The impact of discontinuing single-room isolation of patients with vancomycin-resistant enterococci: a quasi-experimental single-centre study in South Korea

OBJECTIVES

There is limited data on the effects of discontinuing single-room isolation while maintaining contact precautions, such as the use of gowns and gloves. In April 2021, our hospital ceased single-room isolation for patients with vancomycin-resistant enterococci (VRE) because of single-room unavailability. This study assessed the impact of this policy by examining the incidence of hospital-acquired VRE bloodstream infections (HA-VRE BSI).

METHODS

This retrospective quasi-experimental study was conducted at a tertiary-care hospital in Seoul, South Korea. Time-series analysis was used to evaluate HA-VRE BSI incidence at the hospital level and in the haematology unit before (phase 1) and after (phase 2) the policy change.

RESULTS

At the hospital level, HA-VRE BSI incidence level (VRE BSI per 1000 patient-days per month) and trend did not change significantly between phase 1 and phase 2 (coefficient -0.015, 95% confidence interval (CI): -0.053 to 0.023, P=0.45 and 0.000, 95% CI: -0.002 to 0.002, P=0.84, respectively). Similarly, HA-VRE BSI incidence level and trend in the haematology unit (-0.285, 95% CI: -0.618 to 0.048, P=0.09 and -0.018, 95% CI: -0.036 to 0.000, P = 0.054, respectively) did not change significantly across the two phases.

CONCLUSIONS

Discontinuing single-room isolation of VRE-colonized or infected patients was not associated with an increase in the incidence of VRE BSI at the hospital level or among high-risk patients in the haematology unit. Horizontal intervention for multi-drug-resistant organisms, including measures such as enhanced hand hygiene and environmental cleaning, may be more effective at preventing VRE transmission.

Disease burden of bacteraemia with extended-spectrum beta-lactamase-producing and carbapenem-resistant Enterobacterales in Korea

BACKGROUND

Despite the significant impact of multi-drug-resistant bacteraemia, especially extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and carbapenem-resistant Enterobacterales (CRE), the burden of disease has not been investigated thoroughly.

AIM

To evaluate the clinical outcomes and socio-economic burden of ESBL-E and CRE bacteraemia nationwide in the Republic of Korea.

METHODS

A search was undertaken for all cases of ESBL-E and CRE bacteraemia and matched controls in 10 hospitals in the Republic of Korea over 6 months. Patients with ESBL-E or CRE bacteraemia were classified as the R group, and matched controls with antibiotic-susceptible bacteraemia and without infection were classified as the S and N groups, respectively. Patients' clinical data were collected, and the economic burden was estimated based on medical expenses, loss of productivity and total costs.

FINDINGS

In total, 795 patients were identified, including 265 patients with ESBL-E or CRE bacteraemia and their matched controls. The mean total length of stay for patients with ESBL-E and CRE in the R group was 1.53 and 1.90 times that of patients in the S group, respectively. The 90-day mortality rates for ESBL-E in the R and S groups were 12.1% and 5.6%, respectively, and the corresponding figures for CRE were 28.6% and 12.0%. There were significant differences in the total costs between the R, S and N groups for both ESBL-E and CRE (ESBL-E: $11,151 vs $8712 vs $6063, P=0.004; CRE: $40,464 vs $8748 vs $7279, P=0.024).

CONCLUSION

The clinical and economic burden imposed by ESBL-E or CRE bacteraemia was extremely high. These findings suggest that efforts to control resistant bacteraemia are necessary to reduce this burden.

MPFL reconstruction with proximal rather than distal femoral tunnel position leads to less favorable short-term results

BACKGROUND

This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament (MPFL) reconstruction (MPFLR) between anatomic femoral tunnel positions: proximal (near adductor tubercle [AT]) and distal (near medial epicondyle [ME]).

HYPOTHESIS

MPFLR with the proximal femoral tunnel position has worse clinical and radiological outcomes than those with the distal femoral tunnel position.

PATIENTS AND METHODS

Fifty-five patients who underwent isolated MPFLR with proximal or distal femoral tunnels with at least 2 years of follow-up were retrospectively analyzed. Based on postoperative CT images, 28 patients were classified as group AT and the remaining 27 patients were classified as group ME. The International Knee Documentation Committee, Lysholm, Tegner, Kujala scores, and complications were evaluated. Radiologically, the Caton-Deschamps Index (CDI), patellar tilt angle, patellofemoral osteoarthritis (PFOA), patellofemoral cartilage status by the International Cartilage Repair Society (ICRS) grade, bone contusion, and MPFL graft signal intensity were evaluated.

RESULTS

All clinical scores significantly improved in both groups (p<0.01). No statistically significant difference was noted between the two groups in regards to their preoperative demographic data, postoperative clinical scores, complications, or radiological findings (CDI, patellar tilt angle, PFOA, bone contusion, and graft signal intensity). The group AT had worse cartilage status on the medial facet of the patella (p=0.02). The ICRS grade for the medial facet of the patella statistically progressed in group AT compared to group ME (p=0.04) as well.

DISCUSSION

Both groups showed significantly improved clinical outcomes. However, for the medial facet of the patella, MPFLR with the proximal femoral tunnel position had worse cartilage status and ICRS grade progression than those with the distal femoral tunnel position.

LEVEL OF EVIDENCE

III; retrospective comparative study.

Correlation between oxygen flow-controlled resistive switching and capacitance behavior in gallium oxide memristors grown via RF sputtering

We studied on the bipolar resistive switching (RS)-dependent capacitance of Ga2O3 memristors, grown using controlled oxygen flow via a radio frequency sputtering process. The Ag/Ga2O3/Pt memristor structure was employed to investigate the capacitance changes associated with RS behavior and oxygen concentration. In the low-resistance state (LRS), capacitance increased by over 60 times compared to the high-resistance state (HRS). Furthermore, in the HRS state, increasing the oxygen flow from 0 to 0.3 sccm resulted in an 80 % decrease in capacitance, while in the LRS state, capacitance increased by 128 %. These results indicate that RS-dependent capacitance in Ga2O3 memristors is influenced by the density of oxygen vacancies. The presence of oxygen vacancies affects charge storage capacity and capacitance, with higher oxygen concentrations leading to reduced capacitance in HRS and increased capacitance in LRS. The results contribute to the understanding of the capacitance behavior in Ga2O3 memristors and highlight the significance of oxygen vacancies in their operation.

Monosynaptic inputs to ventral tegmental area glutamate and GABA co-transmitting neurons

A unique population of ventral tegmental area (VTA) neurons co-transmits glutamate and GABA as well as functionally signals rewarding and aversive outcomes. However, the circuit inputs to VTA VGluT2+VGaT+ neurons are unknown, limiting our understanding of the functional capabilities of these neurons. To identify the inputs to VTA VGluT2+VGaT+ neurons, we coupled monosynaptic rabies tracing with intersectional genetic targeting of VTA VGluT2+VGaT+ neurons in mice. We found that VTA VGluT2+VGaT+ neurons received diverse brain-wide inputs. The largest numbers of monosynaptic inputs to VTA VGluT2+VGaT+ neurons were from superior colliculus, lateral hypothalamus, midbrain reticular nucleus, and periaqueductal gray, whereas the densest inputs relative to brain region volume were from dorsal raphe nucleus, lateral habenula, and ventral tegmental area. Based on these and prior data, we hypothesized that lateral hypothalamus and superior colliculus inputs were glutamatergic neurons. Optical activation of glutamatergic lateral hypothalamus neurons robustly activated VTA VGluT2+VGaT+ neurons regardless of stimulation frequency and resulted in flee-like ambulatory behavior. In contrast, optical activation of glutamatergic superior colliculus neurons activated VTA VGluT2+VGaT+ neurons for a brief period of time at high stimulation frequency and resulted in head rotation and arrested ambulatory behavior (freezing). For both pathways, behaviors induced by stimulation were uncorrelated with VTA VGluT2+VGaT+ neuron activity. However, stimulation of glutamatergic lateral hypothalamus neurons, but not glutamatergic superior colliculus neurons, was associated with VTA VGluT2+VGaT+ footshock-induced activity. We interpret these results such that inputs to VTA VGluT2+VGaT+ neurons may integrate diverse signals related to the detection and processing of motivationally-salient outcomes. Further, VTA VGluT2+VGaT+ neurons may signal threat-related outcomes, possibly via input from lateral hypothalamus glutamate neurons, but not threat-induced behavioral kinematics.

