Identification and characterization of a calcium-binding peptide from salmon bone for the targeted inhibition of α-amylase in digestion

α-Amylase, essential for carbohydrate digestion, relies on calcium (Ca) for its structural integrity and enzymatic activity. This study explored the inhibitory effect of salmon bone peptides on α-amylase activity through their interaction with the enzyme's Ca-binding sites. Among the various salmon bone hydrolysates, salmon bone trypsin hydrolysate (SBTH) exhibited the highest α-amylase inhibition. The peptide IEELEEELEAER (PIE), with a sequence of Ile-Glu-Glu-Leu-Glu-Glu-Glu-Glu-Leu-Glu-Ala-Glu-Arg from SBTH, was found to specifically target the Ca-binding sites in α-amylase, interacting with key residues such as Asp206, Trp203, His201, etc. Additionally, cellular experiments using 3 T3-L1 preadipocytes indicated PIE's capability to suppress adipocyte differentiation, and decreases in intracellular triglycerides, total cholesterol, and lipid accumulation. In vivo studies also showed a significant reduction in weight gain in the group treated with PIE(6.61%)compared with the control group (33.65%). These findings suggest PIE is an effective α-amylase inhibitor, showing promise for obesity treatment.

Effect of Laparoscopic and Open Pancreaticoduodenectomy for Pancreatic or Periampullary Tumors: Three-year Follow-up of a Randomized Clinical Trial

OBJECTIVE

This study aimed to estimate whether the potential short-term advantages of laparoscopic pancreaticoduodenectomy (LPD) could allow patients to recover in a more timely manner and achieve better long-term survival than with open pancreaticoduodenectomy (OPD) in patients with pancreatic or periampullary tumors.

BACKGROUND

LPD has been demonstrated to be feasible and may have several potential advantages over OPD in terms of shorter hospital stay and accelerated recovery than OPD.

METHODS

This noninferiority, open-label, randomized clinical trial was conducted in 14 centers in China. The initial trial included 656 eligible patients with pancreatic or periampullary tumors enrolled from May 18, 2018, to December 19, 2019. The participants were randomized preoperatively in a 1:1 ratio to undergo either LPD (n=328) or OPD (n=328). The 3-year overall survival (OS), quality of life, which was assessed using the 3-level version of the European Quality of Life-5 Dimensions, depression, and other outcomes were evaluated.

RESULTS

Data from 656 patients [328 men (69.9%); mean (SD) age: 56.2 (10.7) years] who underwent pancreaticoduodenectomy were analyzed. For malignancies, the 3-year OS rates were 59.1% and 54.3% in the LPD and OPD groups, respectively ( P =0.33, hazard ratio: 1.16, 95% CI: 0.86-1.56). The 3-year OS rates for others were 81.3% and 85.6% in the LPD and OPD groups, respectively ( P =0.40, hazard ratio: 0.70, 95% CI: 0.30-1.63). No significant differences were observed in quality of life, depression and other outcomes between the 2 groups.

CONCLUSION

In patients with pancreatic or periampullary tumors, LPD performed by experienced surgeons resulted in a similar 3-year OS compared with OPD.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03138213.

Characterization and the mechanism underlying the cryoprotective activity of a peptide from large yellow croaker (Pseudosciaena crocea)

Ice crystal-induced protein denaturation is the main cause of the deterioration of fish during frozen storage and transportation. In this study, the ultra-performance liquid chromatography - quadrupole - time of flight (UPLC-Q-TOF) technique was used to identify and screen tryptic peptides Ile-Glu-Glu-Leu-Glu-Glu-Leu-Glu-Ala-Glu-Arg (IEELEEELEAER) from large yellow croaker (Pseudosciaena crocea). The results were used study their cryoprotective effects on turbot fish meat during freeze-thaw cycles at different concentrations, and to investigate their anti-freezing mechanism. The results showed that the I-2.0 group effectively inhibiting the degeneration and structure changes of myofibrillar proteins after three freeze-thaw cycles, and the Ca2+-ATPase activity (1.65 μmolPi/mg/h), increased by 55.86% compared with that of the control group. Additionally, peptide IEELEEELEAER could provide antifreeze protection by binding to the surface of ice crystals and inhibiting their transformation. This peptide acts as a natural cryoprotectant and might be used for the cryogenic storage and transportation of fish products.

