The present study finds an easy-to-control method to monitor the quality of surimi production and processing for all the stages, and provides ideas for quality design of surimi products. PRACTICAL APPLICATION: The quality of surimi seafood is affected by the process used for surimi production. Early detection of the material quality can efficiently prevent resource wastage. The feature indicators and their correlations help in easy-to-control of all surimi processing stages. Low-field nuclear magnetic resonance (LF-NMR) is a fast, nondestructive method for monitoring food real-time, but the instrument is expensive; whereas water-holding capacity and texture profile analysis (TPA) are traditional methods but time-consuming and material-consuming. Surimi enterprises or researchers choose the right methods based on their needs.

Investigation of enhanced oxidation stability of microencapsulated enzymatically produced tuna oil concentrates using complex coacervation

Tuna oil was selectively hydrolysed using Thermomyces lanuginosus lipase for 6 h to prepare omega-3 acylglycerol concentrate with the DHA content significantly increased from 24.9% in tuna oil to 36.3% in the acylglycerol concentrate. The acylglycerol concentrate was subsequently encapsulated into the "multi-core" microcapsules using gelatin-sodium hexametaphosphate complex coacervates as the shell material. Rancimat, Oxipres and thermogravimetric analyses all showed that the microencapsulated acylglycerol concentrate had unexpectedly improved oxidation stability, compared to those produced using tuna oil, even though the concentrated oils themselves were significantly less stable than tuna oil. The incorporation of enzymatic tuna oil acylglycerol concentrate also significantly improved the oxidation stability of microencapsulated standard refined unconcentrated tuna oil. A wide range of characteristics including lipid and fatty acid composition, oil-in-water (O/W) emulsion properties, morphology, nanomechanical strength and physicochemical stability of acylglycerol, acylglycerol oil-in-water (O/W) emulsion and final microcapsules were investigated throughout the preparation. The result suggests that high levels of monoacylglycerol (about 35%) and diacylglycerol (about 8.5%) were produced in the acylglycerol. The acylglycerol O/W emulsion exhibited significantly smaller droplet size, lower zeta-potential and higher surface hydrophobicity, which contributed to the formation of the microcapsule with a significantly smoother surface and more compact structure, finally leading to improved oxidative stability compared to those prepared from native tuna oil.

Temozolomide-Doxorubicin Conjugate as a Double Intercalating Agent and Delivery by Apoferritin for Glioblastoma Chemotherapy

We designed a conjugated compound by coupling temozolomide (TMZ) with doxorubicin (DOX) via an acylhydrazone linkage as a potential prodrug used for glioblastoma multiforme (GBM) treatment. Viscosity and spectroscopic studies revealed that the drug conjugate could act as a nonclassical double intercalating agent. Although free TMZ is an inefficient DNA binder in comparison to DOX, the TMZ moiety interacted with DNA as an induced intercalator, arising from the synergistic effect of DOX moiety that mediated conformational changes of the DNA helix. Two binding modes were proposed to interpret the double intercalating effect of the drug conjugate on intra- and inter-DNA interactions that could cause DNA cross-linking and fibril aggregates. We also developed a delivery nanoplatform with a loading efficiency of 83% using copper-bound apoferritin as a nanocarrier. In sharp contrast to the short half-life of free TMZ, the nanocomposite was stable under physiological conditions without detectable drug decomposition after a 2 week storage, and drug release was activatable in the presence of glutathione at millimolar levels. The antitumor effect of the drug conjugate and nanocomposite against GBM cells was reported to demonstrate the potential therapeutic applications of double intercalating materials.

