Antidepressant Exposure and DNA Methylation: Insights from a Methylome-Wide Association Study

Importance

Understanding antidepressant mechanisms could help design more effective and tolerated treatments.

Objective

Identify DNA methylation (DNAm) changes associated with antidepressant exposure.

Design

Case-control methylome-wide association studies (MWAS) of antidepressant exposure were performed from blood samples collected between 2006-2011 in Generation Scotland (GS). The summary statistics were tested for enrichment in specific tissues, gene ontologies and an independent MWAS in the Netherlands Study of Depression and Anxiety (NESDA). A methylation profile score (MPS) was derived and tested for its association with antidepressant exposure in eight independent cohorts, alongside prospective data from GS.

Setting

Cohorts; GS, NESDA, FTC, SHIP-Trend, FOR2107, LBC1936, MARS-UniDep, ALSPAC, E-Risk, and NTR.

Participants

Participants with DNAm data and self-report/prescription derived antidepressant exposure.

Main Outcomes and Measures

Whole-blood DNAm levels were assayed by the EPIC/450K Illumina array (9 studies, N exposed = 661, N unexposed = 9,575) alongside MBD-Seq in NESDA (N exposed = 398, N unexposed = 414). Antidepressant exposure was measured by self- report and/or antidepressant prescriptions.

Results

The self-report MWAS (N = 16,536, N exposed = 1,508, mean age = 48, 59% female) and the prescription-derived MWAS (N = 7,951, N exposed = 861, mean age = 47, 59% female), found hypermethylation at seven and four DNAm sites (p < 9.42x10 -8 ), respectively. The top locus was cg26277237 ( KANK1, p self-report = 9.3x10 -13 , p prescription = 6.1x10 -3 ). The self-report MWAS found a differentially methylated region, mapping to DGUOK-AS1 ( p adj = 5.0x10 -3 ) alongside significant enrichment for genes expressed in the amygdala, the "synaptic vesicle membrane" gene ontology and the top 1% of CpGs from the NESDA MWAS (OR = 1.39, p < 0.042). The MPS was associated with antidepressant exposure in meta-analysed data from external cohorts (N studies = 9, N = 10,236, N exposed = 661, f3 = 0.196, p < 1x10 -4 ).

Conclusions and Relevance

Antidepressant exposure is associated with changes in DNAm across different cohorts. Further investigation into these changes could inform on new targets for antidepressant treatments.

3 Key Points

Question: Is antidepressant exposure associated with differential whole blood DNA methylation?Findings: In this methylome-wide association study of 16,536 adults across Scotland, antidepressant exposure was significantly associated with hypermethylation at CpGs mapping to KANK1 and DGUOK-AS1. A methylation profile score trained on this sample was significantly associated with antidepressant exposure (pooled f3 [95%CI]=0.196 [0.105, 0.288], p < 1x10 -4 ) in a meta-analysis of external datasets. Meaning: Antidepressant exposure is associated with hypermethylation at KANK1 and DGUOK-AS1 , which have roles in mitochondrial metabolism and neurite outgrowth. If replicated in future studies, targeting these genes could inform the design of more effective and better tolerated treatments for depression.

An Automated Brain Metastasis Detection and Segmentation System from MRI with a Large Multi-Institutional Dataset

PURPOSE/OBJECTIVE(S)

Developments of automated systems for brain metastasis (BM) detection and segmentation from MRI for assisting early detection and stereotactic radiosurgery (SRS) have been reported but most based upon relatively small datasets from single institutes. This work aims to develop and evaluate a system using a large multi-institutional dataset, and to improve both identification of small/subtle BMs and segmentation accuracy of large BMs.

MATERIALS/METHODS

A 3D U-Net system was trained and evaluated to detect and segment intraparenchymal BMs with a size > 2mm using 1856 MRI volumes from 1791 patients treated with SRS from seven institutions (1539 volumes for training, 183 for validation, and 134 for testing). All patients had 3D post-Gd T1w MRI scans pre-SRS. Gross tumor volumes (GTVs) of BMs for SRS were curated by each institute first. Then, additional efforts were spent to create GTVs for the untreated and/or uncontoured BMs, including central reviews by two radiologists, to improve accuracy of ground truth. The training dataset was augmented with synthetic BMs of 3773 MRIs using a 3D generative pipeline. Our system consists of two U-Nets with one using small 3D patches dedicated for detecting small BMs and another using large 3D patches for segmenting large BMs, and a random-forest based fusion module for combining the two network outputs. The first U-Net was trained with 3D patches containing at least one BM < 0.1 cm3. For detection performance, we measured BM-level sensitivity and case-level false-positive (FP) rate. For segmentation performance, we measured BM-level Dice similarity coefficient (DSC) and 95-percentile Hausdorff distance (HD95). We also stratified performances based upon BM sizes.

