Total Syntheses of Phorbol and 11 Tigliane Diterpenoids and Their Evaluation as HIV Latency-Reversing Agents

Tigliane diterpenoids possess exceptionally complex structures comprising common 5/7/6/3-membered ABCD-rings and disparate oxygen functionalities. While tiglianes display a wide range of biological activities, compounds with HIV latency-reversing activity can eliminate viral reservoirs, thereby serving as promising leads for new anti-HIV agents. Herein, we report collective total syntheses of phorbol (13) and 11 tiglianes 14-24 with various acylation patterns and oxidation states, and their evaluation as HIV latency-reversing agents. The syntheses were strategically divided into five stages to increase the structural complexity. First, our previously established sequence enabled the expeditious preparation of ABC-tricycle 9 in 15 steps. Second, hydroxylation of 9 and ring-contractive D-ring formation furnished phorbol (13). Third, site-selective attachment of two acyl groups to 13 produced four phorbol diesters 14-17. Fourth, the oxygen functionalities were regio- and stereoselectively installed to yield five tiglianes 18-22. Fifth, further oxidation to the most densely oxygenated acerifolin A (23) and tigilanol tiglate (24) was realized through organizing a 3D shape of the B-ring. Assessment of the HIV latency-reversing activities of the 12 tiglianes revealed seven tiglianes (14-17 and 22-24) with 20- to 300-fold improved efficacy compared with prostratin (12), a representative latency-reversing agent. Therefore, the robust synthetic routes to a variety of tiglianes with promising activities devised in this study provide opportunities for advancing HIV eradication strategies.

Idiopathic Intracranial Hypertension with Disproportionately Enlarged Subarachnoid Space Hydrocephalus on Imaging

The pathophysiology of idiopathic intracranial hypertension (IIH) and idiopathic normal-pressure hydrocephalus (iNPH) differs in terms of cerebrospinal fluid (CSF) pressure and imaging-related characteristics. A 51-year-old man presented with optic nerve papillary edema, visual disturbance, bilateral abducens nerve palsy, and a wide-based gait. Imaging showed characteristic findings of IIH and disproportionately enlarged subarachnoid space hydrocephalus (DESH) - characteristic of iNPH. A CSF examination revealed marked CSF hypertension. IIH with iNPH-like imaging features (DESH) was diagnosed, and ventriculoperitoneal shunt surgery was performed. Postoperatively, the visual acuity and visual field improved. This report also describes the distinct and overlapping pathophysiological mechanisms of IIH and iNPH.

Visual Illusion Created by a Striped Pattern through Augmented Reality for the Prevention of Tumbling on Stairs

A fall on stairs can be a dangerous accident. An important indicator of falling risk is the foot clearance, which is the height of the foot when ascending stairs or the distance of the foot from the step when descending. We developed an augmented reality system with a holographic lens using a visual illusion to improve the foot clearance on stairs. The system draws a vertical striped pattern on the stair riser as the participant ascends the stairs to create the illusion that the steps are higher than the actual steps, and draws a horizontal striped pattern on the stair tread as the participant descends the stairs to create the illusion of narrower stairs. We experimentally evaluated the accuracy of the system and fitted a model to determine the appropriate stripe thickness. Finally, participants ascended and descended stairs before, during, and after using the augmented reality system. The foot clearance significantly improved, not only while the participants used the system but also after they used the system compared with before.

Identification of surgical forceps using YOLACT++ in different lighted environments

Forceps tracking in laparoscopic surgery contributes to improved surgical outcomes. We identified forceps using YOLACT++ for fast and accurate segmentation. Differences in the illumination of the environment can affect the image recognition accuracy in deep learning. Therefore, we examined the speed and accuracy of YOLACT++ forceps identification in different illuminated environments. We expected that this experiment would help us understand the optimal lighted environments for YOLACT++ and to further improve the performance of the forceps identification model. The greatest accuracy was obtained under a light-shielded environment with light shining only on the suture area. Although a laparotomy with a clear view of the surgical site is easier for the physician to operate in, we concluded that the forceps identification model of YOLACT++ can be used more effectively in the laparoscopic surgical environment.Clinical Relevance- This study contributes to analyzing the cause of surgical errors in laparoscopic surgery.

