Pure-Shift-Based Proton Magnetic Resonance Spectroscopy for High-Resolution Studies of Biological Samples

Proton magnetic resonance spectroscopy (1H MRS) presents a powerful tool for revealing molecular-level metabolite information, complementary to the anatomical insight delivered by magnetic resonance imaging (MRI), thus playing a significant role in in vivo/in vitro biological studies. However, its further applications are generally confined by spectral congestion caused by numerous biological metabolites contained within the limited proton frequency range. Herein, we propose a pure-shift-based 1H localized MRS method as a proof of concept for high-resolution studies of biological samples. Benefitting from the spectral simplification from multiplets to singlet peaks, this method addresses the challenge of spectral congestion encountered in conventional MRS experiments and facilitates metabolite analysis from crowded NMR resonances. The performance of the proposed pure-shift 1H MRS method is demonstrated on different kinds of samples, including brain metabolite phantom and in vitro biological samples of intact pig brain tissue and grape tissue, using a 7.0 T animal MRI scanner. This proposed MRS method is readily implemented in common commercial NMR/MRI instruments because of its generally adopted pulse-sequence modules. Therefore, this study takes a meaningful step for MRS studies toward potential applications in metabolite analysis and disease diagnosis.

[Colorectal adenocarcinoma with enteroblastic differentiation: a clinicopathological analysis of eight cases]

Objective: To investigate the clinicopathological features of colorectal adenocarcinoma with enteroblastic differentiation (CAED). Methods: Eight cases of CAED diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China from January 2017 to August 2023 were collected. The histopathological, immunohistochemical, molecular and prognostic features of 8 CAED cases were analyzed. The relevant studies were also reviewed. Results: Among the eight patients, there were six males and two females, with an average age of 58 years (range: 29-77 years, median age: 61.5 years). Preoperative serum alpha-fetoprotein levels were elevated in five patients (14.0-286.6 μg/L). Four tumors were located in the colon, and four tumors in the rectum. Two patients were clinically staged as advanced stage (stage Ⅳ), and distant metastasis occurred at the initial diagnosis (one case had liver metastasis, and the other had lung, bone and multiple lymph nodes metastases). Six patients were clinically staged as locally-advanced stage (Stage Ⅱ-Ⅲ). Three of them developed distant metastases after surgery (one case had liver metastasis, one case had lung metastasis, and one case had peritoneal metastasis). Additionally, two patients died at 9 months and 24 months after surgery, respectively. The tumors were composed of various proportions of adenocarcinoma components with enteroblastic differentiation (30%-100%) and classical tubular adenocarcinoma components. The component with enteroblastic differentiation exhibited morphology similar to embryonic intestinal epithelium: cuboidal or columnar tumor cells arranged in tubular, papillary, cribriform, or solid nest patterns, with clear cytoplasm. Immunohistochemical studies showed that tumor cells expressed at least one oncofetal protein (SALL4, Glypican-3, and AFP). In addition, focal squamous differentiation was observed in 3 cases (3/8). Compared to the primary tumor, both CAED and squamous differentiation components were increased in the metastatic tumors. Based on the sequencing results of KRAS, NRAS and BRAF of the primary and/or metastatic tumors, 5 cases were wild-type, while KRAS exon 2 (G13D) mutations were identified in 2 cases. Conclusions: CAED is a rare colorectal malignancy with a dismal prognosis. Accurate pathological diagnosis is prognostically valuable. The histological features of enteroblastic differentiation, elevated serum AFP levels, and the expression of oncofetal proteins play an important role in the tumor diagnosis.

Strain-insensitive micro torsion and temperature sensor based on a helical taper seven-core fiber structure

We propose a multimode interference-based optical fiber NHTSN sensor with a helical taper for simultaneous measurement of micro torsion and temperature. The sensor consists of single mode fiber (SMF), no-core fiber (NCF), and seven-core fiber (SCF). A helical taper is fabricated in the SCF using a flame heater, forming the SMF-NCF-Helical Taper SCF-NCF-SMF (NHTSN) structure. Theoretical analysis and experimental results demonstrate that the introduction of helical taper not only imparts directionality to the torsion measurement, but also results in a significant improvement in torsion sensitivity due to the increased inter-mode optical path difference (OPD) and enhanced inter-mode coupling. In the experiment, the torsion sensitivity of the NHTSN sensor reaches -1.255 nm/(rad/m) in the twist rate (TR) range of -3.931 rad/m to 3.931 rad/m, which is a 9-fold improvement over the original structure. Further reduction of the helical taper diameter increases the sensitivity to -1.690 nm/(rad/m). In addition, the sensor has a temperature sensitivity of up to 97 pm/°C from 20 °C to 90 °C, and simultaneous measurement of torsion and temperature is attainable through a dual-parameter measurement matrix. The NHTSN sensor possesses advantages of compact size, high sensitivity, good linearity, and strain-independence, endowing it with potential applications in structural health monitoring (SHM) and engineering machinery.

Exogenous carbon monoxide promotes GPX4-dependent ferroptosis through ROS/GSK3β axis in non-small cell lung cancer

The gas therapy is drawing increasing attention in the treatment of many diseases including cancer. As one of gas signaling molecules, carbon monoxide (CO) has been proved to exert anti-cancer effects via triggering multiple cell death types, such as autophagy, apoptosis and necrosis. Here, we showed that low concentration CO delivered from CO-releasing molecule 3 (CORM-3) effectively induced ferroptosis, known as a novel proinflammatory programmed cell death, in vitro and in vivo. Mechanistically, we found that CO triggered ferroptosis by modulating the ROS/GSK3β/GPX4 signaling pathway, resulting in the accumulation of lipid hydroperoxides and the occurrence of ferroptosis. We think our findings provide novel insights into the anti-cancer mechanisms of CO, and suggest that CO could potentially be exploited as a novel ferroptosis inducer for cancer treatment in the future.

An Ultra-low Detection Limit Fe3+ Optical Fiber Fluorescent Sensor Based on a Anti-B18H22 Derivative with Aggregation-induced Emission Enhancement

A fluorescent Fe3+ probe ((C10H7NO2)2B18H20, M1) by introducing two isoquinoline-1-carboxylic acid group into the 6,9-position of anti-B18H22 was designed and synthesized. The structure of M1 was investigated by 1H NMR, MS, FT-IR and theoretical calculation, and its optical properties were characterized with UV-Vis and PL. M1 showed aggregation induced emission enhancement (AIEE) properties in THF/H2O solution, and exhibited an excellent selectivity toward Fe3+ in THF/H2O (v/v, ƒw = 95%) solution with a detection limit of 1.93 × 10-5 M. The interaction mechanism of probe for detecting Fe3+ is attributed to the involvement of intramolecular charge transfer (ICT) process. Furthermore, a optical fiber fluorescent Fe3+ sensor based on M1 sensing film was developed, the detection limit of the optical fiber Fe3+ fluorescent sensor could be improved to13.8 pM, the ultra-low detection limit is superior to most reported fluorescent probes (or sensors) towards Fe3+. This method has the advantages of high sensitivity, anti-interference and easy to operate, and has great potential in the field of the analysis of environmental and biological samples.

