Upfront boost to gross disease followed by elective pelvic radiation improves compliance to radiation therapy delivery metrics in locally advanced vulvar cancer

Locally advanced cancer of the vulva (LACV) is commonly diagnosed in older women (>65 years), and is treated using combined multimodality therapy (CMT) that includes radiation therapy (RT). Compliance to optimal RT metrics, including completion of > 20 fractions, overall treatment duration of < 8 weeks (56 days), and < 1 week intra-treatment break is associated with better disease outcomes. However, published results note that a significant number of patients with LACV do not adhere to these metrics. The aim of our study is to evaluate whether a modified sequence of RT delivery, treating the localized boost volume upfront followed by the larger elective nodal volume is associated with improved compliance to optimal RT delivery metrics.

The gut ecosystem and immune tolerance

The gastrointestinal tract is home to the largest microbial population in the human body. The gut microbiota plays significant roles in the development of the gut immune system and has a substantial impact on the maintenance of immune tolerance beginning in early life. These microbes interact with the immune system in a dynamic and interdependent manner. They generate immune signals by presenting a vast repertoire of antigenic determinants and microbial metabolites that influence the development, maturation and maintenance of immunological function and homeostasis. At the same time, both the innate and adaptive immune systems are involved in modulating a stable microbial ecosystem between the commensal and pathogenic microorganisms. Hence, the gut microbial population and the host immune system work together to maintain immune homeostasis synergistically. In susceptible hosts, disruption of such a harmonious state can greatly affect human health and lead to various auto-inflammatory and autoimmune disorders. In this review, we discuss our current understanding of the interactions between the gut microbiota and immunity with an emphasis on: a) important players of gut innate and adaptive immunity; b) the contribution of gut microbial metabolites; and c) the effect of disruption of innate and adaptive immunity as well as alteration of gut microbiome on the molecular mechanisms driving autoimmunity in various autoimmune diseases.

Hyperon Polarization along the Beam Direction Relative to the Second and Third Harmonic Event Planes in Isobar Collisions at sqrt[s_{NN}]=200 GeV

The polarization of Λ and Λ[over ¯] hyperons along the beam direction has been measured relative to the second and third harmonic event planes in isobar Ru+Ru and Zr+Zr collisions at sqrt[s_{NN}]=200  GeV. This is the first experimental evidence of the hyperon polarization by the triangular flow originating from the initial density fluctuations. The amplitudes of the sine modulation for the second and third harmonic results are comparable in magnitude, increase from central to peripheral collisions, and show a mild p_{T} dependence. The azimuthal angle dependence of the polarization follows the vorticity pattern expected due to elliptic and triangular anisotropic flow, and qualitatively disagrees with most hydrodynamic model calculations based on thermal vorticity and shear induced contributions. The model results based on one of existing implementations of the shear contribution lead to a correct azimuthal angle dependence, but predict centrality and p_{T} dependence that still disagree with experimental measurements. Thus, our results provide stringent constraints on the thermal vorticity and shear-induced contributions to hyperon polarization. Comparison to previous measurements at RHIC and the LHC for the second-order harmonic results shows little dependence on the collision system size and collision energy.

The Evolving Landscape of Fecal Microbial Transplantation

The human gastrointestinal tract houses an enormous microbial ecosystem. Recent studies have shown that the gut microbiota plays significant physiological roles and maintains immune homeostasis in the human body. Dysbiosis, an imbalanced gut microbiome, can be associated with various disease states, as observed in infectious diseases, inflammatory diseases, autoimmune diseases, and cancer. Modulation of the gut microbiome has become a therapeutic target in treating these disorders. Fecal microbiota transplantation (FMT) from a healthy donor restores the normal gut microbiota homeostasis in the diseased host. Ample evidence has demonstrated the efficacy of FMT in recurrent Clostridioides difficile infection (rCDI). The application of FMT in other human diseases is gaining attention. This review aims to increase our understanding of the mechanisms of FMT and its efficacies in human diseases. We discuss the application, route of administration, limitations, safety, efficacies, and suggested mechanisms of FMT in rCDI, autoimmune diseases, and cancer. Finally, we address the future perspectives of FMT in human medicine.

Measurements of the Elliptic and Triangular Azimuthal Anisotropies in Central ^{3}He+Au, d+Au and p+Au Collisions at sqrt[s_{NN}]=200 GeV

The elliptic (v_{2}) and triangular (v_{3}) azimuthal anisotropy coefficients in central ^{3}He+Au, d+Au, and p+Au collisions at sqrt[s_{NN}]=200  GeV are measured as a function of transverse momentum (p_{T}) at midrapidity (|η|<0.9), via the azimuthal angular correlation between two particles both at |η|<0.9. While the v_{2}(p_{T}) values depend on the colliding systems, the v_{3}(p_{T}) values are system independent within the uncertainties, suggesting an influence on eccentricity from subnucleonic fluctuations in these small-sized systems. These results also provide stringent constraints for the hydrodynamic modeling of these systems.

Observation of Directed Flow of Hypernuclei _{Λ}^{3}H and _{Λ}^{4}H in sqrt[s_{NN}]=3 GeV Au+Au Collisions at RHIC

We report here the first observation of directed flow (v_{1}) of the hypernuclei _{Λ}^{3}H and _{Λ}^{4}H in mid-central Au+Au collisions at sqrt[s_{NN}]=3  GeV at RHIC. These data are taken as part of the beam energy scan program carried out by the STAR experiment. From 165×10^{6} events in 5%-40% centrality, about 8400 _{Λ}^{3}H and 5200 _{Λ}^{4}H candidates are reconstructed through two- and three-body decay channels. We observe that these hypernuclei exhibit significant directed flow. Comparing to that of light nuclei, it is found that the midrapidity v_{1} slopes of _{Λ}^{3}H and _{Λ}^{4}H follow baryon number scaling, implying that the coalescence is the dominant mechanism for these hypernuclei production in the 3 GeV Au+Au collisions.

Beam Energy Dependence of Triton Production and Yield Ratio (N_{t}×N_{p}/N_{d}^{2}) in Au+Au Collisions at RHIC

We report the triton (t) production in midrapidity (|y|<0.5) Au+Au collisions at sqrt[s_{NN}]=7.7-200  GeV measured by the STAR experiment from the first phase of the beam energy scan at the Relativistic Heavy Ion Collider. The nuclear compound yield ratio (N_{t}×N_{p}/N_{d}^{2}), which is predicted to be sensitive to the fluctuation of local neutron density, is observed to decrease monotonically with increasing charged-particle multiplicity (dN_{ch}/dη) and follows a scaling behavior. The dN_{ch}/dη dependence of the yield ratio is compared to calculations from coalescence and thermal models. Enhancements in the yield ratios relative to the coalescence baseline are observed in the 0%-10% most central collisions at 19.6 and 27 GeV, with a significance of 2.3σ and 3.4σ, respectively, giving a combined significance of 4.1σ. The enhancements are not observed in peripheral collisions or model calculations without critical fluctuation, and decreases with a smaller p_{T} acceptance. The physics implications of these results on the QCD phase structure and the production mechanism of light nuclei in heavy-ion collisions are discussed.

Measurement of Sequential ϒ Suppression in Au+Au Collisions at sqrt[s_{NN}]=200 GeV with the STAR Experiment

We report on measurements of sequential ϒ suppression in Au+Au collisions at sqrt[s_{NN}]=200  GeV with the STAR detector at the Relativistic Heavy Ion Collider (RHIC) through both the dielectron and dimuon decay channels. In the 0%-60% centrality class, the nuclear modification factors (R_{AA}), which quantify the level of yield suppression in heavy-ion collisions compared to p+p collisions, for ϒ(1S) and ϒ(2S) are 0.40±0.03(stat)±0.03(sys)±0.09(norm) and 0.26±0.08(stat)±0.02(sys)±0.06(norm), respectively, while the upper limit of the ϒ(3S) R_{AA} is 0.17 at a 95% confidence level. This provides experimental evidence that the ϒ(3S) is significantly more suppressed than the ϒ(1S) at RHIC. The level of suppression for ϒ(1S) is comparable to that observed at the much higher collision energy at the Large Hadron Collider. These results point to the creation of a medium at RHIC whose temperature is sufficiently high to strongly suppress excited ϒ states.

