Efficient roxarsone degradation by low-dose peroxymonosulfate with the activation of recycling iron-base composite material: Critical role of electron transfer

Pollutant degradation via electron transfer based on advanced oxidation processes (AOPs) provides an economical and energy-efficient method for pollution control. In this study, an iron-rich waste, heating pad waste (HPW), was recycled as a raw material, and a strong magnetic catalyst (Fe-HPW) was synthesized at high temperature (900 °C). Results showed that in the constructed Fe-HPW/PMS system, effective roxarsone (ROX) degradation and TOC removal (72.54%) were achieved at a low-dose of oxidant (PMS, 0.05 mM) and catalyst (Fe-HPW, 0.05 g L-1), the ratio of PMS to ROX was only 2.5:1. In addition, the released inorganic arsenic was effectively removed from the solution. The analysis of the experimental results showed that ROX was effectively degraded by forming PMS/catalyst surface complexes (Fe-HPW-PMS*) to mediate electron transfer in the Fe-HPW/PMS system. Besides, this system performed effective ROX degradation over a wide pH range (pH=3-9) and showed high resistance to different water parameters. Overall, this study not only provides a new direction for the recycling application of HPW but also re-emphasizes the neglected nonradical pathway in advanced oxidation processes.

Low-dose lenvatinib and anti-programmed cell death protein-1 combination therapy in patients with heavily pre-treated recurrent ovarian and endometrial cancer: a pilot study

OBJECTIVE

Treatment options for heavily pre-treated recurrent ovarian and endometrial cancer are limited. Lenvatinib plus anti-programmed cell death protein-1 (PD-1) combination therapy has been efficacious in advanced endometrial cancer, but at the recommended dose level, high-grade adverse events occur and lead to drug discontinuation. This study evaluated the feasibility of low-dose lenvatinib plus anti-PD-1 therapy in patients with recurrent ovarian and endometrial cancer.

METHODS

This is a single-arm, protocol-based pilot study. Patients with recurrent ovarian cancer or endometrial cancer who had at least one line of previous therapy were included and given lenvatinib 8 or 12 mg daily (based on the patient's weight) and anti-PD-1 therapy. The primary endpoint was the objective response rate.

RESULTS

Twenty-one patients were enrolled, including 15 with ovarian cancer and six with endometrial cancer. All patients were pre-treated, and the median number of lines of previous treatment of the ovarian and endometrial cancer cohorts was three and two, respectively. After a median follow-up of 11.0 months (range 6.8-23.9), the objective response rate for the ovarian cancer and endometrial cancer cohorts was 46.7% (95% CI 21.3% to 73.4%) and 66.7% (95% CI 22.3% to 95.7%), respectively. The median duration of response for the ovarian cancer and endometrial cancer cohorts was 5.3 (95% CI 0 to 11.7) and 6.1 (95% CI 2.4 to 9.8) months, respectively. The median progression-free survival for the ovarian cancer and endometrial cancer cohorts was 4.1 (95% CI 2.6 to 5.6) and 6.6 (95% CI 1.7 to 11.5) months, respectively. No grade 4 or 5 adverse events occurred. Eight (38.1%) patients had a lenvatinib dose reduction. There was no discontinuation of lenvatinib alone, and only one patient discontinued both drugs due to adverse events.

CONCLUSION

Low-dose lenvatinib in combination with anti-PD-1 therapy showed promising efficacy and favorable tolerability in patients with heavily pre-treated ovarian and endometrial cancer.

Efficient degradation of chlorpyrifos and intermediate in soil by a novel microwave induced advanced oxidation process: A two-stage reaction

The application of microwave/peroxymonosulfate (MW/PMS) in soil remediation has been limited by some shortages including low utilization efficiency of oxidants, low MW absorption capacity of soil particles and incomplete degradation of intermediate. In this study, heating pad waste (HPW) was added in the MW/PMS system to increase the ability of absorbing MW and degradation efficiency of toxic intermediate. A two-stage method for degradation of chlorpyrifos (CPF) and its intermediate 3,5,6-trichloro-2-pyridinol (TCP) by MW/PMS assisted with HPW was proposed. In the first stage, more than 90% of CPF was degraded within 15 min before the addition of HPW, and most of the CPF was converted into TCP through direct or indirect pathways under the action of 1O2. In the second stage, more than 70% of the generated TCP was rapidly degraded through SO4•- oxidation and electron transfer. The TCP was further degraded with the assistance of HPW through methylation, hydroxylation and dechlorination etc., and the toxicity of degradation products was decreased significantly. pH and soil organic matter had little influences on CPF and TCP degradation. Therefore, a new strategy for remediation of CPF contaminated-soil was provided based on MW/PMS technology and the concept of "treating waste with waste".

Decreased macular deep capillary plexus is associated with functional progression of normal tension glaucoma patients with unilateral visual field loss

PURPOSE

To investigate whether quantitative optical coherence tomography angiography (OCTA) metrics of the superficial/deep macular retina are associated with the development of visual field (VF) loss in the fellow eyes of normal tension glaucoma (NTG) patients with unilateral VF loss.

METHODS

A longitudinal study was conducted in which 61 eyes with normal VF (mean VF mean deviation -0.7±1.6 dB) from 61 NTG patients were included. All subjects underwent OCTA imaging, spectral-domain-OCT imaging and VF testing. OCTA metrics of superficial capillary plexus and deep capillary plexus (DCP) in the macular region were measured. Relationships between baseline OCTA metrics, demographics and ocular characteristics and the risk of VF glaucoma progression were analysed with a Cox proportional hazards model.

RESULTS

During a mean follow-up of 38 months, 11 fellow eyes (18.0%) with normal VF at baseline were determined to have VF progression, while 21.3% of affected eyes had VF progression. After adjustment for potential confounding factors, decreased baseline DCP in the fellow eyes was significantly associated with future VF progression (HR 1.33, 95% CI 1.03 to 1.73, p=0.031).

CONCLUSION

Decreased DCP was associated with a higher risk of developing VF damage in NTG patients with unilateral VF loss. Assessments of DCP may help improve the evaluation of the risk of functional deterioration in fellow eyes with an initially normal VF.

Progressive peripapillary capillary vessel density loss and long-term visual field progression in Normal tension glaucoma

PURPOSE

To explore the association between progressive peripapillary capillary vessel density (pcVD) reduction and the progression of visual field (VF) impairment in individuals with normal tension glaucoma (NTG).

DESIGN

Prospective cohort study.

METHODS

The study enrolled 110 participants with one eye each, totalling 110 NTG eyes. VF defects were evaluated using standard automated perimetry mean deviation (MD), while pcVD measurements were obtained using optical coherence tomography angiography throughout the follow-up period. Estimates of VF progression were determined by event-based and trend-based analyses. Fast VF progression was defined as an MD slope steeper than -0.5 dB/year, while the slow progression or stable VF was defined as an MD slope better or equal to -0.25 dB/year. Linear mixed-effects models were employed to analyse the rates of change in pcVD reduction and VF MD decline over time. Additionally, univariable and multivariable linear models were used to examine the relationship between pcVD changes and VF loss rates in NTG.

RESULTS

Slow VF progression or stable VF was observed in 45% of subjects, while 25% had moderate progression and 30% showed fast progression. Patients with VF progression exhibited faster rate of pcVD reduction in peripapillary global region (-0.73 ± 0.40%/year vs. -0.56 ± 0.35%/year, p = 0.022). Moreover, this rate positively correlated with VF MD decline in NTG (estimate 0.278, 95% CI 0.122-0.433, p = 0.001).

CONCLUSION

In individuals with NTG, faster VF progression was linked to a quicker reduction in pcVD, suggesting a positive correlation between pcVD decline and VF deterioration.