Efficacy and Toxicity of Different Target Volume Delineations of Radiotherapy Based on the Updated RTOG/NRG and EORTC Guidelines in Patients with High Grade Glioma: A Randomized, Controlled Clinical Trial

PURPOSE/OBJECTIVE(S)

Postoperative radiotherapy with concomitant and adjuvant temozolomide (TMZ) is the standard of care for newly diagnosed high grade glioma, but the optimal method for target volume delineations for intensity modulated radiation therapy (IMRT) is still unclear. We hypothesized that compared with the EORTC guidelines, IMRT based on the updated RTOG/NRG guidelines was equally effective, without increasing toxicities for patients with high-grade glioma. The purpose of this randomized phase 2 study was to compare the efficacy and toxicity of IMRT based on different target volume delineations (updated RTOG/NRG versus EORTC guidelines) with concomitant and adjuvant TMZ for patients with high grade glioma.

MATERIALS/METHODS

A total of 302 patients with newly diagnosed high-grade glioma (WHO grade 3-4) were randomly assigned (1:1) to receive postoperative IMRT based on either updated RTOG/NRG guidelines (RTOG/NRG group, n = 151) or EORTC guideline (EORTC group, n = 151), with concomitant and adjuvant TMZ. In the RTOG/NRG group, an initial volume consisting of enhancement, postoperative cavity, plus surrounding edema (or fluid-attenuated inversion recovery [FLAIR] abnormality defined by magnetic resonance imaging [MRI]) and a 2-cm margin received 46 Gy in 23 fractions followed by a boost of 14 Gy in 7 fractions to the area of enhancement plus the cavity and a 2-cm margin. In the EORTC group, a single planning volume was used to deliver 60 Gy in 30 fractions to the area of enhancement and the cavity with a 2-cm margin. The primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS) and toxicities associated with each treatment.

RESULTS

No statistically significant differences were observed between groups for 1-year OS (71.8% for RTOG/NRG group and 69.9% for EORTC group, respectively; P = 0.759) or 1-year PFS (46.7% for RTOG/NRG group and 43.6% for EORTC group, respectively; P = 0.674). Efficacy did not differ by MGMT methylation status. There were no differences in grade 3-4 toxicities (leukopenia, lymphopenia, neutropenia, thrombocytopenia, fatigue, nausea and vomiting) between the two groups. No grade 5 toxicities were observed in both groups. Multivariate analyses showed that tumor MGMT status (methylated vs unmethylated) and WHO grade (grade 3 vs grade 4) were associated with OS and PFS. However, radiation type (RTOG/NRG group vs EORTC), sex, age, and Karnofsky scale did not significantly influence OS or PFS.

CONCLUSION

Compared with EORTC guidelines for postoperative radiotherapy, IMRT based on RTOG/NRG guidelines was equally effective, without increasing toxicities for patients with high-grade glioma. This trial is registered with chictr.org.cn, number ChiCTR2100046667.

Deletion of ARGLU1 causes global defects in alternative splicing in vivo and mouse cortical malformations primarily via apoptosis

Haploinsufficient mutation in arginine and glutamine-rich protein 1 (Arglu1), a newly identified pre-mRNA splicing regulator, may be linked to neural developmental disorders associated with mental retardation and epilepsy in human patients, but the underlying causes remain elusive. Here we show that ablation of Arglu1 promotes radial glial cell (RG) detachment from the ventricular zone (VZ), leading to ectopic localized RGs in the mouse embryonic cortex. Although they remain proliferative, ectopic progenitors, as well as progenitors in the VZ, exhibit prolonged mitosis, p53 upregulation and cell apoptosis, leading to reduced neuron production, neuronal loss and microcephaly. RNA seq analysis reveals widespread changes in alternative splicing in the mutant mouse embryonic cortex, preferentially affecting genes involved in neuronal functions. Mdm2 and Mdm4 are found to be alternatively spliced at the exon 3 and exon 5 respectively, leading to absence of the p53-binding domain and nonsense-mediated mRNA decay (NMD) and thus relieve inhibition of p53. Removal of p53 largely rescues the microcephaly caused by deletion of Arglu1. Our findings provide mechanistic insights into cortical malformations of human patients with Arglu1 haploinsufficient mutation.

Mapping internal temperatures during high-rate battery applications

Electric vehicles demand high charge and discharge rates creating potentially dangerous temperature rises. Lithium-ion cells are sealed during their manufacture, making internal temperatures challenging to probe1. Tracking current collector expansion using X-ray diffraction (XRD) permits non-destructive internal temperature measurements2; however, cylindrical cells are known to experience complex internal strain3,4. Here, we characterize the state of charge, mechanical strain and temperature within lithium-ion 18650 cells operated at high rates (above 3C) by means of two advanced synchrotron XRD methods: first, as entire cross-sectional temperature maps during open-circuit cooling and second, single-point temperatures during charge-discharge cycling. We observed that a 20-minute discharge on an energy-optimized cell (3.5 Ah) resulted in internal temperatures above 70 °C, whereas a faster 12-minute discharge on a power-optimized cell (1.5 Ah) resulted in substantially lower temperatures (below 50 °C). However, when comparing the two cells under the same electrical current, the peak temperatures were similar, for example, a 6 A discharge resulted in 40 °C peak temperatures for both cell types. We observe that the operando temperature rise is due to heat accumulation, strongly influenced by the charging protocol, for example, constant current and/or constant voltage; mechanisms that worsen with cycling because degradation increases the cell resistance. Design mitigations for temperature-related battery issues should now be explored using this new methodology to provide opportunities for improved thermal management during high-rate electric vehicle applications.

Prognostic signatures of sphingolipids: Understanding the immune landscape and predictive role in immunotherapy response and outcomes of hepatocellular carcinoma

Background

Hepatocellular carcinoma (HCC) is a complex disease with a poor outlook for patients in advanced stages. Immune cells play an important role in the progression of HCC. The metabolism of sphingolipids functions in both tumor growth and immune infiltration. However, little research has focused on using sphingolipid factors to predict HCC prognosis. This study aimed to identify the key sphingolipids genes (SPGs) in HCC and develop a reliable prognostic model based on these genes.

Methods

The TCGA, GEO, and ICGC datasets were grouped using SPGs obtained from the InnateDB portal. A prognostic gene signature was created by applying LASSO-Cox analysis and evaluating it with Cox regression. The validity of the signature was verified using ICGC and GEO datasets. The tumor microenvironment (TME) was examined using ESTIMATE and CIBERSORT, and potential therapeutic targets were identified through machine learning. Single-cell sequencing was used to examine the distribution of signature genes in cells within the TME. Cell viability and migration were tested to confirm the role of the key SPGs.

Results

We identified 28 SPGs that have an impact on survival. Using clinicopathological features and 6 genes, we developed a nomogram for HCC. The high- and low-risk groups were found to have distinct immune characteristics and response to drugs. Unlike CD8 T cells, M0 and M2 macrophages were found to be highly infiltrated in the TME of the high-risk subgroup. High levels of SPGs were found to be a good indicator of response to immunotherapy. In cell function experiments, SMPD2 and CSTA were found to enhance survival and migration of Huh7 cells, while silencing these genes increased the sensitivity of Huh7 cells to lapatinib.

Conclusion

The study presents a six-gene signature and a nomogram that can aid clinicians in choosing personalized treatments for HCC patients. Furthermore, it uncovers the connection between sphingolipid-related genes and the immune microenvironment, offering a novel approach for immunotherapy. By focusing on crucial sphingolipid genes like SMPD2 and CSTA, the efficacy of anti-tumor therapy can be increased in HCC cells.