Beam Energy Dependence of Fifth- and Sixth-Order Net-Proton Number Fluctuations in Au+Au Collisions at RHIC

We report the beam energy and collision centrality dependence of fifth and sixth order cumulants (C_{5}, C_{6}) and factorial cumulants (κ_{5}, κ_{6}) of net-proton and proton number distributions, from center-of-mass energy (sqrt[s_{NN}]) 3 GeV to 200 GeV Au+Au collisions at RHIC. Cumulant ratios of net-proton (taken as proxy for net-baryon) distributions generally follow the hierarchy expected from QCD thermodynamics, except for the case of collisions at 3 GeV. The measured values of C_{6}/C_{2} for 0%-40% centrality collisions show progressively negative trend with decreasing energy, while it is positive for the lowest energy studied. These observed negative signs are consistent with QCD calculations (for baryon chemical potential, μ_{B}≤110  MeV) which contains the crossover transition range. In addition, for energies above 7.7 GeV, the measured proton κ_{n}, within uncertainties, does not support the two-component (Poisson+binomial) shape of proton number distributions that would be expected from a first-order phase transition. Taken in combination, the hyperorder proton number fluctuations suggest that the structure of QCD matter at high baryon density, μ_{B}∼750  MeV at sqrt[s_{NN}]=3  GeV is starkly different from those at vanishing μ_{B}∼24  MeV at sqrt[s_{NN}]=200  GeV and higher collision energies.

Collision-System and Beam-Energy Dependence of Anisotropic Flow Fluctuations

Elliptic flow measurements from two-, four-, and six-particle correlations are used to investigate flow fluctuations in collisions of U+U at sqrt[s_{NN}]=193  GeV, Cu+Au at sqrt[s_{NN}]=200  GeV and Au+Au spanning the range sqrt[s_{NN}]=11.5-200  GeV. The measurements show a strong dependence of the flow fluctuations on collision centrality, a modest dependence on system size, and very little if any, dependence on particle species and beam energy. The results, when compared to similar LHC measurements, viscous hydrodynamic calculations, and trento model eccentricities, indicate that initial-state-driven fluctuations predominate the flow fluctuations generated in the collisions studied.

Differential immune response to xenobiotic-modified self-molecule in simple and connective tissue disease-associated primary biliary cholangitis

BACKGROUND AND AIMS

Our previous studies demonstrated that 2-octynoic acid (2OA) might alter the conformational structure of the inner lipoic acid (LA) binding domain (ILD) in the E2 subunit of pyruvate dehydrogenase complex (PDC-E2), leading to the loss of immune tolerance in simple primary biliary cholangitis (S-PBC). Here, we further explore if this etiological mechanism also accounts for connective tissue disease-associated PBC (CTD-PBC).

METHODS

Intein-mediated protein ligation was used to prepare ILD, LA-ILD and 2OA-ILD, and their reactivity with serum samples from 124 S-PBC and 132 CTD-PBC patients was examined. The antibodies to LA, 2OA, LA-ILD and 2OA-ILD, the isotypes of antibodies to LA, 2OA and ILD, were comparatively detected between the two patient groups by enzyme-linked immunosorbent assay and immunoblotting.

RESULTS

Both the percentage and reactivity of antibody to 2OA in S-PBC were significantly higher than in CTD-PBC. Antibodies to 2OA and to LA between the two groups separately shared the same characteristics. Remarkably, coexistence of the antibodies to LA-ILD and to 2OA, and coexistence of the antibodies to LA and to 2OA in S-PBC were both significantly more frequent than in CTD-PBC, whereas the percentage of anti-LA antibody without anti-2OA antibody in S-PBC was markedly lower than in CTD-PBC. Moreover, the isotype of antibody to LA was predominantly IgG in CTD-PBC, whilst this isotype was mainly IgM in S-PBC.

CONCLUSION

Xenobiotic 2OA might play less important pathogenic role in CTD-PBC than in S-PBC, suggesting that different underlying mechanisms are involved in their immune intolerance to PDC-E2.

Treatment with a JAK1/2 inhibitor ameliorates murine autoimmune cholangitis induced by IFN overexpression

The interferon (IFN) signaling pathways are major immunological checkpoints with clinical significance in the pathogenesis of autoimmunity. We have generated a unique murine model named ARE-Del, with chronic overexpression of IFNγ, by altering IFNγ metabolism. Importantly, these mice develop an immunologic and clinical profile similar to patients with primary biliary cholangitis, including high titers of autoantibodies and portal inflammation. We hypothesized that the downregulation of IFN signaling pathways with a JAK1/2 inhibitor would inhibit the development and progression of cholangitis. To study this hypothesis, ARE-Del+/- mice were treated with the JAK1/2 inhibitor ruxolitinib and serially studied. JAK inhibition resulted in a significant reduction in portal inflammation and bile duct damage, associated with a significant reduction in splenic and hepatic CD4+ T cells and CD8+ T cells. Functionally, ruxolitinib inhibited the secretion of the proinflammatory cytokines IFNγ and TNF from splenic CD4+ T cells. Additionally, ruxolitinib treatment also decreased the frequencies of germinal center B (GC B) cells and T follicular helper (Tfh) cells and led to lower serological AMA levels. Of note, liver and peritoneal macrophages were sharply decreased and polarized from M1 to M2 with a higher level of IRF4 expression after ruxolitinib treatment. Mechanistically, ruxolitinib inhibited the secretion of IL-6, TNF and MCP1 and the expression of STAT1 but promoted the expression of STAT6 in macrophages in vitro, indicating that M1 macrophage polarization to M2 occurred through activation of the STAT6-IRF4 pathway. Our data highlight the significance, both immunologically and clinically, of the JAK/STAT signaling pathway in autoimmune cholangitis.

Dual B-cell targeting therapy ameliorates autoimmune cholangitis

OBJECTIVE

The ability to regulate B cell development has long been recognized to have therapeutic potential in a variety of autoimmune diseases. However, despite the presence of a classic autoantibody in primary biliary cholangitis (PBC), B cell depleting therapy and indeed therapy with other biologic agents has been disappointing. Unsuccessful treatment using Rituximab is associated with elevation of B-cell activating factor (BAFF) level. Indeed, therapies for PBC remain directed at modulating bile salt biology, rather than targeting effector pathways. With these data in mind, we proposed that targeting two major stages of B cell development, namely long-lived memory B cells and short-lived peripheral autoreactive plasma cells would have therapeutic potential.

METHODS

To address this thesis, we administrated anti-BAFF and anti-CD20 monoclonal antibody to ARE-Del mice, a well-characterized murine model of human PBC. We evaluated and compared the therapeutic efficacy of the two agents individually and the combination of anti-BAFF and anti-CD20 in female mice with well-established disease.

RESULTS

Our data demonstrate that there was an increased level of B cell depletion that resulted in a significantly more effective clinical and serologic response using the combination of agents as compared with the use of the individual agents. The combination of anti-BAFF and anti-CD20 treatment was more effective in reducing serum levels of antimitochondrial antibody (AMA), total IgM and IgG compared to mice treated with the 2 individual agents. Combination treatment efficiently depleted B cells in the peripheral blood, peritoneal cavity and spleen. Importantly, we identified a unique IgM+ FCRL5+ B cell subset which was sensitive to dual B-cell targeting therapy and depletion of this unique population was associated with reduced portal infiltration and bile duct damage. Taken together, our data indicate that dual B cell targeting therapy with anti-BAFF and anti-CD20 not only led to the efficient depletion of B cells both in the peripheral blood and tissues, but also led to significant clinical improvement. These findings highlight the potential application of combination of anti-BAFF and anti-CD20 in treating patients with PBC. However, additional studies in other animal models of PBC should be undertaken before considering human trials in those PBC patients who have incomplete responses to conventional therapy.

