Cortico-cortical connectivity is influenced by levodopa in tremor-dominant Parkinson's disease

Resting tremor is the most common presenting motor symptom in Parkinson's disease (PD). The supplementary motor area (SMA) is a main target of the basal-ganglia-thalamo-cortical circuit and has direct, facilitatory connections with the primary motor cortex (M1), which is important for the execution of voluntary movement. Dopamine potentially modulates SMA and M1 activity, and both regions have been implicated in resting tremor. This study investigated SMA-M1 connectivity in individuals with PD ON and OFF dopamine medication, and whether SMA-M1 connectivity is implicated in resting tremor. Dual-site transcranial magnetic stimulation was used to measure SMA-M1 connectivity in PD participants ON and OFF levodopa. Resting tremor was measured using electromyography and accelerometry. Stimulating SMA inhibited M1 excitability OFF levodopa, and facilitated M1 excitability ON levodopa. ON medication, SMA-M1 facilitation was significantly associated with smaller tremor than SMA-M1 inhibition. The current findings contribute to our understanding of the neural networks involved in PD which are altered by levodopa medication and provide a neurophysiological basis for the development of interventions to treat resting tremor.

Longitudinal characterization of serum metabolome and lipidome reveals that the ceramide profile is associated with metabolic health in early postpartum cows experiencing different lipolysis

Reduced feed intake in early lactation prompts increased fat mobilization to meet dairy cows' energy needs for milk production. The increased lipolysis in cows presents significant health risks with unclear mechanisms. The objectives of our study were to compare the longitudinal profiles of metabolites and lipids of serum from high and low-lipolysis cows. Forty multiparous Holstein dairy cows were enrolled in the retrospective study. Serum samples were collected on d 7 before expected calving, as well as on d 5, d 7, d 14, and d 21 postpartum. Dairy cows were grouped according to mean serum nonesterified fatty acids on d 5 and 7 after parturition as low (<0.600 mmol/L; n = 8; LFM) and high (>0.750 mmol/L; n = 8; HFM), indicating fat mobilization during early lactation. Lactational performance and serum metabolic parameters related to glucose and lipid metabolism, liver functions, oxidative status, and inflammatory responses were determined. Serum samples were subjected to LC-MS-based metabolomics and lipidomics. Despite differences in postpartum BW change, there were no observed variations in milk yield and composition between 2 groups. Serum BHBA, glucose, leptin, aspartate aminotransferase, IL-6, and TNF-α were greater in cows with HFM than in LFM. Serum adiponectin, revised quantitative insulin sensitivity check index and albumin were lower in cows with HFM than LFM. Intensified fat mobilization in the HFM cows came along with reduced estimated insulin sensitivity, impaired liver functions, and increased oxidative stress and inflammatory responses. Differences in metabolic patterns were observed across the transition period when comparing serum blood matrices (e.g., in different amino acids, acylcarnitines, and sphingolipids). The serum metabolome of the HFM cows was characterized by higher concentrations of glycine, acylcarnitines, carnosine, Cer(d20:0/18:0), Cer(d18:1/16:0), and Cer(t18:0/24:0) compared with LFM. The differential serum metabolites and lipids at different sampling times during the peripartum period were enriched in the sphingolipid metabolism. Differences in serum metabolic status parameters suggest that cows adopt varied metabolic adaptation strategies to cope with energy deficits postpartum. Our investigation found a comprehensive remodeling of the serum metabolic profiles in transition dairy cattle, highlighting the significance of alterations in sphingolipid species, as they play a crucial role in insulin resistance and metabolic disorders.

Data-driven calibration of decoupling matrix for MIMO precision motion stages

Decoupling control is a commonly employed technique for achieving high precision in multiple-input multiple-output (MIMO) motion control systems. A static decoupling matrix, which can be determined using geometric construction, is widely used due to its practicality and simplicity. However, inaccurate geometric parameters will lead to a coarse decoupling matrix, and result in interactions among the system axes and performance deterioration. To tackle this challenge, various attempts have been undertaken to calibrate the decoupling matrix. Data-driven on-line approaches have gained considerable attention for their ability to calibrate the decoupling matrix without interrupting the normal operation of the system. This paper presents a data-driven approach to calibrate the decoupling matrix for MIMO and linear time invariant (LTI) systems. Through some reasonable assumptions, a calibrated static decoupling matrix can be derived to improve the performance of the system. Moreover, considering the inevitable presence of measurement noise, the consistency of the proposed method has been analyzed. As a result, the instrument variable is introduced in the improved method to eliminate the impact of the measurement noise. Finally, the effectiveness and practicality of the proposed method are demonstrated through both numerical simulations and experiments carried out on an ultraprecision wafer stage.

3D Shape Measurement of Aeroengine Blade Based on Fringe Projection Profilometer Improved by Multi-Layer Concentric Ring Calibration

The precision requirements for aeroengine blade machining are exceedingly stringent. This study aims to improve the accuracy of existing aeroengine blade measurement methods while achieving comprehensive measurement. Therefore, this study proposes a new concentric ring calibration method and designs a multi-layer concentric ring calibration plate. The effectiveness of this calibration method was verified through actual testing of standard ball gauges. Compared with the checkerboard-grid calibration method, the average deviation of the multilayer concentric ring calibration method for measuring the center distance of the standard sphere is 0.02352, which improves the measurement accuracy by 3-4 times. On the basis of multi-layer concentric ring calibration, this study builds a fringe projection profiler based on the three-frequency twelve-step phase shift method. Compared with the CMM, the average deviation of the blade chord length measured by this solution is 0.064, which meets the measurement index requirements of aeroengine fan blades.

Adaptive Weighted Error-Correction Method Based on the Error Distribution Characteristics of Multi-Channel Alignment

As process nodes of advanced integrated circuits continue to decrease below 10 nm, the requirement for overlay accuracy is becoming stricter. The alignment sensor measures the position of the alignment mark relative to the wafer; thus, sub-nanometer alignment position accuracy is vital. The Phase Grating Alignment (PGA) method is widely used due to its high precision and stability. However, the alignment error caused by the mark asymmetry is the key obstacle preventing PGA technology from achieving sub-nanometer alignment accuracy. This error can be corrected using many methods, such as process verification and multi-channel weighted methods based on multi-diffraction, multi-wavelength and multi-polarization state alignment sensors. However, the mark asymmetry is unpredictable, complex and difficult to obtain in advance. In this case, the fixed-weight method cannot effectively reduce the alignment error. Therefore, an adaptive weighted method based on the error distribution characteristic of a multi-channel is proposed. Firstly, the simulation result proves that the error distribution characteristic of the multi-alignment result has a strong correlation with the mark asymmetry. Secondly, a concrete method of constructing weight values based on error distribution is described. We assume that the relationship between the weight value of each channel and the deviations of all channels' results is second-order linear. Finally, without other prior process correction in the simulation experiment, the residual error's Root Mean Square (RMS) of fixed weighted method is 14.0 nm, while the RMS of the adaptive weighted method is 0.01 nm, when dealing with five typical types of mark asymmetry. The adaptive weighted method exhibits a more stable error correction effect under unpredictable and complicated mark asymmetry.