Functional and Morphological Outcomes after Trabeculectomy and Deep Sclerectomy-Results from a Monocentric Registry Study

The aim of this study was to compare the effectiveness of trabeculectomy (TE) and deep sclerectomy (DS) in lowering intraocular pressure (IOP) and thereby preserving visual field and peripapillary retinal nerve fiber layer (RNFL) tissue in primary open-angle glaucoma (POAG) cases. IOP, number of IOP-lowering medications, visual acuity, mean defect of standard automated perimetry, and mean peripapillary RNFL thickness were retrospectively collected and followed up for 3 years after surgery. TE was performed in 104 eyes and DS in 183 eyes. Age, gender, laterality, IOP, number of medications, visual acuity, perimetry mean defect, and peripapillary RNFL thickness were equally distributed at baseline. Mean IOP decreased from 23.8 ± 1.4 mmHg and 23.1 ± 0.4 mmHg to 13.4 ± 0.6 mmHg (p < 0.001) and 15.4 ± 0.7 mmHg (p = 0.001) in the TE and DS groups, respectively. Mean defect remained stable (TE: -11.5 ± 0.9 dB to -12.0 ± 1.1 (p = 0.090); DS: -10.5 ± 0.9 dB to -11.0 ± 1.0 dB (p = 0.302)), while mean peripapillary RNFL thickness showed further deterioration during follow-up (TE group: 64.4 ± 2.1 μm to 59.7 ± 3.5 μm (p < 0.001); DS group: 64.9 ± 1.9 μm to 58.4 ± 2.1 μm (p < 0.001)). Both TE and DS were comparably effective concerning postoperative reduction in IOP and medication. However, glaucoma disease further progressed during follow-up.

Involvement of GA3-oxidase in inhibitory effect of nitric oxide on primary root growth in Arabidopsis

Both NO and GAs are essential for regulating various physiological processes and stress responses in plants. However, the interaction between these two molecules remains unclear. We investigated the distinct response patterns of Arabidopsis thaliana Col-0 and GA synthesis functional deficiency mutants to NO by measuring root length. To investigate underlying mechanisms, we detected bioactive GA content using UHPLC-ESI-MS/MS, assessed the accumulation of ROS by chemical staining Arabidopsis roots. We also conducted RNA-seq analysis and compared results between Col-0 and ga3ox1, with and without SNP (as NO donor) treatment. Phenotypic results revealed that the inhibitory effect of NO on primary roots of Arabidopsis was primarily mediated by GA3-oxidase, rather than GA20-oxidase or GA2-oxidase. The content of GA3 decreased in Col-0 treated with SNP, whereas this decrease was not observed in ga3ox1. The deficiency of GA3-oxidase alleviated the buildup of H2 O2 in roots when treated with SNP. We identified 222 DEGs. GO annotation of these DEGs revealed that all top 20 GO terms were related to stress responses. Moreover, three DEGs were annotated to GA-related processes (DDF1, DDF2, EXPA1), and seven DEGs were associated with root development (RAV1, RGF2, ERF71, ZAT6, MYB77, XT1, and DTX50). In summary, NO inhibits primary root growth partially by repressing GA3-oxidase catalysed GA3 synthesis in Arabidopsis. ROS, Ca2+ , DDF1, DDF2, EXPA1 and seven root development-related genes may be involved in crosstalk between NO and GAs.

PRESERFLO MicroShunt implantation versus trabeculectomy for primary open-angle glaucoma: a two-year follow-up study

BACKGROUND

To compare the intermediate-term efficacy of PRESERFLO (PF) MicroShunt implantation with trabeculectomy (TE) in patients with primary open-angle glaucoma, focusing on longitudinal changes of functional and structural parameters.

METHODS

This retrospective comparative study included 104 eyes of 104 patients who underwent TE and 83 eyes of 83 patients that underwent PF implantation between January 2019 and December 2020, with a minimum follow-up of two years. Baseline and postoperative intraocular pressure (IOP), number of IOP-lowering medications, visual field mean defect (MD) and peripapillary retinal nerve fibre layer (RNFL) thickness measured using optical coherence tomography were assessed and compared between groups.

RESULTS

Baseline characteristics (age, sex, IOP, number of IOP-lowering medications, MD, RNFL thickness) were comparable between the two groups (all P > 0.05). During the two-year of follow-up, mean IOP decreased from 24.09 ± 1.15 mmHg and 21.67 ± 0.77 mmHg to 11.37 ± 1.13 mmHg (P < 0.001) and 15.50 ± 1.54 mmHg (P = 0.028), and the mean number of IOP-lowering medications decreased from 3.25 ± 0.14 and 3.51 ± 0.14 to 0.53 ± 0.14 (P < 0.001) and 1.06 ± 0.43 (P < 0.001) in the TE and PF groups, respectively. MD remained stable [- 11.54 ± 0.93 dB and - 11.17 ± 1.66 to - 10.67 ± 0.91 dB (P = 0.226) and - 10.40 ± 4.75 dB (P = 0.628) in the TE and PF groups, respectively] but RNFL thickness decreased continuously during follow-up [62.79 ± 1.94 µm and 62.62 ± 2.05 µm to 57.41 ± 1.81 µm (P < 0.001) and 60.22 ± 1.98 µm (P = 0.182) in the TE and PF groups, respectively].

CONCLUSION

PF implantation is comparably effective in the intermediate term in lowering IOP and reducing the use of IOP-lowering medications over a two-year follow-up period. Although visual field defects were stable, RNFL continued to decrease during postoperative follow-up.

Magnetic and Ferroelectric Manipulation of Valley Physics in Janus Piezoelectric Materials

The realization of multiferroic materials offers the possibility of multifunctional electronic device design. However, the coupling between the multiferroicity and piezoelectricity in Janus materials is rarely reported. In this study, we propose a mechanism for manipulating valley physics by magnetization reversing and ferroelectric switching in multiferroic and piezoelectric material. The ferromagnetic VSiGeP4 monolayer exhibits a large valley polarization up to 100 meV, which can be effectively operated by reversing magnetization. Interestingly, the antiferromagnetic VSiGeP4 bilayers with AB and BA stacking configurations allow the coexistence of valley polarization and ferroelectricity, supporting the proposed strategy for manipulating valley physics via ferroelectric switching and interlayer sliding. In addition, the VSiGeP4 monolayer contains remarkable tunable piezoelectricity regulated by electron correlation U. This study proposes a feasible idea for regulating valley polarization and a general design idea for multifunctional devices with multiferroic and piezoelectric properties, facilitating the miniaturization and integration of nanodevices.

Effects of regular zooplankton supplement on the bacterial communities and process performance of biofilm for wastewater treatment

Biofilm processing technologies were widely used for wastewater treatment due to its advantages of low cost and easy management. However, the aging biofilms inevitably decrease the purification efficiency and increase the sludge production, which limited the widely application of biofilms technologies in rural area. In this study, we proposed a novel strategy by introducing high-trophic organisms to prey on low-trophic organisms, and reduce the aged biofilms and enhance treatment efficiencies in rural wastewater treatment. The effect of three typical zooplankton (Paramecium, Daphnia, and Rotifer) supplement on the purification efficiency and biofilm properties in the contact oxidation process were investigated, and the reaction conditions were optimized by an orthogonal experiment. Under optimal conditions, the biofilms weight decreased 67.6%, the oxygen consumption rate of biofilms increased 9.4%, and wastewater treatment efficiency was obviously increased after zooplankton supplement. Microbial sequencing results demonstrated that the zooplankton optimize the contact oxidation process by altering the bacterial genera mainly Diaphorobacter, Thermomonas, Alicycliphilus and Comamonas. This research provides insight into mechanism of the zooplankton supplement in biological contact oxidation process and provides a feasible strategy for improving the rural sewage treatment technology.

A Feasibility Study of Dose Band Prediction in Radiotherapy: Predicting a Dose Spectrum

PURPOSE/OBJECTIVE(S)

Current deep learning-based dose prediction methods can only predict a specific dose distribution. If the predicted dose is inaccurate, no more options can be selected. We proposed a novel dose prediction method named dose band prediction, which outcomes a spectrum of predicted dose distribution for planning and quality assurance (QA).