Evidence for Nonlinear Gluon Effects in QCD and Their Mass Number Dependence at STAR

The STAR Collaboration reports measurements of back-to-back azimuthal correlations of di-π^{0}s produced at forward pseudorapidities (2.6<η<4.0) in p+p, p+Al, and p+Au collisions at a center-of-mass energy of 200 GeV. We observe a clear suppression of the correlated yields of back-to-back π^{0} pairs in p+Al and p+Au collisions compared to the p+p data. The observed suppression of back-to-back pairs as a function of transverse momentum suggests nonlinear gluon dynamics arising at high parton densities. The larger suppression found in p+Au relative to p+Al collisions exhibits a dependence of the saturation scale Q_{s}^{2} on the mass number A. A linear scaling of the suppression with A^{1/3} is observed with a slope of -0.09±0.01.

Downregulation of Programmed Death-1 Pathway Promoting CD8 + T Cell Cytotoxicity in Primary Biliary Cholangitis

BACKGROUND

Primary biliary cholangitis (PBC) is an autoimmune disease. CD8 + T cell (CTLs) cytotoxicity played a crucial rule in of PBC with unclear detailed pathogenesis.

AIMS

The role of the programmed death-1 (PD-1) pathway in CD8 + T cell cytotoxicity in patients with PBC was determined.

METHODS

We recruited 69 patients with PBC and 57 healthy controls (HCs). PD-1 pathway in peripheral CD8 + T cells and related cytokines were detected, and gene expression levels were detected. Immunofluorescence staining of PD-1/PD-L1 was performed on liver tissue. PD-1 ± CTLs were cocultured with human intrahepatic biliary epithelial cells (HiBECs) to measure CTL cytotoxicity, proliferation and cytokine levels and HiBEC apoptosis. The upstream signaling pathway of PD-1 was detected.

RESULTS

PBC patients exhibited Tbet gene upregulation and PD-1 downregulation in CTLs, with PD-1 expression reduced in CTLs and PD-L1 reduced in the liver portal region relative to HCs. Higher plasma IL-10, interferon-γ and transforming growth factor-β concentrations were observed in the PBC group than the HC group. In CTL and HiBEC coculture experiment, compared with PD-1- CTLs, PD-1 + CTLs exhibited weaker cytotoxicity, less proliferation and lower cytokine production. When the system was blocked by anti-PD-1 antibodies, these effects were antagonized.

CONCLUSIONS

PD-1 expression in CD8 + T cells decreased, and PD-1 pathway-related cytokines changed in patients with PBC. PD-1/PD-L1 pathway silencing increased CD8 + T cell proliferation, related cytokine production and CTL cytotoxic effects on HiBECs in coculture experiment. The PD-1/PD-L1 pathway might represent an important pathway in the immunological mechanism underlying PBC.

Measurements of Proton High-Order Cumulants in sqrt[s_{NN}]=3 GeV Au+Au Collisions and Implications for the QCD Critical Point

We report cumulants of the proton multiplicity distribution from dedicated fixed-target Au+Au collisions at sqrt[s_{NN}]=3.0  GeV, measured by the STAR experiment in the kinematic acceptance of rapidity (y) and transverse momentum (p_{T}) within -0.5<y<0 and 0.4<p_{T}<2.0  GeV/c. In the most central 0%-5% collisions, a proton cumulant ratio is measured to be C_{4}/C_{2}=-0.85±0.09 (stat)±0.82 (syst), which is 2σ below the Poisson baseline with respect to both the statistical and systematic uncertainties. The hadronic transport UrQMD model reproduces our C_{4}/C_{2} in the measured acceptance. Compared to higher energy results and the transport model calculations, the suppression in C_{4}/C_{2} is consistent with fluctuations driven by baryon number conservation and indicates an energy regime dominated by hadronic interactions. These data imply that the QCD critical region, if created in heavy-ion collisions, could only exist at energies higher than 3 GeV.

Measurements of _{Λ}^{3}H and _{Λ}^{4}H Lifetimes and Yields in Au+Au Collisions in the High Baryon Density Region

We report precision measurements of hypernuclei _{Λ}^{3}H and _{Λ}^{4}H lifetimes obtained from Au+Au collisions at sqrt[s_{NN}]=3.0  GeV and 7.2 GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider, and the first measurement of _{Λ}^{3}H and _{Λ}^{4}H midrapidity yields in Au+Au collisions at sqrt[s_{NN}]=3.0  GeV. _{Λ}^{3}H and _{Λ}^{4}H, being the two simplest bound states composed of hyperons and nucleons, are cornerstones in the field of hypernuclear physics. Their lifetimes are measured to be 221±15(stat)±19(syst)  ps for _{Λ}^{3}H and 218±6(stat)±13(syst)  ps for _{Λ}^{4}H. The p_{T}-integrated yields of _{Λ}^{3}H and _{Λ}^{4}H are presented in different centrality and rapidity intervals. It is observed that the shape of the rapidity distribution of _{Λ}^{4}H is different for 0%-10% and 10%-50% centrality collisions. Thermal model calculations, using the canonical ensemble for strangeness, describes the _{Λ}^{3}H yield well, while underestimating the _{Λ}^{4}H yield. Transport models, combining baryonic mean-field and coalescence (jam) or utilizing dynamical cluster formation via baryonic interactions (phqmd) for light nuclei and hypernuclei production, approximately describe the measured _{Λ}^{3}H and _{Λ}^{4}H yields. Our measurements provide means to precisely assess our understanding of the fundamental baryonic interactions with strange quarks, which can impact our understanding of more complicated systems involving hyperons, such as the interior of neutron stars or exotic hypernuclei.

Probing the Gluonic Structure of the Deuteron with J/ψ Photoproduction in d+Au Ultraperipheral Collisions

Understanding gluon density distributions and how they are modified in nuclei are among the most important goals in nuclear physics. In recent years, diffractive vector meson production measured in ultraperipheral collisions (UPCs) at heavy-ion colliders has provided a new tool for probing the gluon density. In this Letter, we report the first measurement of J/ψ photoproduction off the deuteron in UPCs at the center-of-mass energy sqrt[s_{NN}]=200  GeV in d+Au collisions. The differential cross section as a function of momentum transfer -t is measured. In addition, data with a neutron tagged in the deuteron-going zero-degree calorimeter is investigated for the first time, which is found to be consistent with the expectation of incoherent diffractive scattering at low momentum transfer. Theoretical predictions based on the color glass condensate saturation model and the leading twist approximation nuclear shadowing model are compared with the data quantitatively. A better agreement with the saturation model has been observed. With the current measurement, the results are found to be directly sensitive to the gluon density distribution of the deuteron and the deuteron breakup process, which provides insights into the nuclear gluonic structure.

Search for the Chiral Magnetic Effect via Charge-Dependent Azimuthal Correlations Relative to Spectator and Participant Planes in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

The chiral magnetic effect (CME) refers to charge separation along a strong magnetic field due to imbalanced chirality of quarks in local parity and charge-parity violating domains in quantum chromodynamics. The experimental measurement of the charge separation is made difficult by the presence of a major background from elliptic azimuthal anisotropy. This background and the CME signal have different sensitivities to the spectator and participant planes, and could thus be determined by measurements with respect to these planes. We report such measurements in Au+Au collisions at a nucleon-nucleon center-of-mass energy of 200 GeV at the Relativistic Heavy-Ion Collider. It is found that the charge separation, with the flow background removed, is consistent with zero in peripheral (large impact parameter) collisions. Some indication of finite CME signals is seen in midcentral (intermediate impact parameter) collisions. Significant residual background effects may, however, still be present.