Measurement of the Spectral Shape of the β-Decay of ^{137}Xe to the Ground State of ^{137}Cs in EXO-200 and Comparison with Theory

We report on a comparison between the theoretically predicted and experimentally measured spectra of the first-forbidden nonunique β-decay transition ^{137}Xe(7/2^{-})→^{137}Cs(7/2^{+}). The experimental data were acquired by the EXO-200 experiment during a deployment of an AmBe neutron source. The ultralow background environment of EXO-200, together with dedicated source deployment and analysis procedures, allowed for collection of a pure sample of the decays, with an estimated signal to background ratio of more than 99 to 1 in the energy range from 1075 to 4175 keV. In addition to providing a rare and accurate measurement of the first-forbidden nonunique β-decay shape, this work constitutes a novel test of the calculated electron spectral shapes in the context of the reactor antineutrino anomaly and spectral bump.

SAT0219 PATIENT CHARACTERISTICS, TREATMENT PATTERNS, AND RESOURCE UTILIZATION OF SJOGREN’S SYNDROME PATIENTS IN A LARGE US HEALTH NETWORK

Background:

Sjogren’s syndrome (SS) is a chronic progressive autoimmune disorder which occurs as primary (pSS) or secondary SS (sSS). With no approved disease modifying therapy, there is limited information on the treatment patterns and resource utilization among these patients (pts).

Objectives:

To describe pts characteristics, treatment patterns and healthcare resource utilization (HCRU) using electronic health records (EHR) of pts with pSS and sSS treated at the Providence St. Josephs Health system (PSJH).

Methods:

Pts ≥18 years of age with at least one clinical encounter with ICD-9-CM or ICD-10-CM diagnosis of SS, between Jan 2013 and Mar 2019 were included. Date of first encounter with SS diagnosis (index date) was used to assess pts demographics. Pt baseline comorbidities were evaluated during the 24 months pre-index period. Treatment patterns and HCRU were assessed during the 12 months post-index follow-up. Descriptive statistics were used to describe pts’ demographic and clinical characteristics, and medications use in the baseline and follow up.

Results:

Study cohort included 9,108 SS pts of which 76.5% had sSS diagnosis on index date. Majority of SS pts were women, Caucasian, with mean age of 58.3 yrs, and from western states in the US (Table 1). Endocrine conditions including hypo- and hyperthyroidism, and diabetes was the most common (45.5%) comorbidity at baseline, followed by rheumatologic disorders (25.6%) and neurological conditions (22.2%). Among patients with treatment information (4088, 44.88%), 42.95% were using symptomatic treatments for dry eye and mouth at baseline (Table 1). In the follow-up, SS pts had average 5.8 healthcare visits per patient per year (PPPY), including 0.6 inpatient and 3.4 outpatient visit respectively. About 40% of the SS pts (53.8% pSS and 35.8% sSS) were diagnosed by rheumatologists. Majority of the SS pts initiated treatment with cDMARDs (82%) and remained on the same treatment during 1 year follow-up (Fig 2).

Table 1.

Baseline Demographic and Clinical Pts Characteristics

SS Pts (n=9,108)DemographicsAge (years) on index date, mean (SD)58.3 (15.1)Female, n (%)8,338 (91.6)Caucasian, n (%)6.936 (76.2)Western Region, n (%)8,998 (98.8)Married, n (%)5,164 (56.7)Never Smoked, n (%)4,847 (53.2)Primary diagnosis, n (%)2,137 (23.5)Comorbidities, n (%)Cardiovascular1,408 (17.2)Endocrine3,733 (45.5)Oncology800 (9.8)Blood disorders1,221 (14.9)Pulmonary1,802 (22.0)Neurological1,821 (22.2)Liver/Kidney1,782 (21.7)Rheumatologic disorders2,096 (25.6)Autoimmune/ Immune related1,527 (18.6)Baseline Medications, n (%)Symptomatic11,756 (43.0)NSAIDs21,578 (38.6)cDMARDs31,435 (35.1)Corticosteroid41,393 (34.1)bDMARDs5266 (6.5)

1cevimeline, pilocarpine hydrochloride, ophthalmic insert etc;2aspirin, ibuprofen, naproxen;3methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, myophenolate mofetil, azathioprine;4prednisone;5sarilumab, belimumab, ustekinumab, infliximab, adalimumab, certolizumab pegol, golimumab, etanercept, abatacept, tocilizumab, rituximab, tofacitinib, baricitinib

Figure 1.