MATERIALS/METHODS

Upper-Band and Lower-Band losses were involved in 3D convolution neural networks to establish the Upper-Band Network (UBN) and Lower-Band Network (LBN). Each voxel's ideal dose spectrum (dose band) was defined by the maximum/minimum rational dose predicted by UBN/LBN. 130 NPC cases with Tomotherapy (dataset 1), 49 cervix cases with IMRT (dataset 2) and 43 cervix cases with VMAT (dataset 3) were enrolled to establish and evaluate our dose band prediction method.

RESULTS

The dose band prediction method can successfully predict a spectrum of doses. Upper-Band/Lower-Band presents maximum/minimum rational dose; Middle-Line presents the average of Upper-Band and Lower-Band. The clinical implement dose was used as the reference dose. We evaluated the maximum interval between the reference and Upper-Band/Middle-Line/Lower-Band doses, and the percentage dose difference was used as the evaluation method. The differences in PTV for Upper-Band, Middle-Line and Lower-Band in dataset 1 were within 2.47%, 0.54%, and 2.8%; in dataset 2, they were within 0.37%, 1.15%, and 2.69%; in dataset 3, they were within 0.96%, 0.35%, and 1.66%. The mean difference of OARs for the Upper-Band, Middle-Line and Lower-Band in dataset 1 were within 8.13%, 4.97%, and 8.19%; in dataset 2, they were within 8.8%, 4.48%, and 5.52%; in dataset 3, they were within 4.01%, 3.13%, and 5.79% (shown in Table 1).

CONCLUSION

Dose Band prediction achieved high-accuracy dose prediction by the Middle-Line. More importantly, the Upper-Band/Lower-Band provided a spectrum of possible rational doses. Our Dose Band prediction method is based on a specific loss function, so it can easily be applied in various network and patient cases. Dose Band prediction towards a more robust plan QA and planning assistance. Table 1. The maximum interval of doses (percentage dose difference, %).

Construction and Evaluation of Clinical Prediction Model for Immunotherapy-related Adverse Events and Clinical Benefit in Cancer Patients Receiving Immune Checkpoint Inhibitors Based on Serum Cytokine Levels

Immune checkpoint inhibitors (ICIs) have revolutionized the therapeutic landscape of cancer therapy. This study aimed to develop novel risk classifiers to predict the risk of immune-related adverse events (irAEs) and the probability of clinical benefits. Patients with cancer who received ICIs from the First Affiliated Hospital of Xi 'an Jiaotong University from November 2020 to October 2022 were recruited and followed up. Logistic regression analyses were performed to identify independent predictive factors for irAEs and clinical response. Two nomograms were developed to predict the irAEs and clinical responses of these individuals, with a receiver operating characteristic curve to assess their predictive ability. Decision curve analysis was performed to estimate the clinical utility of the nomogram. This study included 583 patients with cancer. Among them, 111 (19.0%) developed irAEs. Duration of treatment (DOT)>3 cycles, hepatic-metastases, IL2>2.225 pg/mL, and IL8>7.39 pg/mL were correlated with higher irAEs risk. A total of 347 patients were included in the final efficacy analysis, with an overall clinical benefit rate of 39.7%. DOT>3 cycles, nonhepatic-metastases, and irAEs and IL8>7.39 pg/mL were independent predictive factors of clinical benefit. Ultimately, 2 nomograms were successfully established to predict the probability of irAEs and their clinical benefits. Ultimately, 2 nomograms were successfully established to predict the probability of irAEs and clinical benefits. The receiver operating characteristic curves yielded acceptable nomogram performance. Calibration curves and decision curve analysis supported the hypothesis that nomograms could provide more significant net clinical benefits to these patients. Specific baseline plasma cytokines were closely correlated with irAEs and clinical responses in these individuals.

Stage specific glaucomatous changes of the macula recorded using spectral domain optical coherence tomography

BACKGROUND

This study aimed to compare the thickness of different macular retinal layers in glaucomatous eyes and healthy controls, and evaluate the diagnostic performance of spectral domain optical coherence tomography (SD-OCT) parameters.

METHODS

In this cross-sectional comparative study, 48 glaucomatous eyes and 44 healthy controls were included. The thickness of the total retina and all retinal layers were obtained using the Early Treatment Diagnostic Retinopathy Study (ETDRS) grid. The minimal and average values of outer and inner ETDRS-rings were calculated. The diagnostic performance for detection of glaucoma was evaluated using the area under the receiver operating characteristic curve (AUC).

RESULTS

The thickness of the total retina, ganglion cell layer (GCL), and inner-plexiform layer (IPL) was significantly thinner in glaucomatous eyes in all sectors except the center (all p<0.05). The thickness of retinal nerve fiber layer (RNFL) was significantly thinner in the glaucoma group except in the center, nasal inner, and temporal outer sectors (all p<0.05). Layer thinning advanced with glaucoma severity. The minimal outer GCL thickness showed the highest AUC value for discrimination between glaucomatous eyes and healthy controls(0.955). The minimal outer IPL showed the highest AUC value for discriminating early-stage glaucomatous eyes from healthy controls (0.938).

CONCLUSIONS

Glaucomatous eyes were found to have significant thinning in the macular region. GCL and IPL showed high ability to discriminate glaucomatous and early-stage glaucomatous eyes from controls. Applying the minimal value to the ETDRS grid has the potential to provide good diagnostic abilities in glaucoma screening.

Progressive Macular Vessel Density Loss Observed on Optical Coherence Tomography Angiography in Glaucoma Patients With Single-Hemifield Visual Field Defects

PRCIS

Faster hemispheric mVD loss was found in the affected hemifield of POAG patients without significant changes in hemispheric thickness. The progression of mVD loss was associated with the severity of VF damage.

PURPOSE

To evaluate the changes in macular vessel density (mVD) loss in primary open angle glaucoma (POAG) patients with visual field (VF) defects confined to 1 hemifield.

MATERIALS AND METHODS

This longitudinal cohort study used linear mixed models to evaluate the changes in the hemispheric mean total deviation (mTD), mVD, macular ganglion cell complex, macular ganglion cell-inner plexiform layer, and retinal nerve fiber layer between affected hemifields, unaffected hemifields, and healthy controls.

RESULTS

Twenty-nine POAG eyes and 25 healthy eyes were followed for an average of 29 months. In POAG eyes, the rates of decline in hemispheric mTD and hemispheric mVD in the affected hemifields were significantly faster than those in the unaffected hemifields (-0.42±1.24 vs. 0.02±0.69 dB/year, P =0.018 and -2.16±1.01 vs. -1.77±0.90% / year, P =0.031, respectively). There were no differences in the rate of hemispheric thickness change between the 2 hemifields. The rate of hemispheric mVD decline in both hemifields of POAG eyes was significantly faster than that of the healthy controls (All P <0.05). An association between the reduced mTD of the VF and the rate of hemispheric mVD loss in the affected hemifield was observed (r=0.484, P =0.008). Faster rates of mVD loss (β=-1.72±0.80, P =0.050) were significantly related to reduced hemispheric mTD in the multivariate analysis.

CONCLUSIONS

Faster hemispheric mVD loss was found in the affected hemifield of POAG patients without significant changes in hemispheric thickness. The progression of mVD loss was associated with the severity of VF damage.