Combination design of drive mechanism considering delay of surgical robot

Surgical robots have contributed greatly to the development of minimally invasive surgery. However, these robots suffer from issues such as the looseness of wires acting as the robot's drive mechanism, and high maintenance cost. The objective of this study was to derive a combination of driving mechanisms other than wires that satisfies the required positional accuracy of a surgical robot. The robot operation trajectory was obtained using a virtual surgical simulator. Based on the operation trajectory obtained in the suture task experiment, the delay of each joint was virtually simulated, and the robot's position was calculated. The positions of the robot with and without delay were compared, and the drive mechanism combinations that satisfy the required positional accuracy were obtained. Thus, satisfactory accuracy was achieved when the alternative drive mechanism was properly placed.Clinical Relevance- This paper presents an accurate and low-maintenance surgical robot that uses few wires and alternative drive mechanisms.

Differences in coordination between dominant and non-dominant hands in tele-operation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023;2023:1-4. [PMID: 38083449 DOI: 10.1109/embc40787.2023.10340192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

The intuitive tele-operation of industrial robot arms is necessary for the teaching of autonomous movement. We developed a novel interface, namely the iFeel Desktop Haptic Device, for operating robots intuitively. However, when a user uses two interfaces with two hands, there are differences in coordination between the dominant and non-dominant hands. In this paper, we investigated the differences in coordination between dominant and non-dominant hands using two devices for the development of cooperative control. In an experiment, when the participants manipulated the two interfaces to operate a virtual tracking system, we measured the tracking error in each degree of freedom (i.e., X, Y, Z, pitch, yaw, and roll directions). The results show that there were significant differences between the dominant and non-dominant hands for movement in the X, Y, Z, and pitch directions. We conclude that the operations that involve more body parts have a greater difference between dominant and non-dominant hands.

An Intuitive Endoscope Operating System With an Interface Suitable for Cartesian Coordinate Input. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023;2023:1-4. [PMID: 38082852 DOI: 10.1109/embc40787.2023.10340632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Endoscopes are useful tools for inspecting and observing places that are inaccessible to humans and ordinary cameras. However, it is difficult to operate an endoscope intuitively because there is an embodiment difference between the endoscope and the human body. In this study, we developed an endoscope operating system that uses a Cartesian coordinate input interface. To investigate the range of movement achieving the required accuracy, we measured the actual movement of the endoscope tip using a magnetic three-dimensional positioning sensor. We compared the actual and estimated positions and postures at the endoscope tip and estimated the errors. The results showed that the error of the thrust output was sufficiently small. Furthermore, we can achieve the required accuracy in the range of movement from -74.9° to 80.0° in the roll direction, and from -37.5° to 50.0° in the yaw direction.Clinical relevance- This paper presents an accurate and intuitive endoscope operating system with a new interface.

Assessment of a karate performer's position estimation system without any markers

Karate has become more popular, and researches have been conducted on training methods and motion analysis related to karate. The AR system for karate is an effective system for training and for the audience to understand the performance. To develop the AR system, it is necessary to acquire the movement of the performer. The purpose of the research is to assess a motion capture system to estimate a karate performer's full-body position and posture from HoloLens 2, without wearing any attachments. We used ThreeDPoseUnityBarracuda to estimate the position and posture of the performer's joints. In the experiment, the estimated joint's positions were compared with actual positions using the inertial three-dimensional motion capture. As results, although the error increased when the performer's movement was large, the median error between the estimated and actual positions was a maximum of 0.24 m at the x-coordinate of the right hand, and high accuracy was obtained when the performer's movement was small.

Synthesis and Biological Evaluation of Simplified Ansellone Analogues with Lipophilic Side Chains as HIV-Latency-Reversing Agents

Structurally simplified analogues of ansellone A, in which the decalin skeleton is replaced with a lipophilic chain, were prepared and their HIV latency-reversing activities biologically evaluated. In particular, two analogues bearing ether and alkenyl side chains, respectively, showed comparable activities to that of ansellone A. Each of the simplified compounds was easily synthesised using Prins cyclisation chemistry.

Total Synthesis of Ansellone G and Phorbadione

The first total synthesis of marine sesterterpenoid ansellone G (2) was accomplished. This strategy utilizes the Prins cyclization reaction of a chloro-substituted homoallyl alcohol to synthesize the hydrobenzopyran skeleton. The preintroduction of the chloro groups facilitated the functional group transformation for 2 after constructing the carbon framework. Furthermore, we also successfully synthesized phorbadione (3) by dehydrating the tertiary alcohol. The HIV latency-reversing activity of the synthesized 2, 3, and deacetylated 2 was also evaluated.