HCRU for pSS and sSS Pts

Figure 2.

Treatment Sequencing for pSS and sSS Pts. Note: Discontinued: pts who discontinued and didn’t advance to any therapy; same treatment: pts continued on index treatment till we have information.

Conclusion:

Observation of higher comorbidities suggests substantial burden of SS pts on healthcare system, with majority of pts being diagnosed outside of rheumatology offices.

Acknowledgments: :

We acknowledge the contributions of Manasi Suryavanshi towards drafting and reviewing the abstract.

Disclosure of Interests:

Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Joe Zhuo Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Roshanthi Weerasinghe Grant/research support from:., Qian Xia Shareholder of: I own shares of Bristol-Myers Squibb Company, Employee of: I am a paid employee of Bristol-Myers Squibb Company, Chidananda Samal Consultant of: I work as a consultant for Bristol-Myers Squibb Company, Niyati Sharma Consultant of: I work as a consultant for Bristol-Myers Squibb Company

SAT0129 ROLE OF SHARED EPITOPE ON THE EFFECTIVENESS OF TNFI TREATMENT FOR PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Rheumatoid arthritis (RA) has been shown a strong genetic association with particularHLA–DRB1alleles containing shared epitope (SE). However, whether SE is clinically useful in treatment choices is insufficiently investigated1and previous studies have presented mixed findings in the role of SE in the response of TNFi therapies2,3.

Objectives:

To assess the role of SE in response to TNFi treatment in real-world RA patients (pts).

Methods:

Pts enrolled in a large RA registry, Brigham and Women’s Hospital RA Sequential Study, with known SE and received TNFi therapies were included for the analysis. TNFi pts were identified by the first-time use of the drugs between March 2003 to June 2018. For this analysis, all pts were followed up to 1 year. Summary statistics are reported for demographics, serostatus and disease activity (DA) at baseline and follow-up, stratified by SE status. Given the strong association of SE and anti-citrullinated protein antibody (ACPA), the analysis was further stratified by ACPA status. The effect of SE on change in DA was assessed using linear regression model with age, gender, RA disease duration, baseline DA, smoking status, SE, ACPA and ACPA-SE interaction as covariates.

Results:

Of the 484 TNFi pts included in the study, 68.8% were SE+. SE+ pts (vs SE-) were more likely to be rheumatoid factor positive, have erosive disease and a higher disease duration, irrespective of ACPA status. No difference in the change of DA was observed by SE. In SE- pts, ACPA+ pts had a greater reduction of DA than ACPA- pts (Table 1). After accounting for baseline differences, there was no significant effect of SE status on the mean change from baseline in any of the 3 DA measures.(Figure 1) The change in DA was not associated with ACPA but was significantly affected by disease duration and baseline DA.

Table 1.

Disease Activity in TNFi Patients, Stratified by SE and ACPA Status

ParameterSE+ (1 & 2 alleles, n=333)SE- (n=151)ACPA+ACPA–OverallACPA+ACPA-Overall(n=264)(n=69)(n=333)(n=90)(n=61)(n=151)Baseline, Mean (SD)DAS28 CRP3.94 (1.69)3.57 (1.61)3.86 (1.67)3.85 (1.49)3.45 (1.65)3.69 (1.57)CDAI23.06 (18.13)18.95 (15.96)22.25 (17.78)21.91 (15.96)17.72 (17.06)20.26 (16.48)SDAI24.08 (18.82)19.96 (16.59)23.27 (18.45)22.58 (16.34)18.55 (17.87)20.99 (17.01)Follow-up, Mean (SD)DAS28 CRP3.42 (1.55)2.69 (1.32)3.27 (1.53)3.19 (1.43)3.11 (1.53)3.16 (1.47)CDAI17.61 (15.53)12.11 (12.65)16.51 (15.14)15.15 (13.35)14.94 (14.73)15.07 (13.84)SDAI18.35 (15.73)12.45 (12.78)17.15 (15.34)15.31 (13.81)15.71 (15.45)15.46 (14.38)Change, Mean (SD)DAS28 CRP-0.48 (1.31)-0.65 (1.53)-0.52 (1.36)-0.52 (1.50)-0.24 (0.93)-0.42 (1.34)CDAI-4.29 (13.16)-4.79 (13.13)-4.39 (13.12)-6.45 (13.56)-2.63 (9.58)-4.99 (12.28)SDAI-4.74 (14.13)-5.07 (13.90)-4.80 (14.05)-6.87 (14.21)-2.97 (10.32)-5.41 (12.98)Figure 1.