Measurement of the Sixth-Order Cumulant of Net-Proton Multiplicity Distributions in Au+Au Collisions at sqrt[s_{NN}]=27, 54.4, and 200 GeV at RHIC

According to first-principle lattice QCD calculations, the transition from quark-gluon plasma to hadronic matter is a smooth crossover in the region μ_{B}≤T_{c}. In this range the ratio, C_{6}/C_{2}, of net-baryon distributions are predicted to be negative. In this Letter, we report the first measurement of the midrapidity net-proton C_{6}/C_{2} from 27, 54.4, and 200 GeV Au+Au collisions at the Relativistic Heavy Ion Collider (RHIC). The dependence on collision centrality and kinematic acceptance in (p_{T}, y) are analyzed. While for 27 and 54.4 GeV collisions the C_{6}/C_{2} values are close to zero within uncertainties, it is observed that for 200 GeV collisions, the C_{6}/C_{2} ratio becomes progressively negative from peripheral to central collisions. Transport model calculations without critical dynamics predict mostly positive values except for the most central collisions within uncertainties. These observations seem to favor a smooth crossover in the high-energy nuclear collisions at top RHIC energy.

Interstitial Lung Disease in Connective Tissue Disease: A Common Lesion With Heterogeneous Mechanisms and Treatment Considerations

Connective tissue disease (CTD) related interstitial lung disease (CTD-ILD) is one of the leading causes of morbidity and mortality of CTD. Clinically, CTD-ILD is highly heterogenous and involves rheumatic immunity and multiple manifestations of respiratory complications affecting the airways, vessels, lung parenchyma, pleura, and respiratory muscles. The major pathological features of CTD are chronic inflammation of blood vessels and connective tissues, which can affect any organ leading to multi-system damage. The human lung is particularly vulnerable to such damage because anatomically it is abundant with collagen and blood vessels. The complex etiology of CTD-ILD includes genetic risks, epigenetic changes, and dysregulated immunity, which interact leading to disease under various ill-defined environmental triggers. CTD-ILD exhibits a broad spectra of clinical manifestations: from asymptomatic to severe dyspnea; from single-organ respiratory system involvement to multi-organ involvement. The disease course is also featured by remissions and relapses. It can range from stability or slow progression over several years to rapid deterioration. It can also present clinically as highly progressive from the initial onset of disease. Currently, the diagnosis of CTD-ILD is primarily based on distinct pathology subtype(s), imaging, as well as related CTD and autoantibodies profiles. Meticulous comprehensive clinical and laboratory assessment to improve the diagnostic process and management strategies are much needed. In this review, we focus on examining the pathogenesis of CTD-ILD with respect to genetics, environmental factors, and immunological factors. We also discuss the current state of knowledge and elaborate on the clinical characteristics of CTD-ILD, distinct pathohistological subtypes, imaging features, and related autoantibodies. Furthermore, we comment on the identification of high-risk patients and address how to stratify patients for precision medicine management approaches.

[Research progress in the role and mechanism of polysaccharides in regulating glucose and lipid metabolism]

Polysaccharides are a group of compounds composed of multiple monosaccharides of the same or different structures combined by glycosidic bonds, and are widely found in animals and plants and in the cell walls of microorganisms. Polysaccharides possess the advantages of high safety and low toxicity. Recent studies revealed that polysaccharides have a wide range of biological activities including immunoregulation, anti-tumor, antiviral, antioxidant activities, and blood glucose-and lipid- lowering effects. The effects of polysaccharides in improving insulin sensitivity and regulating glucose and lipid metabolism have drawn much attention from researchers. Many polysaccharides can reduce blood glucose and blood lipid by repairing pancreatic islet cells, improving insulin resistance, regulating intestinal flora, enhancing antioxidant capacity, and regulating the activities of key enzymes in glucose and lipid metabolism. This reviews examines the role and mechanism of polysaccharides in regulating glucose and lipid metabolism. The mechanisms of polysaccharide in regulating glucose metabolism include repairing islet cells and increasing insulin content, increasing insulin sensitivity and improving insulin resistance, regulating the activity of key enzymes in glucose metabolism, increasing synthesis of liver glycogen, and regulating intestinal flora. Polysaccharides can also regulate glucose metabolism by improving immune regulation and antagonizing glucagon. Polysaccharide also regulate lipid metabolism by regulating lipid absorption, expression of the related genes such as PPAR-α, enzyme activities in lipid metabolism, improving antioxidant capacity, and modulating intestinal flora and signaling pathways.

Contributions of epiphytic microbiota on the fermentation characteristics and microbial composition of ensiled six whole crop corn varieties

AIMS

The present study is aimed to reveal the variations in epiphytic microbial composition among six whole crop corn (WCC) varieties and their contributions on ensiling characteristics and microbial composition of WCC silage.

METHODS AND RESULTS

Six WCC varieties (JS06, YS23, BS20, JS39, JS40 and JS26) were ensiled for 90 days. All WCC varieties were well fermented with low pH value (<4·0) and high LA (73·6-124 g kg^-1 DM, dry matter) concentration. Of six varieties, JS40 had the highest LA (124 g kg^-1 DM) concentration, which was supported by highest relative abundance of Lactobacillus. Pantoea was the most dominant epiphytic bacteria in all fresh WCC varieties; however, the secondary dominant genera among six WCC were absolutely difference. Lactobacillus became predominant genus in 90-day silages except YS23. YS23 kept the more bacterial genus from fresh to 90-day silages than other silages, meanwhile Acinetobacter and Enterobacter were the dominant bacteria in YS23 silages.

CONCLUSIONS

Among six WCC varieties, JS40 silage had the highest LA. The variations in epiphytic microbiomes among fresh WCC affected terminal microbial community of 90-day silages. There were differences in fermentation characteristics among six WCC varieties, which might be partly attributed to variations in epiphytic microbiomes among fresh WCC.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study not only enriches the research on microbial communities of plant phyllosphere but also provides theoretical basis for selecting WCC varieties and inoculants for the forage production.

Characterization and identification of cellulase-producing Enterococcus species isolated from Tibetan yak (Bos grunniens) rumen and their application in various forage silages

AIMS

Cellulase-producing Enterococcus species isolated from the rumen of Tibetan yak (Bos grunniens) were characterized, and their combined effects on the silage quality of various forages were studied.

METHODS AND RESULTS

The two isolated strains with high cellulolytic potential were identified as Enterococcus faecalis (EF85) and E. faecium (EF83) by 16S rRNA sequencing. Both EF85 and EF83 could grow well at 15-55°C, pH 3·0-6·0 and in 3·0-6·5% NaCl. The cellulase secreted by EF85 and EF83 showed good stability at temperatures from 20 to 45°C and pH from 4·5 to 7·0. A commercial inoculant (CLP), a commercial cellulase (CE) and the two cellulolytic strains (EF85 + EF83) were added to whole-crop corn, sweet sorghum and Napier grass ensiling for 120 days respectively. In Napier grass silage, all inoculants significantly increased lactic acid content and ratio of lactic to acetic acid and decreased pH, butyric acid and ammonia nitrogen contents. The acid detergent fibre and cellulose contents in EF85 + EF83 treatment were significantly lower than those in the other treatments. In whole-crop corn and sweet sorghum silages, all additives had no significant effect on the fermentation quality, while CE and EF85 + EF83 markedly enhanced cellulose degradation and increased free sugar content.