Glioma synapses recruit mechanisms of adaptive plasticity

The role of the nervous system in the regulation of cancer is increasingly appreciated. In gliomas, neuronal activity drives tumour progression through paracrine signalling factors such as neuroligin-3 and brain-derived neurotrophic factor1-3 (BDNF), and also through electrophysiologically functional neuron-to-glioma synapses mediated by AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid) receptors4,5. The consequent glioma cell membrane depolarization drives tumour proliferation4,6. In the healthy brain, activity-regulated secretion of BDNF promotes adaptive plasticity of synaptic connectivity7,8 and strength9-15. Here we show that malignant synapses exhibit similar plasticity regulated by BDNF. Signalling through the receptor tropomyosin-related kinase B16 (TrkB) to CAMKII, BDNF promotes AMPA receptor trafficking to the glioma cell membrane, resulting in increased amplitude of glutamate-evoked currents in the malignant cells. Linking plasticity of glioma synaptic strength to tumour growth, graded optogenetic control of glioma membrane potential demonstrates that greater depolarizing current amplitude promotes increased glioma proliferation. This potentiation of malignant synaptic strength shares mechanistic features with synaptic plasticity17-22 that contributes to memory and learning in the healthy brain23-26. BDNF-TrkB signalling also regulates the number of neuron-to-glioma synapses. Abrogation of activity-regulated BDNF secretion from the brain microenvironment or loss of glioma TrkB expression robustly inhibits tumour progression. Blocking TrkB genetically or pharmacologically abrogates these effects of BDNF on glioma synapses and substantially prolongs survival in xenograft models of paediatric glioblastoma and diffuse intrinsic pontine glioma. Together, these findings indicate that BDNF-TrkB signalling promotes malignant synaptic plasticity and augments tumour progression.

Sexually dimorphic mechanisms of VGLUT-mediated protection from dopaminergic neurodegeneration

Parkinson's disease (PD) targets some dopamine (DA) neurons more than others. Sex differences offer insights, with females more protected from DA neurodegeneration. The mammalian vesicular glutamate transporter VGLUT2 and Drosophila ortholog dVGLUT have been implicated as modulators of DA neuron resilience. However, the mechanisms by which VGLUT2/dVGLUT protects DA neurons remain unknown. We discovered DA neuron dVGLUT knockdown increased mitochondrial reactive oxygen species in a sexually dimorphic manner in response to depolarization or paraquat-induced stress, males being especially affected. DA neuron dVGLUT also reduced ATP biosynthetic burden during depolarization. RNA sequencing of VGLUT+ DA neurons in mice and flies identified candidate genes that we functionally screened to further dissect VGLUT-mediated DA neuron resilience across PD models. We discovered transcription factors modulating dVGLUT-dependent DA neuroprotection and identified dj-1β as a regulator of sex-specific DA neuron dVGLUT expression. Overall, VGLUT protects DA neurons from PD-associated degeneration by maintaining mitochondrial health.

Evaluation of Usefulness of Yeast-Based Biological Phantom and Preliminary Study for Verification of Hypoxic Effect of Flash Radiotherapy

PURPOSE/OBJECTIVE(S)

As a basic hypothesis for the effectiveness of flash radiation therapy, the effect of preserving normal tissue during flash radiation is due to the instantaneous chemical depletion of oxygen. A yeast-based biological phantom was created to verify the hypoxic effect of flash radiation therapy. A study to upgrade the previously developed X-Band LINAC to a flash irradiation mode is in progress, and a preceding study is conducted to evaluate the usefulness of a yeast-based biological phantom manufactured by analyzing the change in oxygen by irradiating a high dose in a general radiation therapy device.

MATERIALS/METHODS

Freeze-dried yeast sample (Saccharomyces cerevisiae, S288C) is activated and sub-cultured. For mass production of yeast samples, yeast culture medium is prepared by adding yeast colonies to the ypd medium. This study was conducted to verify the hypoxic effect among the biological mechanisms that occur during flash radiation therapy at the basic stage, and the oxygen concentration change during general radiation irradiation was measured in real time using a DO (Dissolved oxygen) meter and fiber optic sensor designed to do that. To prevent scatter, which is a concern during flash irradiation, the fiber form was used, and precise experiments are possible as a non-invasive oxygen concentration measurement method. Based on 10MV of general radiation therapy device, high-dose radiation of 500-10,000 cGy is irradiated to measure real-time oxygen concentration change.

RESULTS

As a result of irradiation with high-dose (500-10,000 cGy) radiation of general LINAC, it was confirmed that the oxygen concentration of the yeast culture medium decreased by 5.7-63.2%, and the usefulness of the biological phantom fabricated based on the yeast culture medium was evaluated.

CONCLUSION

Prior to the analysis of oxygen concentration change in yeast cells during X-Band LINAC flash irradiation, a preliminary study was conducted at a high dose in a general LINAC to obtain a significant result of oxygen concentration change and confirm the usefulness of the yeast-based biological phantom. Prior research was conducted and verified as a general irradiation experiment using a yeast-based biological phantom manufactured based on a DO meter and a fiber optic oxygen sensor. After irradiation with high-dose radiation, the oxygen concentration of the yeast culture medium was measured 5 times, and it was confirmed that there was a change in oxygen concentration of 5.7-63.2%, verifying the usefulness and stability of the biological phantom. The usefulness of the yeast-based biological phantom for high doses was confirmed, and it is expected that the usefulness of the biological phantom for flash radiation can be verified by additionally measuring the change in oxygen concentration of the biological phantom according to the high dose rate in the future.

Definitive Radiotherapy in Patients with Clinical T1N0M0 Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Study

PURPOSE/OBJECTIVE(S)

In this study, we aimed to assess the failure pattern and survival outcomes and to analyze the optimal treatment field of definitive RT for T1N0M0 esophageal squamous cell carcinoma (ESCC).

MATERIALS/METHODS

We performed a retrospective analysis in a multi-institutional cohort of patients with histologically confirmed T1N0M0 ESCC. We included patients who underwent RT with definitive aim from 2010 to 2019. Patterns of failure were demonstrated as in-field locoregional, out-field locoregional and distant metastasis. In the survival analysis, freedom from locoregional recurrence and their association with clinicopathologic risk factors were analyzed. We performed a propensity score matching in the cT1b patients to adjust for the heterogeneity of radiation technique, radiation dose and the use of concurrent chemotherapy.

RESULTS

A total of 168 patients were included with a median follow-up of 34.0 months, and there were 20 cT1a, 94 cT1b and 24 cT1x, (cT1, not otherwise specified) patients. The rates of all and locoregional failure were 26.9% and 23.1% for cT1a and 25.0% and 22.4% for cT1b patients. 10 (10.6%) patients experienced grade ≥ 3 adverse events. Among 116 cT1b patients, 69 patients received elective nodal irradiation (ENI) and 47 patients received involved field irradiation (IFI). After propensity score matching, the 3-year FFLRR rate was 84.5% (95% Confidence Interval, 71.0 - 92.1%). There was no significant difference between the ENI and IFI patients in FFLRR (Log-rank P = 0.831). In the multivariate analysis, the use of concurrent chemotherapy was the only factor marginally associated with FFLRR (Hazard ratio, 0.17; 95% CI, 0.02 - 1.13; P = 0.067).

CONCLUSION

cT1a patients who cannot receive endoscopic resection, showed similar rates of failure compared with cT1b patients, which questioned the accuracy of the staging and raised the need for through treatment such as chemoradiotherapy. In cT1b patients, IFI using dose of 50 to 60 Gy with concurrent chemotherapy could be a reasonable treatment option.