Linear Regression Model for Change in Disease Activity*Estimates, p-values are shown as data labels on the graphs; The above model is adjusted for age, gender, RA duration, smoking status, SE status, baseline DA, ACPA and ACPA*SE status

Conclusion:

This real-world study validates the finding from previous studies conducted in clinical settings that SE does not differentiate treatment response for TNFi therapies.

References:

[1]Saruhan-Direskeneli G, et al.Rheumatology (Oxford) 2007;46(12):1842-44

[2]Skapenko A, et al.Clin Exp Rheumatol2019;37(5):783-790

[3]Rigby W, et al.Annals of the Rheumatic Diseases2019;78(2):263-264

Disclosure of Interests:

Joe Zhuo Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Joshua Bryson Shareholder of: I own shares of Bristol-Myers Squibb Company, Employee of: I am a paid employee of Bristol-Myers Squibb Company, Qian Xia Shareholder of: I own shares of Bristol-Myers Squibb Company, Employee of: I am a paid employee of Bristol-Myers Squibb Company, Niyati Sharma Consultant of: I work as a consultant for Bristol-Myers Squibb Company, Chidananda Samal Consultant of: I work as a consultant for Bristol-Myers Squibb Company, Sonie Lama Shareholder of: I own shares of Bristol-Myers Squibb Company., Employee of: I am a paid employee of Bristol-Myers Squibb Company., Michael E. Weinblatt Grant/research support from: BMS, Amgen, Lilly, Crescendo and Sonofi-Regeneron, Consultant of: Horizon Therapeutics, Bristol-Myers Squibb, Amgen, Abbvie, Crescendo, Lilly, Pfizer, Roche, Gilead, Nancy Shadick Grant/research support from: Mallinckrodt, BMS, Lilly, Amgen, Crescendo Biosciences, and Sanofi-Regeneron, Consultant of: BMS

AB1344-HPR POOLED ANALYSIS OF ASSOCIATION BETWEEN ABATACEPT OR OTHER TARGET DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS (TDMARD) AND TYPE 2 DIABETES MELLITUS (T2DM)-RELATED HEALTHCARE RESOURCE UTILIZATION (HCRU) AND COSTS IN TNFI-NAÏVE RHEUMATOID ARTHRITIS (RA) PATIENTS WITH T2DM

Background:

Limited information is available on the impact of target disease-modifying anti-rheumatic drugs (tDMARD) on patients with rheumatoid arthritis (RA) and type 2 diabetes mellitus (T2DM).

Objectives:

The objective was to compare T2DM-related healthcare resource utilization (HCRU) and cost for TNF inhibitors (TNFi)-naive patients pooled from two commercial databases with RA and T2DM receiving abatacept, other non-TNFi, or TNFi.

Methods:

A retrospective, observational study was conducted with MarketScan and PharMetrics (January 2008-September 2018). The study population included TNFi-naïve adult patients with RA and T2DM newly initiating abatacept, TNFi (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab) or other non-TNFi (tocilizumab, anakinra, sarilumab, rituximab, tofacitinib). Date of tDMARD initiation was the index date. Patients had ≥2 RA diagnoses separated by ≥7 days, ≥1 T2DM diagnosis, and had ≥12 months of pre-index continuous enrollment. Follow-up ended at the end of patient insurance enrollment, study period or index treatment. T2DM-related HCRU and costs including inpatient stay, outpatient visits, ER visits, and pharmacy use were measured on a per-patient-per-month (PPPM) basis (2018 USD). Patients treated with abatacept were matched to TNFi and non-TNFi cohorts separately by propensity score adjusted with patients baseline comorbidities, HCRU, and costs.