Diabetes, Edentulism, and Cognitive Decline: A 12-Year Prospective Analysis

Diabetes mellitus (DM) is a recognized risk factor for dementia, and increasing evidence shows that tooth loss is associated with cognitive impairment and dementia. However, the effect of the co-occurrence of DM and edentulism on cognitive decline is understudied. This 12-y cohort study aimed to assess the effect of the co-occurrence of DM and edentulism on cognitive decline and examine whether the effect differs by age group. Data were drawn from the 2006 to 2018 Health and Retirement Study. The study sample included 5,440 older adults aged 65 to 74 y, 3,300 aged 75 to 84 y, and 1,208 aged 85 y or older. Linear mixed-effect regression was employed to model the rates of cognitive decline stratified by age cohorts. Compared with their counterparts with neither DM nor edentulism at baseline, older adults aged 65 to 74 y (β = -1.12; 95% confidence interval [CI], -1.56 to -0.65; P < 0.001) and those aged 75 to 84 y with both conditions (β = -1.35; 95% CI, -2.09 to -0.61; P < 0.001) had a worse cognitive function. For the rate of cognitive decline, compared to those with neither condition from the same age cohort, older adults aged 65 to 74 y with both conditions declined at a higher rate (β = -0.15; 95% CI, -0.20 to -0.10; P < 0.001). Having DM alone led to an accelerated cognitive decline in older adults aged 65 to 74 y (β = -0.09; 95% CI, -0.13 to -0.05; P < 0.001); having edentulism alone led to an accelerated decline in older adults aged 65 to 74 y (β = -0.13; 95% CI, -0.17 to -0.08; P < 0.001) and older adults aged 75 to 84 (β = -0.10; 95% CI, -0.17 to -0.03; P < 0.01). Our study finds the co-occurrence of DM and edentulism led to a worse cognitive function and a faster cognitive decline in older adults aged 65 to 74 y.

A rare case of hepatic sinusoidal occlusive syndrome in a premature neonate with trisomy 21

Trisomy 21 (Down Syndrome) may lead to multiple hematological and hepatobiliary manifestations including the development of transient abnormal myelopoiesis. While many cases resolve, transient abnormal myelopoiesis may lead to significant morbidity and mortality in a small percentage of patients. This condition may present a diagnostic challenge for physicians and currently there is only limited data on effective treatments, particularly with low blast percent transient abnormal myelopoiesis. We present a case of a neonate with trisomy 21 and multiple congenital anomalies who consequently developed hepatic failure with evidence of non-cirrhotic portal hypertension likely due to transient abnormal myelopoiesis. This clinical scenario highlights the need for additional evaluation for transient abnormal myelopoiesis associated hepatic disorder and possibly hepatic sinusoidal occlusive syndrome among trisomy 21 neonates particularly with low blast percentage.

Asymmetric structure optical fiber humidity sensor assisted by the virtual Vernier effect

In this paper, an asymmetric structure optical fiber sensor is proposed to measure relative humidity (RH). The sensing structure is composed of splicing dispersion compensation fiber (DCF) and coreless fiber (NCF), and two sections of single-mode fiber (SMF) at both ends. Peanut shaped structure is used as a beam splitter at the input side, and the NCF is used as a beam combiner at the output side to form interference fringes. The partial cladding of DCF was etched, and polyvinyl alcohol (PVA) was coated on the etched area to form a hygroscopic film. When the ambient humidity changes, the refractive index and thickness of the hygroscopic film will change, which will lead to the wavelength shift of the resonant dip. The experimental results show that the sensitivity of the sensor is 0.1304 nm/RH% and 0.4452 nm/RH% in the RH range of 55%-75% and 75%-95%, respectively. In order to improve the sensitivity further, the original spectrum data is filtered by fast Fourier transform (FFT) and inverse fast Fourier transform (IFFT), and the high-frequency interference components of high-order mode (LP₀₉) and fundamental mode are obtained, which is superimposed with a simulated signal to form Vernier effect. With the method of virtual Vernier effect, the sensitivity in the RH range of 55%-75% is improved to 2.869 nm/RH%, which is 22 times larger than the original sensitivity, and the sensitivity in the RH range of 75%-95% is improved to 2.64 nm/RH%, which is 6 times larger than the original sensitivity.

1465. A Randomized Double-Blinded Placebo-Controlled Study to Determine Efficacy of Immunoglobulin Therapy to Treat BK Viremia in Renal Transplant Recipients

Background

BK viremia in renal transplant recipients increases risk of BK virus-associated nephropathy (BKVAN), posing a threat to allograft function. Up to 30% of all renal transplant recipients develop BK viremia and 1-10% will develop BKVAN. With no effective antiviral, the mainstay of therapy to prevent BKVAN is immunosuppression reduction (IR). Case series showed potential efficacy of using intravenous immunoglobulins (IVIG) to treat BK viremia. However, a randomized placebo-controlled study is needed.

Methods

A multicenter prospective double-blinded randomized placebo-controlled proof-of-concept study was conducted at three transplant institutions. 14 adult renal transplant recipients diagnosed with BK viremia were randomized (1:1) to receive IVIG and IR versus placebo and IR and were followed for 12 months, with the primary endpoint defined as resolution of BK viremia by month 3. Samples were collected at 1, 2, 3, 6, and 12 months for viral load quantification and immunological assays.

Results

At enrollment, clinical characteristics of the IVIG group (n = 5) were similar to the control group (n = 9), except that a larger number of participants in the control group had delayed graft function (0% vs. 77.8%, p = 0.02) and a higher baseline BK viral load (11300 vs 99300 copies/mL, p = 0.04). At 3 months, 2 out of 5 patients in the treatment group and 4 out of 9 patients in the control group cleared their viremia (40% vs 44.4%, RR 0.89, 95% CI 0.21 – 3.35, p &gt; 0.99). Patients who received IVIG and IR had reduction in viral load at 6 months only (11300 vs 141 copies/mL, p = 0.008). Those who received IR alone had continued reduction in viral load starting at 2 months (99300 vs 4700, 1542, 906, 278 copies/mL; p &lt; 0.05). No participant progressed to BKVAN. Immunological profiles of each participant will be correlated to the viral load.

Serum BK viral loads were higher in the placebo group than the IVIG group at enrollment, but not significantly different between the two groups at any of the follow-up time points. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. * p = 0.04. Bar – median (Mann-Whitney between group comparisons).

Median serum BK viral loads of the IVIG group decreased at the 6 months follow-up time point. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. ** p = 0.008 (Mann-Whitney comparing enrollment to each follow-up time point).

Median serum BK viral loads of the placebo group continued to decrease at each follow-up time point. The dotted line represents threshold of viremia clearance at less than 1000 copies/mL. * p = 0.04; ** p = 0.006; *** p = 0.0008, 0.0003 (Mann-Whitney comparing enrollment to each follow-up time point).

Conclusion

This proof-of-concept study illustrates that a clinical trial of IVIG versus placebo for the treatment of BK viremia in renal transplant recipients is feasible. IVIG may not be more effective than IR alone; its immunosuppressive effect may even limit BK clearance. A larger sample is needed to attenuate baseline differences between groups and to provide a higher level of evidence on IVIG therapy in BK viremia.

Disclosures

All Authors: No reported disclosures.

[The study of the correlation between age and the pathogenic factors of primary glaucoma: a review]

Age is an important risk factor for primary glaucoma. While the specific mechanism of primary glaucoma remained unclear, the change of ocular anatomy, the disturbance of aqueous humor balance, the change of ocular biomechanics and the disorder of neurometabolism contribute to the occurrence and development of primary glaucoma. This paper reviewes the latest studies on the correlation between age and the risk factors of glaucoma in the above four aspects, so as to provide some references for the in-depth discussion of the pathophysiology of primary glaucoma, and advancement on diagnosis, treatment and research of primary glaucoma.