Unique functional responses differentially map onto genetic subtypes of dopamine neurons

Dopamine neurons are characterized by their response to unexpected rewards, but they also fire during movement and aversive stimuli. Dopamine neuron diversity has been observed based on molecular expression profiles; however, whether different functions map onto such genetic subtypes remains unclear. In this study, we established that three genetic dopamine neuron subtypes within the substantia nigra pars compacta, characterized by the expression of Slc17a6 (Vglut2), Calb1 and Anxa1, each have a unique set of responses to rewards, aversive stimuli and accelerations and decelerations, and these signaling patterns are highly correlated between somas and axons within subtypes. Remarkably, reward responses were almost entirely absent in the Anxa1+ subtype, which instead displayed acceleration-correlated signaling. Our findings establish a connection between functional and genetic dopamine neuron subtypes and demonstrate that molecular expression patterns can serve as a common framework to dissect dopaminergic functions.

Structural basis for ion selectivity in potassium-selective channelrhodopsins

KCR channelrhodopsins (K+-selective light-gated ion channels) have received attention as potential inhibitory optogenetic tools but more broadly pose a fundamental mystery regarding how their K+ selectivity is achieved. Here, we present 2.5-2.7 Å cryo-electron microscopy structures of HcKCR1 and HcKCR2 and of a structure-guided mutant with enhanced K+ selectivity. Structural, electrophysiological, computational, spectroscopic, and biochemical analyses reveal a distinctive mechanism for K+ selectivity; rather than forming the symmetrical filter of canonical K+ channels achieving both selectivity and dehydration, instead, three extracellular-vestibule residues within each monomer form a flexible asymmetric selectivity gate, while a distinct dehydration pathway extends intracellularly. Structural comparisons reveal a retinal-binding pocket that induces retinal rotation (accounting for HcKCR1/HcKCR2 spectral differences), and design of corresponding KCR variants with increased K+ selectivity (KALI-1/KALI-2) provides key advantages for optogenetic inhibition in vitro and in vivo. Thus, discovery of a mechanism for ion-channel K+ selectivity also provides a framework for next-generation optogenetics.

Deploying synthetic coevolution and machine learning to engineer protein-protein interactions

Fine-tuning of protein-protein interactions occurs naturally through coevolution, but this process is difficult to recapitulate in the laboratory. We describe a platform for synthetic protein-protein coevolution that can isolate matched pairs of interacting muteins from complex libraries. This large dataset of coevolved complexes drove a systems-level analysis of molecular recognition between Z domain-affibody pairs spanning a wide range of structures, affinities, cross-reactivities, and orthogonalities, and captured a broad spectrum of coevolutionary networks. Furthermore, we harnessed pretrained protein language models to expand, in silico, the amino acid diversity of our coevolution screen, predicting remodeled interfaces beyond the reach of the experimental library. The integration of these approaches provides a means of simulating protein coevolution and generating protein complexes with diverse molecular recognition properties for biotechnology and synthetic biology.

Cardiogenic control of affective behavioural state

Emotional states influence bodily physiology, as exemplified in the top-down process by which anxiety causes faster beating of the heart1-3. However, whether an increased heart rate might itself induce anxiety or fear responses is unclear3-8. Physiological theories of emotion, proposed over a century ago, have considered that in general, there could be an important and even dominant flow of information from the body to the brain9. Here, to formally test this idea, we developed a noninvasive optogenetic pacemaker for precise, cell-type-specific control of cardiac rhythms of up to 900 beats per minute in freely moving mice, enabled by a wearable micro-LED harness and the systemic viral delivery of a potent pump-like channelrhodopsin. We found that optically evoked tachycardia potently enhanced anxiety-like behaviour, but crucially only in risky contexts, indicating that both central (brain) and peripheral (body) processes may be involved in the development of emotional states. To identify potential mechanisms, we used whole-brain activity screening and electrophysiology to find brain regions that were activated by imposed cardiac rhythms. We identified the posterior insular cortex as a potential mediator of bottom-up cardiac interoceptive processing, and found that optogenetic inhibition of this brain region attenuated the anxiety-like behaviour that was induced by optical cardiac pacing. Together, these findings reveal that cells of both the body and the brain must be considered together to understand the origins of emotional or affective states. More broadly, our results define a generalizable approach for noninvasive, temporally precise functional investigations of joint organism-wide interactions among targeted cells during behaviour.

All-optical physiology resolves a synaptic basis for behavioral timescale plasticity

Learning has been associated with modifications of synaptic and circuit properties, but the precise changes storing information in mammals have remained largely unclear. We combined genetically targeted voltage imaging with targeted optogenetic activation and silencing of pre- and post-synaptic neurons to study the mechanisms underlying hippocampal behavioral timescale plasticity. In mice navigating a virtual-reality environment, targeted optogenetic activation of individual CA1 cells at specific places induced stable representations of these places in the targeted cells. Optical elicitation, recording, and modulation of synaptic transmission in behaving mice revealed that activity in presynaptic CA2/3 cells was required for the induction of plasticity in CA1 and, furthermore, that during induction of these place fields in single CA1 cells, synaptic input from CA2/3 onto these same cells was potentiated. These results reveal synaptic implementation of hippocampal behavioral timescale plasticity and define a methodology to resolve synaptic plasticity during learning and memory in behaving mammals.

Response After Repeated Ketamine Injections in a Rat Model of Neuropathic Pain

Ketamine, an N-methyl-D-aspartate antagonist, reduces pain by decreasing central sensitization and pain windup. However, chronic ketamine use can cause tolerance, dependency, impaired consciousness, urinary symptoms, and abdominal pain. This study aimed to investigate the effects of repeated ketamine injections and ketamine readministration after discontinuation in a rat model of neuropathic pain. To induce neuropathic pain, partial sciatic nerve ligation (PSNL) was performed in 15 male Wistar rats, and these animals were divided into three groups: PSNL (control), PSNL + ketamine 5 mg/kg (K5), and PSNL + ketamine 10 mg/kg (K10; n=5 each). Ketamine was injected intraperitoneally daily for 4 weeks, discontinued for 2 weeks, and then readministered for 1 week. Following PSNL, the mechanical withdrawal threshold was determined weekly using the Von Frey. The K10 group showed a significant increase in the mechanical withdrawal threshold, presented here as the target force (in g), at 21 and 28 days compared to the time point before ketamine injection (mean±SE, 276.0±24.0 vs. 21.6±2.7 and 300.0±0.0 vs. 21.6±2.7, respectively; P<0.01) and at 14, 21, and 28 days compared to the control group (108.2±51.2 vs. 2.7±1.3, 276.0±24.0 vs. 2.5±1.5, and 300.0±0.0 vs. 4.0±0.0, respectively; P<0.05). However, in the K10 group, the ketamine effects decreased significantly at 7 days after readministration compared to those after 28 days of repeated injections (P<0.05). In the K10 group, repeated ketamine injections showed a significant increase in antinociceptive effect for >2 weeks, but this ketamine effect decreased after drug readministration.

Hetero-Integration of Silicon Nanomembranes with 2D Materials for Bioresorbable, Wireless Neurochemical System

Although neurotransmitters are key substances closely related to evaluating degenerative brain diseases as well as regulating essential functions in the body, many research efforts have not been focused on direct observation of such biochemical messengers, rather on monitoring relatively associated physical, mechanical, and electrophysiological parameters. Here, a bioresorbable silicon-based neurochemical analyzer incorporated with 2D transition metal dichalcogenides is introduced as a completely implantable brain-integrated system that can wirelessly monitor time-dynamic behaviors of dopamine and relevant parameters in a simultaneous mode. An extensive range of examinations of molybdenum/tungsten disulfide (MoS₂ /WS₂ ) nanosheets and catalytic iron nanoparticles (Fe NPs) highlights the underlying mechanisms of strong chemical and target-specific responses to the neurotransmitters, along with theoretical modeling tools. Systematic characterizations demonstrate reversible, stable, and long-term operational performances of the degradable bioelectronics with excellent sensitivity and selectivity over those of non-dissolvable counterparts. A complete set of in vivo experiments with comparative analysis using carbon-fiber electrodes illustrates the capability for potential use as a clinically accessible tool to associated neurodegenerative diseases.