Phytoremediation and environmental effects of three Amaranthaceae plants in contaminated soil under intercropping systems

Intercropping is a widely used agricultural system; however, the effect of intercropping between accumulator plants on phytoextraction in heavy metal-contaminated soils remains unknown. Here, a field experiment was conducted to investigate the phytoextraction efficiency and related environmental effects of three Amaranthaceae plants (Amaranthus hypochondriacus, Celosia argentea, and Pfaffia glomerata) using mono- and intercropping models. In monocropping, the total biomass of A. hypochondriacus was only 51.2 % of that of C. argentea. Compared with monocropping, intercropping reduced the fresh weight per plant of A. hypochondriacus by 53.0 % (intercropping with C. argentea) and 40.5 % (intercropping with P. glomerata) but increased the biomass per plant of C. argentea and P. glomerata by 128.2 and 14.2 %, respectively. The Cd uptake of the three plants in the monocropping models showed the following trend: C. argentea > P. glomerata > A. hypochondriacus. Interplanting A. hypochondriacus and C. argentea further increased the phytoextraction efficiency by 361.2 % (compared with A. hypochondriacus monocropping) and 52.0 % (compared with C. argentea monocropping). Soil exchangeable Cd, Pb, Cu, Zn, K, and P, soil N-NO3- and N-NH4+, soil common bacteria and arbuscular mycorrhiza (AM) fungi, and soil total organic carbon (TOC) play key roles in Cd and Pb uptake by the three accumulator plants (p < 0.05). The biomass of common bacteria, Gm+, Gm- bacteria, fungi, AM fungi, and actinomycetes increased with the three accumulators planted in the mono- and intercropping models. Compared with C. argentea monocropping, the biomass of soil microbes in the rhizosphere soil was obviously increased in the intercropping A. hypochondriacus and C. argentea models. These results suggest that interplanting A. hypochondriacus and C. argentea can increase Cd removal efficiency from Cd-contaminated soils, and this model could be recommended to remediate Cd-contaminated soils on a field scale.

CO2-responsive deep eutectic solvents for the enhanced extraction of hesperidin from Fertile orange peel

Hesperidin, also known as vitamin P, is widely studied for its distinctive potential in food and pharmaceutical industries. This work focuses on the research of CO2-responsive deep eutectic solvents (DESs) used as recyclable extractants for efficient extraction of hesperidin from Fertile orange peel. Reversible phase transformation of DES solution was achieved by bubbling CO2/N2. The maximum extraction yield of 22.39 mg/g was obtained for hesperidin under the following conditions: DES-6 (triethanolamine: 4-methoxyphenol = 1:1) used as extractant, water content of 35 wt%, solid-liquid ratio of 1:60 g/mL, extraction temperature of 25 °C, and ultrasonic time of 25 min, which was much higher than that extracted by methanol. Hesperidin of 74.38% was recovered in top phase after CO2 triggering. Density function theory (DFT) results indicated that hydrogen and π-π bonds were the main factors affecting hesperidin extraction. This study provides a new idea for extracting natural bioactive compounds using recyclable extractants.

Phase transitions associated with magnetic-field induced topological orbital momenta in a non-collinear antiferromagnet

Resistivity measurements are widely exploited to uncover electronic excitations and phase transitions in metallic solids. While single crystals are preferably studied to explore crystalline anisotropies, these usually cancel out in polycrystalline materials. Here we show that in polycrystalline Mn3Zn0.5Ge0.5N with non-collinear antiferromagnetic order, changes in the diagonal and, rather unexpected, off-diagonal components of the resistivity tensor occur at low temperatures indicating subtle transitions between magnetic phases of different symmetry. This is supported by neutron scattering and explained within a phenomenological model which suggests that the phase transitions in magnetic field are associated with field induced topological orbital momenta. The fact that we observe transitions between spin phases in a polycrystal, where effects of crystalline anisotropy are cancelled suggests that they are only controlled by exchange interactions. The observation of an off-diagonal resistivity extends the possibilities for realising antiferromagnetic spintronics with polycrystalline materials.

Point spread function modeling for photoacoustic tomography - I: three-dimensional detection geometries

Photoacoustic computed tomography (PACT) has been under intensive investigation as a promising noninvasive biomedical imaging modality. Various acoustic detector arrays have been developed to achieve enhanced imaging performance. In this paper, we study the effect of the detection geometry on image quality through point spread function (PSF) modeling based on back-projection image reconstruction. Three commonly-used three-dimensional detection geometries, namely, spherical, cylindrical, and planar detector arrays, are investigated. The effect of detector bandwidth and aperture on PSF in these detection geometries is also studied. This work provides a performance evaluation tool for acoustic detector arrays used in PACT and can be helpful in the design and selection of detector arrays in practical imaging applications.