A 10-year cohort on prognostic outcomes in patients presenting with acute myocardial infarction complicated by cardiogenic shock and/or cardiac arrest

Background

Cardiogenic shock (CS) and cardiac arrest (CA) complicating acute myocardial infarction (AMI) portend unfavourable outcomes. This study examined the prognosis of patients presenting with AMI complicated by CS and/or CA.

Methods

Consecutive patients presented with AMI to a percutaneous coronary intervention-capable tertiary institution between 2011 and 2021 were studied. Patients were stratified based on the presence or absence of CS (CS+ or CS−) and CA (CA+ or CA−). The primary outcome was 30-day cardiovascular-related mortality. Subgroup analyses based on AMI-type and sex were conducted. Kaplan-Meier curves for cardiovascular-related mortality based on the AMI-type and sex were constructed.

Results

The study included 11,608 AMI patients, 283 of whom had CS+/CA+, 1,068 had CS+/CA−, 54 had CS−/CA+ and 10,203 had CS−/CA−. Cardiovascular-related mortality was significantly higher for CS+/CA+ (57.6%), followed by CS+/CA− (41.6%), CS−/CA+ (20.4%) and CS−/CA− (2.4%). Kaplan-Meier curves demonstrated CS+/CA+ group had the highest mortality (HR=36.26; 95% CI: 29.71–44.25, p&lt;0.001), followed by CS+/CA− (HR=21.59; 95% CI: 18.47–25.24, p&lt;0.001) and CS−/CA+ (HR=9.18; 95% CI: 5.02–16.80, p&lt;0.001), with CS−/CA− as the reference. Those with NSTEMI had consistently higher cardiovascular-related mortality rates than their STEMI counterparts for all groups, apart from the CS+/CA+ group. The sex-specific analysis demonstrated that the survival curves for females with CS+/CA+, CS+/CA− and CS−/CA+ converged, whilst the survival curves for males diverged over time. The multivariable Cox regression revealed the presence of CS and CA are independent predictors of cardiovascular-related mortality, but not NSTEMI, when adjusted for age, gender, diabetes, left ventricular ejection fraction, chronic renal failure, and culprit vessel.

Conclusions

AMI associated with CA and CS portends the least favourable survival, followed by those with CS or CA alone. Excess mortality was observed in the traditionally perceived lower-risk groups, particularly in women. This calls for increased awareness amongst clinicians when managing this subset of high-risk patients.

Funding Acknowledgement

Type of funding sources: None.

Three-channel metasurface based on simultaneous and independent control of near and far field under a single line light source

Metasurface based on independent and simultaneous control of near field and far field has significant potential for use in multichannel optics platform devices. However, the previous studies cannot satisfy independent and simultaneous control of near field and far field under a single line source, which made a significant challenge to multichannel optical platforms working in a compact environment. To manipulate effectively and freely the amplitude and phase of transmission under line source, Marius' law and Propagation phase was introduced on all-dielectric encoding metasurfaces meta-atoms. The Marius' law and Propagation phase can control the size and rotation angle of meta-atoms to encode grayscale amplitude images and holographic phase images. Finite-difference time-domain simulation results reveal that dual channel metasurface under a single line source achieves the same display effect as the dual channel metasurface under multiple light sources, which proves the feasibility of our studies. Moreover, under different angles of the line source, we encode the near-field binary image by using the degeneracy rotation angle of meta-atoms. Finally, a three-channel metasurface was obtained without affecting the display of the previous two-channel metasurface. As a result, the independent control amplitude, phase, and polarization of the incident light wave were achieved. The proposed metasurface could be applied in creating a multi-channel metasurface optical platform in a compact environment, which has application potential in image displays, optical storage, optical anti-counterfeiting, and information encryption technology.

[Association of DNA methylation of IFNG gene with no/low response to hepatitis B vaccine in children]

Objective: To explore the association of DNA methylation with immune response to hepatitis B (HepB) vaccine in Han nationality children from Guangxi province. Methods: A total of 263 children aged 8-9 months who had completed HepB immunization program were recruited from three hospitals in Guangxi province by using unmatched case-control method. Children with the HepB surface antibody concentration(Anti-HBs)<100 mIU/ml was set as the case group and ≥100 mIU/ml as the control group. Multiplex PCR and heavy sulfite sequencing were used to treat the samples. Illumina platform was used for high-throughput DNA methylation sequencing of IFNG gene target regions and CpG sites. Unconditional logistic regression was used to analyze the association between cytosine-phospho-guanosine DNA methylation at 18 loci of IFNG gene and HepB immune response level. Results: There were 104 children in the case group and 159 in the control group. The median (Q₁, Q₃) level of anti-HBs in two groups were 62.34 (30.06, 98.88) mIU/ml and 1 089.10 (710.35, 1 233.45) mIU/ml. The methylation levels of IFNG_1 gene 44 and 93 locus in the case group were higher than those in the control group (P<0.05). The unconditional logistic regression model showed that the DNA methylation level of IFNG_1 gene at 44 (OR=1.18, 95%CI: 1.03-1.35) and 93 (OR=1.21, 95%CI: 1.07-1.38) locus was associated with the HepB response level. Conclusion: The changes of DNA methylation at locus 44 and 93 of IFNG_1 gene may be relevant factors affecting the response level of HepB in Han nationality children from Guangxi province.

P-524 Bi-allelic CFAP61 variants cause male infertility in humans and mice with severe oligoasthenoteratozoospermia

Study question

Are mutations in cilia and flagella-associated protein 61 (CFAP61) associated with human male infertility?

Summary answer

Bi-allelic variants ([NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in CFAP61 were identified as contributory genetics factor in severe oligoasthenoteratozoospermia (OAT).

What is known already

Cfap61 knockout mice were infertile due to multiple morphological abnormalities of the sperm flagella (MMAF). However, so far there is no direct evidence that mutations of CFAP61 cause OAT and male infertility.

Study design, size, duration

Variant screening was performed by whole-exome sequencing (WES) from 325 infertile patients with OAT and 392 fertile individuals. A knockout mouse model was generate to confirm the candidate disease-causing gene, intracytoplasmic sperm injection (ICSI) was used to evaluate the efficiency of clinical treatment.

Participants/materials, setting, methods

A total 325 OAT-affected patients and 392 men with normal fertility were recruited from China. WES was performed, followed by Sanger sequencing validation. In silico bioinformatics predictions and in vitro functional analyses were performed to evaluate the impacts of candidate disease-causing variants. Hematoxylin and eosin (H&E) staining, electron microscopy, and immunofluorescence assays were performed to evaluate the sperm morphology. Two OAT-affected men with CFAP61 variants were treated by ICSI, and pregnancy outcomes were followed.

Main results and the role of chance

We identified bi-allelic CFAP61 variants [NM_015585.4: c.1654C&gt;T (p.R552C) and c.2911G&gt;A (p.D971N), c.144-2A&gt;G and c.1666G&gt;A (p.G556R)] in two (0.62%) of the 325 OAT-affected men. In silico bioinformatics analysis predicted that all four variants were deleterious, and in vitro functional analysis confirmed the deleterious effects of the mutants. Notably, H&E staining and electron microscopy analyses of the spermatozoa revealed multiple morphological abnormalities of sperm flagella, the absence of central pair microtubules, and mitochondrial sheath malformation in sperm flagella from man with CFAP61 variants. Further immunofluorescence assays revealed markedly reduced CFAP61 staining in the sperm flagella. In addition, Cfap61-deficient mice showed the OAT phenotype, suggesting that loss of function of CFAP61 was the cause of OAT. Two individuals accepted ICSI therapy using their own ejaculated sperm, and one of them succeeded in fathering a healthy baby.