CONCLUSION

The combined inoculation of the cellulolytic strain EF85 and EF83 to various forages reduced the fibre content of the resulting silages.

SIGNIFICANCE AND IMPACT OF THE STUDY

Few studies involved inoculation of silage with Enterococcus species in different forage types. The isolated cellulolytic strains of E. faecalis EF85 and E. faecium EF83 could be a great alternative for commercial inoculants and enzymes in silage production.

Curcumin suppresses tumor growth of gemcitabine-resistant non-small cell lung cancer by regulating lncRNA-MEG3 and PTEN signaling

BACKGROUND

Lung cancer is one of the most aggressive malignancies and the efficacy of chemotherapy or concurrent chemoradiation is limited in clinical application. Curcumin has been reported to block cancer development by modulating multiple signaling pathways. However, whether curcumin can inhibit gemcitabine-resistant non-small cell lung cancer through regulation of lncRNA and the involved molecular mechanisms are rarely reported.

MATERIALS AND METHODS

MTT assay, clonogenic assay, apoptosis assay, qRT-PCR, Western blotting, immunohistochemistry, xenograft experiment were carried out in the present study.

RESULTS

The results showed that curcumin suppressed gemcitabine-resistant non-small cell lung cancer cell proliferation and induced apoptosis. Curcumin upregulated the expression of lncRNA-MEG3 and PTEN, and MEG3 overexpression could increase the level of PTEN expression, while MEG3 knockdown decreased the level of PTEN expression in gemcitabine-resistant non-small cell lung cancer cells. Curcumin treatment failed to inhibit the proliferation and induce apoptosis in MEG3 knockdown or PTEN knockdown cells.

CONCLUSIONS

These findings show the antitumor activity of curcumin for potential clinical application in gemcitabine-resistant non-small cell lung cancer treatment.

Improvement of fermentation quality and cellulose convertibility of Napier grass silage by inoculation of cellulolytic bacteria from Tibetan yak (Bos grunniens)

AIMS

To isolate and identify cellulolytic bacteria from yak rumen and further evaluate the effects of the isolates on the silage quality, structural carbohydrates degradation and cellulose convertibility of Napier grass silage.

METHODS AND RESULTS

Two out of 218 strains were selected based on their most extensive transparent zone and the highest filter paper disintegration rate. The two isolates (JFL12 and JF85) could grow normally at 15-55°C, pH 3·0-7·0 and NaCl (3·0, 6·5%), and were identified as Enterococcus casseliflavus and Enterococcus faecalis by 16S rDNA sequence analysis, respectively. Napier grass was ensiled with no additive control (C), Lactobacillus plantarum (Lp), JFL12, JF85, JFL12 + Lp and JF85 + Lp for 3, 5, 7, 14, 30 and 60 days. All inoculated silages had higher lactic acid content, lower pH, ammonia nitrogen (NH₃ -N) and lignocellulose contents than the control silage. Silages treated with JFL12 + Lp and JF85 + Lp had the lowest pH and NH₃ -N contents, the highest lactic acid content and lignocellulose degradation among all treatments. The isolates with or without Lp significantly (P < 0·01) increased water soluble carbohydrates (WSC), glucose, fructose and sucrose contents as compared with the control silage. Silages treated with JFL12 + Lp and JF85 + Lp had higher glucose yield and cellulose convertibility than the other silages.

CONCLUSIONS

Therefore, the application of isolates (JFL12 and JF85) with Lp had synergistic effects on accelerating the degradation of structural carbohydrates and improving the silage quality.

SIGNIFICANCE AND IMPACT OF THE STUDY

Napier grass presents difficulty to ensiling due to its low WSC and high structural carbohydrates contents. The screened cellulolytic bacteria could be a candidate strain in improving fermentation quality and structural carbohydrates degradability of ensiled forages.

Effects of various epiphytic microbiota inoculation on the fermentation quality and microbial community dynamics during the ensiling of sterile Napier grass

AIM

To investigate epiphytic microbiota transformation of forages, their adaptation and contributions to fermentation quality of silage.

METHODS AND RESULTS

Gamma-irradiated chopped Napier grass were ensiled with distilled water (STR), extracted epiphytic microbiota of Napier grass (NAP), sudan grass (SUD), whole crop corn (WCC) and forage sorghum (FS). Inoculating Napier grass with WCC significantly increased lactic acid (LA) concentrations during the initial ensiling period followed by a decline after 30 days. Relative to other silages (except STR) inoculation with NAP resulted in lower LA and greater pH, ammonia-N and dry matter (DM) losses. Silage inoculated with FS and SUD maintained lower pH as well as higher (P < 0·05) LA concentrations after 60 days of storage. During day 3 of ensilage, WCC, NAP and SUD inoculated silage were dominated by bacterial genera of Lactobacillus, while Lactococcus dominated the FS silage. Final silages were dominated by Lactobacillus in all treatment silages, however Enterobacter (16·3%) in NAP and Acetobacter (25·7%) in WCC silage were also prominent during the final ensiling.

CONCLUSION

The inoculation of epiphytic microbiota of forage sorghum and sudan grass positively influenced the microbial community and fermentability of sterile Napier grass silage.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first time to investigate the effects of various epiphytic microbiota as silage inoculants which can be used as alternative source of environmental friendly and economically feasible silage additives.

Effect of sorbic acid and dual-purpose inoculants on the fermentation quality and aerobic stability of high dry matter rice straw silage

AIMS

This study aimed to evaluate the feasibility of sorbic acid (SA) as a silage additive and its effects on fermentation quality and aerobic stability of high dry matter (DM) silage.

METHODS AND RESULTS

High DM rice straw was ensiled with distilled water (C), 1 × 10⁶  CFU per gram fresh weight (FW) Lactobacillus plantarum and 1 × 10⁶  CFU per gram FW Lactobacillus buchneri (LP+LB) or SA for 45 days with a subsequent aerobic stability test. After ensiling, LP+LB silage had the highest lactic acid (LA) content and the lowest pH value, whereas SA silage had the highest DM and water-soluble carbohydrate (WSC) contents, and the lowest ethanol and ammonia nitrogen (NH₃ -N) contents among all silages (P < 0·001). Compared to C silage, SA significantly (P < 0·01) reduced the counts of yeasts but not lactic acid bacteria (LAB). During 6-day aerobic exposure, the continuous pH increase and LA decrease were observed in C and LP+LB silages, and there was no significant change in pH, DM, NH₃ -N and WSC contents of SA silage over the whole aerobic exposure. The SA addition slowed the decline of LA and acetic acid (AA) contents as well as the growth of yeasts and aerobic bacteria under aerobic exposure.

CONCLUSION

In this study, L. buchneri could not function in high DM rice straw silage while SA effectively improved both the fermentation quality and aerobic stability.

SIGNIFICANCE AND IMPACT OF THE STUDY

The SA was more effective than dual-purpose inoculants to improve the aerobic stability of high DM rice straw silage. Thus, SA can be served as a potential antifungal additive for silage with high DM.

An analysis of abnormalities in the B cell receptor repertoire in patients with systemic sclerosis using high-throughput sequencing

Systemic sclerosis is a chronic multisystem autoimmune disease that is associated with polyclonal B cell hyperreactivity. The CDR3 of BCRs is the major site of antigen recognition. Therefore, we analyzed the BCR repertoire of patients with SSc. The BCR repertoires in 12 subjects including eight SSc patients and four healthy controls were characterized by high-throughput sequencing, and bioinformatics analysis were studied. The average CDR3 length in the SSc group was significantly shorter. The SSc patient displayed more diverse BCR. Moreover, SSc patients with mild skin sclerosis, anti-Scl70, interstitial lung disease or female sex were more diversified. B cells from the SSc patients showed a differential V and J gene usage. SSc patients had distinct BCR repertoires.These findings reflected the differences of BCR repertoires between SSc patients and controls. The higher-usage genes for the BCR sequence might be potential biomarkers of B cell-targeted therapies or diagnosis for SSc.