Aqueous two-phase system based on pH-responsive polymeric deep eutectic solvent for efficient extraction of aromatic amino acids

Recently, more and more attention has been paid to the construction of stimulus-responsive aqueous two-phase systems (ATPSs) for the extraction and separation of various bioactive compounds. In this work, an ATPS based on a pH-responsive polymeric deep eutectic solvent (PDES) and phosphate salt was constructed for the first time. The pH-response properties of the PDES were studied through a series of experiments. Additionally, the phase formation mechanism was studied through experiments and simulations. This novel PDES-based ATPS was used to extract aromatic amino acids (AAAs). The extraction efficiencies for tyrosine (Tyr), phenylalanine (Phe), and tryptophan (Trp) reached 95.25%, 99.05%, and 99.10%, respectively. By adjusting pH, PDES was recycled and reused. This novel and recyclable PDES-based ATPS could be an efficient method for the extraction of AAAs, which could also be applied used as a versatile and sustainable method for the extraction of other bioactive compounds in the future.

The global burden of lymphoma: estimates from the Global Burden of Disease 2019 study

OBJECTIVES

The aim of this study was to describe the global trends in the burden of lymphoma from 1990 to 2019.

STUDY DESIGN

The data used in this study were from the Global Burden of Disease 2019 study.

METHODS

This study described the age-standardised rates of incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of lymphoma (non-Hodgkin and Hodgkin's lymphoma, NHL and HL, respectively) annually from 1990 to 2019, stratified by sociodemographic index (SDI) and 21 world regions. The estimated annual percentage changes in these indexes were calculated.

RESULTS

In 2019, the age-standardised rates of HL per 100,000 population were lower than those of NHL in terms of incidence (1.1 vs 6.7 per 100,000 person-years, respectively) and prevalence (0.3 vs 5.7 per 100,000 person-years, respectively) but not mortality (21.6 vs 3.2 per 100,000 person-years, respectively). From 1999 to 2019, the global incidence of HL decreased and the incidence of NHL increased, and the prevalence of both HL and NHL increased, but the mortality rates decreased. When stratified by SDI, the incidence of HL decreased in all but middle-SDI regions, the mortality rate of HL decreased in all regions, and both the incidence and mortality rate of NHL increased in all but high-SDI regions. The prevalence of HL and NHL increased in all SDI regions, especially in middle-SDI regions. YLLs and DALYs of HL in all SDI regions and those of NHL in high-SDI regions decreased. YLDs slightly increased in middle- to high-SDI regions.

CONCLUSIONS

Lymphoma remains a major public health issue, and better prevention, precise identification, and promising treatments are vitally important.

Bulk and transparent supramolecular glass from evaporation-induced noncovalent polymerization of nucleosides

Understanding the nature of glass is one of the most important challenges in chemistry, physics, and materials science. In this study, transparent bulk supramolecular glasses with excellent optical behaviors and good mechanical properties were fabricated via the non-covalent polymerization of nucleosides. Hydrogen bonding is the main driving force in the formation of bulk supramolecular glasses. The directional and saturated character of hydrogen bonding enables the formation of a short-range ordered structure, while the weak nature and reversibility of hydrogen bonds allow for the asymmetric and random connections of the short-range ordered structure into a long-range disordered network. Various relaxations, including β, γ, and δ relaxations, are observed at temperatures below the glass transition temperature, demonstrating the metastable nature of bulk supramolecular glasses. This investigation offers supramolecular insights into the nature of glass materials.

Deliberate foreign body ingestion in patients with underlying mental illness: A retrospective multicentre study

OBJECTIVE

Deliberate foreign body ingestion (DFBI) is characterised by recurrent presentations among patients with mental health conditions, intellectual disabilities and in prisoners. We aimed to profile the characteristics and evaluate the care of such patients in this study.

METHODS

Adult patients with an endoscopic record of attempted foreign body retrieval between January 2013 and September 2020 were identified at three Australian hospitals. Those with a documented mental health diagnosis were included and their standard medical records reviewed. Presentation history, demographics, comorbidities and endoscopic findings were recorded and described.

RESULTS

A total of 166 admissions were accounted for by 35 patients, 2/3 of which had borderline personality disorder (BPD). Repetitive presentations occurred in more than half of the cohort. There was an increased trend of hospital admissions throughout the years. At least half of the cohort had a documented mental health review during their admission. An average of 3.3 (2.9) foreign bodies were ingested per single episode. Endoscopic intervention was performed in 76.5% of incidents. The combined Length of stay for all patients was 680 days.

CONCLUSION

Deliberate foreign body ingestion in mental health patients is a common, recurring and challenging problem that is increasing in frequency and requires collaborative research to further guide holistic management.