Limitations, reasons for caution

Limitations include the lack of in vivo data from the one of patients, and the exact molecular mechanism should be further investigated.

Wider implications of the findings

Our findings indicate that CFAP61 is essential for spermatogenesis and that bi-allelic CFAP61 variants lead to OAT and male infertility in humans and mice. In addition, our results show that ICSI treatment can be recommended for CFAP61-related OAT.

Trial registration number

not applicable

A novel AIEE active anti-B18H22derivative-based Cu2+and Fe3+fluorescence off-on-off sensor

A novel fluorescence sensor for successive detection of Cu²⁺and Fe³⁺based on anti-B₁₈H₂₂derivative which possesses 5-hydroxyisoquinoline as an ionophore was synthesized via a one-pot and its structure and photophysical properties were characterized by NMR, HRMS, FTIR, UV-vis, PL and theoretical calculation. The fluorophore displays two emission peaks at 460 nm and 670 nm in THF solution coming from the emission of the locally excited state and intramolecular charge transfer fluorescence, respectively. The complex exhibited obvious aggregation-induced emission enhancement (AIEE) characteristics in THF/H₂O solution by increasing the aqueous concentration from 70% to 95%. The AIEE molecules showed a high selectivity towards Cu²⁺over other metal ions by forming a 2:1 metal-to-ligand complex in THF/H₂O (fw = 20%) solution, the fluorescence intensity increased as a linear function of the Cu²⁺concentration at 460 nm due to the inhibition of PET effect. The fluorescent emission was quenched linearly by the addition of Fe³⁺, which provides a method for successive determination of Cu²⁺and Fe³⁺based on 'off-on-off' fluorescence of the fluorescent. The detection limit of Cu²⁺and Fe³⁺was 5.7 × 10^-6M and 7.2 × 10^-5M respectively. Morever, a rapid identification of Cu²⁺in the aqueous solution by naked eyes can be realized. In addition, the molecules were pH-sensitive, the fluorescence quenching can be observed in strongly alkaline environment. The method has been applied to the determination of copper ions in water samples with satisfactory results.

LincRNA‑EPS increases TGF‑β expression to inhibit the Wnt/β‑catenin pathway, VSMC osteoblastic differentiation and vascular calcification in diabetic mice

In patients with diabetes, the Wnt/β-catenin pathway in vascular smooth muscle cells (VSMCs) is continuously activated by low-intensity inflammation, which leads to the osteoblastic differentiation of these cells and the deposition of calcium and phosphorus in blood vessels. The aim of the present study was to determine whether long intergenic non-coding RNA-erythroid pro-survival (lincRNA-EPS) was able to ameliorate vascular calcification (VC) associated with diabetes. VSMCs isolated from C57BL/6 mice were transfected with lincRNA-EPS overexpression vector in vitro and their osteoblastic differentiation was evaluated under high-glucose conditions. In addition, a mouse model of diabetes was established, which included a lincRNA-EPS knockout group and a lincRNA-EPS high expression group. Blood vessel samples from the mice were examined to determine the degree of calcification. The levels of inflammatory factors in serum were also detected. The VSMCs transfected with lincRNA-EPS overexpression vector exhibited less osteoblastic differentiation and migration and significantly lower levels of Wnt pathway-associated proteins than those transfected with empty control. Furthermore, the in vivo experiments revealed that the overexpression of lincRNA-EPS significantly reduced VC in diabetic mice. Therefore, on the basis of these findings, it is suggested that lincRNA-EPS overexpression may provide a novel and effective method for the treatment of VC in patients with diabetes.

Hydroxyethyl cellulose sensitized SMDMS structure with optical fiber relative humidity and temperature simultaneous measurement sensor

We have manufactured an intensity modulated optical fiber SMDMS sensor with hydroxyethyl cellulose (HEC) hydrogel coating for simultaneous measurement of RH and temperature. The SMDMS sensor was manufactured by splicing single-mode fiber (SMF), multi-mode fiber (MMF), dispersion compensation fiber (DCF), MMF, and SMF in sequence to form a structure of SMF + MMF + DCF + MMF + SMF (SMDMS). The cladding of MMFs and DCF were corroded by hydrofluoric acid (HF) and coated with HEC hydrogel to excite a strong evanescent field and increase the sensitivity of the SMDMS sensor. The adsorption of water molecules by HEC will cause a change in the effective refractive index of cladding mode, which will eventually change the intensity of the transmission spectrum. The experimental results indicate that the sensitivities are 0.507 dB/%RH and 0.345 dB/°C in the RH range of 30%-80% and temperature range of 10°C-50°C, respectively. At last, a dual-parameter measurement matrix is constructed based on the experimental results to achieve the simultaneous measurement of RH and temperature. The SMDMS sensor has the advantages of high sensitivity and good robustness, and has potential application prospects in daily life and other fields.

To evaluate if ultrasound gel or water-based media affects ER/PR staining patterns on breast core biopsy specimens

Introduction/Objective

IHC staining for biomarkers ER, PR and HER-2 (CerB2) forms an essential component of breast cancer management and prognostication. Staining for these biomarkers is dependent on optimal fixation of the specimen in formalin. Scoring systems employed for ER and PR grade the intensity of the nuclear staining along with the percentage of the cells stained. This study aims to determine if ultrasound gel used during core biopsy as opposed to water affects immunohistochemical staining of biomarkers ER and PR in breast cancer specimens, following an observation that ultrasound gel assisted core biopsies may affect ER/PR nuclear staining scores through excess cytoplasmic staining.

Methods/Case Report

We included a total of 50 cases of invasive breast carcinoma diagnosed on core biopsy from KK Women’s and Children’s Hospital from February 2019 to July 2020. These included 25 cases with gel and 25 cases with water applied to the breast prior to the procedure. All biopsies were optimally fixed in formalin as per recommended latest ASCO/CAP guidelines. The control group included 25 resection cases of invasive breast carcinoma which had neither gel nor water and had been optimally fixed in formalin. Cytoplasmic staining for ER and PR was graded as being present or absent and was compared against the excision specimens (control group) to determine if using the gel was significant in producing cytoplasmic staining. The data was analyzed on SPSS using multiple logistic regression.

Results (if a Case Study enter NA)

Using the gel appeared to be statistically significant in producing cytoplasmic staining for ER (p=0.042) as opposed to using water (p=0.274). For PR staining, both gel-based (p=0.250) and water-based media (p=0.286) were not statistically significant in causing cytoplasmic staining.

Conclusion

The preliminary findings of this small retrospective case-control study gives an insight that gel-based media may have a role in causing cytoplasmic staining for oestrogen receptor in breast cancer biopsy specimens which may interfere with accurate scoring and impact results of external quality assurance schemes to which laboratories subscribe to. However the study is limited by the small sample size and exclusion of any other pre- analytical factors like needle bore or number of cores taken which may have had an impact on the staining.

889 Management of Paediatric Appendicitis During the First Wave of COVID-19: Comparison of Our Centre to National Practice

Aim

Our hospital took part in a multi-centre prospective cohort study “the CASCADE study” investigating the management and early outcomes of children with appendicitis in the UK and Ireland during the first wave of the COVID-19 pandemic (1). The aim of this study was to compare our local outcomes to those at a national level.