Arginyl-tRNA-protein transferase 1 contributes to governing optimal stability of the human immunodeficiency virus type 1 core

Background

The genome of human immunodeficiency virus type 1 (HIV-1) is encapsulated in a core consisting of viral capsid proteins (CA). After viral entry, the HIV-1 core dissociates and releases the viral genome into the target cell, this process is called uncoating. Uncoating of HIV-1 core is one of the critical events in viral replication and several studies show that host proteins positively or negatively regulate this process by interacting directly with the HIV-1 CA.

Results

Here, we show that arginyl-tRNA-protein transferase 1 (ATE1) plays an important role in the uncoating process by governing the optimal core stability. Yeast two-hybrid screening of a human cDNA library identified ATE1 as an HIV-1-CA-interacting protein and direct interaction of ATE1 with Pr55^gag and p160^{gag − pol} via HIV-1 CA was observed by cell-based pull-down assay. ATE1 knockdown in HIV-1 producer cells resulted in the production of less infectious viruses, which have normal amounts of the early products of the reverse transcription reaction but reduced amounts of the late products of the reverse transcription. Interestingly, ATE1 overexpression in HIV-1 producer cells also resulted in the production of poor infectious viruses. Cell-based fate-of-capsid assay, a commonly used method for evaluating uncoating by measuring core stability, showed that the amounts of pelletable cores in cells infected with the virus produced from ATE1-knockdown cells increased compared with those detected in the cells infected with the control virus. In contrast, the amounts of pelletable cores in cells infected with the virus produced from ATE1-overexpressing cells decreased compared with those detected in the cells infected with the control virus.

Conclusions

These results indicate that ATE1 expression levels in HIV-1 producer cells contribute to the adequate formation of a stable HIV-1 core. These findings provide insights into a novel mechanism of HIV-1 uncoating and revealed ATE1 as a new host factor regulating HIV-1 replication.

Graphic abstract

Impact of visit-to-visit variability in blood pressure on coronary plaque as assessed by integrated backscatter intravascular ultrasound

Introduction

Visit-to-visit variability (VVV) in blood pressure (BP) has been reported to be a strong predictor of cardiovascular disease. However, the association of VVV in BP and coronary plaque composition has not been fully elucidated.

Purpose

The aim of this study was to examine the relationship between VVV in BP and the tissue characteristics of coronary plaques as assessed by integrated backscatter (IB) intravascular ultrasound (IVUS) in patients with coronary artery disease (CAD).

Methods

One hundred-two consecutive patients with CAD who underwent percutaneous coronary intervention (PCI) using IVUS, and who had at least six clinic visits a year before PCI were included. We measured systolic and diastolic BP (SBP and DBP) at each visit and determined VVV in BP expressed as the standard deviation of the average BP. Gray-scale and IB IVUS examinations were performed for the culprit lesion of a coronary artery just before PCI.

Results

There were no significant associations between the average SBP or DBP and various IVUS parameters. However, VVV in SBP was positively correlated with both the percentage of atheroma volume (PAV) (r=0.227, p=0.023) and percentage of lipid volume (PLV) (r=0.532, p<0.001). VVV in DBP was positively correlated with PLV (r=0.243, p=0.014), while there was no significant correlation between VVV in DBP and PAV. A multiple regression analysis showed that VVV in SBP was independently associated with PAV (p=0.036) and PLV (p<0.001).

Conclusions

Larger VVV in SBP was significantly associated with an increased plaque burden and lipid composition at the culprit lesion of a coronary artery in CAD patients. The improvement of VVV in SBP may contribute to the regression and stabilization of coronary plaques.

Figure 1

Funding Acknowledgement

Type of funding source: None

Different clinical features between left atrial and left atrial appendage thrombus: an insight into more than 16,000 transesophageal echography database

Background

Thrombosis localization inside the left atrium (LA) is very frequently in the left atrial appendage (LAA). Some cases show atrial thrombus outside LAA, whose characteristics have not well elucidated.

Purpose

To reveal the different clinical background between thrombus inside LAA and outside LAA in a large transesophageal echo (TEE) database.

Methods

We searched the TEE database over 8 years of our center to identify patients in whom LA thrombus was pointed out. After initial TEE imaging, LA thrombus was confirmed with repeated TEE by echocardiography specialist or other modality, such as CT images.