Mouse model of Graves' orbitopathy induced by the immunization with TSHR A and IGF-1R α subunit gene

PURPOSE

The study aimed to establish a mouse model of Graves' disease (GD) with Graves' orbitopathy (GO; GD + GO) that can represent the clinical disease characteristics.

METHODS

A eukaryotic expression plasmid of insulin-like growth factor 1 receptor (IGF-1R) α subunit (pcDNA3.1/IGF-1Rα) and a thyrotropin receptor (TSHR) A subunit plasmid (pcDNA3.1/TSHR-289) were injected in female BALB/c mice followed by immediate electroporation to induce a GD + GO model. Grouping was performed according to the frequency of injection (2- to 4-week intervals) and type of injected plasmids: T: pcDNA3.1/TSHR-289( +), I: pcDNA3.1/IGF-1Rα( +), or co-injection T + I: pcDNA3.1/TSHR-289( +) and pcDNA3.1/IGF-1Rα( +). Serum TSH, T4, TSAb, TSBAb, body weight, and blood glucose levels were evaluated. Thyroid 99mTcO4- imaging and retrobulbar magnetic resonance imaging (MRI) were performed, and bilateral eye muscle volumes were measured. Immunohistochemistry and hematoxylin-eosin staining were performed on the relevant tissues, and semi-quantitative analysis was performed.

RESULTS

A total of 60% of mice (3/5, one mouse died) in the T group developed GD + GO. In the T + I group, 83.3% of mice (5/6) developed GD + GO. Mice in the I group did not develop GD. Compared with the control group, serum T4, TSAb, and TSBAb of the mice in the GD + GO model groups were increased to varying degrees (P < 0.05), and serum TSH and body weight were significantly lower compared to the control group (P < 0.05). The thyroid uptake capacity of 99mTcO4- and the volume of eye muscle of mice in the GD + GO group were significantly higher compared to the control group (P < 0.05). The thyroid and retrobulbar muscles of these mice showed varying inflammatory infiltration and interstitial muscle edema. The severity of GD + GO in the co-injection group was not related to injection frequency; however, GD and ocular signs in co-injection mice were more severe compared to the T group.

CONCLUSIONS

We successfully induced a GD + GO mouse model by a repeated co-injection of pcDNA3.1/IGF-1Rα and pcDNA3.1/TSHR-289 plasmids. Injection of pcDNA3.1/IGF-1Rα alone failed to induce GD. Co-injection of two plasmids induced more severe GD + GO than pcDNA3.1/TSHR-289( +) alone.

[A randomized controlled trial on the effect of early eschar dermabrasion combined with antimicrobial soft silicone foam dressing in the treatment of deep partial-thickness burn wounds in children]

Objective: To explore the effect of early eschar dermabrasion combined with antimicrobial soft silicone foam dressing (hereinafter referred to as foam dressing) in treating the deep partial-thickness burn wounds in children. Methods: This study was a randomized controlled trial. From June 2021 to December 2022, 78 pediatric patients with deep partial-thickness burns who met the inclusion criteria were admitted to the Department of Burns in Guiyang Steel Plant Employees Hospital. According to the random number table, the pediatric patients were divided into two groups, with 38 cases left in combined treatment group (with 20 males and 18 females, aged 26.00 (16.75, 39.75) months) and 39 cases in foam dressing group (with 21 males and 18 females, aged 19.00 (14.00, 31.00) months) after the exclusion of one dropped-out child in follow-up. The pediatric patients in combined treatment group underwent eschar dermabrasion of the wound within 48 hours after injury, the wound was covered with foam dressing after operation, and the dressing was replaced once every 7 days; for the pediatric patients in foam dressing group, the wound was sterilized within 48 hours after injury and covered with foam dressing, and the dressing was replaced once every 2 to 3 days. After the wound healing, the children in both groups were routinely applied with silicone gel twice a day for 3 weeks before started wearing elastic sleeves for more than 18 hours a day, and continuously for over than 6 months. The degree of pain during dressing change was evaluated using the children's pain behavior inventory FLACC. The adverse reactions during the treatment period, number of dressing changes, and wound healing time were observed and recorded. Six months after wound healing, the Vancouver scar scale (VSS) was used to evaluate the condition of the wound scar. Results: When changing dressing, the FLACC score for pain of pediatric patients in combined treatment group was 3.5 (2.0, 5.0), which was significantly lower than 6.0 (5.0, 8.0) in foam dressing group (Z=-5.40, P<0.05). During the treatment period, no adverse reactions such as wound edema, fluid accumulation, or peripheral skin rash allergies occurred in any pediatric patient in both groups. The number of dressing changes of pediatric patients in combined treatment group was 3 (3, 4) times, which was significantly less than 8 (7, 10) times in foam dressing group (Z=-7.58, P<0.05). The wound healing time of pediatric patients in combined treatment group was (19±5) days, which was significantly shorter than (25±6) days in foam dressing group (t=-4.48, P<0.05). Six months after wound healing, the VSS score for scar of pediatric patients in combined treatment group was 5 (2, 8), which was significantly lower than 7 (5, 10) in foam dressing group (Z=-3.05, P<0.05). Conclusions: Compared with using foam dressings alone, early eschar dermabrasion combined with foam dressings can reduce the number of dressing changes, alleviate the pain during dressing changes, and shorten the wound healing time in treating children with deep partial-thickness burns, and effectively alleviate scar hyperplasia by combining with anti-scar treatment post burns.

A 1064 nm laser adaptive limiter with visible light transparency based on one dimensional photonic crystals of LiNbO3 defects

Herein, we present the investigation of the visible light transparency and optical limiting characteristics of one dimensional photonic crystals with LiNbO3 defects fabricated by the sputtering technique. Transmission spectroscopy measurements reveal a broad photonic band gap with a 1064 nm defect mode and high transmittance within the visible range. The optical energy limiting performance in the photonic crystal can be attributed to the strong confinement of the optical field surrounding the LiNbO3 defect layer. The low energy 1064 nm laser demonstrates a transmittance of 82.15%. Notably, the optical limiting threshold is lower at 62.03 mJ cm-2 in comparison with conventional optical limiting materials. Additionally, the optical limiter achieves a transmittance of 68.57% within the visible light band.

Multispectral stealth multilayer etched film structure based on ultrathin silver

Spontaneous infrared radiation dissipation is a critical factor in facilitating object cooling, which influences the thermal stability and stealth efficacy of infrared stealth devices. Furthermore, the compatibility between efficient visible, infrared, and radar stealth is challenging due to different camouflage principles in different bands. This Letter presents a five-layer etched film structure to achieve multispectral stealth, and the utilization of the high-quality ultrathin silver films enables highly efficient infrared selective emission. This etched film structure with few layers demonstrates potential applications in diverse domains, including multi-band anti-detection and multispectral manipulation.