Abstract P5-15-03: Imaging is not indicated in staging of asymptomatic patients with early breast cancer – Are we following current recommendations?

Breast cancer is the most common malignancy in women with estimated care costs of $20.50 billion/year by 2020. In 2012, ASCO released the Choosing Wisely Initiative which recommended against the use of routine staging imaging in patients with newly diagnosed early stage breast cancer. We examined physician's adherence rate and factors associated with non-adherence to current guidelines in patients with early stage breast cencer treated within a large urban health care system.

We identified all women with stage I-II breast cancer diagnosed between January 1, 2014 and December 31, 2015 from the Cancer Registry of the Mount Sinai Health System. Patients with history of prior malignancy or symptom-triggered imaging were excluded. Demographic, clinical and treatment related factors were collected. Medical records were reviewed to identify patients who had routine staging scans. Data of initial and follow-up imaging over 1-year period were collected. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from logistic regression models.

Among 917 breast cancer patients, the median age at diagnosis was 59 years (range 26-98). One hundred seventy one patients (18.6%) had routine staging imaging with a mean number of initial scans of 1.48. Eighty-two patients (48%) had at least 1 subsequent scan in the 1-year follow up (range 1-4 scans/year). PET/CT was the most frequent modality (49%), followed by CT scan (33%). The medical oncologist was the ordering provider in 50.3% of the cases and surgical oncologist in 43.2%. Routine staging scans identified no cases of metastatic disease. False-positive findings were identified in 49.7% and incidental findings in 9.3% of cases. Total cost of imaging in this group was $3990/patient. Young age (&lt;50 years old), tumor size &gt;2cm, positive lymph nodes, and triple negative disease were associated with presence of routine staging scans on univariate and multivariate analysis (Table 1).

Our study highlights the prevalence of unnecessary staging scans in up to 18.6% of patients with early stage I-II breast cancer. Routine imaging resulted in increased radiation exposure, multiple subsequent imaging, and increased economical burden particularly for those of young age, T2 tumors, positive lymph nodes, and triple negative disease. Further educational efforts are needed to avoid unnecessary scans in patients with early stage breast cancer and improve high-value practices among medical and surgical oncologists.

Factors associated with routine staging scans in early breast cancer OR95% CIp-value Univariate Analysis:   Age &lt; 501.691.17-2.420.005T2 tumors4.353.01-6.28&lt;0.0001Positive lymph nodes5.073.43-7.51&lt;0.0001Triple negative disease2.941.86-4.63&lt;0.0001 Multivariate Analysis:   Age &lt; 501.571.03-2.390.037T2 tumors3.472.34 -5.17&lt;0.0001Positive lymph nodes4.042.64-6.18&lt;0.0001Triple negative disease2.991.76-5.05&lt;0.0001

Citation Format: Velazquez AI, Nguyen NT, Rodriguez-Bonilla C, Shao T. Imaging is not indicated in staging of asymptomatic patients with early breast cancer – Are we following current recommendations? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-15-03.

[The effect of corneal biomechanical properties on opaque bubble layer in small incision lenticule extraction (SMILE)]

Objective: To investigate the influence of corneal biomechanical properties on opaque bubble layer (OBL) in small incision lenticule extraction (SMILE). Methods: In this nested case control study, 20 patients (31 eyes) were enrolled in OBL group, while 51 patients (98 eyes) were included in non-OBL group. The parameters were obtained by Pentacam HR and Corvis ST examinations. Independent t test was used to analyze the difference of corneal biomechanical parameters between the two groups and multivariable logistics regression was applied to analysis the influence of corneal biomechanical properties on OBL. Results: This study enrolled 129 eyes in 71 cases including 30 males and 41 females, with a mean age of (22.50±5.18) years old. It has shown that the spherical equivalent (SE) [(-4.64±1.33) and (-5.78±1.61) D], central corneal thickness (CCT) [(572±29) and (550±32)μm], residual stromal thickness (RST)[(356±31) and (325±36 μm)], and lenticule thickness (LT) [(96±23) and (115±25) μm] were significantly different between OBL group and non-OBL group (t=3.58, -3.43, -5.68 and 3.64, respectively, P<0.05). There were significant differences in deflection amplitude at the first applanation and highest concavity (A1 DefA and HC DefA), deflection area at the highest concavity (HC DefArea), maximum deformation amplitude (DAmax), maximum deflection amplitude (DefAmax) and stiff parameter (SP) (108.85±13.77 and 100.19±14.13) between the two groups (t=-2.75, 2.41, 3.62, 4.09, 2.22 and -2.99, respectively, P<0.05). The OR and 95% confidence interval of SP in crude and adjusted logistics models were 1.04, (1.01-1.07) (P=0.005), and 1.01, (1.00-1.05) (P=0.426), respectively. Conclusions: The occurrence of OBL could be influenced by various corneal biomechanical factors. The thicker CCT, thicker RST and the stiffer cornea may increase the risk for the occurrence of OBL. Fully acknowledgement on the relationship between corneal biomechanics and surgical outcomes and evaluation of the occurrence of OBL in SMILE surgery is of great importance for improving the safety and predictability of SMILE. (Chin J Ophthalmol, 2019, 55:115-121).

Phylogenetic identification of lactic acid bacteria isolates and their effects on the fermentation quality of sweet sorghum (Sorghum bicolor) silage

AIM

To isolate, screen and identify the lactic acid bacteria (LAB) from elephant silage during the process of the fermentation and their effects on the fermentation quality of sweet sorghum silage.

METHODS AND RESULTS

The isolated strains were identified based on morphological, physiological and biochemical characteristics as well as 16S rRNA analysis. Seven LAB strains were isolated from elephant grass silage. Three strains (Pediococcus acidilactici (AZZ1), Lactobacillus plantarum subsp. plantarum (AZZ4), L. plantarum subsp. argentoratensis (AZZ7) and one commercial bacteria L. plantarum, ecosyl MTD/1(CB)) were chosen as additives at 6 log colony forming units per gram of fresh sweet sorghum grass in laboratory silos (680 g). Silos for each treatment were opened after 5, 7, 14, 30 and 60 days, respectively. All isolates were characterized as Gram-positive, catalase-negative and grow normally in 6·5% NaCl. The strains AZZ1, AZZ2 and AZZ5, were identified as Pediococcus genus while AZZ3, AZZ4, AZZ6 and AZZ7 were Lactobacillus genus. Compared to the control, all the isolates improved the silage quality of sweet sorghum silage, indicated by significantly (P < 0·05) lower pH and ammonia-nitrogen contents and undesirable micro-organism counts, and higher lactic acid (LA) contents and ratios of lactic acid/acetic acid. During ensiling, AZZ4 performed better among all of inoculants, indicated by significantly (P < 0·05) decreased on pH and ammonia-N contents and higher increased on LA contents.

CONCLUSION

Strain AZZ4 is recommended as starter culture for sweet sorghum.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first time to investigate the effects of LAB isolates from elephant grass silage and use them as additives, which is to find out how LAB inoculants improve the fermentation quality of sweet sorghum silage.