The influence of residual pectin composition and content on nanocellulose films from ramie fibers: Micro-nano structure and physical properties

In this study, cellulose nanofibril (CNF) films from ramie fibers were prepared with different pectin compositions and contents, and the influence of residual pectin on the overall performances of CNF films was evaluated. There was no significant effect of the residual pectin composition on the properties of obtained CNF films. However, when the content of residual pectin was increased from 0.45 % to 9.16 %, the surface area and water absorption of CNF films were increased from 0.2223 to 0.3300 m2/g, and from 93.51 % to 122.42 %, respectively. Pectin covers the CNF surface and act as a physical barrier between the cellulose fibrils; thus the nanocellulose films with high pectin content will have a loose and porous structure, resulting in a high surface area and a high water absorption. Besides, with the residual pectin content decreasing from 9.16 % to 0.45 %, the UVA light transmittance and tensile strength of CNF films were increased from 30.6 % to 59.9 %, and from 37.67 to 100.26 MPa, respectively. After removal of amorphous pectins in CNFs, the low pectin containing CNFs are able to pack more compactly to form a strong and thin film. This paper provides guidance for the preparation of CNF films with different performance requirements.

Zwitterionic Eutectogel-Based Wearable Strain Sensor with Superior Stretchability, Self-Healing, Self-Adhesion, and Wide Temperature Tolerance

Ionic conductive eutectogels have great application prospects in wearable strain sensors owing to their temperature tolerance, simplicity, and low cost. Eutectogels prepared by cross-linking polymers have good tensile properties, strong self-healing capacities, and excellent surface-adaptive adhesion. Herein, we emphasize for the first time the potential of zwitterionic deep eutectic solvents (DESs), in which betaine is a hydrogen bond acceptor. Polymeric zwitterionic eutectogels were prepared by directly polymerizing acrylamide in zwitterionic DESs. The obtained eutectogels owned excellent ionic conductivity (0.23 mS cm^-1), superior stretchability (approximately 1400% elongation), self-healing (82.01%), self-adhesion, and wide temperature tolerance. Accordingly, the zwitterionic eutectogel was successfully applied in wearable self-adhesive strain sensors, which can adhere to skins and monitor body motions with high sensitivity and excellent cyclic stability over a wide temperature range (-80 to 80 °C). Moreover, this strain sensor owned an appealing sensing function on bidirectional monitoring. The findings in this work can pave the way for the design of soft materials with versatility and environmental adaptation.

Extraction and purification of grape seed polysaccharides using pH-switchable deep eutectic solvents-based three-phase partitioning

T-butanol is widely used in three-phase partitioning (TPP), which is harmful to the environment. pH-switchable deep eutectic solvents (DESs) can be used as recyclable alternatives to t-butanol. This study aimed to construct DES-based TPP for extracting and purifying grape seed polysaccharides (GSP). The main influence factors were investigated in single-factor experiments. DES-1 (dodecanoic acid: octanoic acid = 1:1)-based extraction was screened, and the extraction yield reached the maximum of 98.04 mg/g under the optimal conditions. Furthermore, DES can be recycled, only suffering a small loss capacity in extraction yield after 25 cycles. Most importantly, the extractability of DES could be completely recovered after switching and regeneration. The molecular weight of obtained GSP was 60 kDa, and the main monosaccharides of GSP included mannose, glucose, galactose, and arabinose. This study provides an efficient and sustainable method for the extraction of bioactive substances.

Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy

Laparoscopic pancreatoduodenectomy (LPD) is a demanding abdominal operation that necessitates meticulous surgical skills and teamwork. The management of the pancreatic uncinate process is one of the most important and difficult processes in LPD because of its deep anatomical location and difficult exposure. Complete resection of the uncinate process and mesopancreas has become the cornerstone of LPD. In particular, it is even more difficult to avoid positive surgical margins and incomplete lymph node dissection when the tumor is located in the uncinate process. No-touch LPD, which is an ideal oncological operation process fitting the "tumor-free" principle, has been reported by our group previously. This article introduces the management of the uncinate process in no-touch LPD. Based on the multi-angle arterial approach, in this protocol, the median-anterior and left-posterior approaches to the SMA are used to correctly deal with the important vascular structure, the inferior pancreaticoduodenal artery (IPDA), in order to ensure the safe and complete excision of the uncinate process and mesopancreas. For the achievement of the no-touch isolation technique in LPD, the pancreatic head and the blood supply to the duodenal region must be severed at the very early stage of the operation; after that, the tumor can be isolated intact, resection can be performed in situ, and finally, the tissue can be removed en bloc. This paper aims to show the distinctive ways to manage the uncinate process in no-touch LPD and investigate the viability and safety of this approach. Moreover, the technique may increase the R0 resection rate.

Sex Specific Global Burden of Osteoporosis in 204 Countries and Territories, from 1990 to 2030: An Age-Period-Cohort Modeling Study

BACKGROUND

Osteoporosis is a highly prevalent disease with distinct sex pattern. We aimed to estimate the sex specific incidence, prevalence, and disability-adjusted life (DALYs) years of osteoporosis between 1990 and 2019, with additional predictions from 2020 to 2034.