Broadband High Optical Transparent Intelligent Metasurface for Adaptive Electromagnetic Wave Manipulation

Intelligent metasurfaces have garnered widespread attention owing to their properties of sensing electromagnetic (EM) environments and multifunctional adaptive EM wave manipulation. However, intelligent metasurfaces with broadband high optical transparency have not been studied to date, and most of the previous intelligent metasurfaces lack an integrated design for their actuators and sensors, resulting in lower integration levels. This study proposes a novel intelligent metasurface with adaptive EM wave manipulation ability and high optical transparency from visible to infrared bands. This metasurface consists of a transparent and current-controlled reconfigurable metasurface as an actuator by integrating patterned vanadium dioxide (VO2) into metal-meshed resonant units, transparent broadband microstrip antenna as a sensor, recognition-and-feedback module, and actuator- and sensor-integrated design on the same substrate. The EM-regulating capability of the designed transparent intelligent metasurface is theoretically analyzed using the coupled mode theory, and a prototype metasurface device is fabricated for experimental verification. Simulation and experimental results demonstrate that the metasurface exhibits over 80% normalized transmittance from 380 to 5,000 nm and adaptive EM wave manipulation (reflective strong shielding function with a shielding efficiency of over 24 dB, high transmittance function with a transmission loss of 1.24 dB, and strong absorption function with an absorption of 97%) according to the EM wave power parameters without manual intervention. This study provides an avenue for transparent intelligent metasurfaces with extensive application prospects in areas such as intelligent optical windows, radar enclosures, and communication.

A visible-near-infrared transparent miniaturized frequency-selective metasurface with a microwave transmission window

In this work, we propose a meshed miniaturized frequency-selective metasurface (MMFSM), which is insensitive to the incidence microwave angle and has great optical imaging quality by extending the effective length of the aperture within the periodic unit and replacing large metal parts with different metallic meshes. Experimental results indicated that our MMFSM had an average normalized transmittance of 87.2% in the visible-near-infrared band, a passband loss of 1.446 dB, and an oblique incidence stabilization angle of 50° (the passband loss was less than 2.38 dB). These are excellent characteristics required for applications in the optics and communication fields.

[Retrospective analysis of 350 cases with dissection of lymph nodes posterior to right recurrent laryngeal nerve in endoscopic thyroidectomy through gasless axillary posterior approach]

Objective: To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (ⅥB compartment) in endoscopic thyroidectomy through gasless axillary posterior approach. Methods: A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data. Results: All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and ⅥB compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. ⅥB compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%). Conclusion: The dissection of ⅥB compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients.

Quantitatively mapping local quality of super-resolution microscopy by rolling Fourier ring correlation

In fluorescence microscopy, computational algorithms have been developed to suppress noise, enhance contrast, and even enable super-resolution (SR). However, the local quality of the images may vary on multiple scales, and these differences can lead to misconceptions. Current mapping methods fail to finely estimate the local quality, challenging to associate the SR scale content. Here, we develop a rolling Fourier ring correlation (rFRC) method to evaluate the reconstruction uncertainties down to SR scale. To visually pinpoint regions with low reliability, a filtered rFRC is combined with a modified resolution-scaled error map (RSM), offering a comprehensive and concise map for further examination. We demonstrate their performances on various SR imaging modalities, and the resulting quantitative maps enable better SR images integrated from different reconstructions. Overall, we expect that our framework can become a routinely used tool for biologists in assessing their image datasets in general and inspire further advances in the rapidly developing field of computational imaging.

Identification and functional analysis of circRIPK2 in lipopolysaccharide induced chicken macrophages

1. It was hypothesised that a circular RIPK2 (circRIPK2) highly expressed in chicken macrophages plays an important role during bacterial infection.2. After PCR amplification, Sanger sequencing and RNase R exonuclease treatment of chicken macrophages, it was found that circRIPK2 was a stable circular RNA, which was formed by reverse splicing of exons 4 to 9 of the RIPK2.3. The circRIPK2 can promote the lipopolysaccharide (LPS) induced cellular injury by reducing cell viability and increasing the expression of pro-inflammatory cytokines and apoptosis genes.4. Six miRNAs were identified as interacting with circRIPK2, potentially targeting 1,817 genes, which were significantly enriched in the Wnt signalling pathway, adherens junction and NOD-like receptor signalling pathway.5. This study provides better understanding of the function of circRIPK2, which may prove a potential biomarker and indicate potential targets for the treatment of bacterial infection.

High-Performance Transparent Ultrabroadband Electromagnetic Radiation Shielding from Microwave toward Terahertz

In the era of fifth-generation networks and Internet-of-Things, the use of multiband electromagnetic radiation shielding is highly desirable for next-generation electronic devices. Herein, we report a systematic exploration of optoelectronic behaviors of ultrathin-silver-based shielding prototype (USP) film structures at the nanometer scale, unlocking the transparent ultrabroadband electromagnetic interference (EMI) shielding from microwave to terahertz frequencies. A theoretical model is proposed to optimize USP structures to achieve increased transparency, whereby optical antireflection resonances are introduced in dielectrics in conjunction with remarkable EMI shielding capability. USP can realize a state-of-the-art effective electromagnetic radiation shielding bandwidth with measured frequencies from 8 GHz up to 2 THz. Experimental results show that a basic USP (dAg = 10 nm) offers an average shielding efficiency of ∼27.5 dB from the X- to Ka-bands (8-40 GHz) and maintains a stable shielding performance of ∼22.6 dB across a broad range of 0.5-2 THz, with a measured optical transmittance of ∼95.2%. This extraordinary performance of ultrathin-silver-based film structures provides a new ultrabroadband EMI shielding paradigm for potential applications in next-generation electronics.

A Method for Measuring Parameters of Defective Ellipse Based on Vision

Ellipse detection has a very wide range of applications in the field of object detection, especially in the geometric size detection of inclined microporous parts. However, due to the processing methods applied to the parts, there are certain defects in the features. The existing ellipse detection methods do not meet the needs of rapid detection due to the problems of false detection and time consumption. This article proposes a method of quickly obtaining defective ellipse parameters based on vision. It mainly uses the approximation principle of circles to repair defective circles, then combines this with morphological processing to obtain effective edge points, and finally uses the least squares method to obtain elliptical parameters. By simulating the computer-generated images, the results demonstrate that the center fitting error of the simulated defect ellipses with major and minor axes of 600 and 400 pixels is less than 1 pixel, the major and minor axis fitting error is less than 3 pixels, and the tilt angle fitting error is less than 0.1°. Further, experimental verification was conducted on the engine injection hole. The measurement results show that the surface size deviation was less than 0.01 mm and the angle error was less than 0.15°, which means the parameters of defective ellipses can obtained quickly and effectively. It is thus suitable for engineering applications, and can provide visual guidance for the precise measurement of fiber probes.