Switch effect on controlled water splitting by biaxial strain regulating the promising two-dimensional Janus X2PAs (X = Si, Ge and Sn) photocatalyst

Two-dimensional photocatalytic materials with unique properties have been well-reported in recent decades. However, strategies for controlling the photocatalytic process are still ongoing. Herein, Janus X₂PAs (X = Si, Ge and Sn) monolayers have been explored by first-principles calculations to meet this challenge. All strain-free X₂PAs monolayers exhibit excellent photocatalytic properties with high carrier mobility (2.39 × 10²-1.34 × 10⁴ cm² V^-1 s^-1), suitable band edge positions straddling the standard redox potential of water and large visible light absorption coefficients (up to 10⁵ cm^-1). Most importantly, a reaction switch effect is proposed for the first time towards controlling the microscopic photocatalytic process of water splitting on X₂PAs monolayers through macroscopic mechanical strain. This effect renders the Janus X₂PAs photocatalytic switches among the states of only oxygen evolution reaction, only hydrogen evolution reaction and the full redox reaction for controlled water splitting. This work not only provides a new avenue for designing highly tunable photocatalysts but also offers new physical insights into controlling the photocatalytic water-splitting reaction.

A novel risk classifier to predict the in-hospital death risk of nosocomial infections in elderly cancer patients

Background

Elderly cancer patients are more predisposed to developing nosocomial infections during anti-neoplastic treatment, and are associated with a bleaker prognosis. This study aimed to develop a novel risk classifier to predict the in-hospital death risk of nosocomial infections in this population.

Methods

Retrospective clinical data were collected from a National Cancer Regional Center in Northwest China. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm was utilized to filter the optimal variables for model development and avoid model overfitting. Logistic regression analysis was performed to identify the independent predictors of the in-hospital death risk. A nomogram was then developed to predict the in-hospital death risk of each participant. The performance of the nomogram was evaluated using receiver operating characteristics (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results

A total of 569 elderly cancer patients were included in this study, and the estimated in-hospital mortality rate was 13.9%. The results of multivariate logistic regression analysis showed that ECOG-PS (odds ratio [OR]: 4.41, 95% confidence interval [CI]: 1.95-9.99), surgery type (OR: 0.18, 95%CI: 0.04-0.85), septic shock (OR: 5.92, 95%CI: 2.43-14.44), length of antibiotics treatment (OR: 0.21, 95%CI: 0.09-0.50), and prognostic nutritional index (PNI) (OR: 0.14, 95%CI: 0.06-0.33) were independent predictors of the in-hospital death risk of nosocomial infections in elderly cancer patients. A nomogram was then constructed to achieve personalized in-hospital death risk prediction. ROC curves yield excellent discrimination ability in the training (area under the curve [AUC]=0.882) and validation (AUC=0.825) cohorts. Additionally, the nomogram showed good calibration ability and net clinical benefit in both cohorts.

Conclusion

Nosocomial infections are a common and potentially fatal complication in elderly cancer patients. Clinical characteristics and infection types can vary among different age groups. The risk classifier developed in this study could accurately predict the in-hospital death risk for these patients, providing an important tool for personalized risk assessment and clinical decision-making.

[Analysis of vaginal microecology in 23 181 cases of the gynecological female outpatients]

Objective: To analyze the vaginal microecological status of vaginitis population and non-vaginitis population of gynecological female outpatients. Methods: A total of 30 265 women who visited the gynecological outpatient clinic of Beijing Obstetrics and Gynecology Hospital from December 2018 to December 2020 completed vaginal microecological examination. After removing the follow-up patients, 23 181 women were divided into group with symptoms and signs of vaginitis (6 697 cases) and group without symptoms and signs of vaginitis (16 484 cases), according to whether the women with symptoms and signs of vaginitis or not. And the vaginal microecological status of the two groups was compared and analyzed. Results: (1) The total detection rate of vaginitis in the initial women was 34.87% (8 083/23 181), of which 46.10% (3 087/6 697) in group with symptoms and signs of vaginitis and 30.31% (4 996/16 484) in group without symptoms and signs of vaginitis, nearly 1/3 of the gynecological outpatients without signs and symptoms of vaginitis had vaginitis. (2) Among the types of simple vaginitis, vulvovaginal candidiasis (VVC) was the most frequent in group with symptoms and signs of vaginitis (16.01%, 1 072/6 697), followed by aerobic vaginitis (AV; 12.83%, 859/6 697), with significant differences compared with group without symptoms and signs of vaginitis (all P<0.001). There were no statistical differences between the two groups of bacterial vaginosis (BV) and trichomonal vaginitis (TV), indicating that BV and TV were more likely to be neglected (all P>0.05). (3) The proportion of various combinations of vaginitis among 2 632 cases of mixed vaginitis were, in descending order: BV+AV, VVC+AV, BV+AV+VVC, AV+TV, AV+TV+BV, BV+VVC. (4) Microecological analysis of 15 098 cases diagnosed with non-vaginitis had normal flora (including those with normal flora and those with normal flora but decreased function) in 14 013 cases (92.81%, 14 013/15 098), abnormal flora in 429 cases (2.84%, 429/15 098) and the BV intermediate in 656 cases (4.34%, 656/15 098); this indicated that the vast majority of the microecological tests were normal in the vaginal microbiota of those without vaginitis. Conclusions: Microecological examination could diagnose multiple pathogenic infections at once, and is especially important as a guide for the definitive diagnosis of mixed vaginitis and vaginitis with atypical clinical symptoms. Vaginal infections such as BV and TV that are easily overlooked should be concerned.

Thyroid stimulating hormone correlates with triglyceride levels but is not associated with the severity of acute ischemic stroke in patients with euthyroidism: a cross-sectional study

Background

Growing evidence suggests an association between thyroid stimulating hormone (TSH) and severity of acute ischemic stroke (AIS). However, few studies have ruled out the potential influences of abnormal thyroid hormones when assessing this association. This study aimed to investigate the association between TSH levels and the severity of AIS patients with euthyroidism, and to explore the potential mechanism of TSH on this disease by analyzing the correlation of TSH with lipid profiles.

Methods

This retrospective study consisted of 345 patients with normal T3 and T4 levels admitted for first-ever cerebral ischemic stroke. Baseline data of participant were collecte. Laboratory data, including serum levels of TSH and lipid profiles were measured in our hospital's clinical laboratory on admission. Stroke severity was recorded using the National Institutes of Health Stroke Scale (NIHSS). Associations between TSH levels and disease severity were analyzed with logistic regression analysis. Correlations between TSH and lipid profiles were analyzed with Spearman's rank correlation analysis.

Results

Among the 345 patients with AIS, the median age was 63 years (63±12 years), 106 patients (30.7%) were female, 237 (68.7%) patients were mild-severity and 108 (31.3%) patients were severity. Data analysis showed that higher serum TSH levels were associated with the mild severity of patients with AIS (P=0.042 in Kruskal-Wallis test, P=0.025 in logistic regression analysis, and P=0.044 in multiple logistic regression), but not in AIS patients with euthyroidism (P=0.078, P=0.337, respectively). Furthermore, TSH levels were correlated with triglycerides (TG) levels not only in total patients (r=0.135, P=0.012) but also in the patients with euthyroidism (r=0.133, P=0.018).

Conclusions

TSH levels are associated with the severity of AIS patients, but not in patients with euthyroidism, predicting that stratified management of TSH may be beneficial in patients with AIS. Moreover, TSH levels are correlated with TG levels in patients with AIS.

Population-based associations between progression of normal-tension glaucoma and Yang-deficient constitution among Chinese persons

PURPOSE

To explore the association between constitution types as defined by traditional Chinese medicine (TCM) and risk for normal-tension glaucoma (NTG).

DESIGN

Population-based cohort study.

METHODS

Persons were identified in a population cohort aged ≥30 years with NTG, defined as having an untreated mean intraocular pressure measurement ≤21 mm Hg over six separate occasions, with no single reading >24 mm Hg (as in the Collaborative Normal Tension Glaucoma Study). The Body Constitution in Traditional Chinese Medicine Questionnaire was used to assess each participant's TCM constitution types. The association between various constitutions and visual field progression according to Early Manifest Glaucoma Trial criteria was assessed using Cox regression HR models.