Method

This was a prospective cohort study with data collected from 01/04/2020 to 31/05/2020. Primary outcome was treatment strategy for appendicitis. Secondary outcomes were duration of symptoms, ultrasound findings, rate of simple vs perforated appendicitis and complications.

Results

Overall, only a minority (2/24 [8%]) were initially treated non-operatively, with both proceeding to appendicectomy due to pain. Remaining children (24/26 [92%]) were primarily treated with appendicectomy. All were performed laparoscopically with no conversions to open. Ultrasound was performed for most children (23/26 [88%]) which accurately identified appendicitis (22/23 [95%]) and negative appendicectomy rate of zero. Rates of complex appendicitis were not higher than expected (10/26 [38%]) but had a longer duration of symptoms (median 66.0h [IQR21.5] vs 30.0h [27.2], p = 0.008) and more complications (4 vs 1). Post-operative length of stay was significantly shorter for simple appendicitis than complicated (median 1.0d [IQR0.0] vs 4.0 [IQR2.8], p = 0.001).

Conclusions

Practice in our centre contrasts with the CASCADE study's National findings where 39% were treated non-operatively, only 48% of appendicectomies were performed laparoscopically, only 53% of children had diagnostic imaging and negative appendicectomy rate was 4.5%. Rates of complications for simple and complex appendicitis were similar, but post-operative length of stay shorter in our centre.

Single core-offset Mach-Zehnder interferometer coated with PVA for simultaneous measurement of relative humidity and temperature

A single core-offset Mach-Zehnder interferometer (MZI) coated with polyvinyl alcohol (PVA) for simultaneous measurement of relative humidity (RH) and temperature is proposed in this paper. The sensing structure is fabricated by splicing dispersion compensating fiber (DCF) and no-core fiber (NCF) and splicing two single-mode fibers (SMF) at both ends, where the core-offset is located at the splicing of SMF and DCF. A part of the cladding of DCF is etched to excite the high-order cladding mode (LP₁₀), and PVA is coated on the etched area. The refractive index of PVA varies due to the adsorption of water molecules. Therefore, when the ambient relative humidity and temperature change, the change of MZI phase difference causes the wavelength of the resonant dip to shift. The experimental results indicate that the proposed sensor has a sensitivity of 0.256 nm/RH% for RH range of 30%-95%, and a sensitivity of 0.153 nm/℃ for temperature range of 20℃-80℃, respectively. The simultaneous measurement of RH and temperature can be achieved by demodulating the sensitivity coefficient matrix. The proposed sensor has the characteristics of good repeatability, high sensitivity, and good stability, which make it potentially applications for the detection of RH and temperature measurement.

[Japan narrow-band imaging Expert Team type 2B colorectal cancer: consistency between endoscopic prediction and pathological diagnosis]

OBJECTIVE

To explore the potential factors that affect the accuracy of endoscopic diagnosis for Japan narrow-band imaging (NBI) Expert Team (JNET) type 2B colorectal lesions.

OBJECTIVE

The clinical data were collected from 261 patients with JNET type 2B colorectal lesions diagnosed in Nanfang Hospital between July, 2018 and July, 2021. We analyzed the macroscopic type, size, location or pit pattern classification of the lesions for their potential influence of the diagnostic accuracy of JNET type 2B lesions.

OBJECTIVE

The 261 lesions included 91 low-grade intramucosal neoplasia lesions (34.9%), 132 high-grade intramucosal neoplasia lesions (50.6%), 13 submucosal invasive cancer lesions (5.0%), and 25 deep submucosal invasive cancer lesions (9.6%). The coincidence rate between endoscopic prediction and pathological diagnosis of these lesions was 55.6% (145/ 261). The macroscopic type and size of the lesions were significantly associated with the diagnostic accuracy of JNET type 2B lesions (P < 0.001). There was a significant difference in the diagnostic accuracy among the lesions with different pit pattern types (P < 0.001).

OBJECTIVE

Both the macroscopic type and size affect the accuracy of endoscopic diagnosis of JNET type 2B colorectal lesions. JNET classification combined with pit pattern types can have better accuracy in predicting the pathological diagnosis of these lesions.

[Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma: a clinicopathological study]

Objective: To investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis and prognosis of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinomas. Methods: Two cases of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma were collected at Fudan University Shanghai Cancer Center, Shanghai, China from 2017 to 2018. The clinicopathological characteristics were analyzed. Hematoxylin and eosin, and immunohistochemical stains were performed, and the relevant literatures were reviewed. Results: The two patients were both male, aged 60 and 74 years, respectively. Their symptoms were both abdominal pain. The tumor arose in the esophagogastric junction in case 1, and the cardia to the fundus and the posterior wall of the upper part of gastric body in case 2. Both tumors were present as an ulcerative mass. The patients died of tumor 11 months and 8 months after surgery, respectively. Histologically, the tumor cells arranged in sheets, nests, cords or trabecular patterns, and pseudoavleolar structure. The tumor cells were epithelioid with uniform morphology, while the tumors showed scant stroma and massive necrosis. Variable rhabdoid cells and multinucleated giant cells were seen in both cases. SMARCA4 encoding protein BRG1 was undetectable in both tumors, while SMARCB1 encoding protein INI1 was detected. The tumor cells were diffusely positive for vimentin and negative for epithelial marker (CKpan), gastrointestinal stromal tumor markers (CD117 and DOG1), myogenic markers (desmin and myogenin), melanoma markers (S-100 protein, SOX10 and HMB45), and lymphohematopoietic markers (LCA and CD20). Conclusions: Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma is a rare and highly aggressive tumor with poor prognosis. The detection of subunits protein expression of SWI/SNF complex is important for diagnosis of the tumor.

Ammonia Gas Sensor Based on Graphene Oxide-Coated Mach-Zehnder Interferometer with Hybrid Fiber Structure

A graphene oxide-coated in-fiber Mach-Zehnder interferometer (MZI) formed with a multimode fiber-thin core fiber-multimode fiber (MMF-TCF-MMF) is proposed and experimentally demonstrated for ammonia gas (NH₃) sensing. The MZI structure is composed of two segments of MMF of length 2 mm, with a flame-tapered TCF between them as the sensing arm. The MMFs act as mode couplers to split and recombine light owing to the core diameter mismatch with the other fibers. A tapered TCF is formed by the flame melting taper method, resulting in evanescent wave leakage. A layer of graphene oxide (GO) is applied to the tapered region of the TCF to achieve gas adsorption. The sensor operates on the principle of changing the effective refractive index of the cladding mode of a fiber through changing the conductivity of the GO coating by adsorbed NH₃ molecules, which gives rise to a phase shift and shows as the resonant dip shifts in the transmission spectrum. So the concentration of the ammonia gas can be obtained by measuring the dip shift. A wavelength-shift sensitivity of 4.97 pm/ppm with a linear fit coefficient of 98.9% is achieved for ammonia gas concentrations in the range of 0 to 151 ppm. In addition, we performed a repetitive dynamic response test on the sensor by charging/releasing NH₃ at concentration of 200 ppm and a relative humidity test in a relative humidity range of 35% to 70%, which demonstrates the reusability and stability of the sensor.

Sex differences in pharmacotherapy and long-term outcomes in patients with ischaemic heart disease and left ventricular dysfunction

Background

Left ventricular dysfunction and ischaemic heart disease are common amongst women, however, women tend to present later and are less likely to receive guideline-directed medical therapy compared to their male counterparts.