Results:

A total of 16,236 patients meeting criteria were identified. Most patients were female (74.3%), and the overall average age of 55.4 years (Table 1). After matching, 850 pairs of abatacept vs non-TNFi patients, and 1,096 pairs of abatacept vs TNFi patients were included in the adjusted results. Patients initiating abatacept had $144 lower adjusted T2DM-related costs as compared to non-TNFi and $79 lower costs than TNFi cohorts (Table 2).

Table 1.

Patient Characteristics

Abataceptn=1,134Non-TNFin=1,353TNFin=13,749TotalN=16,236Age, mean years (SD)58.5 (11.3)57.7 (11.2)54.9 (10.6)55.41 (10.7)Gender, female, n (%)936 (82.5)993 (73.4)10,142 (73.8)12,071 (74.3)CCI, mean (SD)2.2 (1.4)2.3 (1.4)1.8 (1.1)1.89 (1.14)DCSI, n (%) Cardiovascular361 (31.8)406 (30.0)2,500 (18.2)3,267 (20.1) Neuropathy294 (25.9)374 (27.6)3,161 (23.0)3,829 (23.6) Nephropathy146 (12.9)193 (14.3)1,151 (8.4)1,490 (9.2) PVD131 (11.6)155 (11.5)874 (6.4)1,160 (7.1) Retinopathy103 (9.1)119 (8.8)922 (6.7)1,144 (7.0) Cerebrovascular74 (6.5)102 (7.5)620 (4.5)796 (4.9) Metabolic9 (0.8)20 (1.5)141 (1.0)170 (1.0)

CCI: Charlson comorbidity index; DCSI: diabetes complications severity index; PVD: peripheral vascular disease.

Table 2.

Adjusted T2DM-related HCRU and Costs after Propensity Score Matching

Abataceptn=850Non-TNFin=850Diff (ABA- Non-TNF)Abataceptn=1,096TNFin=1,096Diff (ABA- TNF)T2DM-related HCRU (per 1000 Patients per Month)Number of Hospitalizations13.920.4-6.5*12.614.9-2.3*Number ofER Visits22.016.15.9*18.416.32.0*Number ofOutpatient Visits311334.8-23.7*299.3286.912.4T2DM-related Costs (PPPM $)Inpatient Costs507535-28413475-62ER Costs271710*2225-3Outpatient Costs190323-13318617016*Pharmacy Costs1071007*97128-31Total Costs831975-144719798-79*

*P<0.05

Conclusion:

TNFi-naive RA patients with T2DM newly initiating abatacept had lower adjusted rates of T2DM-related hospitalizations compared to patients who initiated a non-TNFi or a TNFi. Total costs were lower among patients initiating abatacept vs. patients who initiated a non-TNFi or a TNFi. Findings suggest that initial abatacept among TNFi-naïve patients may be able to reduce healthcare utilization arising from T2DM complications and reduce T2DM-related costs in RA patients.

Disclosure of Interests:

Xue Han Employee of: BMS, Qian Xia Shareholder of: I own shares of Bristol-Myers Squibb Company, Employee of: I am a paid employee of Bristol-Myers Squibb Company, Ying Bao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Vardhaman PATEL Employee of: Bristol Myers Squibb, Amrina Roy Employee of: Mu-Sigma, Varshini Rajagopalan Employee of: Mu-Sigma, Francis Lobo Shareholder of: Bristol-Myers Squibb (US), Employee of: Bristol-Myers Squibb (US)

SAT0061 ROLE OF SHARED EPITOPE IN THE PROGNOSIS OF RHEUMATOID ARTHRITIS IN RELATION TO ACPA POSITIVITY

Background:

The mechanistic association ofHLA-DRB1alleles that code a “shared epitope” (SE) with rheumatoid arthritis (RA) is not yet clear. Previous data has suggested the carriage of SE is associated with the production of cyclic citrullinated peptide antibodies (anti-CCP)1and severe RA2-4. The interrelationship among SE, anti-citrullinated protein antibody (ACPA) positivity and disease outcomes is not fully understood.