Metasurface with Electrically Tunable Microwave Transmission Amplitude and Broadband High Optical Transparency

Metasurfaces with tunable microwave transmission amplitude and broadband high optical transparency hold great promise for the next generation of optically transparent and smart electromagnetic transmission devices. In this study, a novel and electrically tunable metasurface with high optical transparency in the visible-infrared broadband is proposed and fabricated by integrating meshed electric-LC resonators and patterned VO₂. Simulations and experiments demonstrate that the designed metasurface has a normalized transmittance greater than 88% over a wide wavelength range of 380-5000 nm, and the transmission amplitude can be continuously tuned from -1.27 to -15.38 dB at 10 GHz under current excitation, indicating significantly limited passband loss and strong electromagnetic shielding capability in the on and off cases, respectively. This study provides a simple, practical, and feasible method for optically transparent metasurfaces with electrically tunable microwave amplitude, paving the way for the application of VO₂ in multiple fields such as intelligent optical windows, smart radomes, microwave communications, and optically transparent electromagnetic stealth.

Single-shot isotropic differential interference contrast microscopy

Differential interference contrast (DIC) microscopy allows high-contrast, low-phototoxicity, and label-free imaging of transparent biological objects, and has been applied in the field of cellular morphology, cell segmentation, particle tracking, optical measurement and others. Commercial DIC microscopy based on Nomarski or Wollaston prism resorts to the interference of two polarized waves with a lateral differential offset (shear) and axial phase shift (bias). However, the shear generated by these prisms is limited to the rectilinear direction, unfortunately resulting in anisotropic contrast imaging. Here we propose an ultracompact metasurface-assisted isotropic DIC (i-DIC) microscopy based on a grand original pattern of radial shear interferometry, that converts the rectilinear shear into rotationally symmetric along radial direction, enabling single-shot isotropic imaging capabilities. The i-DIC presents a complementary fusion of typical meta-optics, traditional microscopes and integrated optical system, and showcases the promising and synergetic advancements in edge detection, particle motion tracking, and label-free cellular imaging.

Integrated analysis of mRNA and microRNA expression pattern reveals differential transcriptome signatures in RIPK2 over-expressing chicken macrophages infected with avian pathogenic E. coli

1. As RIPK2 (receptor interacting serine/threonine kinase 2) has been shown to to alleviate excessive inflammatory responses, the following study conducted a systematic and in-depth analysis of the mRNA-seq and miRNA-seq data from chicken macrophages with/without over-expression of RIPK2 (oeRIPK2) combined with/without avian pathogenic E. coli (APEC) infection to identify the miRNA-mRNA interaction network and potential signalling pathways involved.2. A total of 9,201 differentially expressed (DE) mRNAs and 300 DE miRNA were identified in both oeRIPK2+APEC vs. APEC and oeRIPK2 vs. the wild-type (WT). Moreover, 4,269 instances of co-expression between miRNAs and mRNAs were seen involving 1,652 DE mRNAs and 164 DE miRNAs.3. Functional analysis of the DE mRNAs in the miRNA-mRNA interaction network showed that 223 biological processes and five KEGG pathways were significantly enriched in the two comparisons. In total, 128 pairs of miRNA-mRNA interactions were involved in the identified MAPK signalling pathway and focal adhesion immune related pathways.4. Significantly, these screened miRNAs (gga-miR-222b-5p and gga-miR-214) and their target genes were highly correlated with APEC infection and RIPK2. These recognised key genes, miRNA and the overall miRNA-mRNA regulatory network, enables better understanding of the molecular mechanism of host response to APEC infection, especially related to RIPK2.

Regulation of CO2 by the sea in areas around Latin America in a context of climate change

Anthropogenic activities are increasing the atmospheric carbon dioxide (CO₂); around a third of the CO₂ emitted by these activities has been taken up by the ocean. Nevertheless, this marine ecosystem service of regulation remains largely invisible to society, and not enough is known about regional differences and trends in sea-air CO₂ fluxes (FCO2), especially in the Southern Hemisphere. The objectives of this work were as follows: first to put values of FCO2 integrated over the exclusive economic zones (EEZ) of five Latin-American countries (Argentina, Brazil, Mexico, Peru, and Venezuela) into perspective regarding total country-level greenhouse gases (GHG) emissions. Second, to assess the variability of two main biological factors affecting FCO2 at marine ecological time series (METS) in these areas. FCO2 over the EEZs were estimated using the NEMO model, and GHG emissions were taken from reports to the UN Framework Convention on Climate Change. For each METS, the variability in phytoplankton biomass (indexed by chlorophyll-a concentration, Chla) and abundance of different cell sizes (phy-size) were analyzed at two time periods (2000-2015 and 2007-2015). Estimates of FCO2 at the analyzed EEZs showed high variability among each other and non-negligible values in the context of greenhouse gas emissions. The trends observed at the METS indicated, in some cases, an increase in Chla (e.g., EPEA-Argentina) and a decrease in others (e.g., IMARPE-Peru). Evidence of increasing populations of small size-phytoplankton was observed (e.g., EPEA-Argentina, Ensenada-Mexico), which would affect the carbon export to the deep ocean. These results highlight the relevance of ocean health and its ecosystem service of regulation when discussing carbon net emissions and budgets.

Contemporary review of the management of left ventricular thrombus

Funding Acknowledgements

Type of funding sources: None.

Introduction

Left ventricular thrombus (LVT) is a known complication of acute myocardial infarction (AMI) and other cardiomyopathies. LVT increases the risk of stroke and systemic embolism, hence treatment with oral anticoagulation is indicated. While the initial treatment options for LVT is clear, the management of patients after the initial duration of anticoagulation is more complex and varied.

Purpose

We aimed to undertake a comprehensive literature review to study the currently available evidence regarding not only the initial type and duration of anticoagulation for LVT, but also potential treatment options after the initial period of anticoagulation in the setting of both LVT persistence and resolution.

Methods

MEDLINE, EMBASE, Scopus, and Google Scholar were searched from inception to August 2022. Data from randomized controlled trials (RCTs), observational studies and case series discussing management of LVT were included in this summarized synthesis.

Results

Of 2050 studies screened, 30 studies (24 observational studies, 3 case series, 2 RCTs, 1 non-randomized, open-label trial) were included. A total of 17 studies compared warfarin with direct oral anticoagulants (DOACs) for the initial anticoagulation strategy, with the vast majority showing similar outcomes (Table 1). Half (n = 9/18) of the studies repeated imaging between 3-6 months. All studies (n=30) used transthoracic echo with or without contrast as the imaging modality of choice, with selected patients undergoing computed tomography (CT) or cardiac magnetic resonance (CMR). If the LVT persisted, most studies recommended continuing anticoagulation (n = 11/16, 69%) or switching to a different class of anticoagulants (n = 6/16, 38%). In the event of LVT non-resolution, high-risk features of embolization (protruding, mobile vs layered clot) may aid in the discussion of risk and benefit of long-term anticoagulation. Even upon resolution of the LVT, some studies (n=5) recommend continuing anticoagulation in the presence of high-risk features of recurrence (eg. persistently depressed left ventricle ejection fraction (LVEF) and/or apical wall dyskinesis). Regardless, medical management should be optimized together with the appropriate revascularization strategy as clinically indicated.