Structural basis for channel conduction in the pump-like channelrhodopsin ChRmine

ChRmine, a recently discovered pump-like cation-conducting channelrhodopsin, exhibits puzzling properties (large photocurrents, red-shifted spectrum, and extreme light sensitivity) that have created new opportunities in optogenetics. ChRmine and its homologs function as ion channels but, by primary sequence, more closely resemble ion pump rhodopsins; mechanisms for passive channel conduction in this family have remained mysterious. Here, we present the 2.0 Å resolution cryo-EM structure of ChRmine, revealing architectural features atypical for channelrhodopsins: trimeric assembly, a short transmembrane-helix 3, a twisting extracellular-loop 1, large vestibules within the monomer, and an opening at the trimer interface. We applied this structure to design three proteins (rsChRmine and hsChRmine, conferring further red-shifted and high-speed properties, respectively, and frChRmine, combining faster and more red-shifted performance) suitable for fundamental neuroscience opportunities. These results illuminate the conduction and gating of pump-like channelrhodopsins and point the way toward further structure-guided creation of channelrhodopsins for applications across biology.

TAMI-28. IDENTIFICATION OF A NEUROLIGIN-3 BINDING PARTNER IN HIGH-GRADE GLIOMAS AND NORMAL PROGENITORS

High-grade gliomas, including diffuse intrinsic pontine glioma, are lethal cancers whose progression is strongly regulated by neuronal activity. One way in which gliomas detect neuronal activity is via interaction with the ectodomain of post-synaptic adhesion protein neuroligin-3 (NLGN3), which is shed from neurons and oligodendrocyte precursors (OPCs) by the ADAM10 sheddase in an activity dependent manner. NLGN3 signaling drives glioma growth, but the cognate binding partner of shed NLGN3 (sNLGN3) on glioma cells is unknown. Here, we employed a proximity labeling technique to identify chondroitin sulfate proteoglycan 4 (CSPG4) as a putative binding partner of sNLGN3 in gliomas. We then confirmed complexing between recombinant proteins with size exclusion chromatography and are determining kinetics and affinity by surface plasmon resonance. When looking for evidence of binding in cells, we were surprised to find that sNLGN3 triggers regulated intramembrane proteolysis (RIP) of CSPG4, leaving no trace of the interaction at the membrane. sNLGN3 binding first induces ADAM10-mediated cleavage and release of the CSPG4 ectodomain, followed by gamma secretase-mediated release of the intracellular domain and downstream signaling in OPCs and gliomas. Pre-treatment of glioma cells or OPCs with an ADAM10 inhibitor entirely blocks sNLGN3-induced CSPG4 shedding. Acute depletion of CSPG4 via CRISPR gene editing renders glioma cells insensitive to the growth-promoting effects of sNLGN3 in vitro. Furthermore, we find that tamoxifen-induced deletion of NLGN3 from murine OPCs reduces the total number of OPCs, suggesting that this signaling axis promotes maintenance of OPC stemness in an autocrine fashion. Indeed, gamma secretase inhibition accelerates OPC differentiation in vitro, pointing towards a fundamental role for sNLGN3-CSPG4 signaling in OPCs and high-grade gliomas. Altogether, our results form a critical missing link in understanding how glioma cells detect a key neuronal activity-regulated signal, suggest intriguing links to OPC biology and identify a therapeutic target to disrupt neuron-glioma interactions.

Sox6 expression distinguishes dorsally and ventrally biased dopamine neurons in the substantia nigra with distinctive properties and embryonic origins

Dopamine (DA) neurons in the ventral tier of the substantia nigra pars compacta (SNc) degenerate prominently in Parkinson's disease, while those in the dorsal tier are relatively spared. Defining the molecular, functional, and developmental characteristics of each SNc tier is crucial to understand their distinct susceptibility. We demonstrate that Sox6 expression distinguishes ventrally and dorsally biased DA neuron populations in the SNc. The Sox6+ population in the ventral SNc includes an Aldh1a1+ subset and is enriched in gene pathways that underpin vulnerability. Sox6+ neurons project to the dorsal striatum and show activity correlated with acceleration. Sox6- neurons project to the medial, ventral, and caudal striatum and respond to rewards. Moreover, we show that this adult division is encoded early in development. Overall, our work demonstrates a dual origin of the SNc that results in DA neuron cohorts with distinct molecular profiles, projections, and functions.

Electrically driven strain-induced deterministic single-photon emitters in a van der Waals heterostructure

Quantum confinement in transition metal dichalcogenides (TMDCs) enables the realization of deterministic single-photon emitters. The position and polarization control of single photons have been achieved via local strain engineering using nanostructures. However, most existing TMDC-based emitters are operated by optical pumping, while the emission sites in electrically pumped emitters are uncontrolled. Here, we demonstrate electrically driven single-photon emitters located at the positions where strains are induced by atomic force microscope indentation on a van der Waals heterostructure consisting of graphene, hexagonal boron nitride, and tungsten diselenide. The optical, electrical, and mechanical properties induced by the local strain gradient were systematically analyzed. The emission at the indentation sites exhibits photon antibunching behavior with a g⁽²⁾(0) value of ~0.3, intensity saturation, and a linearly cross-polarized doublet, at 4 kelvin. This robust spatial control of electrically driven single-photon emitters will pave the way for the practical implementation of integrated quantum light sources.

Synergistic SERS Enhancement in GaN-Ag Hybrid System toward Label-Free and Multiplexed Detection of Antibiotics in Aqueous Solutions

Noble metal-based surface-enhanced Raman spectroscopy (SERS) has enabled the simple and efficient detection of trace-amount molecules via significant electromagnetic enhancements at hot spots. However, the small Raman cross-section of various analytes forces the use of a Raman reporter for specific surface functionalization, which is time-consuming and limited to low-molecular-weight analytes. To tackle these issues, a hybrid SERS substrate utilizing Ag as plasmonic structures and GaN as charge transfer enhancement centers is presented. By the conformal printing of Ag nanowires onto GaN nanopillars, a highly sensitive SERS substrate with excellent uniformity can be fabricated. As a result, remarkable SERS performance with a substrate enhancement factor of 1.4 × 1011 at 10 fM for rhodamine 6G molecules with minimal spot variations can be realized. Furthermore, quantification and multiplexing capabilities without surface treatments are demonstrated by detecting harmful antibiotics in aqueous solutions. This work paves the way for the development of a highly sensitive SERS substrate by constructing complex metal-semiconductor architectures.

P–205 Epothilone D as an actin cytoskeleton stabilizer improved mitochondria bioenergenesis and blastocyst formation of mouse preimplantation embryo

Study question

What is primary factor of bioenergetics product activity between microtubule instability and the functional activity of mitochondria in embryo?

Summary answer

The actin cytoskeleton instability is presumably the primary cause for the bioenergenesis of mitochondrial function to the preimplantation embryo development.

What is known already

Mitochondria are cellular organelles dynamically moving and morphological changes. It provides for homeostatic energy to the cell. The dynamic property of the mitochondria is associated with the microtubule network in the cell. However, the stability of the microtubule was clearly identified for preimplantation embryo development.

Study design, size, duration

This study is designed to assess the ATP productivity of the mitochondria, and specifically to observe what its primary factor is in terms of providing microtubule stability in mammalian cells. Additionally, we investigated the relationship between blastocyst formation and actin cytoskeleton stabilization by EpD with 2-cell mice.