RESULTS

Among 142 participants (245 eyes), 23 persons (17.6%) and 25 eyes (10.2%) progressed, over a mean (SD) follow-up duration of 3.49 (0.99) years. Progression rates were highest in participants with Yang-deficient constitution (n=19, 13.4%), among whom 7 (36.8%) exhibited worsening fields. After adjusting for sex, age, central corneal thickness, retinal nerve fibre layer thickness and mean deviation on visual field testing, Yang-deficient constitution (HR 4.63, 95% CI 1.77 to 12.1, p=0.002) and higher mean intraocular pressure during follow-up (HR 1.25, 95% CI 1.01 to 1.56, p=0.044) were associated with field progression.

CONCLUSIONS

Yang-deficient constitution and higher intraocular pressure are risk factors for visual field progression in NTG patients. Yang deficiency is characterised by abnormal vasoregulation, and these results may be consistent with prior studies linking NTG progression to Raynaud's phenomenon and migraine.

Efficacy and Safety of Probiotics in Geriatric Patients with Constipation: Systematic Review and Meta-Analysis

BACKGROUND

Probiotics may be an effective alternative to traditional drug therapy for constipation in the elderly.

OBJECTIVE

To assess the efficacy and safety of probiotics in managing constipation among the elderly.

METHODS

Eight databases were queried for randomized controlled trials (RCTs) investigating probiotics' efficacy in addressing constipation among the elderly until January 2023. The meta-analysis was conducted employing R software version 4.2.2. The Cochrane risk of bias tool was utilized to evaluate the risk of bias, and the GRADE approach was employed to assess the credibility of the evidence concerning the efficacy of probiotics in treating constipation in older individuals.

RESULTS

A total of six RCTs involving 444 patients were included. Two studies were rated as low risk of bias. The meta-analysis findings revealed that probiotics, when compared to a placebo, led to an increase in stool frequency (MD = 1.02,95% CI [0.21, 2.07], p<0.05, very low quality), the probiotic group exhibited a notable impact on ameliorating symptoms associated with constipation (OR = 11.28, 95%CI [7.21, 17.64], p < 0.05, very low quality), no significant disparities were observed in terms of efforts to evacuate, manual maneuvers, and the incidence of adverse events (p>0.05).

CONCLUSION

The available evidence indicates a degree of uncertainty, ranging from low-to-very low, suggesting the efficacy of probiotics in augmenting bowel frequency and ameliorating constipation-related symptoms among elderly patients with constipation. Nevertheless, given the quality of the studies included, it is advisable to conduct further well-designed investigations with substantial sample sizes to substantiate the findings of this study.

Mie Resonances Enabled Subtractive Structural Colors with Low-Index-Contrast Silicon Metasurfaces

All-dielectric structural colors are attracting increasing attention due to their great potential for various applications in display devices, imaging security certification, optical data storage, and so on. However, it remains a great challenge to achieve vivid structural colors with low-aspect-ratio silicon nanostructures directly on a silicon substrate, which is highly desirable for future integrated optoelectronic devices. The main obstacle comes from the difficulty in achieving strong Mie resonances by Si nanostructures on low-index-contrast substrates. Here, we demonstrate a generic principle to create vivid bright field structural colors by using silicon nanopillars directly on top of the silicon substrate. Complementary colors across the full visible spectrum are achieved as a result of the enhanced absorption due to Mie resonances. It is shown that the color saturation increases with the increasing of the nanopillar height. Remarkably, blue and black colors are generated by trapezoid nanopillar arrays as a result of the absorption at long wavelengths or all visible wavelengths. Our strategy provides a powerful scheme for accelerating the integrated optoelectronic applications in nanoscale color printing, imaging, and displays.

Pandemic influenza A (H1N1) virus causes abortive infection of primary human T cells

Influenza A virus still represents a noticeable epidemic risk to international public health at present, despite the extensive use of vaccines and anti-viral drugs. In the fight against pathogens, the immune defence lines consisting of diverse lymphocytes are indispensable for humans. However, the role of virus infection of lymphocytes and subsequent abnormal immune cell death remains to be explored. Different T cell subpopulations have distinct characterizations and functions, and we reveal the high heterogeneity of susceptibility to viral infection and biological responses such as apoptosis in various CD4⁺ T and CD8⁺ T cell subsets through single-cell transcriptome analyses. Effector memory CD8⁺ T cells (CD8⁺ T_EM) that mediate protective memory are identified as the most susceptible subset to pandemic influenza A virus infection among primary human T cells. Non-productive infection is established in CD8⁺ T_EM and naïve CD8⁺ T cells, which indicate the mechanism of intracellular antiviral activities for inhibition of virus replication such as abnormal viral splicing efficiency, incomplete life cycles and up-regulation of interferon-stimulated genes in human T cells. These findings provide insights into understanding lymphopenia and the infectious mechanisms of pandemic influenza A virus and broad immune host–pathogen interactional atlas in primary human T cells.

Faster Macular Vessel Density Loss in More Advanced Primary Open Angle Glaucoma Eyes

PURPOSE

The aim of the study was to characterize and compare the longitudinal changes of macular vessel density (VD) in primary open angle glaucoma (POAG) eyes across different disease stages.

METHODS

This is a sub-analysis of a prospective cohort study. A total of 103 eyes (53 eyes in the mild stage, 50 eyes in the moderate-to-advanced stage) of 75 POAG patients followed for more than 1 year with at least 2 qualified optical coherence tomography (OCT) angiography (OCTA) images were included. The rates of macular VD change were determined by linear regression and compared using the generalized linear mixed models between groups. Mixed effect models were used to evaluate the demographic and ocular parameters associated with the VD loss rate.

RESULTS

With a mean follow-up time of 2.36 years, the rates of macular VD change were significantly different from zero in both groups. The rates of macular VD loss were significantly faster in moderate-to-advanced-stage group than in mild-stage group in whole image (-2.46%/year vs. -1.47%/year, p = 0.002);, superior hemifield (-2.42%/year vs. -1.30%/year, p = 0.001); parafovea (-2.35%/year vs. -1.26, p = 0.001); superior (-2.20%/year vs. -1.01%/year, p = 0.002), nasal (-2.41%/year vs. -1.04%/year, p = 0.001), inferior (-2.46%/year vs. -1.43%/year, p = 0.018), and temporal sectors (-2.32%/year vs. -1.58%/year, p = 0.012). Baseline mean deviation and OCT parameters were associated with the rates of macular VD loss.

CONCLUSIONS

OCTA measurements could detect vascular deterioration over time in POAG eyes at different stages. The rates of macular VD loss were significantly faster in more advanced POAG eyes.

Serum adenosine deaminase activity and acute cerebral infarction: a retrospective case-control study based on 7913 participants

BACKGROUND

Adenosine deaminase (ADA) is a key enzyme that catalyzes the deamination of adenosine into inosine, which eventually decomposes into uric acid (UA). A body of papers have reported that adenosine and UA are closely related to cerebrovascular events. However, the association between serum ADA activity and acute cerebral infarction (ACI) remains unclear.

METHODS

7913 subjects were enrolled, including 3968 ACI patients and 3945 controls, in this study. An automatic biochemistry analyzer was used to determine serum activity.

RESULTS

Serum ADA activity was found that was significantly decreased in patients with ACI (10.10 ± 3.72 U/L) compared to those without ACI (11.07 ± 2.85 U/L, p < 0.001). After Logistic regression analysis, ADA concentrations were negatively correlated with ACI (OR = 1.161, 95% CI: 1.140-1.183, p < 0.001). Smoking and alcohol consumption decreased serum ADA concentrations in patients with ACI, whereas diabetes and hypertension had the opposite effect.

CONCLUSIONS

Serum ADA concentrations in patients with ACI are markedly decreased, suggesting that the decreased ADA concentrations may be involved in the pathogenesis of ACI. We hypothesized that decreased ADA activity may be an adaptive mechanism to maintain adenosine levels and protect against ischemic brain injury.