Effects of applying lactic acid bacteria and propionic acid on fermentation quality, aerobic stability and in vitro gas production of forage-based total mixed ration silage in Tibet

Total mixed ration (TMR) silage technology has been practically used to feed ruminants in Tibet. This study was conducted on forage-based TMR to evaluate the effects of supplementing lactic acid bacteria and propionic acid on its fermentation characteristics, aerobic stability and in vitro gas production kinetics and digestibility. Experimental treatments included four variants: (1) TMR supplemented with 10 mL deionised water per kilogram fresh matter (Control); (2) TMR supplemented with 1 × 106 cfu/g Lactobacillus plantarum (L); (3) TMR supplemented with 0.3% propionic acid (P); (4) TMR supplemented with a combination of 1 × 106 cfu/g Lactobacillus plantarum and 0.3% propionic acid (LP). The latter three additives were first dissolved in deionised water and then applied as a water solution (10 mL/kg fresh matter). All treatments were ensiled in laboratory-scale silos for 45 days, and then exposed to air for 12 days to evaluate the aerobic stability of TMR silage. Further, the four experimental treatments were fermented with buffered rumen fluid to measure in vitro gas production and nutrients’ digestibility. The results indicated that all TMR silages possessed good fermentation characteristics with low pH values (&lt;4.18) and ammonia nitrogen (NH3-N) contents (&lt;100 g/kg total nitrogen), and high lactic acid contents (&gt;66 g/kg DM) and Flieg points (&gt;80). The addition of L and LP stimulated a more efficient homofermentation of TMR silage than in the variant without L, as evidenced by higher ratios of lactic:acetic acid. The addition of P had no effect (P &gt; 0.05) on lactic acid production of TMR silage compared with the Control, whereas it decreased NH3-N content (P &lt; 0.05). Under aerobic conditions, L silage showed less aerobic stability compared with the Control silage, whereas P and LP silages were more (P &lt; 0.05) aerobically stable. Compared with the Control, all additives elevated (P &lt; 0.05) the total gas production and in vitro dry matter digestibility of TMR silages. L silage had a higher (P &lt; 0.05) in vitro neutral detergent fibre digestibility than the Control silage. Data obtained from this study suggested that TMR silage based on oat and common vetch can be well conserved with or without additives. Lactic acid bacteria were compatible with propionic acid, and addition of lactic acid bacteria together with propionic acid can improve the fermentation quality, aerobic stability and in vitro dry matter digestibility of TMR silage.

Effects of storage temperature and combined microbial inoculants on fermentation end products and microbial populations of Italian ryegrass (Lolium multiflorum Lam.) silage

AIMS

To examine five lactic acid bacteria (LAB) strains (LCG9, LTG7, I5, TG1 and LI3) isolated from the Tibetan Plateau, and evaluate their combined effects on the silage quality of Italian ryegrass (Lolium multiflorum Lam.) at three temperatures (10, 15 and 25°C).

METHODS AND RESULTS

The isolated strains were evaluated by morphological, physiological and biochemical tests. Six combined inoculants LCG9+LI3, LCG9+I5, LCG9+TG1, LTG7+LI3, LTG7+I5 and LTG7+TG1 were added to Italian ryegrass for ensiling 30 days in laboratory silos (1L) at various temperatures, respectively. All the isolates could grow normally at 5-20°C, pH 3·5-7·0 and NaCl (3·0, 6·5%). Compared to three corresponding controls, all the inoculants improved the silage quality of Italian ryegrass at different temperatures, indicated by markedly (P < 0·05) higher lactic acid (LA) contents and ratios of lactic acid/acetic acid (LA/AA), and lower pH and ammonia nitrogen (NH3 -N) contents and undesirable micro-organism counts. At 10°C, LTG7+LI3, I5 or TG1 inoculants performed superior to LCG9+LI3, I5 or TG1 inoculants, evidenced by distinctly (P < 0·05) higher LA contents and ratios of LA/AA, and lower pH and NH3 -N contents. LTG7+LI3 or TG1 silages had obviously (P < 0·05) higher LAB counts than LTG7+I5 silage at 10°C.

CONCLUSIONS

Therefore, the combined inoculants LTG7 + LI3 or TG1 are recommended as starter cultures for Italian ryegrass silage at low temperatures.

SIGNIFICANCE AND IMPACT OF THE STUDY

Temperature is a key factor affecting ensilage. In cold regions, low temperature could be an adverse environmental condition during ensiling. However, few studies have focused on improving silage quality at low temperatures. Moreover, analysis of effects of combined LAB strains with their physiological and biochemical characteristics help us use combined LAB inoculants to realize the fermentation optimization.

[Epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic diseases in preschool children]

Objective: To understand the epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city. Methods: During April 2014 to April 2015, 91 kindergartens over 3 years old were investigated. In the investigation, 16 439 questionnaires were distributed to parents, and 15 291 valid questionnaires were collected. Conners abbreviated symptom questionnaire (brief symptom questionnaire) was filled out by parents to assess the children's hyperactive behaviors. Information of allergic disease history was reported by parents, including allergic dermatitis/eczema, food/drug allergy, allergic rhinitis and asthma. Multivariate unconditional logistic regression was used to analyze the relevant factors of comorbidity of hyperactivity behavior and allergy diseases. Results: The average age of the 15 291 children were (4.5±1.0) years old, among which 53.7% (8 218/15 291) were boys. The prevalence of hyperactive behaviors was 8.6%(1 317/15 291), and the comorbidity rate of hyperactivity and allergic deseases was 1.7% (258/15 291). After confounding factors including gender, age, delivery mode, father's age and pregnancy complications adjusted, poor sleep quality (OR=4.45, 95%CI: 2.85-6.94), long duration of watching TV at weekend (OR=1.39, 95%CI: 1.00-1.94) and poor eating behavior (OR=1.78, 95%CI: 1.07-2.98) were relevant factors of the comorbidity of hyperactivity and allergic diseases. Conclusion: The prevalence of comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city was not high. Poor night sleep quality, long duration of watching TV and frequently picky eating were relevant factors of the comorbidity of hyperactive behaviors and allergic diseases.

[Potential interaction effect on attention-deficit/hyperactivity disorder between mother's educational level and preschoolers' dietary pattern]

Objective: To explore the interaction effect between mother's educational level and preschoolers' dietary pattern on attention-deficit/hyperactivity disorder (ADHD). Methods: In 2014, there were 16 439 children aged 3-6 years old from 91 kindergartens in Ma'anshan municipality of China. A semi-quantitative food frequency questionnaire and the 10-item Chinese version of the Conners' Abbreviated Symptom Questionnaire (C-ASQ) were administered to assess the usual dietary intake and symptoms on ADHD. Social-demographic information was collected through questionnaires. Unconditional logistic regression was used to analyze the multiplication interaction effect between mother's educational level and preschoolers' dietary pattern on ADHD. Excel software was used to analyze the additive interaction effect of mother's educational level and preschoolers'dietary pattern on ADHD. Results: Results showed that factors as: mother's low educational level[aOR=1.31 (1.13-1.52)], scores related to preschoolers in the top quintile of "food processing" [aOR=1.31 (1.16-1.48)] and "snack" [aOR=1.45 (1.29-1.63)]patterns showed greater odds while preschoolers in the top quintile of "vegetarian" [aOR=0.80 (0.71-0.90)]showed less odds for having ADHD symptoms. Both multiplication and additive interactions were observed between mothers with less education. The processed dietary patterns (OR=1.17, 95%CI: 1.11-1.25), relative excess risk of interaction (RERI), attributable proportion (AP) and the interaction index (SI) appeared as 0.21, 0.13 and 1.47, respectively. Multiplication interaction was observed between levels of mother's low education and the snack dietary pattern (OR=1.21, 95%CI: 1.14-1.29), with RERI, AP and SI as 0.49, 0.26 and 2.36, respectively. However, neither multiplication interaction or additive interaction was noticed between levels of mother's low education and the vegetarian dietary pattern (OR=0.97, 95%CI: 0.92-1.03), with RERI, AP and SI as 0.09, 0.05 and 1.15, respectively. Conclusions: Levels of mother's low education presented a risk factor for ADHD symptoms in preschool children. Both multiplication interaction and additive interaction were observed between mother's low education levels and the processed dietary pattern. Multiplication interaction was noticed between mother's education levels and the snack dietary pattern but not with the vegetarian dietary pattern.