METHODS

We collected osteoporosis disease burden data from the Global Burden of Disease study covering the years 1990 through 2019 in 204 countries and territories. The data included information on the number of incident cases of osteoporosis, DALYs, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR) and age-standardized DALYs rates. Additionally, we performed an age-period-cohort analysis to forecast the burden of osteoporosis.

RESULTS

The global number of incidence cases of osteoporosis, in 2019, reached 41.5 million cases. From 1990 to 2019, the low-middle socio-demographic index (SDI) region had the highest estimated annual percentage change in the world. Compared to males, female's ASIR and ASPR were all about 1.5 times higher than males for the same years in the same SDI regions. The projected global total number of incidence cases for osteoporosis between 2030 and 2034 is estimated to reach 263.2 million (154.4 million for females and 108.8 for males). Additionally, the burden in terms of DALYs is predicted to be 128.7 million (with 78.4 million for females and 50.3 million for males).

CONCLUSION

The global burden of osteoporosis is still increasing, mainly observed in high SDI countries. Females bear a burden 1.5 times higher than males in terms of incidence and DALYs. Steps should be taken to reduce the osteoporosis burden, especially in high SDI countries.

Nutritional properties and osteogenic activity of simulated digestion components and peptides from Larimichthys crocea

Fish provides a range of health benefits due to its nutritional and bioactive components. However, the bioactive peptides derived from Larimichthys crocea proteins were not fully investigated, especially the beneficial effects related to bone growth in vitro. In this study, the water extract protein was subjected to the simulated in vitro digestion process, and the osteogenic effect of enzymatic hydrolysate at different digestion stages was evaluated by the proliferation of osteoblast. The protein hydrolyzates of group pepsin treatment for 1 h and pepsin treatment for 2 h showed higher osteogenic activity in vitro. Two peptides including IERGDVVVQDSPSD from pepsin treatment for 1 h and RGDLGIEIPTEK from pepsin treatment for 2 h were identified, which revealed eminent effects in terms of promoting osteoblast proliferation and enhancing ALP activity. Moreover, the available nutrients in the proteins were determined by the molecular weight distribution and free amino acid composition. Those peptides also showed stronger interaction with RGD than integrins. Therefore, the peptides from Larimichthys crocea can be used as an effective ingredient for promoting bone growth in the future.

Laparoscopic Radical Antegrade Modular Pancreatosplenectomy via Dorsal-Caudal Artery Approach for Pancreatic Neck-Body Cancer

Laparoscopic radical resection of the pancreatic neck is one of the most complicated radical operations for pancreatic cancer, especially for patients who have had neoadjuvant chemotherapy. Here, we present a technique to perform laparoscopic radical antegrade modular pancreatosplenectomy (L-RAMPS) using the dorsal-caudal artery approach by making full use of the high-definition vision and operation modes of the laparoscope. The innovation and optimization of this operation are provided in the protocol. Priority should be given to the dorsal resection plane, including the dorsal side of the superior mesenteric artery (SMA), the dorsal side of the pancreatic head, the root of the celiac artery (CeA), the ventral side of the left renal vessels, and the renal hilum. On the condition that the operation for pancreatic neck-body cancer is feasible and safe, the second step is to perform tumor resection en bloc surrounding the SMA and CeA from the caudal to the cephalic side to increase the rate of R0 (radical zero) resection and further prognosis.

Poly(thioctic acid): From Bottom-Up Self-Assembly to 3D-Fused Deposition Modeling Printing

Inspired by the bottom-up assembly in nature, an artificial self-assembly pattern is introduced into 3D-fused deposition modeling (FDM) printing to achieve additive manufacturing on the macroscopic scale. Thermally activated polymerization of thioctic acid (TA) enabled the bulk construction of poly(TA), and yielded unique time-dependent self-assembly. Freshly prepared poly(TA) can spontaneously and continuously transfer into higher-molecular-weight species and low-molecular-weight TA monomers. Poly(TA) and the newly formed TA further assembled into self-reinforcing materials via microscopic-phase separation. Bottom-up self-assembly patterns on different scales are fully realized by 3D FDM printing of poly(TA): thermally induced polymerization of TA (microscopic-scale assembly) to poly(TA) and 3D printing (macroscopic-scale assembly) of poly(TA) are simultaneously achieved in the 3D-printing process; after 3D printing, the poly(TA) modes show mechanically enhanced features over time, arising from the microscopic self-assembly of poly(TA) and TA. This study clearly demonstrates that micro- and macroscopic bottom-up self-assembly can be applied in 3D additive manufacturing.

Watchman device migration and embolization: a report from the NCDR LAAO registry

Background

Incomplete anchoring of the Watchman left atrial appendage closure (LAAO) device can result in substantial device migration or device embolization requiring percutaneous or surgical retrieval.