[Association of nutritional status with clinical outcomes of stroke patients with acute anterior circulation large vessel occlusion after emergency endovascular treatment]

OBJECTIVE

To explore the influence of nutritional status on 90-day functional outcomes of stroke patients with acute large vessel occlusion in the anterior circulation after endovascular treatment (EVT).

METHODS

We retrospectively analyzed the baseline, laboratory, surgical and 90-day follow-up data of patients with stroke resulting from acute large vessel occlusion in the anterior circulation, who underwent emergency endovascular treatment in our hospital from July, 2015 to December, 2020. A favorable outcome was defined as a modified Rankin scale score ≤2 at 90 days. Univariate and multivariate regression analyses were performed to explore the relationship between nutritional status and 90-day functional outcomes of the patients.

RESULTS

A total of 459 patients (mean age of 68.29±11.21 years, including 260 males) were enrolled in this study. According to their prognostic nutritional index (PNI), the patients were divided into normal nutrition group (392 cases, 85.4%), moderate malnutrition group (44 cases, 9.6%), and severe malnutrition group (23 cases, 5.0%). Univariate analysis showed that the patients with good clinical outcomes had a lower proportion of malnutrition with a younger age, a lower rate of diabetes, lower baseline blood pressure, lower baseline NIHSS score, higher baseline ASPECT score, and higher rates of good collateral circulation and complete vascular recanalization. Multivariate analysis showed that in addition to age, diabetes, baseline systolic blood pressure, successful recanalization, baseline ASPECT score, baseline NIHSS score and collateral circulation, a greater PNI was a protective factor for a good 90-day outcome of patients after EVT (moderate vs severe: OR=0.245, 95% CI: 0.066-0.908, P=0.035; normal vs severe: OR=0.185, 95% CI: 0.059-0.581, P=0.004).

CONCLUSION

Nutritional status an important factor affecting the 90-day outcomes after EVT of stroke patients with acute large vessel occlusion in the anterior circulation.

Abstract 1405: Novel ADC platform delivers promising in vivo activity and safety

The physiochemical properties of an antibody-drug conjugate (ADC) are one key design attribute that can impacts its stability and pharmacokinetics/pharmacodynamics and are one of the key design attributes. Typically, ADCs with better hydrophilicity are less prone to aggregation, and have lower systemic clearance, and greater anti-tumor activities and thus a larger therapeutic index. However, the need to incorporate lipophilic payloads with an enhanced bystander effects has posed significant challenges to ADC and linker design, especially at drug-antibody ratios of 8 and even 16higher. Here we present a novel ADC platform that can greatly improveimproves the hydrophilicity, physiochemical stability, and pharmacokinetics of ADCs conjugated to lipophilic payloads such as exatecan, MMAE, SN38 and EErribulin. All payloads which are allare expect to exhibit strong bystander effects.By introducing PEG, polyhydroxyl and/or polycarboxyl groups, we generated hydrophilic linkers that enable site specific and, highly homogeneous conjugation of payloads to multiple prototypical antibodies at DAR 4, 8 and even 16. Compared. These ADCs were evaluated for their binding affinity, hydrophilicity, physiochemical stability, in vitro and in vivo anti-tumor activities, tolerability, and pharmacokinetics. In addition, comparisons were made with with theirthe corresponding naked unconjugated parent antibodies and conventional vedotin- and deruxtecan-based ADCs., these ADCs were evaluated for their binding affinity, hydrophilicity, physiochemical stability, in vitro and in vivo anti-tumor activities, tolerability, and pharmacokinetics. These novel ADCs were found to be stable at 37℃ for up to 30 days, after for at least 5 cycles of freeze-thaw, and at concentrations as high as 100 mg/mL, as assessed by visual inspection, hydrophobic interaction chromatography and size exclusion chromatography. Binding affinities of these ADCs to target-positive cell lines were similar to their corresponding naked unconjugated parent antibodies. These ADCs demonstrated strong tumor growth inhibition with single or repeated dosing in multiple tumor xenograft mouse models. The pharmacokinetic profiles of these ADCs are similar to those of the naked respective parent unconjugated antibodies. Assessments of ADCs using these new platform linkers in cynomolgus monkeys demonstrated showed better tolerability than ADCs using the traditional drug linkers.In summary, our novel ADC platform enables conjugation of hydrophobic payloads at high DARs as high as 8 or 16 with favorable physiochemical properties, results in robust pharmacokinetics, strong potency in vivo, and better tolerability. Therefore the potential for a meaningful therapeutic window may be realized through this novel ADC platform.

Citation Format: Haidong Liu, Wenke Qi, Lei Wang, Guobao Wang, Xinyue Chen, Julia Gavrilyuk, Tae Han, Baiteng Zhao, Xiao Shang. Novel ADC platform delivers promising in vivo activity and safety [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1405.

Abstract 1758: The preclinical pharmacology of PRO1102, a novel exatecan-based HER2-directed antibody-drug conjugate with robust anti-tumor activity

PRO1102 is an antibody-drug conjugate (ADC) directed toward HER2, a validated protein target that is overexpressed in multiple cancers, including breast and gastrointestinal cancer. PRO1102 is comprised of 1) trastuzumab, a clinically and commercially validated HER2-directed antibody, 2) a cleavable, hydrophilic linker, and 3) exatecan, a topoisomerase 1 inhibitor. The mechanism of action and the clinical potential of PRO1102 was evaluated in a series of experiments. PRO1102 maintained the same binding attributes of the parent antibody, trastuzumab, in vitro. In mouse xenograft studies, PRO1102 demonstrated robust anti-tumor activity across multiple HER2-expressing cell lines that was generally better than ADCs with alternative drug-linker technologies, such as those associated with monomethyl auristatin E, mertansine (DM1) and deruxtecan. In addition, PRO1102 retained activity in cancer cells with moderate and low HER2 expression, suggesting the potential to benefit a broader range of patients of HER2-expressing cancers. The pharmacokinetics of PRO1102 was evaluated in rats and PRO1102 was stable in circulation with disposition similar to the parent antibody. Tolerability was evaluated in mice and at PRO1102 dose levels associated with robust anti-tumor activity, PRO1102 was well tolerated. PRO1102 exhibits the attributes needed for an effective ADC with robust activity in a broad selection of HER2-expressing cancers.

Citation Format: Lei Wang, Haidong Liu, Xiao Shang, Tae H. Han, Baiteng Zhao. The preclinical pharmacology of PRO1102, a novel exatecan-based HER2-directed antibody-drug conjugate with robust anti-tumor activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1758.

Abstract 1085: PRO1184, a novel folate receptor alpha-directed antibody-drug conjugate, demonstrates robust anti-tumor activity in mouse carcinoma models

PRO1184 is an antibody-drug conjugate (ADC) directed toward folate receptor alpha (FOLR1), a glycosyl phosphatidylinositol anchored membrane protein. FOLR1 is overexpressed in many cancers with unmet medical need, including ovarian, lung, and breast cancers, while normal tissue expression is limited. PRO1184 is comprised of a 1) human monoclonal antibody that selectively binds to FOLR1, 2) a cleavable, hydrophilic linker, and 3) exatecan, a topoisomerase 1 inhibitor. Upon binding to FOLR1 on the surface of malignant cells, PRO1184 is internalized and exatecan released through enzymatic cleavage of the linker. Exatecan blocks the ligation step of the cell cycle and generates DNA single- and double-strand breaks, which leads to cell death. The mechanism of action and clinical potential of PRO1184 was tested in a series of studies. PRO1184 bound selectively and specifically to FOLR1 with nM affinity. PRO1184 was efficiently internalized and demonstrated cytotoxicity against multiple cell lines, in vitro. In mouse carcinoma models, PRO1184 demonstrated robust anti-tumor activity across multiple tumor types that represent ovarian, non-small cell lung, and breast cancer. In addition, PRO1184 was more potent with greater tumor growth inhibition than that of a DM4-conjugated ADC. PRO1184 was tolerated at the 60 mg/kg dose level in cynomolgus monkeys and the safety profile was generally more favorable than that for a DXd-based ADC. The pharmacokinetics (PK) of PRO1184 were similar to that of the unconjugated parent antibody in rats. PRO1184 has the potential for a meaningful therapeutic window to provide an appropriate benefit to risk profile for patients with FOLR1-expressing cancers.