Effect of lactic acid bacteria-treated King grass silage on the performance traits and serum metabolites in New Zealand white rabbits (Oryctolagus cuniculus)

This study examined the effects of Lactobacillus plantarum and Pediococcus acidilactici-treated silage of King grass (Pennisetum purpureophoides) on the productive traits and blood biochemistry of New Zealand white (NZW) rabbits. King grass was ensiled without or with L. plantarum (T1), P. acidilactici (T2) and P. acidilactici + L. plantarum (T3). A total of 72 male NZW rabbits (6 weeks) of similar weight and appearance were housed in groups in metallic cages in a completely randomized design. The performance traits, daily feed intake, body weight gain and feed convention ratio were not affected by the silage treatment. Triglyceride and alanine aminotransferase (ALT) concentration was increased (p < .05) in T2 (0.92 mmol/L) compared to the other treatments. The superoxide dismutase (SOD), phosphorous (P) and magnesium (Mg) increased (p < .05) in T1 (658.01 nmol/ml, 5.1 mg/kg and 2.43 mg/kg, respectively) compared to the control and other experimental groups. Cu and Mn decreased (p < .05), while Zn increased (p < .05) in the treated groups compared to the control. The CP decreased (p < .05) in the treatment groups compared to the control. Neutral detergent fibre (NDF) increased (p < .05) in T2 (54.40%) compared to the other treatments. The inoculation of lactic acid bacteria-treated King grass silage supplementation positively affected rabbit performance and improved blood cholesterol profile, antioxidant status and improve nutrients digestibility.

[Dietary patterns among preschoolers and its association with education level of the parents]

Objective: To identify the dietary patterns among preschoolers in Ma'anshan, and to investigate its association with the education levels of the parents. Methods: A total of 16 439 children aged 3-6 were recruited from 91 kindergartens in Ma'anshan city to participate in the study. Food frequency and socio-demographic information were collected through questionnaire survey. Dietary data was collected using a food frequency questionnaire (FFQ), and principal-components analysis was used to derive the dietary patterns. Ordinal multinomial logistic regression was employed to explore the association between the education level of parents and the dietary patterns. Results: Five dietary patterns- "processed" , "beverage" , "snack" , "protein" and "vegetarian" were identified. Data showed that the total variance was 48.02% and the cumulative proportion of processed reached 24.78%. Low educational level of the father was positively associated with both "beverage" (OR=1.36, 95%CI: 1.15-1.63) and "snack" dietary pattern (OR=1.21, 95%CI: 1.01-1.43). Low educational level of mother was positively associated with the "processed" (OR=1.31, 95%CI: 1.09-1.57) and "beverage" dietary pattern (OR=1.48, 95%CI: 1.23-1.77), and showed a negative correlation with "protein" (OR=0.62, 95%CI: 0.52-0.74) and "vegetarian" dietary pattern (OR=0.72, 95%CI: 0.60-0.86). Conclusion: Findings from this study showed that preschoolers in Ma'anshan tend to choose unhealthy dietary pattern. Dietary pattern was directly influenced by the parents, and especially the education level of the mothers.

Abstract P3-07-07: The updated ASCO/CAP guidelines for HER2 testing create more uncertainty for clinicians

Background: Accurate assessment of the Human Epidermal Growth Factor Receptor 2 (HER2) status has been an integral part of clinical decision making in treatments of breast cancer. In 2007, American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) published a series of guidelines on how to determine the status of HER2. The guidelines were updated in 2013 with the goal of reducing the numbers of false negative cases. The new guidelines are based on a combination of HER2:CEP17 ratio and average HER2 copy number. We sought to assess the overall effect of the new guidelines.

Methods: We retrospectively identified all cases of invasive breast cancer with HER2 testing done in 2014 from the pathology database of Mount Sinai Beth Israel, Mount Sinai St. Luke's and Roosevelt Hospitals. Our pathology department guideline is to perform initial testing for HER2 with immunohistochemistry (IHC) by the HercepTest (Dako) method. Those with IHC of 2+ would be followed by reflex HER2 dual probe FISH. The HER2:CEP 17 ratio and average HER2 copy number were then reviewed for each IHC 2+ case using the 2013 guidelines. These cases were then rescored using the 2007 guidelines. All equivocal cases as determined by the new 2013 guidelines (HER2:CEP17 ratio &lt;2.0 with an average HER2 copy number ≥4.0 and &lt;6.0 signals/cell) were further evaluated to determine whether repeat HER2 testing was performed as suggested by the new guidelines and whether HER2 directed therapy was recommended for patient.

Results: Among 853 cases identified in the database, 337 were IHC 2+. Using 2007 guidelines, 27/337 cases (8.0%) were amplified (HER2:CEP 17 ratio &gt;2.2), 6 (1.8%) were equivocal (HER2:CEP 17 ratio 1.8-2.2), and 305 cases (90.2%) were non-amplified (HER2:CEP 17 ratio &lt;1.8). Using the 2013 guidelines, 29/337 cases (8.6%) were amplified (HER2:CEP 17 ratio ≥2 or HER2 copy number ≥6), 23 (6.8%) were equivocal (HER2:CEP17 ratio &lt;2.0 with an average HER2 copy number ≥4.0 and &lt;6.0), and 284 (84.3%) were non-amplified (HER2:CEP 17 ratio &lt;2 with an average HER2 copy number &lt;4.0). The new guidelines resulted in change in HER2 status in 24 cases (7.1%): 2 cases changed from equivocal to amplified, 1 case changed from equivocal to non-amplified, but 20 cases changed from non-amplified to equivocal. Of the 23 equivocal cases determined using the 2013 guidelines, only 13 cases had repeat HER2 analysis. On repeat HER2 testing, one case was found to be HER2 amplified, 4 cases were non-amplified, and 8 cases remained equivocal. Only one equivocal case received HER2 directed treatment.

Conclusion: The 2013 ASCO/CAP guidelines for HER2 assessment identified a slightly increased number of patients eligible for HER2 directed therapy, but also resulted in a significant increase in the number of equivocal cases. The new guidelines appear to have generated more uncertainty for the clinician due to the rise in equivocal cases. Further studies are needed to determine whether patients with equivocal HER2 status would benefit from HER2 directed therapy.

Citation Format: Chen J, Klein P, Shao T. The updated ASCO/CAP guidelines for HER2 testing create more uncertainty for clinicians. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-07.

Characteristics of Lactobacillus parafarraginis ZH1 and its role in improving the aerobic stability of silages

AIMS

Lactobacillus parafarraginis ZH1 isolated from silage was characterized, and the effects of inoculating ZH1 and Lact. buchneri (LB) on the aerobic stability of sweet corn stalk (SCS) silage and whole-plant oat (WPO) silage ensiled at 15 and 30°C were studied.

METHODS AND RESULTS

After ensiling of SCS or WPO in plastic bottle silo for 45 days, silos were opened, and aerobic stability was studied by monitoring temperature change with thermo recorders in silage for 6 days. SCS silage and WPO silage were well conserved naturally at both storage temperatures. However, silages were prone to aerobic deterioration due to the presence of residual yeasts. ZH1 inoculated silages ensiled at both temperatures, LB inoculated silages ensiled at 30°C had better aerobic stability than the uninoculated silages and the LB-inoculated silage at 15°C.

CONCLUSIONS

Strain ZH1 improved the aerobic stability of SCS silage and WPO silage ensiled at both 15 and 30°C, while LB improved the aerobic stability of silage only ensiled at the high temperature of 30°C.

SIGNIFICANCE AND IMPACT OF THE STUDY

The new strain ZH1 can be used as an effective inhibitor for aerobic deterioration of silage maintained from 15 to 30°C.