Participants/materials, setting, methods

We prepared the microtubule stability regulation model with the HEK293 cell line by using the microtubule stabilizer as an Epothilone D (EpD). Then we analyzed the metabolic activity of the cells through oxidative phosphorylation (OXP) ratios analysis. Also, we performed confocal live imaging to observe mitochondria morphology depending on the cells’ microtubule. Next, we treated EpD to 2-cell culture media for the analysis of blastocyst development ratios.

Main results and the role of chance

EpD significantly increased fusion form. Also, EpD enhance bioenergy ratios like OXP in the mitochondria and functional activity related marker, like mTOR compared with the control. These results suggest that microtubule stabilization enhances mitochondrial metabolism by increasing oxygen consumption. Also, EpD in 2-cell culture media led to a significant increase in the speed of development and 50% higher hatched out blastocyst formation ratios compared to the control group.

Limitations, reasons for caution

This study had limited animal experiments. For the next study, we are planning with an aim to improve the quality and development ratios of human embryos by EpD.

Wider implications of the findings: Microtubule stabilizer has a possibility to recover the mitochondria’s functional activity in the preimplantation embryo development. Mitochondrial functional activity along the actin cytoskeleton may play a pivotal role in determining the embryo quality and development ratios for archive pregnancy.

Trial registration number

non-clinical trials

P–657 Prostaglandin D2 is correlated with follicles development and a reliable marker of ovarian reserve of poor ovarian responder patients

Study question

Is the prostaglandin D2 (PGD2) associated with growing follicles and ovarian reserve of poor ovarian responders?

Summary answer

PGD2 is correlated with ovarian stimulation activity and follicle growth. Especially, poor ovarian responders show a significant decrease in the level of follicular fluid.

What is known already

Prostaglandins (PGs) are involved in the female reproductive process, mainly ovulation, fertilization, and implantation.

Study design, size, duration

We investigated the PGD2 level in the follicular fluid of poor ovarian responders. The collection of human follicular fluid was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. Follicular fluid was collected from patients with normal ovarian response and patients with POR.

Participants/materials, setting, methods

We studied whether prostaglandin has related to POR in the clinical key factor by measuring human follicular fluid. Follicular fluid was collected from patients with normal ovarian response and patients with POR. The concentration of PGD2 in follicular fluid was determined with ELISA kits following the manufacturer’s protocol.

Main results and the role of chance

We analyzed the level of PGD2 in the follicular fluid of patients with normal ovarian response and patients with POR using an ELISA. The PGD2 concentration was significantly lower in the follicular fluid of patients with POR than in the follicular fluid of young and old patients with normal ovarian response.

Limitations, reasons for caution

This study has an identification of biomarker of the clinical samples as POR criteria patients. Therefore, further investigations aimed at specific recovery of low PGD2 metabolic activity in the CCs during control ovarian stimulation.

Wider implications of the findings: Until now there is no specific biomarker of POR. AMH is just an ovary reserve marker for an indication of ovary function. PGD2 is one of the metabolites in steroid metabolism in the ovary. Therefore, we can find some cure through further study for improved PGD2 production to POR patients.

Trial registration number

none

P–658 Lovastatin promotes the expression of LDL receptor and enhances E2 production in the cumulus cells

Study question

Lovastatin enhanced E2 productive ratios in the cumulus cells through promoted expression of Low-density lipoprotein receptor (LDLR).

Summary answer

Lovastatin up-regulated gene expression of LDLR in the CCs. And the high expression of LDLR promoted E2 productive ratios from CCs.

What is known already

We already reported that the up-regulation of LDLR correlated with clinical pregnancy. Therefore, we found lovastatin as an up-regulator of LDLR expression of clinical pregnancy.

Study design, size, duration

This is an expended study of LDLR to enhance steroidogenesis regarding the effect of lovastatin in the CCs. The collection of human cumulus cells was approved by the Institutional Research and Ethical Committees of CHA University (approval number: 1044308–201611-BR–027–04) from January to December 2019. The CCs were collected from 12 patients with normal ovarian response after oocyte denudation for ICSI.

Participants/materials, setting, methods

We studied whether lovastatin has up-regulated LDLR expression in human CCs. Cumulus cells were collected from patients with young (∼ 36) and old aged patients (37 ∼). After culturing human CCs, they were treated lovastatin for one day. The concentration of E2 in culture medium was measured using Chemiluminescence immunoassay. The mRNA isolated from CCs was analyzed gene expression level through real time-PCR.

Main results and the role of chance

The concentration of E2 was significantly increased in the culture medium treated with lovastatin. The CCs treated with lovastatin increased the expression of LDLR and StAR which are components of the steroidogenesis pathway.

Limitations, reasons for caution

We have found that the role of lovastatin promotes the E2 production by increasing the ldlr gene of CCs. Therefore, further investigations aimed at lovastatin effect on human oocytes embryo whether enhanced quality of oocytes or not.

Wider implications of the findings: Previous data show that high activation of LDLR and StAR was associated with embryo quality and clinical pregnancy in infertile women. Our data suggest that lovastatin is stimulated LDLR expression to enhanced pregnancy ratios of IVF patients.

Trial registration number

none

Diagnostic test accuracy of 18F-FDG PET/CT for prediction of programmed death ligand 1 (PD-L1) expression in solid tumours: a meta-analysis

AIM

To investigate the predictive value of integrated 2-[¹⁸F]-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron-emission tomography/computed tomography (PET/CT) for the prediction of programmed death ligand 1 (PD-L1) expression in solid tumours via a systematic review and meta-analysis.

MATERIALS AND METHODS

The PubMed, Cochrane, and EMBASE databases, from the earliest available date of indexing through 31 October 2020, were searched for studies evaluating the diagnostic performance of ¹⁸F-FDG PET/CT for prediction of PD-L1 expression in solid tumours other than lung cancer.

RESULTS

Across seven studies (473 patients), the pooled sensitivity for ¹⁸F-FDG PET/CT was 0.75 (95% confidence interval [CI]: 0.65-0.82) without heterogeneity (I² = 47.2, p=0.08) and a pooled specificity of 0.73 (95% CI: 0.64-0.81) with heterogeneity (I² = 53.8, p=0.04). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 2.8 (95% CI: 2.1-3.7) and negative likelihood ratio (LR-) of 0.35 (95% CI: 0.26-0.47). The pooled diagnostic odds ratio (DOR) was 8 (95% CI: 5-13). Hierarchical summary receiver operating characteristic (ROC) curve and indicates that the area under the curve was 0.80 (95% CI: 0.77-0.84).

CONCLUSION

The current meta-analysis showed a moderate sensitivity and specificity of ¹⁸F-FDG PET/CT for the prediction of PD-L1 expression in solid tumours. At present, the literature regarding the use of ¹⁸F-FDG PET/CT for the prediction of PD-L1 expression in solid tumours still limited; thus, further large multicentre studies would be necessary to substantiate the diagnostic accuracy of ¹⁸F-FDG PET/CT for prediction of PD-L1 expression in solid tumours.

Distinct Signaling by Ventral Tegmental Area Glutamate, GABA, and Combinatorial Glutamate-GABA Neurons in Motivated Behavior

Ventral tegmental area (VTA) neurons play roles in reward and aversion. We recently discovered that the VTA has neurons that co-transmit glutamate and GABA (glutamate-GABA co-transmitting neurons), transmit glutamate without GABA (glutamate-transmitting neurons), or transmit GABA without glutamate (GABA-transmitting neurons). However, the functions of these VTA cell types in motivated behavior are unclear. To identify the functions of these VTA cell types, we combine recombinase mouse lines with INTRSECT2.0 vectors to selectively target these neurons. We find that VTA cell types have unique signaling patterns for reward, aversion, and learned cues. Whereas VTA glutamate-transmitting neurons signal cues predicting reward, VTA GABA-transmitting neurons signal cues predicting the absence of reward, and glutamate-GABA co-transmitting neurons signal rewarding and aversive outcomes without signaling learned cues related to those outcomes. Thus, we demonstrate that genetically defined subclasses of VTA glutamate and GABA neurons signal different aspects of motivated behavior.