Purpose

To report rates and characteristics of in-hospital and post-discharge Watchman device migration and embolization events in the United States.

Methods

We performed a retrospective analysis of Watchman procedures (January 2016 through March 2021) reported to the National Cardiovascular Data Registry LAAO Registry. We excluded patients with prior LAAO interventions, no device released, and missing device information. In-hospital events were assessed among all patients and post-discharge events were assessed among patients with 45-day follow-up.

Results

Of 120,278 Watchman procedures, device migration or embolization occurred in 0.07% of patients (n=84) during the index hospitalization and surgery was performed in 39 patients. The in-hospital mortality rate was 14% among patients with device migration or embolization and 20.5% among patients who underwent surgery. In-hospital migration or embolization was more common: at hospitals with a lower median annual procedure volume (24 vs. 41 procedures, p&lt;0.0001), with first-generation Watchman versus next-generation Watchman FLX devices (0.08% vs. 0.04%, p=0.0048), with larger LAA ostia (median 23 mm vs. 21 mm, p=0.004), and with a smaller difference between device and LAA ostial size (median difference 4 mm vs. 5 mm, p=0.04). There were no differences by age, sex, hospital type, hospital size, or teaching versus non-teaching status. Of 98,147 patients with 45-day follow-up, device migration or embolization after discharge occurred in 0.06% (n=54) patients and cardiac surgery was performed in 7.4% (n=4) of cases. The 45-day mortality rate was 3.7% (n=2) among patients with post-discharge device migration or embolization. Post-discharge migration or embolization was more common among men (79.7% of events but 58.9% of all procedures, p=0.0019), taller patients (177.9 cm vs. 172 cm, p=0.0005), and those with greater body mass (99.9 kg vs. 85.5 kg, p=0.0055); in contrast to in-hospital events, there were no differences in hospital volume, device characteristics, or LAA characteristics.

Conclusions

Watchman device migration or embolization is rare but associated with high mortality (Figure 1) and frequently requires surgical retrieval. A substantial proportion of all device migration or embolization cases occur after discharge and different patient and procedure characteristics are associated with in-hospital versus post-discharge cases. Given the morbidity and mortality associated with device migration or embolization, risk mitigation strategies and on-site cardiac surgical back-up are of paramount importance.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health

Separation and Purification of Astragalus membranaceus Polysaccharides by Deep Eutectic Solvents-Based Aqueous Two-Phase System

(1) Background: Aqueous two-phase systems (ATPSs) have been widely used in the separation and purification of bioactive substances in recent years. (2) Methods: In this study, deep eutectic solvents (DESs)-based ATPSs were employed for the extraction and separation of Astragalus membranaceus polysaccharides (AMP). The optimal DES (choline chloride:urea = 1:1) was first screened to extract AMP, and the effect of DES concentration, solid-liquid ratio, pH, extraction temperature, and extraction time on the extraction yield of AMP were investigated. (3) Results: The maximum extraction yield was 141.11 mg/g under the optimum conditions. AMP was then preliminarily purified by ATPS, to further realize the recycling and reuse of DES. The effect of type of salts, salt concentration, and extraction temperature on extraction efficiency was investigated. The extraction efficiency was 97.85% for AMP under the optimum ATPS conditions. Finally, the obtained AMP was studied by molecular weight determination, infrared spectroscopy analysis, and monosaccharide composition analysis. (4) Conclusions: This ATPS extraction based on DESs is simple, environmentally friendly, low-cost, and has high extraction efficiency, which provides new ideas for the extraction of plant polysaccharides and other bioactive compounds.

P-329 Endometrioma impairs oocyte development by extensive premature activation of primordial follicles in an experimental endometrioma mouse model

Study question

What are the pathological mechanisms of endometrioma-associated poor ovarian function?

Summary answer

Endometrioma prematurely activated primordial follicles and subsequently impaired ovarian functions through disrupting folliculogenesis and deteriorating oocyte quality.

What is known already

Endometrioma is the most common subtype of endometriosis, of which the endometriotic lesions implant in the ovary. Women with endometrioma are usually coupled with disrupted folliculogenesis, hampered ovulation, impaired oocyte quality and undesired infertility, presenting with reduced ovarian reserve, low oocyte retrieval rates and poor fertility outcomes. However the underlying mechanisms of the disrupted folliculogenesis, hampered ovulation and impaired oocyte quality in endometrioma-associated infertility are still unclear.

Study design, size, duration

An experimental mouse model of endometrioma (OMA) was established to study the effects of endometriosis in ovary on the development and functions of follicles. Four to eight mice were included in experimental and sham control groups each. Ovaries were collected 4 weeks after transplantation of endometrial fragments. Follicle counts and specific developmental markers were used to evaluate the development and functions of follicles. Oocyte quality was studied by meiotic competence, cortical distributions and ATP synthesis.