Citation Format: Baiteng Zhao, Lei Wang, Haidong Liu, Suping Huang, Xiao Shang, Tae Han. PRO1184, a novel folate receptor alpha-directed antibody-drug conjugate, demonstrates robust anti-tumor activity in mouse carcinoma models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1085.

Dissipation-driven entanglement between two microwave fields in a four-mode hybrid cavity optomechanical system

The generation and manipulation of highly pure and strongly entangled steady state in a quantum system are vital tasks in the standard continuous-variable teleportation protocol. Especially, the manipulation implemented in integrated devices is even more crucial in practical quantum information applications. Here we propose an effective approach for creating steady-state entanglement between two microwave fields in a four-mode hybrid cavity optomechanical system. The entanglement can be achieved by combining the processes of three beam-splitter interactions and two parametric-amplifier interactions. Due to the dissipation-driven and cavity cooling processes, the entanglement obtained can go far beyond the entanglement limit based on coherent parametric coupling. Moreover, our proposal allows the engineered bath to cool both Bogoliubov modes almost simultaneously. In this way, a highly pure and strongly entangled steady state of two microwave modes is obtained. Our finding may be significant for using the hybrid opto-electro-mechanical system fabricated on chips in various quantum tasks, where the strong and pure entanglement is an important resource.

Anti-inflammatory, anti-angiogenetic and antiviral activities of dammarane-type triterpenoid saponins from the roots of Panax notoginseng

Panax notoginseng has been used both as a traditional medicine and as a functional food for hundreds of years in Asia. However, the active constituents from P. notoginseng and their pharmacologic properties still need to be further explored. In this study, one new dammarane-type triterpenoid saponin (1), along with fourteen known analogs (2-15) were isolated and identified from the roots of P. notoginseng. The anti-inflammatory, anti-angiogenetic and anti-dengue virus effects of these isolated compounds were further evaluated. Compounds 1, 3, 5-7 and 10-12 exerted anti-inflammatory effects in two different zebrafish inflammatory models. Among them, 11, with the most significant activities, alleviated the inflammatory response by blocking the MyD88/NF-κB and STAT3 pathways. Moreover, compound 15 showed anti-angiogenetic activities in Tg(fli1:EGFP) and Tg(flk1:GFP) zebrafish, while 3 and 5 only inhibited angiogenesis in Tg(fli1:EGFP) zebrafish. Additionally, compounds 1, 3, 6, 8, 9 and 12 suppressed the replication of dengue virus either at the viral adsorption and entry stages or at the intracellular replication step. In conclusion, these findings enrich knowledge of the diversity of saponins in P. notoginseng and suggest that the dammarane-type triterpenoid saponins from P. notoginseng may be developed as potential functional foods to treat inflammation, angiogenesis or dengue-related diseases.

Early Alpha-Fetoprotein Response Is Associated With Survival in Patients With HBV-Related Hepatocellular Carcinoma Receiving Lenvatinib

Background/Purpose

Lenvatinib is a first-line treatment for unresectable hepatocellular carcinoma (uHCC). We assessed the value of early alpha-fetoprotein (AFP) response for predicting clinical outcomes with lenvatinib treatment in patients with HBV-related uHCC and elevated AFP levels.

Methods

This retrospective analysis included patients with HBV-related uHCC and baseline AFP levels ≥20 ng/ml who received lenvatinib for >1 month between November 2018 and May 2021. Early AFP response was defined as a >20% decrease in AFP serum level from baseline after 4 weeks of lenvatinib treatment. Radiological response (Response Evaluation Criteria in Solid Tumors v1.1), progression-free survival, and overall survival were assessed in AFP responders and non-responders.

Results

Of the 46 patients analyzed, 30 (65.2%) were early AFP responders and 16 (34.8%) were non-responders. Compared to the non-responders, early AFP responders had a significantly higher objective response rate (34.5% vs 6.3%, p=0.0349), disease control rate (82.8% vs 50.0%; p=0.0203) and longer median progression-free survival (13.0 vs 7.0 months; HR, 0.464; 95% CI, 0.222-0.967; p=0.028). A subsequent multivariate analysis confirmed that early AFP response (HR, 0.387; 95% CI, 0.183-0.992; p=0.0154), Eastern Cooperative Oncology Group Performance Status of 0 (HR, 0.890; 95% CI, 0.811-0.976; p=0.0132) and Albumin-Bilirubin grade 1 (HR, 0.457; 95% CI, 0.269-0.963; p=0.0327) were independent prognostic factors for longer progression-free survival.

Conclusion

AFP is an important prognostic factor and a predictive biomarker for survival benefit with lenvatinib treatment in patients with HBV-related uHCC.

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma treated with lenvatinib: A retrospective analysis

Our study investigated the correlation between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma (HCC) treated with lenvatinib. We retrospectively evaluated 40 consecutive patients with unresectable HCC receiving lenvatinib between November 2018 and May 2020 at the First Hospital of Jilin University. Skeletal muscle mass was measured before treatment initiation. Prognostic significance was assessed with univariate and multivariate Cox proportional hazards models. Overall survival (OS) and progression-free survival (PFS) were evaluated for patients with and without sarcopenia. Sarcopenia was present in 23/40 patients (57.5%). After a median follow-up of 9.2 months, patients with sarcopenia had significantly worse OS and PFS compared with those without sarcopenia (OS: 8.4 months [m] vs 14.7 m, P = .02; PFS: 4.2 m vs 9.0 m, P = .04). Multivariate Cox proportional hazards models identified presence of sarcopenia as an independent risk factor for shorter OS (hazard ratio [HR], 0.257; 95% confidence interval [CI], 0.083-0.794; P = .02). In subgroup analysis, sarcopenia was associated with worse survival than non-sarcopenic patients, irrespective of age, Barcelona clinic liver cancer stage, or albumin-bilirubin grade. Our results show sarcopenia may be a predictor of poor prognosis in patients with HCC receiving lenvatinib. Management of sarcopenia is a vital factor for improving survival outcomes in patients with HCC.

Abstract P196: Novel hydrophilic drug linkers enable exatecan-based antibody-drug conjugates with promising physiochemical properties and in vivo activity

The physiochemical properties of an antibody-drug conjugate (ADC) can impact its stability and pharmacokinetics/pharmacodynamics and are one of the key design attributes. Typically, ADCs with better hydrophilicity are less prone to aggregation and have lower systemic clearance and greater anti-tumor activities. However, the need of incorporating lipophilic payloads with enhanced bystander activity has posed significant challenges to ADC and linker design, especially at higher drug-antibody ratios (DAR). Here we present novel hydrophilic linkers that can greatly improve the hydrophilicity of ADCs conjugated to lipophilic payloads such as exatecan. Exatecan is camptothecin analogue that has failed as a small molecule drug in clinical trials due to lack of therapeutic window but retains considerable promise as an ADC payload because of its high potency and resistance to Pgp efflux. By introducing highly polar PEG, polyhydroxyl and/or polycarboxyl groups, we generated hydrophilic linkers that enable site specific, highly homogeneous conjugation of exatecan to multiple prototypical monoclonal antibodies at DAR8. The linkers may also allow for other DARs such as DAR4 and DAR16. These exatecan-based ADCs with novel hydrophilic linkers were evaluated for their binding affinity and stability and compared with corresponding naked antibodies and deruxtecan-based and conventional vedotin-based ADCs for hydrophilicity, pharmacokinetics, in vitro and in vivo anti-tumor activities. Safety assessments in cynomolgus monkeys have also been planned. ADCs conjugated with the novel hydrophilic linkers were stable at 37oC for 15 days, after 5 cycles of freeze-thaw, and at concentrations as high as 100 mg/mL, as assessed by visual inspection, hydrophobic interaction chromatography, and size-exclusion chromatography. Binding affinity to target-positive cell lines was similar to corresponding naked antibodies. At DAR8, these ADCs were more hydrophilic than deruxtecan-based ADCs and DAR2 species of conventional vedotin-based ADCs. These ADCs also demonstrated potent in vitro cell growth inhibition and induced comparable or stronger tumor regression with single or multiple dosing in multiple mouse xenograft models. The pharmacokinetics profiles of these ADCs are similar to those of the naked antibodies. In summary, our novel hydrophilic linkers can enable conjugation of exatecan-based ADCs at high DARs with favorable physiochemical properties, which result in robust stability, pharmacokinetics, potency, and the potential for a meaningful therapeutic window.