Root et al. examine ventral tegmental area (VTA) neurons that release glutamate without GABA, GABA without glutamate, or both glutamate and GABA. Cell types have differential projection densities and unique neuronal activity profiles related to cues predicting rewarding, nonreward, or aversive outcomes and in the receipt of predicted rewards.

[Identification of the side population associated with ATP-binding cassette transporters activity using imaging flow cytometry]

DyeCycle Violet efflux, caused by ATP-binding cassette transporters activity, was analyzed in human colorectal adenocarcinoma cell lines SW480, HT-29, Caco-2 by neans of FACSAria III flow cytometer and ImageStreamX Mk II imaging flow cytometer. Along with similarity of cytometry data obtained on the two instruments, the use of imaging flow cytometry made it possible to characterize the morphology of side population cells, as well as morphology of other cell populations differing in the degree of dye accumulation. The population of cells, which are smaller than the side population cells and practically do not take the dye, is of the special interest. Probably, this population may contribute to the tumor resistance to chemotherapy.

Subepithelial neutrophil infiltration as a predictor of the surgical outcome of chronic rhinosinusitis with nasal polyps

BACKGROUND

Neutrophils present as major inflammatory cells in refractory chronic rhinosinusitis with nasal polyps (CRSwNP), regardless of the endotype. However, their role in the pathophysiology of CRSwNP remains poorly understood. We investigated factors predicting the surgical outcomes of CRSwNP patients with focus on neutrophilic localization.

METHODS

We employed machine-learning methods such as the decision tree and random forest models to predict the surgical outcomes of CRSwNP. Immunofluorescence analysis was conducted to detect human neutrophil elastase (HNE), Bcl-2, and Ki-67 in NP tissues. We counted the immunofluorescence-positive cells and divided them into three groups based on the infiltrated area, namely, epithelial, subepithelial, and perivascular groups.

RESULTS

On machine learning, the decision tree algorithm demonstrated that the number of subepithelial HNE-positive cells, Lund-Mackay (LM) scores, and endotype (eosinophilic or non-eosinophilic) were the most important predictors of surgical outcomes in CRSwNP patients. Additionally, the random forest algorithm showed that, after ranking the mean decrease in the Gini index or the accuracy of each factor, the top three ranking factors associated with surgical outcomes were the LM score, age, and number of subepithelial HNE-positive cells. In terms of cellular proliferation, immunofluorescence analysis revealed that Ki-67/HNE-double positive and Bcl-2/HNE-double positive cells were significantly increased in the subepithelial area in refractory CRSwNP.

CONCLUSION

Our machine-learning approach and immunofluorescence analysis demonstrated that subepithelial neutrophils in NP tissues had a high expression of Ki-67 and could serve as a cellular biomarker for predicting surgical outcomes in CRSwNP patients.

A compact and stable incidence-plane-rotating second harmonics detector

We describe a compact and stable setup for detecting the optical second harmonics, in which the incident plane rotates with respect to the sample. The setup is composed of rotating Fresnel rhomb optics and a femtosecond ytterbium-doped fiber laser source operating at the repetition frequency of 10 MHz. The setup including the laser source occupies an area of 1 m² and is stable so that the intensity fluctuation of the laser harmonics can be less than 0.2% for 4 h. We present the isotropic harmonic signal of a gold mirror of 0.5 pW and demonstrate the integrity and sensitivity of the setup. We also show the polarization-dependent six-fold pattern of the harmonics of a few-layer WSe₂, from which we infer the degree of local-field effects. Finally, we describe the extensibility of the setup to investigate the samples in various conditions such as cryogenic, strained, ultrafast non-equilibrium, and high magnetic fields.

Multi-chord IR-visible two-color interferometer on KSTAR

Major parts of an IR-visible two-color interferometer (TCI) on KSTAR have been upgraded for the multi-chord operation: (1) a diode-pumped-solid-state (DPSS) laser (660 nm) replacing the former HeNe laser (633 nm), (2) vacuum-compatible vibration isolator with titanium retro-reflectors, and (3) full digital phase comparator for multi-chord real-time density signals. The commercial compact DPSS laser suits the multiple chord configuration with its strong beam power (500 mW) and long coherent length (>100 m). Ti retro-reflectors are mounted on vacuum-compatible vibration isolators. The isolators are essential for the visible beams to avoid any fringe skips due to their short wavelength, considering the speed of the mechanical vibration (up to hundreds of μm). Field-programmable-gate-array (FPGA) modules count the entire fringes fast enough with a signal output rate up to 1.25 MHz, solving the fringe skip issues. The FPGA module enables the full digital processing of the phase comparator with a CORDIC algorithm after the sampling rate of 160 MS/s for the 40 MHz intermediate frequency of each beam. The full digital signals are transferred to the main plasma control system in real-time. Stable single-input-single-output operation of the KSTAR density control was demonstrated with the TCI. The real-time density profile control is also promising in the near future, with multiple actuators such as pellets and gas puffings.

Atomic-layer-confined multiple quantum wells enabled by monolithic bandgap engineering of transition metal dichalcogenides

Quantum wells (QWs), enabling effective exciton confinement and strong light-matter interaction, form an essential building block for quantum optoelectronics. For two-dimensional (2D) semiconductors, however, constructing the QWs is still challenging because suitable materials and fabrication techniques are lacking for bandgap engineering and indirect bandgap transitions occur at the multilayer. Here, we demonstrate an unexplored approach to fabricate atomic-layer-confined multiple QWs (MQWs) via monolithic bandgap engineering of transition metal dichalcogenides and van der Waals stacking. The WO_X/WSe₂ hetero-bilayer formed by monolithic oxidation of the WSe₂ bilayer exhibited the type I band alignment, facilitating as a building block for MQWs. A superlinear enhancement of photoluminescence with increasing the number of QWs was achieved. Furthermore, quantum-confined radiative recombination in MQWs was verified by a large exciton binding energy of 193 meV and a short exciton lifetime of 170 ps. This work paves the way toward monolithic integration of band-engineered heterostructures for 2D quantum optoelectronics.

Polarization Control of Deterministic Single-Photon Emitters in Monolayer WSe2

Single-photon emitters, the basic building blocks of quantum communication and information, have been developed using atomically thin transition metal dichalcogenides (TMDCs). Although the bandgap of TMDCs was spatially engineered in artificially created defects for single-photon emitters, it remains a challenge to precisely align the emitter's dipole moment to optical cavities for the Purcell enhancement. Here, we demonstrate position- and polarization-controlled single-photon emitters in monolayer WSe₂. A tensile strain of ∼0.2% was applied to monolayer WSe₂ by placing it onto a dielectric rod structure with a nanosized gap. Excitons were localized in the nanogap sites, resulting in the generation of linearly polarized single-photon emission with a g⁽²⁾ of ∼0.1 at 4 K. Additionally, we measured the abrupt change in polarization of single photons with respect to the nanogap size. Our robust spatial and polarization control of emission provides an efficient way to demonstrate deterministic and scalable single-photon sources by integrating with nanocavities.

Deep brain optogenetics without intracranial surgery

Achieving temporally precise, noninvasive control over specific neural cell types in the deep brain would advance the study of nervous system function. Here we use the potent channelrhodopsin ChRmine to achieve transcranial photoactivation of defined neural circuits, including midbrain and brainstem structures, at unprecedented depths of up to 7 mm with millisecond precision. Using systemic viral delivery of ChRmine, we demonstrate behavioral modulation without surgery, enabling implant-free deep brain optogenetics.

Progress of x-ray imaging crystal spectrometer utilizing double crystal assembly on KSTAR

The x-ray imaging crystal spectrometer (XICS) for Korea Superconducting Tokamak Advanced Research (KSTAR) has been upgraded to increase its performance including measurement capabilities and stable operation. A dual crystal assembly for simultaneous measurements of the helium-like and hydrogen-like Ar spectra is successfully installed for improving measurement capabilities. Using a safety viewing port with an illuminator and removing the XICS control system from the harsh KSTAR tokamak hall for a stable operation are newly performed. The experimental results from the improved XICS are investigated.