Conclusions

Current evidence on the management of LVT is limited. This updated review summarizes the available evidence for the management for LVT. Evidence-based recommendations on the management of these patients is warranted to appropriately guide clinicians.

End-stage kidney disease in Brunei Darussalam (2011-2020)

INTRODUCTION

The Brunei Dialysis and Transplant Registry (BDTR) recorded data on patients with end-stage kidney disease (ESKD) from 2011 to 2020, mainly for planning of services and benchmarking of standards. We report the trends of epidemiologic and performance parameters, compare performances between modalities of Kidney Replacement Therapy and evaluate the survival of ESKD patients over the 10-year period.

MATERIALS AND METHODS

Three groups of data were analysed from the BDTR over the 10-year period. Epidemiological data, blood parameters and dialysis are key performance indicators.

RESULTS

There are increments in prevalence and incidence of treated ESKD patients in Brunei over 10 years, especially with haemodialysis (HD). The projected prevalence and incidence showed an anticipated annual increase of 42.2 per million population (pmp) and 9.9 pmp respectively. Diabetes mellitus (DM) (79%) was the main cause of ESKD. HD (86%), peritoneal dialysis (PD) (9%) and transplant (5%) were the main modalities of kidney replacement therapy in 2020. Cumulative results over the decade showed significant improvements in serum phosphate, peritonitis rates and HD blood flow rates. PD patients have better survival rates, lower systolic blood pressure and better adequacy. PD survival (patient survival of 91%, 73% and 56% at 1, 3 and 5 years respectively) was superior to HD survival (86% and 64% at 1 and 2 years, respectively), but patient demographics (age and DM status) were different. The 2020 dataset showed satisfactory anaemia management but mineral bone disease management was sub-optimal. Seventy percent of prevalent HD patients had arteriovenous fistula access. Thirty-two percent and fifty-two percent of HD and PD patients, respectively, achieved target dialysis adequacy. Peritonitis rate was 0.3 episodes per patient year.

CONCLUSION

Brunei has a high incidence and prevalence of treated ESKD in the last decade, especially DM-related ESKD. This study has identified many specific areas to be targeted for improvements and provided evidence for further proliferation of PD and transplant preference policy.

Finite time stable inversion in discrete frequency domain: Accuracy analysis, improvement and application to wafer stage

Stable inversion represents a classic approach to achieve the exact inverse input for non-minimum-phase (NMP) systems. Solutions deduced based on state-space equations and transfer functions have been frequently proposed, however they are basically developed in the infinite-time horizon and are inherently time-domain computation methods. Considering the practical finite-time tracking tasks, this paper investigates the finite-time stable inversion problem. In particular, the discrete-frequency-domain solution which enables frequency-domain computation is studied. As the main contribution of the paper, the accuracy issues of the discrete-frequency-domain solution are revealed and an easy-to-use procedure is provided to improve the inversion accuracy by utilizing pre-actuation and post-actuation methods. Simulation and experiment both verify the effectiveness of the developed discrete-frequency-domain stable inversion technique.

The KNee OsteoArthritis Prediction (KNOAP2020) challenge: An image analysis challenge to predict incident symptomatic radiographic knee osteoarthritis from MRI and X-ray images

OBJECTIVES

The KNee OsteoArthritis Prediction (KNOAP2020) challenge was organized to objectively compare methods for the prediction of incident symptomatic radiographic knee osteoarthritis within 78 months on a test set with blinded ground truth.

DESIGN

The challenge participants were free to use any available data sources to train their models. A test set of 423 knees from the Prevention of Knee Osteoarthritis in Overweight Females (PROOF) study consisting of magnetic resonance imaging (MRI) and X-ray image data along with clinical risk factors at baseline was made available to all challenge participants. The ground truth outcomes, i.e., which knees developed incident symptomatic radiographic knee osteoarthritis (according to the combined ACR criteria) within 78 months, were not provided to the participants. To assess the performance of the submitted models, we used the area under the receiver operating characteristic curve (ROCAUC) and balanced accuracy (BACC).

RESULTS

Seven teams submitted 23 entries in total. A majority of the algorithms were trained on data from the Osteoarthritis Initiative. The model with the highest ROCAUC (0.64 (95% confidence interval (CI): 0.57-0.70)) used deep learning to extract information from X-ray images combined with clinical variables. The model with the highest BACC (0.59 (95% CI: 0.52-0.65)) ensembled three different models that used automatically extracted X-ray and MRI features along with clinical variables.

CONCLUSION

The KNOAP2020 challenge established a benchmark for predicting incident symptomatic radiographic knee osteoarthritis. Accurate prediction of incident symptomatic radiographic knee osteoarthritis is a complex and still unsolved problem requiring additional investigation.

Method of micro hole tilt adjustment based on a vision-guided touch probe

In order to meet the increasing miniaturization and high precision requirements of high-performance devices in aerospace and other fields for space array micro holes with a high aspect ratio, a method of measuring geometric parameters by penetrating the micro holes with a contact probe guided by vision is proposed, which can achieve rapid and efficient measurements. This method adopts the principle of vision measurement, preliminarily determines the geometric parameters of measurement through the processing of micropore images, and then needs to establish a collaborative measurement model of vision and probe using the principle of vision to guide the probe to go deep into the hole to measure and adjust the inclined micropores. According to this principle, a five-axis measuring system is set up, and a hole with a diameter of 3 mm is tested at different angles. The experimental results preliminarily verify the effectiveness and feasibility of the proposed method.

Accurate and Comprehensive Spectrum Characterization for Cavity-Enhanced Electro-Optic Comb Generators

Cavity-enhanced electro-optic comb generators (CEEOCGs) can provide optical frequency combs with excellent stability and configurability. The existing methods for CEEOCGs spectrum characterization, however, are based on approximations and have suffered from either iterative calculations or limited applicable conditions. In this paper, we show a spectrum characterization method by accumulating the optical electrical field with respect to the count of the round-trip propagation inside of CEEOCGs. The identity transformation and complete analysis of the intracavity phase delay were conducted to eliminate approximations and be applicable to arbitrary conditions, respectively. The calculation efficiency was improved by the noniterative matrix operations. Setting the maximum propagation count as 1000, the spectrum of the center ±300 comb modes can be characterized with merely the truncation error of floating-point numbers within 1.2 s. More importantly, the effects of all CEEOCG parameters were comprehensively characterized for the first time. Accordingly, not only the exact working condition of CEEOCG can be identified for further optimization, but also the power of each comb mode can be predicted accurately and efficiently for applications in optical communications and waveform synthesis.

A two-variable control and optimization method for imbalance of high pressure compressor based on improved genetic algorithm

To solve the problem of low quality rate for one-time assembly of high-pressure compressors, an improved genetic algorithm (GA) is used to adjust and optimize the imbalance after assembly. This paper takes the post-assembly imbalance of a multi-stage rotor of a high-pressure compressor as the objective function, to reduce the post-assembly imbalance by adjusting the arrangement order of rotor blades and the assembly phase between rotors. We used a four-sector staggered distribution method to generate high-quality initial populations and added an elite retention strategy. The crossover and mutation probabilities are adaptively adjusted according to the fitness function values. The threshold termination condition is added to make the algorithm converge quickly so as to achieve fast, stable, and efficient search. The simulation results show that the imbalance is reduced by 99.46% by using the improved genetic algorithm, which is better than the traditional GA. The experimental results show that the imbalance of the two correction surfaces can be reduced to 640 and 760 g·mm, respectively, which is 86.7% and 87.1% better than the zero-degree assembly.