Results

In a consecutive 16,142 TEE cases, LA thrombus was suspected in 162 cases (1%), finally 38 cases were identified as LA thrombus. They were divided into two groups; LAA only group and outside LAA group. Atrial fibrillation was concomitant in 34 patients (89%). History of stroke was significantly higher in LAA group (46.2% vs 8.3%, p=0.03) and malignant tumor was significantly higher in outside LAA group (23.1% vs 58.3%, p=0.035). LA thrombus was the first symptom in 3 cases of outside LAA group, following by malignant tumor was newly detected. Oral anticoagulation was prescribed in 23 cases (61%) at TEE study, mostly treated with warfarin, and median 123 days later thrombus dissolution was confirmed in 21 cases (55%). During mean follow up of 893 days, 4 patients experienced ischemic stroke, but two of them were due to self-interruption.

Conclusion

Outside LAA thrombus is minor but more concomitant with malignant tumor. Physician must be aware that screening of cancer is important if outside LAA thrombus is detected.

Funding Acknowledgement

Type of funding source: None

Epidemiology of long-stay patients in the pediatric intensive care unit: prevalence, characteristics, resource consumption and complications

Background

The impact of pediatric intensive care unit (PICU) utilization and resource consumption among long-stay patients has not been characterized recently. This study aimed to describe the resource consumption and characteristics of long-stay patients in a PICU.

Methods

This was a single-center descriptive cohort study of 1309 patients admitted to a PICU in 2017. The main outcome was ICU length of stay (LOS). Patients were divided into prolonged LOS (PLS) and non-PLS groups if they had an LOS of ≥ 28 or < 28 days, respectively. Two groups were compared to characterize PLS.

Results

Thirty-two (2.4%) patients had a PLS and utilized 33% of PICU bed days. Factors associated with PLS with odds ratio [95% confidence interval (CI)] were being a neonate (7.8 [2.5-25.4], p = <0.001), being an infant (2.9 [1.0-9.0], p = 0.04), admission for a respiratory ailment (7.3 [1.6-44.2], p = 0.003), cardiovascular dysfunction (24.1 [4.8-152.1], p = <0.001), post-cardiac operation (8.0 [1.7-50.1], p = 0.003), post-cardiopulmonary arrest (22.8 [1.7-211.9], p = 0.01), and transfer from another facility (4.2 [1.8-10.7], p = 0.001). PLS patients developed more nosocomial infections and disproportionately received monitoring and therapeutic resources.

Conclusions

A PLS was associated with substantial PICU utilization and complication rates. Future studies should aim to alleviate both institutional and patient-related issues in the affected population harboring possible risk factors for PLS.

Abstract P4-02-05: Apocrine morphology and LAR molecular subtype predict prognosis of TNBC patients with residual disease after neoadjuvant chemotherapy

Background: TNBC molecular subtype classification updated by Lehmann et al. includes 4 subtypes: basal-like 1 and 2 (BL1), (BL2), mesenchymal (M), and luminal androgen receptor (LAR), and as a modifier of these subtypes, an Immunomodulatory (IM) gene expression signature. However, molecular subtypes have not been linked to morphological features of TNBC. Apocrine carcinoma has been proposed as a TNBC category that expresses androgen receptor. LAR-subtype TNBC has a poor response to neoadjuvant systemic therapy (NST). We hypothesized that defining the apocrine-featured TNBC by morphology and molecular subtype predict the prognosis of patients with residual disease after NST. Methods: We created the Pan-Pacific TNBC Consortium dataset, which contains paired samples of matched pre and post-NST TNBC tumors from 4 institutions. All patients received NST and didn't have a pathological complete response (pCR). Three pathologists examined hematoxylin and eosin-stained slides of 86 pre-NST samples and determined (1) the presence of apocrine differentiation, (2) the level of tumor-infiltrating lymphocytes (TILs), (3) the histological grade (HG), and (4) the rate of necrosis. These morphological features were compared among the subtypes. For a sample to be considered apocrine positive, apocrine differentiation had to be identified by 2 or more pathologists. Fisher's exact test was used to test the association of subtypes and morphological features. The log-rank test was used to compare disease-free survival (DFS). Results: Twelve of 24 (50%) apocrine-positive tumor samples were LAR subtype, and12 of 17 (70%) LAR-subtype tumor samples exhibited apocrine differentiation. The other subtypes showed following: BL1, 11/44 (25%); BL2, 0/7 (0%); M, 1/10 (10%); unclassified, 0/8 (0%). The median follow-up time was 22 months. In all populations, 2-year DFS rates were higher in patients with apocrine-positive tumors than in those whose tumors did not exhibit apocrine differentiation (P = .027; 2-year DFS, 85% vs 54%). The LAR subtype was also associated with lower HG, although LAR tumors had a similar prognosis to the other subtypes. In the combined analysis of subtypes and apocrine differentiation, patients with apocrine-positive LAR tumors had a higher 2-year DFS rate than did those with apocrine-negative LAR tumors (P = .044; 2-year DFS, 88% vs. 30%). However, patients with apocrine-positive BL1 tumors had no better DFS than did those with apocrine-negative BL1 tumors (P = .133). TIL levels and the presence of the IM signature were positively associated (P = .01), and apocrine differentiation positivity tended to be negatively associated with TIL level (P = .06). Neither TIL level nor IM signature was associated with survival. Conclusion: Apocrine differentiation was associated with the LAR subtype of TNBC and better prognosis in patients who did not have a pCR. The LAR subtype alone did not predict DFS; however, LAR tumors with apocrine differentiation had a better prognosis than did LAR tumors without apocrine differentiation. Using a combination of morphologic and genomic testing may be helpful in determining the prognosis of patients with apocrine-positive TNBC tumors who have residual disease after NST.