Objectives:

To assess the RA prognosis associated with the carriage of SE, in relation to ACPA positivity.

Methods:

Pts enrolled in a large RA registry, Brigham and Women’s Hospital RA Sequential Study between March 2003 to June 2018, with known SE and ACPA status were included in the analysis. HLA-DRB1 SE status was determined by allele-specific polymerase chain reaction and DNA sequencing for most of the subjects and by GWAS-based imputation for the rest. Disease activity (DA) was measured at baseline (BL) and 1-year follow-up by DAS28(CRP), CDAI and SDAI. Pts were stratified by SE+ (1 or 2 SE alleles) and SE- (0 alleles) and ACPA status. We analyzed the relationship of SE with ACPA positivity and change in DA by a linear regression model separately. A mediation analysis was used to examine the mediating effect of ACPA on association between SE and change in DA.

Results:

Out of 926 pts included in the analysis, 65.1% were SE+, of whom 75.6% were ACPA+. In comparison, 51.7% were ACPA+ in SE- pts. SE+ pts were similar with SE- pts in age, gender, BMI and smoking status, but had longer disease duration, were more likely to be rheumatoid factor positive, have erosive disease and higher comorbidity burden irrespective of ACPA status. The differences were more pronounced if the pts were also ACPA+. Adjusting for BL differences, pts with SE 1 and 2 alleles (vs 0) had an odd ratio of 1.97 (95% CI:1.36-2.84; p=0.0003) and 3.82 (95% CI: 2.44-5.98; p<.0001) to be ACPA +, respectively. The regression analysis suggests that SE+ (vs SE-) pts had an average increase in DAS28 (CRP) of 0.22 (p=0.033), CDAI of 2.07 (p=0.045) and SDAI of 2.43 (p=0.029) over a year (Fig 1). Using a mediation analysis, the direct effect of SE+ account for 78.8% to 81.0% of total effect in the increase in DAS28 (CRP), CDAI and SDAI, and the indirect effect mediated by ACPA account for 19.0% to 21.2% (Table 1).

Table 1.

Mediation Analysis for SE and ACPA Association with Change in DA

ParameterChange in DAS28 CRP (N=666)Change in CDAI (N=653)Change in SDAI (N=629)EstimateP-valueEstimateP-valueEstimateP-valueTotal Effect of SE on DA change0.220.0342.050.0472.400.030Direct effect of SE on DA change excluding mediation of ACPA0.170.1011.570.1401.890.098Indirect effect of SE on DA change due to ACPA mediation and interaction0.040.1830.480.1330.510.143

The model is adjusted with other covariates: Age, Gender, Charlson comorbidity score; baseline biologic use, Smoking status, baseline DA, Interaction term (ACPA*SE)

Figure 1.

Linear Regression Model for SE Association with Change in Disease Activity *Estimates, p-values are shown as data labels on the graphs; Change in disease activity (DA) = (follow-up DA- baseline DA); The above model is adjusted for age, gender, CCI, baseline DA, baseline biologic use, SE status and smoking status

Conclusion:

SE is strongly related to ACPA and a greater burden of disease in RA pts. In pts receiving standard treatments including biologics, SE is predictive of a greater increase in DA, which is partially mediated by the presence of ACPA.

References:

[1] Dayan I, et al.,Arch of Rheumatology, 2010;25:012-018.

[2] Gregerson PK, et al,Arthritis Rheum. 1987;30:1205-1213.

[3] Turesson C, et al.Arthritis Res Ther. 2005;7:R1386-1393.