Measurement method of aero-engine rotor concentricity and perpendicularity based on deep belief neural network

When implementing the traditional assembly method, the rotor is affected by machining errors. The morphology of the rotor is complex, and the machining error of the rotors at all levels are transmitted step by step through the stop mating surface, which affects the performance and service life of the aero-engine. The evaluation of machining error of single-stage rotor is the basis of assembly quality of multi-stage rotor. In order to improve the current situation of complicated and time-consuming rotor machining error evaluation, this paper proposes to establish a deep belief neural network (DBNN) to replace the traditional procedure of depolarization. The network takes the relative evaluation error of the rotor profile data without depolarization as the input and takes the machining error of the rotors obtained after depolarization as the output. First, the evaluation mechanism of the rotor's machining error is analyzed, and the corresponding machining error influence source is selected as the input source of the deep belief neural network. Second, as DBNN is trained, and the appropriate weight initialization method and the optimization algorithm of the prediction network are selected to ensure the optimization of the whole network for feature mapping extraction of the training set. Finally, the assembly of multi-stage rotors is simulated and analyzed. It is shown in the experiments that after the iteration, the prediction network, with good training effects, has converged, and its prediction results tend to be consistent with the real values. The mean prediction error of the concentricity is 0.09 µm while the mean difference of angle of concentricity error value is 0.77°, and the mean difference of perpendicularity error value is 0.21 µm while the mean difference of angle of perpendicularity error value is 1.4°, the corresponding R² determination coefficients were 0.99, 0.98, 0.91, and 0.94, respectively. It meets the requirements of field assembly and fully embodies the effectiveness of the procedure of depolarization based on deep confidence neural network.

[Effects of composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of hypertrophic scars in burn children]

Objective: To explore the effects of pulsed dye laser (PDL) and ultra-pulsed fractional carbon dioxide laser (UFCL) combined with multipoint microinjection of triamcinolone acetonide in the treatment of red hypertrophic scar at early stage in burn children. Methods: A retrospective cohort before-after control study in the same patients was conducted. From February 2019 to December 2020, a total of 67 burn children who met the inclusion criteria (32 males and 35 females, aged 1 to 12 years) with red hyperplastic scar at early stage, were treated in Hunan Provincial People's Hospital (1st Affiliated Hospital of Hunan Normal University). All the children were treated with composite laser technique (PDL and UFCL) combined with triamcinolone acetonide (hereinafter referred to as combined treatment). After 2 months, they received the second combined treatment. Before the first combined treatment and 6 months after the last combined treatment, the scar of children was evaluated with the patient and observer scar assessment scale (POSAS) by physicians and family members. Six months after the last combined treatment, the satisfaction of the patients' family members with the efficacy was recorded and the overall satisfaction rate was calculated. Adverse reactions were recorded throughout the treatment process. Data were statistically analyzed with paired sample t test. Results: Six months after the last combined treatment, the POSAS scores of children on the thickness, blood vessels distribution, color, surface roughness, texture, scope, and overall evaluation of scar evaluated by the physicians, and the POSAS scores of children on the color, degree of pain, degree of itching, hardness, thickness, shape and size, and overall evaluation of scar evaluated by the family members were significantly lower than those before the first combined treatment (with t values of 17.32, 16.73, 15.00, 14.91, 19.62, 28.74, 29.83, 17.43, 20.52, 29.01, 28.82, 24.91, 20.30, and 42.13, respectively, P<0.01). Six months after the last combined treatment, 62 (93%), 3 (4%), and 2 (3%) children's family members were very satisfied, satisfied, and relatively satisfied with the treatment effect, respectively, and the overall satisfaction rate was 97% (65/67). Six months after the last combined treatment, no scar thickening or infection occurred in all the wounds of children. Conclusions: Composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of red hypertrophic scar at early stage in burn children can improve the appearance and texture of scar, reduce scar pain and pruritus, with high satisfaction of children's family members to the treatment effect and less adverse reactions.

Memory related predictive compensation control of Piezoelectric actuators based on global linearization Koopman theory

Piezoelectric actuators (PEAs) are widely applied in precision positioning. However, the nonlinear characteristics such as hysteresis and creep limit the ultra-precision applications. This paper proposes a linear model predictive control (MPC) scheme for compensating the nonlinearity of PEA. Firstly, a global linearization predictor is constructed based on Koopman theory to represent the hysteresis behavior of PEA. The high-precision predictor is implemented by a novel memory related neural network (NN), and the prediction error reaches only 0.002 μm. Then the tracking control problem is transformed into a linear MPC optimization problem, thereby avoids the sophisticated nonconvex optimization problem. In practice, the constrained MPC problem is rewritten into a dense form, and solved by quadratic programming technique. Finally, the validity of the proposed scheme is demonstrated by experiments. The short-term steady-state error of the proposed scheme is 0.002 μm, which is far less than that of the inversion method; the long-term steady-state performance also indicates its effectiveness in compensating creep. Further, the excellent frequency-dependent results show that the proposed scheme is superior to the existing control method. Especially, the computational efficiency can be improved by 20%. The proposed predictor and control method are of great significance for the tracking control of PEA.

High-precision autocollimation method based on a multiscale convolution neural network for angle measurement

A high-precision autocollimation method based on multiscale convolution neural network (MSCNN) for angle measurement is proposed. MSCNN is integrated with the traditional measurement model. Using the multiscale representation learning ability of MSCNN, the relationship between spot shape (large-scale feature), gray distribution (small-scale feature), and the influence of aberration and assembly error in the collimating optical path is extracted. The constructed accurate nonlinear measurement model directly improves the uncertainty of angle measurement. Experiments demonstrate that the extended uncertainty reaches 0.29 arcsec (k = 2), approximately 7 times higher than that with the traditional measurement principle, and solves the nonlinear error caused by aberration and assembly error in the autocollimation system. Additionally, this method has a good universality and can be applied to other autocollimation systems.

Ultrasonics methodology for defect and stress detection of in-serviced T-shaped R-zone components

The T-shaped R-zone component widely exists in aerospace and satellite communication area, such as supporting structure under the wing skin and the mechanical supporting frame of the satellite large load-bearing high-precision test platform, which seriously affects the performance and the safety of the aircraft and the satellite. In this paper, the overall process of ultrasonics methodology of T-shaped R-zone components is proposed, systematically investigated and experimentally verified. The detection of the defect and the stress is respectively realized based on the synthetic aperture total focusing method and the Mohr's stress circle theory with the aid of the linear phased array probe and the longitudinal wave along the stress propagation direction. The theoretical simulations and the experimental measurements both demonstrate the effectiveness of the proposed methodology. The dimensional and the positioning errors are respectively around 0.67 mm and 1.69 mm for the 1 mm × 4 mm crack defect existed in the T-shaped R-zone component. The detecting error of the stress is less than 17.91 MPa in the entire inner of the T-shaped R-zone component, which is applied a pressure in the range of 0-400 MPa.