Citation Format: Masuda H, Miura S, Harano K, Wang Y, Hirota Y, Matsunaga Y, Lim B, Lucci A, Parinyanitikul N, Lee HJ, Gong G, Rao A, Seitz RS, Morris SW, Hout DR, Nakamura S, Tripathy D, Harada O, Krishnamurthy S, Ueno NT. Apocrine morphology and LAR molecular subtype predict prognosis of TNBC patients with residual disease after neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-02-05.

Design factors for determining the radula shape of Euhadra Peliomphala

Biomimetics present useful ideas for various product designs. However, most biomimetics only mimic the features of living organisms. It has not been clarified how a given shape is attained through natural selection. This paper presents the design factors that optimize the radula shape of Euhadra peliomphala. Clarifying the important design factors would help designers in solving several problems simultaneously in order to adapt to complicated and multi-functionalized design mechanisms. We measured the radula of Euhadra peliomphala by using a microscope and modeled the grinding/cutting force using the finite element analysis (FEA). We reproduced the natural selection using multi-objective genetic algorithm (MOGA). We compared the solutions when optimizing the radula shape using objective functions of each combination of stress, cutting force, abrasion, or volume. The results show that the solution obtained through two-objective optimization with stress and cutting force was the closest to the actual radula shape.

Using Brain Activation to Evaluate Arrangements Aiding Hand-Eye Coordination in Surgical Robot Systems

GOAL

To realize intuitive, minimally invasive surgery, surgical robots are often controlled using master-slave systems. However, the surgical robot's structure often differs from that of the human body, so the arrangement between the monitor and master must reflect this physical difference. In this study, we validate the feasibility of an embodiment evaluation method that determines the arrangement between the monitor and master. In our constructed cognitive model, the brain's intraparietal sulcus activates significantly when somatic and visual feedback match. Using this model, we validate a cognitively appropriate arrangement between the monitor and master.

METHODS

In experiments, we measure participants' brain activation using an imaging device as they control the virtual surgical simulator. Two experiments are carried out that vary the monitor and hand positions.

CONCLUSION

There are two common arrangements of the monitor and master at the brain activation's peak: One is placing the monitor behind the master, so the user feels that the system is an extension of his arms into the monitor; the other arranges the monitor in front of the master, so the user feels the correspondence between his own arm and the virtual arm in the monitor.

SIGNIFICANCE

From these results, we conclude that the arrangement between the monitor and master impacts embodiment, enabling the participant to feel apparent posture matches in master-slave surgical robot systems.

Portable and noise-tolerant magnetic field generation system

We have successfully developed a portable pulsed magnetic field generation system incorporating a number of techniques to avoid the effects of noise, including shielding, a self-power capability, and a high-capability semiconductor switch. The system fits into a cubical box less than 0.5 m in linear dimensions and can easily be installed in experimental facilities, including noisy environments such as high-power laser facilities. The system can generate a magnetic field of several tesla sustainable for several tens of microseconds over a spatial scale of several centimeters. In a high-power laser experiment with Gekko-XII, the system operated stably despite being subjected to a high level of electrical noise from laser shots of 600 J.