Enhanced Photoluminescence of Multiple Two-Dimensional van der Waals Heterostructures Fabricated by Layer-by-Layer Oxidation of MoS2

Monolayer transition metal dichalcogenides (TMDs) are promising for optoelectronics because of their high optical quantum yield and strong light-matter interaction. In particular, the van der Waals (vdW) heterostructures consisting of monolayer TMDs sandwiched by large gap hexagonal boron nitride have shown great potential for novel optoelectronic devices. However, a complicated stacking process limits scalability and practical applications. Furthermore, even though lots of efforts, such as fabrication of vdW heterointerfaces, modification of the surface, and structural phase transition, have been devoted to preserve or modulate the properties of TMDs, high environmental sensitivity and damage-prone characteristics of TMDs make it difficult to achieve a controllable technique for surface/interface engineering. Here, we demonstrate a novel way to fabricate multiple two-dimensional (2D) vdW heterostructures consisting of alternately stacked MoS₂ and MoO_x with enhanced photoluminescence (PL). We directly oxidized multilayer MoS₂ to a MoO_x/1 L-MoS₂ heterostructure with atomic layer precision through a customized oxygen plasma system. The monolayer MoS₂ covered by MoO_x showed an enhanced PL intensity 3.2 and 6.5 times higher in average than the as-exfoliated 1 L- and 2 L-MoS₂ because of preserved crystallinity and compensated dedoping by MoO_x. By using layer-by-layer oxidation and transfer processes, we fabricated the heterostructures of MoO_x/MoS₂/MoO_x/MoS₂, where the MoS₂ monolayers are separated by MoO_x. The heterostructures showed the multiplied PL intensity as the number of embedded MoS₂ layers increases because of suppression of the nonradiative trion formation and interlayer decoupling between stacked MoS₂ layers. Our work shows a novel way toward the fabrication of 2D material-based multiple vdW heterostructures and our layer-by-layer oxidation process is beneficial for the fabrication of high performance 2D optoelectronic devices.

Emission wavelength control of CsPb(Br1−xClx)3 nanocrystals for blue light-emitting diode applications

A facile synthetic method of CsPb(Br_1−xCl_x)₃ halide perovskite nanocrystals, which emit light with the wavelengths ranging from green to blue based on an anion exchanging reaction using a halide exchange additive was reported.

Comprehensive Dual- and Triple-Feature Intersectional Single-Vector Delivery of Diverse Functional Payloads to Cells of Behaving Mammals

The resolution and dimensionality with which biologists can characterize cell types have expanded dramatically in recent years, and intersectional consideration of such features (e.g., multiple gene expression and anatomical parameters) is increasingly understood to be essential. At the same time, genetically targeted technology for writing in and reading out activity patterns for cells in living organisms has enabled causal investigation in physiology and behavior; however, cell-type-specific delivery of these tools (including microbial opsins for optogenetics and genetically encoded Ca2+ indicators) has thus far fallen short of versatile targeting to cells jointly defined by many individually selected features. Here, we develop a comprehensive intersectional targeting toolbox including 39 novel vectors for joint-feature-targeted delivery of 13 molecular payloads (including opsins, indicators, and fluorophores), systematic approaches for development and optimization of new intersectional tools, hardware for in vivo monitoring of expression dynamics, and the first versatile single-virus tools (Triplesect) that enable targeting of triply defined cell types.

Vapor-Phase Passivation of Chlorine-Terminated Ge(100) Using Self-Assembled Monolayers of Hexanethiol

Continued scaling of electronic devices shows the need to incorporate high mobility alternatives to silicon, the cornerstone of the semiconductor industry, into modern field effect transistor (FET) devices. Germanium is well-poised to serve as the channel material in FET devices as it boasts an electron and hole mobility more than twice and four times that of Si, respectively. However, its unstable native oxide makes its passivation a crucial step toward its potential integration into future FETs. The International Roadmap for Devices and Systems (IRDS) predicts continued aggressive scaling not only of the device size but also of the pitch in nanowire arrays. The development of a vapor-phase chemical passivation technique will be required to prevent the collapse of these structures that can occur because of the surface tension and capillary forces that are experienced when tight-pitched nanowire arrays are processed via liquid-phase chemistry. Reported here is a vapor-phase process using hexanethiol for the passivation of planar Ge(100) substrates. Results benchmarking it against its well-established liquid-phase equivalent are also presented. X-ray photoelectron spectroscopy was used to monitor the effectiveness of the developed vapor-phase protocol, where the presence of oxide was monitored at 0, 24, and 168 h. Water contact angle measurements compliment these results by demonstrating an increase in hydrophobicity of the passivated substrates. Atomic force microscopy monitored the surface topology before and after processing to ensure the process does not cause roughening of the surface, which is critical to demonstrate suitability for nanostructures. It is shown that the 200 min vapor-phase passivation procedure generates stable, passivated surfaces with less roughness than the liquid-phase counterpart.

A Simple Percutaneous Technique to Reduce Valgus-Impacted Femoral Neck Fractures

The mainstream surgery for valgus-impacted femoral neck fractures (FNFs) is closed reduction and internal fixation under fluoroscopy. However, femoral neck shortening and anterior femoroacetabular impingement are common complications in healed valgus-impacted FNFs after in situ fixation. Some methods have been reported to prevent complications, but these techniques require the use of a transfixing guide wire that passes through the femoral head, which may cause articular cartilage damage. We introduce a simple reduction technique using one Steinmann pin (S-pin) for valgus-impacted FNFs without any interference of the femur head. A S-pin was placed percutaneously at the inferomedial margin of the fracture, and reduction was achieved by applying manual valgus force along the fracture line. By restoring the anatomical alignment, we confirmed the maximum contact area of the fracture and connection of the medial cortical buttress, so the risk of nonunion was also minimized.

Intrinsic and tunable ferromagnetism in Bi0.5Na0.5TiO3 through CaFeO3-δ modification

New (1-x)Bi_0.5Na_0.5TiO₃ + xCaFeO_3-δ solid solution compounds were fabricated using a sol–gel method. The CaFeO_3-δ materials were mixed into host Bi_0.5Na_0.5TiO₃ materials to form a solid solution that exhibited similar crystal symmetry to those of Bi_0.5Na_0.5TiO₃ phases. The random distribution of Ca and Fe cations in the Bi_0.5Na_0.5TiO₃ crystals resulted in a distorted structure. The optical band gaps decreased from 3.11 eV for the pure Bi_0.5Na_0.5TiO₃ samples to 2.34 eV for the 9 mol% CaFeO_3-δ-modified Bi_0.5Na_0.5TiO₃ samples. Moreover, the Bi_0.5Na_0.5TiO₃ samples exhibited weak photoluminescence because of the intrinsic defects and suppressed photoluminescence with increasing CaFeO_3-δ concentration. Experimental and theoretical studies via density functional theory calculations showed that pure Bi_0.5Na_0.5TiO₃ exhibited intrinsic ferromagnetism, which is associated with the possible presence of Bi, Na, and Ti vacancies and Ti³⁺-defect states. Further studies showed that such an induced magnetism by intrinsic defects can also be enhanced effectively with CaFeO_3-δ addition. This study provides a basis for understanding the role of secondary phase as a solid solution in Bi_0.5Na_0.5TiO₃ to facilitate the development of lead-free ferroelectric materials.

Genetically targeted chemical assembly of functional materials in living cells, tissues, and animals

The structural and functional complexity of multicellular biological systems, such as the brain, are beyond the reach of human design or assembly capabilities. Cells in living organisms may be recruited to construct synthetic materials or structures if treated as anatomically defined compartments for specific chemistry, harnessing biology for the assembly of complex functional structures. By integrating engineered-enzyme targeting and polymer chemistry, we genetically instructed specific living neurons to guide chemical synthesis of electrically functional (conductive or insulating) polymers at the plasma membrane. Electrophysiological and behavioral analyses confirmed that rationally designed, genetically targeted assembly of functional polymers not only preserved neuronal viability but also achieved remodeling of membrane properties and modulated cell type-specific behaviors in freely moving animals. This approach may enable the creation of diverse, complex, and functional structures and materials within living systems.