Generalized Cross-Correlation Strain Demodulation Method Based on Local Similar Spectral Scanning

Optical fiber measurement technology is widely used in the strength testing of buildings, the health testing of industrial equipment, and the minimally invasive surgery of modern medical treatment due to its characteristics of free calibration, high precision, and small size. This paper presents an algorithm that can improve the range and stability of strain measurements in order to solve the problems of the small range and measurement failure of optical fiber strain sensors based on optical frequency-domain reflectometry (OFDR). Firstly, a Rayleigh scattering model based on the refractive index perturbation of an optical fiber is proposed to study the characteristics of Rayleigh scattering and to guide the strain demodulation algorithm based on the spectral shift. Secondly, a local similar scanning method that can maintain a high similarity by monitoring local Rayleigh scattering signals (LSs) before and after strain is proposed. Thirdly, a generalized cross-correlation algorithm is proposed to detect spectral offset, solving the problem of demodulation failure in the case of a Rayleigh scattering signal with a low signal-to-noise ratio. Experiments show that the proposed method still has high stability when the spatial resolution is 3 mm. The measurement precision is 6.2 με, which proves that the multi-peaks or pseudo-peaks of the traditional algorithm in the case of a large strain, the high spatial resolution, and the poor signal-to-noise ratio are solved, and the stability of the strain measurement process is improved.

A New Nonlinear Spatial Compliance Model Method for Flexure Leaf Springs with Large Width-to-Length Ratio under Large Deformation

Flexure leaf spring (FLS) with large deformation is the basic unit of compliant mechanisms with large stroke. The stiffness along the non-working directions of FLSs with large width-to-length ratio (w/L) is high. The motion stability of the compliant mechanism based on this type of FLS is high. When this type of FLS is loaded along the width direction, the shear deformation needs to be characterized. Nevertheless, currently available compliance modeling methods for FLS are established based on Euler-Bernoulli beam model and cannot be used to characterize shear models. Therefore, these methods are not applicable in this case. In this paper, a new six-DOF compliance model for FLSs with large w/L is established under large deformation. The shear deformation along the width direction model is characterized based on the Timoshenko beam theory. The new constraint model and differential equations are established to obtain a high-precision compliance model expression for this type of FLS. The effects of structural parameters on the compliance of the FLS are analyzed. Finally, the accuracy of the model is verified both experimentally and by finite element simulation. The relative error between theoretical result and experiment result is less than 5%.

Interferometric laser imaging for droplet-size measurement in spray

An upgraded droplet-size measurement method, based on laser interference particle imaging (IPI) technology, is applied to accomplish high-precision measurement of particle size and spatial distribution of gas-liquid two-phase flow in the atomization field. In this study, an improved morphological-Hough transform interference fringe location algorithm is applied to IPI measurement. The particle size of the standard particle field with a diameter of 24 µm is measured by the upgraded IPI measurement experimentally, whose absolute error and relative error are 0.14 µm and 0.58%, respectively. The atomization field of the 400 µm centrifugal nozzle under different pressures is demonstrated by direct imaging and IPI technology, where the assessment results are evaluated by SMD value and particle size distribution, and the results exhibit good agreement.

POS0014 EFFICACY AND SAFETY OF JAK INHIBITORS IN REFRACTORY OR INITIAL TREATMENT OF ADULT ONSET STILL’S DISEASE

Background

Inappropriate activation of pro-inflammatory cytokines such as interleukin (IL)-1, IL-6 or IL-18, is a pathogenic cornerstone in adult onset Still’s disease (AOSD). Beyond therapies targeting IL-1 and IL-6, Janus kinases (JAK) inhibitors have been suggested to be efficient in refractory AOSD patients [1].

Objectives

To assess the efficacy and safety of JAK inhibitors in the treatment of AOSD patient refractory to, or with initial treatment.

Methods

This retrospective study was based on our single center of the department of rheumatology and immunology. The data was collected from the patients’ medical records using a standardized questionnaire and analyzed at different time points. The response to JAK inhibitors was categorized as complete remission (CR), partial remission (PR) or failure (F) [2].

Results

7 patients were recruited (Table 1), including 4 refractory patients and 3 initial patients. Mean age at JAK inhibitor treatment start was 27.5 years for refractory patients and 35 years for initial patients; and mean disease duration was 66.5 months and 1 month respectively. All patients had fever and polyarthritis, 5 patents had rash. In addition, pulmonary hypertension, abnormal liver function tests, abdominal pain, and heart failure were also observed in our patients. Response to corticosteroids, conventional synthetic or biological Disease Modifying Anti-Rheumatic Drugs (DMARDs) had been considered inadequate in 4 refractory patients. Tofacitinib was added in the initial treatment for 3 patients for high disease activity. In total, baricitinib was used in 2 patients and tofacitinib in 5 patients. Steroids were concurrently used in 6 patients, MTX in three, SASP and NSAIDs in one. At a mean follow up of 3.8 months, complete remission was observed in one patient (with tofacitinib), partial remission was in 5 patients (4 patients with tofacitinib and one with baricitinib), and failure in one (patients with baricitinib). At the last visit, steroids could be decreased but not stopped in those 6 patients. Tolerance of JAK inhibitors was excellent, none infectious disease or other severe side effect were observed.

Table 1.

Characteristics of the AOSD patients

No.SexAge (year)Disease Duration (Month)Main symptomsTreatments before JAKionsetJAKiSteroids at onsetConconmitant treatmentSteroids at the end of F-UF-U(month)Outcome1M2629Fever, polyarthritisPred+MTXTofacitinib0MTX04PR2M259Fever, polyarthritis, rash, pulmonary hypertensionPred+MTXBaricitinib16MTX+Pred124F3M3812Fever, polyarthritis, rashPred+MTX+CsA+NSAIDsTofacitinib24Pred123PR4M21216Fever, polyarthritisPred+MTX+SASP+NSAIDs+TNFiBaricitinib4Pred+MTX+SASP+NSAIDs43PR5F331Fever, polyarthritis, rash, abnormal liver function testsPredTofacitinib40Pred25CR6F471Fever, polyarthritis, rash, abdominal painPredTofacitinib36Pred45PR7F251Fever, polyarthritis, rash, heart failurePredTofacitinib40Pred123PR

Pred: prednisone; MTX: Methotrexate; SASP: salicylazosulfapyridine; CsA: ciclosporin A; NSAIDs: Non-Steroidal Antiinflammatory Drugs; TNFi: Tumor necrosis factor inhibitor. CR: complete remission; PR: partial remission; F: failure.