[4] Moreno I, et al.J Rheumatol. 1996;23:6-9.

Disclosure of Interests:

Joe Zhuo Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Joshua Bryson Shareholder of: I own shares of Bristol-Myers Squibb Company, Employee of: I am a paid employee of Bristol-Myers Squibb Company, Qian Xia Shareholder of: I own shares of Bristol-Myers Squibb Company, Employee of: I am a paid employee of Bristol-Myers Squibb Company, Niyati Sharma Consultant of: I work as a consultant for Bristol-Myers Squibb Company, Sheng Gao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, Sonie Lama Shareholder of: I own shares of Bristol-Myers Squibb Company., Employee of: I am a paid employee of Bristol-Myers Squibb Company., Michael E. Weinblatt Grant/research support from: BMS, Amgen, Lilly, Crescendo and Sonofi-Regeneron, Consultant of: Horizon Therapeutics, Bristol-Myers Squibb, Amgen, Abbvie, Crescendo, Lilly, Pfizer, Roche, Gilead, Nancy Shadick Grant/research support from: Mallinckrodt, BMS, Lilly, Amgen, Crescendo Biosciences, and Sanofi-Regeneron, Consultant of: BMS

Estrogen-related receptor participates in regulating glycolysis and influences embryonic development in silkworm Bombyx mori

Estrogen-related receptors (ERRs) play indispensable roles in development, energy metabolism, and cancers and are metabolic switches in Drosophila. However, the mechanism underlying their metabolic role is unknown in insects. This study analysed the expression profiles of Bombyx mori ERR (BmERR), hexokinase (BmHK), pyruvate kinase (BmPK) and phosphofructokinase (BmPFK) during embryonic development. The expression of BmERR tended to be similar to that of the other genes. We observed a regulatory association between BmERR and glycolytic rate-limiting enzymes by BmERR overexpression, RNA interference (RNAi), and ERR inhibitors in B. mori embryo cells. Subsequently, ERR cis-regulation elements (ERREs) were predicted and identified in the BmPFK promoter. Transfection assays, electrophoretic mobility shift assays and chromatin immunoprecipitation showed that BmERR can bind to one of these elements to regulate the expression of BmPFK. ERREs were also predicted in the BmHK and BmPK promoters. In the eggs, the expression of glycolytic rate-limiting enzyme genes was suppressed when the expression of BmERR was interference by double-stranded BmERR, the glucose levels also was increased. Meanwhile, the development of silkworm embryos was delayed by about 1 day. These results indicate that BmERR can bind to the ERREs of glycolytic gene promoters and regulate the expression of glycolytic genes, ultimately affecting embryonic development in silkworms.

Application of Convolutional Neural Network in Identifying Different Levels of Isokinetic Exercise Efforts

Objective To develop a convolutional neural network （CNN） that can identify isokinetic knee exercises moment of force-time diagrams under different levels of efforts. Methods The 200 healthy young volunteers performed concentric isokinetic right knee flexion-extension reciprocating exercises with maximal effort as well as half the effort at angular velocities of 30°/s and 60°/s twice, respectively, with an interval of 45 min. The moment of force-time diagrams were collected. The 200 subjects were randomly divided into the training set （140 subjects） and the testing set （60 subjects）. The moment of force-time diagrams from subjects in the training set were used to train CNN model, and then the fully trained model was used to predict types of curves from the testing set. Random sampling of subjects along with subsequent development of models were performed 3 times. Results Under the circumstances of isokinetic knee exercises with maximal effort and half the effort, 2 400 moment of force-time diagrams were produced, respectively. Classification accuracy rates of the CNN models after the 3 trainings were 91.11%, 90.49% and 92.08%, respectively, and the average accuracy rate was 91.23%. Conclusion The CNN models developed in this study have a good effect on differentiating isokinetic moment of force-time diagrams of maximal effort exercises from those made with half the effort, which can contribute to identifying levels of efforts exerted by subjects during isokinetic knee exercises.