Participants/materials, setting, methods

Minced endometrial tissues from donor mice were inserted into ovarian bursa in recipient mice. Ovarian follicles in different stages were examined and counted manually with Periodic acid-Schiff staining. Protein expressions of FOXO3, AMH and FSHR were detected by immunohistochemistry to characterise the developing primordial, primary/secondary and antral follicles, respectively. Oocytes were collected from oviduct after superovulation and stained with a-tubulin, LCA-FITC to assess maturity.

Main results and the role of chance

Successful establishment of endometriotic lesions in ovarian tissues was confirmed morphologically and histologically with a success rate of 83.33% in recipient mice. In the OMA ovaries, absolute counts of the follicles in each developmental stage showed significant reduction when compared with sham controls. Percentage of primordial follicles was significantly reduced, but percentage of advanced-staged follicles was significantly increased. Expression of FOXO3 in primordial follicles, AMH in developing follicles (primary, secondary) and FSHR in antral follicles were all significantly decreased in OMA group. Oocytes isolated from OMA ovaries had lower number and size than controls. Large proportion of the oocytes had significantly higher abnormal spindle rates, indicating mitotic disruption. Moreover, a large proportion of the oocytes also had impaired cortical granule migration, indicating affected organelle organization.

Limitations, reasons for caution

Studies based on this animal model may not reflect the exact situation in human. Moreover, success rate of the OMA model cannot reach 100%. Other factors contributing to the endometrioma-associated infertility still undetermined in the OMA models.

Wider implications of the findings

The results demonstrated that endometrioma remarkably deteriorated follicular development, and subsequently impaired oocyte quality by premature activation primordial follicles. The underlying deteriorating effects and mechanism might help to develop novel therapeutic targets to improve fertility outcomes in women with endometrioma.

Trial registration number

N/A

Menopausal hormone therapy: what are the problems in the perception of Chinese physicians?

OBJECTIVE

This study aimed to investigate Chinese physicians' perception and attitudes toward menopausal hormone therapy (MHT).

METHODS

This nationwide online survey was conducted in China. Physicians registered in the WeChat groups of the Gynecological Endocrinology Committee of China's Maternal and Child Health Care Association received a message invitation to complete this anonymous online survey from April 2020 to July 2020. Physicians' knowledge of and attitudes toward MHT were surveyed.

RESULTS

In total, 4672 questionnaires were submitted; only completed questionnaires could be submitted. The message was sent to 6021 doctors, so the response rate was 77.6%. Overall, 77.9-92.9% of physicians knew the common indications and contraindications to MHT. Additionally, 90.6%, 85.4%, 80.7% and 37.5% of physicians thought that MHT would increase the risk of venous thrombosis, breast cancer, endometrial cancer and weight gain, respectively. In total, 58.1% of the physicians mistakenly believed that a sex hormone test was one of the necessary examinations to reassess MHT prescription during follow-up visits. We found that 68.5% of physicians would consider using MHT themselves or recommend MHT to their partners in the future, and 11.4% were currently using MHT.

CONCLUSIONS

Most Chinese physicians have basic knowledge of MHT. Their misunderstandings about MHT mainly centered on the risks of endometrial cancer, weight gain and the necessary examinations during follow-up visits. These misunderstandings need to be clarified in future professional training programs.

On-Site Supramolecular Adhesion to Wet and Soft Surfaces via Solvent Exchange

A series of poly(thioctic acid-catechol)s was prepared by supramolecular copolymerization of two low-molecular-weight monomers, thioctic acid (TA) and catechol (CA). The addition of a small amount of CA molecules significantly improved the adhesion ability of poly(TA) and transformed it into an applicable supramolecular polymer adhesive material. The robust adhesion of poly(TA-CA)s to soft surfaces was achieved by employing a hot-melt method. However, the supramolecular adhesion via the hot-melt method failed to perform in the presence of water. On-site supramolecular adhesion to wet and soft substrates was successfully realized through the solvent exchange behavior between water and the poly(TA-CA)s ethanol solution. Compared to the hot-melt method, the solvent exchange method displays various fascinating advantages and is suitable for adhesion conditions normally under the presence of water.

P–316 A rat model of endometrioma to study endometriosis-related infertility

Study question

Underlying mechanisms and specific treatment for endometriosis-related infertility are still unclear and lacking. Is there any animal model suitable for the study?

Summary answer

Endometium ligation to ovary fat pad in rats is a more appropriate and successful but less detrimental model of endometrioma for infertility pathology and outcomes.