Conclusion

JAK inhibitors treatment may be helpful for some patients with refractory AOSD, or patients with severe disease activity at initial treatment. Different treatment responses were observed in these short series of cases, which might be due to the phenotype of patients. However, the scale of patients in our study was too low to draw a conclusion. Further study and additional information are needed to evaluate more precisely the risk-benefit ratio of this treatment, and a possible difference in efficacy among the different groups of patients or JAK inhibitors.

References

[1]Aosd T, Table E. Ann Rheum Dis 2020;79:842–4.

[2]Vercruysse F, Barnetche T, Lazaro E, et al. Arthritis Res Ther 2019;21:1–11. doi:10.1186/s13075-019-1838-6.

Figure 1.

Changes in laboratory test (A) WBC; (B) CRP; (C) ESR;(D) Ferritin. M0: baseline; M1: month 1; M3: month 3; M5: month 5.

Acknowledgements

None

Disclosure of Interests

None declared

AB1520 EFFECTIVE TREATMENT OF TOCILIZUMAB IN PATIENTS WITH REFRACTORY ADULT-ONSET STILL’S DISEASE

Background

Pro-inflammatory cytokines such as interleukin 6 (IL-6) are involved in the pathogenesis of adult-onset Still’s disease (AOSD). Anti-IL-6 agents such as tocilizumab have been tried to treat AOSD successfully.

Objectives

To access the efficacy of tocilizumab in the treatment of AOSD patient refractory to,or with initial treatment.

Methods

We reviewed three cases with refractory AOSD treated with tocilizumab. All patients fulfill the Cush criteria for AOSD. All patients performed blood culture, auto-antibodies test and bone marrow test to exclude infectious diseases, other rheumatic diseases and tumors. All patients received broad-spectrum antibiotics and had no response. All patients received glucocorticoid therapy and at least one kind of anti-cytokine therapies but didn’t have full response. Then the three patients received intravenous tocilizumab treatment of 8mg/kg every 2 weeks or 4 weeks.

Results

The first patient, a 21-year-old woman, performed positron emission tomography (PET-CT) and lymphoglandula pathology in addition to routine tests. She received high dose methylprednisolone (500mg per day for 3 days and followed by 80mg per day), gamma globulin injection (20g per day for 3 days) and baricitinib 4mg per day for 12 days, but had no response to the treatment. Then she received tocilizumab of 8mg/kg every 2 weeks and stopped baricitinib. And the symptoms and blood tests improved gradually, and the methylprednisolone dose reduced to 16mg per day at the last follow-up.

The second patient is a 52-year-old man, and performed bone marrow cytology and PET-CT to excluded hematological diseases. He received methylprednisolone 80mg per day, adalimumab and tofacitinib treatment. But the patients still got recurrent fever, high ESR, CRP and serum ferritin. Then he stopped adalimumab and tofacitinib, and received tocilizumab of 8mg/kg every 2 weeks and reduced to 8mg/kg every 4 weeks because of economic factors. The patient did not develop fever and the inflammatory indexes such as ESR/CRP gradually decreased to normal range. And methylprednisolone dose reduced to 32mg nowadays.

The third patient is a 30-year-old woman and has recurrent AOSD for 15 years. She had tried glucocorticoids, methotrexate, iguratimod, baritinib and entanercept successively. Yet she still had recurrent arthritis on hand and knee, and elevated ESR/CRP/serum ferritin. Additionally she suffered femoral head necrosis because of excessive doses of glucocorticoid. The patient received tocilizumab 8mg/kg every 4 weeks, then joint symptoms and inflammatory indicators improved significantly. The methylprednisolone dose was also successfully reduced to 4mg/d.

The Figure 1 showed the main course of disease evolution.

Figure 1.

Conclusion

Tocilizumab may be an effective candidate in refractory AOSD despite no response to other treatments.

Disclosure of Interests

None declared

MicroRNA-4463 facilitates the development of colon cancer by suppression of the expression of PPP1R12B

PURPOSE

In the present work, we investigated the expression pattern of miR-4463 in the non-metastasis and metastasis colorectal cancer (CRC) patients and its regulation axis.

METHODS

RT-qPCR assay was performed to assess miR-4463 expression in the serum and tissues of patients with non-metastasis and metastasis, and in the CRC cell lines. MTT assay, colony formation assay, transwell assay, and flow cytometry assay were used to examine the role of miR-4463 in CRC cell viability, proliferation, and migration. Bioinformatic analysis was used to identify the potential target gene of miR-4463, and the targeting relationship between miR-4463 and PPP1R12B was verified in vitro using dual luciferase assay. Western blotting assay was used to determine the protein level of the target gene PPP1R12B in CRC cells under the transfections of miR-4463 mimic, inhibitor and vectors overexpressing PPP1R12B.

RESULTS

miR-4463 was markedly increased in the non-metastasis CRC tissues, and increased even higher in the metastasis CRC tissues, while miR-4463 expression had no significant difference in serum from non-metastasis and metastasis CRC samples. Besides, miR-4463 was upregulated in CRC cell lines. Functionally, miR-4463 promoted CRC cell proliferation, migration, and inhibiting cell apoptosis. Further analysis revealed that the miR-4463/PPP1R12B axis was responsible for the role of this miRNA.

CONCLUSION

We reported the roles of miR-4463 in CRC proliferation and migration, supporting that miR-4463 could be a potential predictive diagnostic marker for colon cancer.

Comparison of two fascial defect closure methods for laparoscopic incisional hernia repair

PURPOSE

Currently there is no consensus regarding the optimal surgical approach to an incisional hernia measuring less than 10 cm. Certain hernia features including defect size, intra-abdominal adhesions, and overlying scar/skin properties contribute to choosing an open versus a laparoscopic approach. This retrospective cohort study was designed to compare incisional hernia defects repaired with laparoscopic suture closure to a hybrid approach with open defect closure, both with laparoscopic intraperitoneal onlay mesh (IPOM) reinforcement.

METHODS

We identified 164 consecutive patients who underwent incisional hernia repair from two centers, North York General Hospital (NYGH) and Humber River Hospital (HRH) between 2015 and 2020. Patients were grouped by totally laparoscopic or hybrid fascial closure. Both techniques included laparoscopically placed intra-peritoneal mesh with 5 cm of overlap in all directions. Patients were analyzed by age, sex, body mass index (BMI), ASA class and hernia size. Primary outcomes included surgical site infection (SSI), other wound complications including seroma/hematoma, length of hospital stay, pain reported at follow-up appointment, and hernia recurrence.

RESULTS

Post-operative pain, surgical site infections and seromas did not differ between the totally laparoscopic and hybrid approach. The recurrence rates were 5.8% and 6.8% for the laparoscopic and hybrid group, respectively, which were not significantly different. The time to recurrence was 15 months (range 8-12) in the laparoscopic group and 7 months (range 6-36) in the hybrid group, also not significantly different. The hernia defect size and BMI were significantly higher in the hybrid group, without increased wound complications.

CONCLUSION

These results suggest that a hybrid approach to incisional ventral hernia repair with open defect closure is comparable to a totally laparoscopic closure. The hybrid technique can help facilitate fascial closure and resection of the hernia sac in patients with higher BMI and hernia defects up to 6 cm.