Combined effects of sous-vide cooking conditions on meat and sensory quality characteristics of chicken breast meat

This study investigated the combined effects of cooking temperature and time on the meat and eating quality characteristics of the sous-vide chicken breast. For the control group, chicken breast samples were cooked in a convection oven until the internal temperature reached 71°C. Each sample for sous-vide cooking was vacuum packaged and then cooked under continuous thermocontrolled conditions in a water bath at 6 combinations of cooking temperature (60 and 70°C) and time (1, 2, and 3 h). Sous-vide cooked chicken meat at 60°C for 1 h (SV60-1h) showed lower cooking loss (6.58 vs. 26.5%, P < 0.05), Warner-Bratzler shear force (21.7 vs. 29.1 N, P < 0.05), and hardness (9.40 vs. 17.3 N, P < 0.05) than meat cooked by conventional oven. Similar to the objective tenderness parameters, cooked chicken meat from the SV60 treatments for all cooking times showed higher scores in all the tenderness attributes than the control group (P < 0.05). However, a higher flavor intensity was observed in the SV70-3h and control groups than in the SV60 treatments (P < 0.05). Owing to a lesser developed flavor in chicken meat from the SV60-1h treatment, the SV60-2h and 3h treatments were assigned a higher acceptability rating for overall impression (P < 0.05). Therefore, cooking temperature and time of sous-vide significantly influenced the physicochemical and palatability characteristics of chicken breast. In this study, the optimum conditions for the sous-vide chicken breast are to continuously cook at 60°C for 2 to 3 h to improve sensory quality characteristics without reducing the water-holding capacity.

Open Reduction and Internal Fixation for Dorsal Fracture-dislocation of the Proximal Interphalangeal Joint

PURPOSE

 The purpose of this study was to investigate and compare the clinical and radiological results of ORIF with inter-fragment screw or buttress plate fixation of acute PIP joint fracture dorsal dislocation.

PATIENTS AND METHODS

 Between January 2007 to December 2016, nineteen patients - 14 men and 5 women with an average age of 40.9 (19 to 64) years - were included in this study; 9 patients underwent small sized interfragmentary screw fixation and 10 patients underwent small buttress plating. The average follow-up period was 45.1 (13 to 78) months. Clinical assessment included measurement of range of motion (ROM) of the proximal and distal interphalangeal joint (PIP, DIP), grip and pinch strength, and pain with use of the Visual Analog Scale (VAS). At the postoperative X-ray, articular step off, gap, and degree of dorsal subluxation was measured, and maintenance of the reduction, fracture union, and the presence of degenerative changes were assessed.

RESULTS

 All patients achieved solid unions without instability. The overall average range of motion of PIP joint were from 9° to 85° (10-83° in the screw group, 8-87° in the plate group without significant difference). However, the screw group (average: 53°) presented more flexion in the distal interphalangeal joint than the plate group (average: 34°). Plate fixation can cause limited DIP flexion. Six of the ten patients from the plate group, underwent implant removal and two of these patients required PIP joint arthrolysis due to the PIP flexion contracture of more than 30°. Three of the nine patients in screw group underwent implant removal and two of the three patients required PIP joint arthrolysis.

CONCLUSION

 Mini plate and screw fixation of acute PIP joint fracture dorsal dislocation can achieve comparable favorable clinical and radiographic outcomes through stable fixation and early range of motion exercise. Screw fixation, if possible, is probably preferable to plate fixation because of better DIP joint ROM and lower incidence of hardware removal. If there is a need for plate fixation the use of a short plate is recommended to avoid joint stiffness.

[Expression of ganglioside GD2 on colorectal adenocarcinoma cells]

Using flow cytometry GD2 ganglioside expression was evaluated both on colorectal adenocarcinoma cell lines and on tumor tissue samples from colorectal cancer patients. The marker was found on EpCAM-positive tumor cells in 6 of 12 patients' samples but not on the HT29 and CaCo-2 cell lines. GD2 expression was not an exceptional feature of cancer stem cells, since its expression level was similar on CD133-positive and CD133-negative tumor cells. Thus, the presence of GD2 ganglioside was revealed on colorectal adenocarcinoma cells for the first time. This finding makes it possible to use targeted therapy to treat this disease.

Transplant outcomes in kidney recipients with lupus nephritis, and systematic review

Background

Despite improved survival of patients with lupus nephritis (LN), some require kidney transplantation because of progression to end-stage renal disease (ESRD). However, the transplant outcomes of these patients and other recipients have not been thoroughly compared.

Methods

In total, 1848 Korean kidney recipients who underwent transplantation from 1998 to 2017 at two tertiary referral centers were evaluated retrospectively. Among them, 28 recipients with LN, and 50 control recipients matched by age, sex, and donor type, were compared with respect to graft and patient survival. We pooled our data with 17 previous cohort studies in which the graft survival of recipients with LN was described in detail.

Results

During the median follow-up period of 9.5 years (maximum 21 years), graft failure (GF) occurred in 10.7% and 16.0% of LN and control recipients, respectively. No differences were found in the rates of GF and death-censored graft failure or patient survival between the two groups. The risks of acute T cell-mediated and antibody-mediated rejection were also similar between the two groups. The pooled analysis showed similar 1- and 5-year graft survival rates between LN and control recipients.

Conclusions

Kidney transplantation is an acceptable option in patients with concurrent LN and ESRD.

Polarized ultraviolet emitters with Al wire-grid polarizers fabricated by solvent-assisted nanotransfer process

Polarized ultraviolet (UV) emitters are essential for various applications, such as photoalignment devices for liquid crystals, high-resolution imaging devices, highly sensitive sensors, and steppers. To increase the high polarization ratio (PR) of a UV emitter, the grating period should be decreased than that of the visible emitter. However, the fabrication of the short period grating directly on UV emitters is still limited. In this study, we demonstrate that 200, 100, and 50 nm period aluminum (Al)-based wire-grid polarizers (WGPs) can be fabricated directly on UV emitters by a solvent-assisted nanotransfer process. The UV emitter with a grating period of 100 nm shows a PR of 84%, and an electroluminescence efficiency that is 22.5% and 48% higher than those of UV emitters with 50 nm and 200 nm period WGPs, respectively, due to the increased photon extraction efficiency (PEE). The higher PEE is attributed to the optical cavity property of the Al metal reflector with low light loss and the surface plasmon effect of the Al grating layer.

Design and validation of a ten nanosecond resolved resistive thermometer for Gaussian laser beam heating

Pulsed laser processing plays a crucial role in additive manufacturing and nanomaterial processing. However, probing the transient temperature field during the pulsed laser interaction with the processed materials is challenging as it requires both high spatial and temporal resolution. Previous transient thermometry studies have measured neither sub-100 µm spatial resolution nor sub-10 ns temporal resolution. The temperature field induced by Gaussian laser beam profiles has also not been accounted for. Here, we demonstrate a 9 ns rise time, 50 µm sized Pt thin-film sensor for probing the temperature field generated by a nanosecond pulsed laser on a semiconductor thin film. The measurement error sources and associated improvements in the thin film fabrication, sensor patterning, and electrical circuitry are discussed. We carried out the first experimental and theoretical analysis of spatial resolution and accuracy for measuring a Gaussian pulse on the serpentine structure. Transparent silica and sapphire substrates, as well as 7-45 nm insulation layer thicknesses, are compared for sensing accuracy and temporal resolution. Finally, the measured absolute temperature magnitude is validated through the laser-induced melting of the 40 nm thick amorphous silicon film. Preliminary study shows its potential application for probing heat conduction among ultrathin films.