Purpose

To investigate if a sex discrepancy exists for optimal medical therapy (OMT) and long-term mortality in a cohort of patients with known ischaemic heart disease (IHD) and left ventricular dysfunction.

Methods

We analysed prospectively collected data from a multicentre registry database collected between 2005–2018 on pharmacotherapy 30-days post percutaneous coronary intervention (PCI) in 13,015 patients with left ventricular ejection fraction (LVEF) &lt;50%. OMT at 30-days was defined as beta-blocker (BB), angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB) ± mineralocorticoid receptor antagonist (MRA). Long-term mortality was determined by linkage with the National Death Index, with median follow up of 4.7 (IQR 2.0–8.6) years.

Results

Mean age was 65±12 years; women represented 20.2% (2,634) of the cohort. Women were on average 5 years older, had higher average BMI, higher rates of hypertension, diabetes, renal dysfunction, prior stroke and rheumatoid arthritis. Men were more likely to have sleep apnoea, be current/ex-smokers and to have had prior myocardial infarction, PCI and bypass surgery. Overall, 72.3% (9,411) of patients were on OMT, which was similar between sexes (72.7% in women vs. 72.2% in men, p=0.58). Rates of BB therapy were similar between sexes (85.2% vs. 84.5%, p=0.38), while women were less likely to be on an ACEi/ARB (80.4% vs. 82.4%, p=0.02) and more likely to be on a MRA (12.1% vs. 10.0%, p=0.003). Amongst those with LVEF ≤35% (n=1,652), BB (88.7% vs. 87.3%, p=0.46), ACEi/ARB (83.3% vs. 82.1%, p=0.59) and MRA use (32.5% vs. 33.3%, p=0.78) was comparable. Aspirin use was similar between sexes (95.3% vs. 95.9%, p=0.12), while women were less likely to be on statin therapy (93.5% vs. 95.3%, p&lt;0.001) and a second antiplatelet agent (94.4% vs. 95.6%, p=0.007). On unadjusted analysis women had significantly higher long-term mortality of 25.4% compared to 19.0% for men (p&lt;0.001). Kaplan-Meier analysis out to 14 years demonstrated that men on OMT have the best long-term survival overall and women on sub-OMT have significantly poorer outcomes compared to men on sub-OMT. However, after adjusting for OMT and other comorbidities there was no difference in long-term mortality between sexes (HR 0.99, 95% CI 0.87–1.14, p=0.94).

Conclusion

From this large multicentre registry, we found similar rates of guideline-directed pharmacotherapy for left ventricular dysfunction between sexes, however women were less likely to be on appropriate IHD secondary prevention. The increased unadjusted long-term mortality amongst women is likely due to differing baseline risk, given that adjusted mortality was similar between sexes.

Kaplan-Meier Survival Analysis

Funding Acknowledgement

Type of funding source: None

Humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer

A relative humidity sensor based on a graphene oxide-coated few-mode fiber Mach-Zehnder interferometer (MZI) is proposed in this paper. The MZI was made by splicing a segment of the few-mode fiber (FMF) between two segments of a no-core fiber (NCF) and two segments of a single mode fiber (SMF) located outside the two NCFs. The core and cladding of the FMF acted as interferometric arms, while the NCFs acted as couplers for splitting and recombining light due to mismatch of mode field diameter. The cladding of the FMF was corroded with hydrofluoric acid, and a layer of graphene oxide (GO) film was coated on the corroded cladding of FMF via the natural deposition method. The refractive index of GO varied upon absorption the water molecules. As a result, the phase difference of the MZI varied and the wavelength of the resonant dip shifted with a change in the ambient relative humidity (RH). High humidity sensitivity of 0.191 and 0.061 nm/%RH in the RH range of 30-55% and 55-95%, respectively, were achieved experimentally. The high sensitivity, compact size, and simple manufacturing of the proposed sensor could offer attractive applications in fields of chemical sensors and biochemical detection.

Data for an Advanced Microstructural and Electrochemical Datasheet on 18650 Li-ion Batteries with Nickel-Rich NMC811 Cathodes and Graphite-Silicon Anodes

The data presented here were collected from a commercial LG Chem cylindrical INR18650 MJ1 lithium-ion (Li-ion) battery (approximate nominal specifications: 3.5 Ah, 3.6 V, 12.2 Wh). Electrochemical and microstructural information is presented, the latter collected across several length scales using X-ray computed tomography (CT): from cell to particle. One cell-level tomogram, four assembly-level and two electrode/particle-level 3D datasets are available; all data was collected in the pristine state. The electrochemical data consists of the full current and voltage charge-discharge curves for 400 operational cycles. All data has been made freely available via a repository [10.5522/04/c.4994651] in order to aid in the development of improved computational models for commercially-relevant Li-ion battery materials.

Melatonin activity and receptor expression in endometrial tissue and endometriosis

STUDY QUESTION

Are melatonin receptors (melatonin receptor 1A (MR1A) and melatonin receptor 1B (MR1B)) expressed in human endometrium and endometriotic tissue, and does melatonin affect endometrial cell proliferation?

SUMMARY ANSWER

Melatonin receptors are expressed in human eutopic endometrium, endometriomas and peritoneal lesions, although to different extents, and melatonin treatment attenuated estradiol-induced endometrial epithelial cell proliferation in culture.

WHAT IS KNOWN ALREADY

Melatonin decreased endometriotic lesion volume in a rat model of endometriosis. Melatonin treatment reduced pain scores in and analgesic use by women with endometriosis.

STUDY DESIGN, SIZE, DURATION

Basic science study using human endometrial tissue and an endometrial epithelial cell line.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Measurement of melatonin receptor expression (mRNA and protein) in women with surgically confirmed endometriosis (endometrioma (n = 20) or peritoneal lesion (n = 11) alone) and women without surgical evidence of endometriosis (control, n = 15). Collection of endometrial and endometriotic tissue samples, gynecologic history and demographic information. Quantification of estradiol (1.0 nM) and melatonin (0.1 nM-1.0 μM) ± estradiol-induced endometrial epithelial cell proliferation in cultures of endometrial epithelial cells (CRL-1671) following 24 and 48 hours of culture.

MAIN RESULTS AND THE ROLE OF CHANCE

MR1A and MR1B were localized by immunohistochemistry in glandular epithelial cells of endometrial biopsies from women with and without endometriosis. Both receptors were expressed in eutopic and ectopic endometrial tissue. mRNA expression of MR1A and MR1B was significantly greater in peritoneal lesions than in either endometriomas or eutopic endometrium. However, protein expression of MR1A was decreased in peritoneal lesions compared to control eutopic endometrium, whereas MR1B expression did not differ between the groups. Melatonin (0.1 nM-1.0 μM) treatment inhibited estradiol (1.0 nM)-induced endometrial epithelial cell proliferation at 48 hours but not 24 hours of culture.

LIMITATIONS, REASONS FOR CAUTION

Beneficial effects of melatonin seen in culture have yet to be comprehensively evaluated in women with endometriosis.

WIDER IMPLICATIONS OF THE FINDINGS

Our data suggest that melatonin may be useful as an adjunct to current endometriosis treatments.

STUDY FUNDING/COMPETING INTEREST(S)

This study was supported by the Canadian Institutes of Health Research (grant MOP142230 to W.G.F.). A.A.M. is supported by a resident research grant through the Physicians Services Incorporated Foundation. The authors have no conflicts of interest.