Citation Format: Haidong Liu, Lei Wang, Julia Gavrilyuk, Tae Han, Baiteng Zhao, Xiao Shang. Novel hydrophilic drug linkers enable exatecan-based antibody-drug conjugates with promising physiochemical properties and in vivo activity [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P196.

Intraocular asymmetry of visual field defects in primary angle-closure glaucoma, high-tension glaucoma, and normal-tension glaucoma in a Chinese population

Direct comparison data on spatial patterns of visual field (VF) defects among primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) are not available. We aimed to compare the intraocular asymmetry of VF loss among patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF defects were categorized into 3 stages (early, moderate, and advanced), and each hemifield was divided into 5 regions according to the Glaucoma hemifield test (GHT). The mean total deviation (TD) of each GHT region was calculated. In the early stage, the paracentral, peripheral arcuate 1 and peripheral arcuate 2 regions in the superior hemifield in the NTG group had significantly worse mean TDs than their corresponding regions in the inferior hemifield. In the advanced stage, the central region in the superior hemifield in the PACG group had a significantly worse mean TD than that in the inferior hemifield. There was no significant difference in the mean TD for any of the five regions between hemifields across all severity levels in the in the HTG group. The superior hemifield was affected more severely than the inferior hemifield in all three subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG than in PACG and HTG.

Nanoscale zero-valent iron supported by attapulgite produced at different acid modification: Synthesis mechanism and the role of silicon on Cr(VI) removal

The attapulgite of different morphologies and mineral compositions were successfully obtained following the treatment by HCl and HF with different concentrations. Variations of morphologies, elemental and mineral components of the pristine and modified attapulgite were investigated and assessed in detail by a series of characterization methods. The SEM-EDS results indicated significant variations on the contents and morphologies of silicon after acid modification. The Cr(VI) removal efficiencies under pristine and modified attapulgite-supported nZVI composites were evaluated with the removal rate in case of 0.5HAT-nZVI being 69.2% more superior than that of 6FAT-nZVI. The reaction kinetic is well fitted with pseudo second order kinetics model. The correlation analysis indicated that Cr(VI) removal efficiency was positively correlated with the content of active silicon in the attapulgite-nZVI composites (R² = 0.979∗∗). Additionally, the reduction of Cr(VI) is more likely to occur in silicon-rich composites based on the analysis of XPS spectra and Cr concentration changes, which were mainly attributed to the enhanced Si-O-Fe coupling mediated by silicon. Attapulgite with more exposure sites of silicon enhanced the Cr(VI) reduction process and promoted crystallization of the reaction products. Simultaneously, the nZVI consumption caused by oxidation and aggregation were improved by silicon in attapulgite. It is concluded that silicon played a significant role on Cr(VI) removal through the reductive precipitation by Si-O-Fe coupling.

Progression of Macular Vessel Density in Primary Open-Angle Glaucoma: A Longitudinal Study

PURPOSE

To evaluate the rate of progression of macular vessel density (mVD) in primary open-angle glaucoma (POAG) and explore the relationship between the progression of mVD and macular ganglion cell-inner plexiform layer (mGCIPL) thickness and parapapillary retinal nerve fiber layer (pRNFL) thickness.

DESIGN

Prospective cohort study.

METHODS

In this study, 102 eyes with POAG were followed for 36.6 ± 6.4 months. The rates of progression were estimated by linear models. The agreement of progression detection among the 3 parameters was evaluated with Kappa statistics. The influence of baseline measurements on the rates of progression of mGCIPL thickness, pRNFL thickness, and mVD was investigated by linear mixed modeling. Kaplan-Meier survival analysis was adopted to calculate the survival probabilities.

RESULTS

The respective rate of progression by linear regression was -0.102 ± 0.054 μm/month, -0.160 ± 0.086 μm/month, and -0.199 ± 0.073 %/month for mGCIPL thickness, pRNFL thickness, and mVD. The agreement in detection of progression among them was poor with the Conger's Kappa coefficient of 0.098 (95% confidence interval: -0.025~0.220, P = .116). The significant factors influencing the rate of progression of mVD were baseline mGCIPL thickness, baseline pRNFL thickness, and baseline mVD (P ≤ .001), while baseline mVD was not a significant factor influencing the rates of progression of mGCIPL thickness and pRNFL thickness (P ≥ .659). Also, pRNFL thickness had a better survival probability compared with the other 2 parameters (P = .025).

CONCLUSIONS

The mGCIPL thickness, pRNFL thickness, and mVD decreased over time in POAG eyes. The rate of reduction of mVD was significantly influenced by the baseline measurements of mGCIPL thickness, pRNFL thickness, and mVD.

Bright Field Structural Colors in Silicon-on-Insulator Nanostructures

Structural coloration with artificially nanostructured materials is emerging as a prospective alternative to traditional pigments for the high resolution, sustainable recycling, and long-time durability. However, achieving bright field structural colors with dielectric nanostructures remains a great challenge due to the weak scattering in an asymmetric environment. Here, we demonstrate all-dielectric bright field structural colors with diffraction-limited resolution on the silicon-on-insulator platform. The backscattering is strongly enhanced from the constructive interference between Mie resonances of individual Si antennas and Fabry-Perot resonances supported by the SiO₂ layer. The fabricated colors with varying hues and saturations show strong insensitivity with respect to the interparticle spacing and, remarkably, the viewing angle under resonant conditions. Compared with creating a quasi-homogeneous environment, our strategy is solid and complementary metal-oxide semiconductor integrable, paving the way for practical applications of structural colors in nanoscale color printing, microdisplays, and imaging.

[UPLC characteristic fingerprint and chemical pattern recognition of Angong Niuhuang Pills]

To establish the UPLC fingerprint of Zhongyi Angong Niuhuang Pills, in order to evaluate its quality by chemical pattern recognition. The method was developed on a column of Poroshell 120 EC-C_(18), with methanol-0.1% formic acid solution as the mobile phase for gradient elution at a flow rate of 0.4 mL·min~(-1). The column temperature was 30 ℃,and the detective wavelength was 254 nm. The similarity of 24 batches of Angong Niuhuang Pills was compared by using Traditional Chinese Medicine Chromatographic Fingerprint Similarity Evaluation System(2004 A). Hydrophobic cluster analysis,principal components analysis and partial least squares discriminant analysis were conducted by using SIMCA 13.0 software to investigate different components among these products. The UPLC characteristic fingerprint was established in this study. And 17 common peaks were identified by standard reference and UPLC-MS. The similarity of 24 batches samples were above 0.980,which can be classified into three categories for pattern recognition. Baicalin,berberine,jatrorrhizine,wogonin and wogonoside were identified as the main markers that cause differences of various batches. The method is simple,rapid,accurate and reproducible,and can provide scientific basis for improving the quality standard of Zhongyi Angong Niuhuang Pills.