What is known already

Nonhuman primates (NHP) have been the most representative animal model for endometriosis since they menstruate in a cyclic pattern and develop endometriosis spontaneously as in human. However, the incidence of spontaneous endometriosis in NHP is low and due to ethical concerns and high cost, the application of NHP for endometriosis study is restricted. Rodents (i.e. rats, mice, rabbits) have been used to analyze the pathophysiology of endometriosis. Because rodents do not develop endometriosis spontaneously, it has to be induced surgically. Ovarian endometriosis is the most common type, but previous experimental models were mostly either subcutaneous, peritoneal wall or mesenteric endometriosis.

Study design, size, duration

An animal study to compare different methods of endometrium transplantation to the ovary as potential animal model of endometrioma to study the endometriosis-related infertility. Compared with NHP and other rodents, rats were chosen due to easy access, low cost, good ovary size, short estrus and reproductive cycle and similar endocrine pattern to human beings. For each transplantation method, at least 5 animals were included and followed up in different time points for comparisons.

Participants/materials, setting, methods

To establish ovarian endometriosis or endometrioma model, uterine tissues were collected from donor rats and then transplanted to recipient rats by either adhesion to ovary, ligation to ovary fat pad, or injection underneath tunica albuginea. Vasculature and histology of engrafts, follicle count and morphology of ovary, receptivity markers of endometrium, immune response and inflammatory cytokines of peritoneal cavity and hormonal changes were assessed after 4 days of transplantation. Implantation rates after conception will be examined.

Main results and the role of chance

Compared with other transplantation methods, only ligation of endometrium fragments to ovary fat pad resulted in endometrioma-like lesion in the ovaries. Compare with sham control ovaries, formation of new vessels from surrounding ovarian vessels to the endometriotic engraft assessed by Cellvizio LAB in vivo imaging was identified, indicating active angiogenesis. Morphology and histology of endometriotic cyst were confirmed in the lesion by H&E staining, suggesting functional endometrium. Stroma markers CD140b, CD106 lkand epithelium markers keratin 17/19 and EpCam were found in the ovary cortex, implying integration of endometrium tissue to the ovarian tissues. Decreased AMH expression and antral follicle count in the ovaries suggested defective follicle development. Reduced receptivity markers HOXA10, LIF and ανβ3 integrin expression in uterine endometrium and implantation rate after nature mating or embryo transfer indicated potential impaired endometrial receptivity. Peripheral and peritoneal levels of COX2 and IL–8 were elevated, suggesting inflammatory response. However, estrogen and progesterone levels were not significant different from baseline and other transplantation methods.

Limitations, reasons for caution

This was an animal model, it might not totally reflect the exact pathological changes of endometrioma in human. Current method was a single and short-term transplantation model, monthly endometrial cells engraftment and slow growing lesions without sufficient estrogen supply might limit the establishment of endometrium-like lesions. Further testings are needed.

Wider implications of the findings: Establishment of animal models for endometrioma is vital important to investigate the pathophysiology, underlying mechanism and potential therapy targets for endometriosis-related infertility. Currently such model is still lacking. An appropriate, adequate and effective but less detrimental model of endometrioma can accelerate the scientific research and clinical application in near future.

Trial registration number

N/A

[Amiodarone promotes heat-induced apoptosis, inflammation and oxidative stress in mouse HL1 atrial myocytes]

OBJECTIVE

To investigate the injury types of atrial myocytes induced by heat exposure and the effect of amiodarone on heat-induced injuries in atrial myocytes.

OBJECTIVE

The optimal temperature for heat exposure and optimal concentration of amiodarone were determined by measuring the cell viability exposed to different temperatures and different concentrations of amiodarone. Heat exposure of HL1 atrial myocytes was conducted using a water bath, and the effect of amiodarone on cell viability was assessed with MTS method; cell apoptosis was detected using flow cytometry, and the levels of IL-1β, IL-6, TNF-α, SOD and MDA were detected with enzyme-linked immunosorbent assay (ELISA).

OBJECTIVE

Compared with the blank control cells, the cells exposed to a temperature of 52 ℃ showed a significantly decreased survival rate and a lowered SOD activity (P < 0.001) with increased IL-1β and MDA levels (P < 0.01) and markedly increased apoptosis rate and IL-6 level (P < 0.001). Compared with the heat exposure group, amiodarone resulted in significantly decreased survival rate of the atrial myocytes (P < 0.01), obviously decreased SOD activity (P < 0.05), and increased cell apoptosis rate (P < 0.05) and IL-1β, IL-6, MDA and TNF-α levels (P < 0.01 or 0.001).

OBJECTIVE

Heat exposure induces apoptosis, inflammation and oxidative stress in mouse HL1 atrial myocytes, and amiodarone can enhance the effects of heat exposure to aggravate the cell injuries.