Revealing weak histidine 15N homonuclear scalar couplings using Solid-State Magic-Angle-Spinning NMR spectroscopy

The tautomeric structure and chemistry of the histidine imidazole ring play active roles in many structurally and functionally important proteins and polypeptides. While in NMR spectroscopy histidine chemical shifts (e.g. ¹⁵N, ¹³C, and ¹H) have been commonly used to characterize the tautomeric structure, hydrogen bonding, and torsion angles, homonuclear ¹⁵N scalar couplings in histidine have rarely been reported. Here, we propose double spin-echo sequences to compare the observed signals with and without a 90° pulse between the two spin-echo periods, such that their signal ratio as a function of the echo time solely depends on homonuclear scalar couplings, allowing for measuring weak homonuclear scalar couplings without influence from transverse dephasing effects, thus capable of revealing hydrogen-bond mediated ¹⁵N-¹⁵N J-couplings that can provide direct and definitive evidence for the formation of N^…H^…N hydrogen-bonding associated with the imidazole ring. We used two ¹³C,¹⁵N labeled histidine samples recrystallized from solutions at pH 6.3 and pH 11.0 to demonstrate the feasibility of this method and reveal the existence of a weak two-bond scalar coupling between the N_δ1 and N_ε2 sites in the histidine imidazole ring in three tautomeric states and the presence of a hydrogen-bond mediated scalar coupling between the N_δ1 site in the imidazole ring and the backbone N_α site in the histidine neutral τ and π states. Our results demonstrate that weak ¹⁵N homonuclear scalar couplings can be measured even when their values are less than their corresponding intrinsic natural linewidths, thus providing direct and definitive evidence for the formation of N^…H^…N hydrogen bonding that is associated with the histidine imidazole ring.

[Consideration of surgeons participating in 2019 coronavirus disease emergency medical rescue]

As a newly epidemic, 2019 coronavirus disease (COVID-19) with a concentrated outbreak poses a great challenge to medical treatment. The severe and critical patients are complex complicatied with the psychological problems, and the medical staff are overworked and under tremendous psychological pressure. The surgeon participated in emergency medical rescue could provide professional treatment for the patients combined with surgical diseases, as well as specialized training for the non-surgeon crew, to reduce surgical-related mortality. With the advantages of good team consciousness, strong aseptic concept and good psychological quality, the surgeons can quickly adapt to and carry out rescue work under the premise of good self-protection. Surgeons need to develop critical care management concepts and focus on the critical care support equipment. Some suggestions are put forward for the standardized training of resident surgeons to cultivate compound talents. It is hoped that this article can lead to the thinking of how to participate in the emergency medical rescue of infectious diseases among surgeons and provide some enlightenment for future surgical education.

FRI0530 THE PREVALENCE AND DETERMINANTS OF SLEEP PROBLEMS IN PATIENTS ACROSS RHEUMATIC DISEASES AND THEIR CORRELATION WITH DISEASE INDICES USING THE ROUTINE ASSESSMENT OF PATIENT INDEX DATA 3 (RAPID3) QUESTIONNAIRE

Background:

Sleep problems are common in rheumatology patients. RAPID3 is a patient reported outcome measure (PROM) that efficiently screens for problems with sleep, anxiety or depression in routine care.

Objectives:

To study prevalence and determinants of self-reported sleep problems across rheumatic diseases in Rheumatology clinics in Singapore, and its correlation with disease indices.

Methods:

RAPID3 questionnaire was filled electronically over 6 months. Demographic data and SNOWMED diagnoses codes were matched through hospital electronic medical records. RAPID3 comprised of 3 questions measuring the extent of difficulty getting a good night’s sleep and dealing with anxiety or depression. Significant problems were considered if they had “much difficulty” or were “unable to do” the component. The relationship of sleep with anxiety, depression, physical function (measured by modified health assessment questionnaire, mdHAQ), pain and patient global assessment (using visual analogue scale, VAS), was evaluated using Pearson’s correlation. Factors associated with significant sleep problems were evaluated by logistic regression.

Results:

4078 patients [mean (SD) age 55.8 (16.3) years, 67.9% female, 70.6% Chinese] were invited to participate, of which 2625 (64.4%) responded. SNOMED diagnosis codes were available for 1570 (59.8%) patients- majority had inflammatory arthritides (n= 843, 53.7%) (Figure 1).

Mean mdHAQ was 0.3 (0.5), pain VAS was 2.4 (2.3) and global VAS was 2.6 (2.2). Data on disease duration, clinical features and medications were not available. 39.3%, 27.5% and 23.8% had problems with sleep, anxiety and depression respectively; and 7.3%, 4.5% and 4.3% had significant problems respectively. Sleep moderately correlated with anxiety (r=0.463, p<0.001) and depression (r=0.436, p<0.001) and weakly correlated with mdHAQ (r= 0.289, p<0.001), global (r=0.339, p<0.001) and pain VAS (r= 0.314, p<0.001).

In multivariable logistic regression, significant sleep problems were associated with anxiety (OR 4.733, CI 2.172-10.310, p<0.001), mdHAQ score ≥ 1 (OR 2.920, CI 1.691-5.043, p< 0.001) and pain VAS >3 (OR 1.884, CI 1.093-3.247, p=0.023). Patients with osteoarthritis and fibromyalgia were more likely than those with inflammatory arthritides to have significant sleep problems, though we were unable to adjust for body mass index as data were unavailable (Table 1).

Table 1.

Determinants of significant disturbances in sleep in patients with rheumatic diseases

VariablesUnivariableMultivariableOdds ratio (95% CI)p-valueOdds ratio (95% CI)p-valueGenderFemale1.79 (1.245-2.57)0.0021.49 (0.86-2.59)0.16EthnicityChineseRefRefMalay1.04 (0.62-1.73)0.890.73 (0.33-1.61)0.43Indian1.59 (1.03-2.44)0.040.97 (0.49-1.90)0.92Others1.05 (0.62-1.77)0.870.92 (0.43-2.00)0.84Age (years)1.00 (1.00-1.01)0.36--mdHAQ ≥16.25 (4.46-8.75)<0.0012.92 (1.69-5.04)0.001Pain VAS >34.15 (3.07-5.61)<0.0011.88 (1.09-3.25)0.02Global VAS > 34.25 (3.13-5.76)<0.0011.63 (0.95-2.80)0.07Significant anxiety15.99 (10.71- 23.89)<0.0014.73 (2.17-10.31)<0.001Significant depression15.58 (10.35-23.45)<0.0013.02 (1.29-7.10)0.11Primary rheuma-tological diagnosisInflammatory arthritidesRefRefConnective tissue diseases1.18 (0.73-1.90)0.510.9 (0.51-1.59)0.71Crystal arthritides1.06 (0.48-2.33)0.880.83 (0.34-2.03)0.68Osteoarthritis3.09 (1.31-7.32)0.012.96 (1.19-7.36)0.02Fibromyalgia9.05 (2.04-40.05)0.0049.62 (2.11-43.84)0.003Others1.63 (0.82-3.29)0.171.20 (0.58-2.47)0.63

Conclusion:

Sleep problems are common in rheumatology patients and correlate significantly with disease indices and psychological distress. Rheumatologists should routinely screen for sleep difficulties, especially in patients with osteoarthritis and fibromyalgia.

References: -

Acknowledgments:

Nil.

Disclosure of Interests:

Charlotte Tan: None declared, Peter Cheung: None declared, Manjari Lahiri Grant/research support from: Manjari Lahiri is the site principal investigator for the Singapore National Biologics Register, which is a multi-pharmaceutical funded register, in which industry sponsors provide support through the Chapter of Rheumatologists, Singapore. Dr Lahiri does not personally receive any remuneration.