RESULTS

For 739 BMs in the 134 testing cases, the overall lesion-level sensitivity was 0.870 with an average case-level FP of 1.34±1.92 (95% CI: 1.02-1.67). The sensitivity was >0.969 for the BMs >0.1 cm3, but dropped to 0.755 for the BMs < 0.1 cm3 (Table 1). The average DSC and HD95 for all detected BMs were 0.786 and 1.35mm. The worse performance for BMs > 20 cm3 was caused by a case with 83 cm3 GTV and artifacts in the MRI volume.

CONCLUSION

We achieved excellent detection sensitivity and segmentation accuracy for BMs > 0.1 cm3, and promising performance for small BMs (<0.1cm3) with a controlled FP rate using a large multi-institutional dataset. Clinical utility for assisting early detection and SRS planning will be investigated. Table 1: Per-lesion detection and segmentation performance stratified by individual BM size. N is the number of BMs in each category.

Measurements of neutrino oscillation parameters from the T2K experiment using 3.6×1021 protons on target

The T2K experiment presents new measurements of neutrino oscillation parameters using 19.7 ( 16.3 ) × 10 20 protons on target (POT) in (anti-)neutrino mode at the far detector (FD). Compared to the previous analysis, an additional 4.7 × 10 20 POT neutrino data was collected at the FD. Significant improvements were made to the analysis methodology, with the near-detector analysis introducing new selections and using more than double the data. Additionally, this is the first T2K oscillation analysis to use NA61/SHINE data on a replica of the T2K target to tune the neutrino flux model, and the neutrino interaction model was improved to include new nuclear effects and calculations. Frequentist and Bayesian analyses are presented, including results on sin 2 θ 13 and the impact of priors on the δ CP measurement. Both analyses prefer the normal mass ordering and upper octant of sin 2 θ 23 with a nearly maximally CP-violating phase. Assuming the normal ordering and using the constraint on sin 2 θ 13 from reactors, sin 2 θ 23 = 0 . 561 - 0.032 + 0.021 using Feldman-Cousins corrected intervals, and Δ m 32 2 = 2 . 494 - 0.058 + 0.041 × 10 - 3 eV 2 using constant Δ χ 2 intervals. The CP-violating phase is constrained to δ CP = - 1 . 97 - 0.70 + 0.97 using Feldman-Cousins corrected intervals, and δ CP = 0 , π is excluded at more than 90% confidence level. A Jarlskog invariant of zero is excluded at more than 2 σ credible level using a flat prior in δ CP , and just below 2 σ using a flat prior in sin δ CP . When the external constraint on sin 2 θ 13 is removed, sin 2 θ 13 = 28 . 0 - 6.5 + 2.8 × 10 - 3 , in agreement with measurements from reactor experiments. These results are consistent with previous T2K analyses.

First Dark Matter Search with Nuclear Recoils from the XENONnT Experiment

We report on the first search for nuclear recoils from dark matter in the form of weakly interacting massive particles (WIMPs) with the XENONnT experiment, which is based on a two-phase time projection chamber with a sensitive liquid xenon mass of 5.9 ton. During the (1.09±0.03)  ton yr exposure used for this search, the intrinsic ^{85}Kr and ^{222}Rn concentrations in the liquid target are reduced to unprecedentedly low levels, giving an electronic recoil background rate of (15.8±1.3)  events/ton yr keV in the region of interest. A blind analysis of nuclear recoil events with energies between 3.3 and 60.5 keV finds no significant excess. This leads to a minimum upper limit on the spin-independent WIMP-nucleon cross section of 2.58×10^{-47}  cm^{2} for a WIMP mass of 28  GeV/c^{2} at 90% confidence level. Limits for spin-dependent interactions are also provided. Both the limit and the sensitivity for the full range of WIMP masses analyzed here improve on previous results obtained with the XENON1T experiment for the same exposure.

Searching for Heavy Dark Matter near the Planck Mass with XENON1T

Multiple viable theoretical models predict heavy dark matter particles with a mass close to the Planck mass, a range relatively unexplored by current experimental measurements. We use 219.4 days of data collected with the XENON1T experiment to conduct a blind search for signals from multiply interacting massive particles (MIMPs). Their unique track signature allows a targeted analysis with only 0.05 expected background events from muons. Following unblinding, we observe no signal candidate events. This Letter places strong constraints on spin-independent interactions of dark matter particles with a mass between 1×10^{12} and 2×10^{17}  GeV/c^{2}. In addition, we present the first exclusion limits on spin-dependent MIMP-neutron and MIMP-proton cross sections for dark matter particles with masses close to the Planck scale.

[Feasibility and safety of transseptal transcatheter mitral valve replacement for severe mitral regurgitation]

A prospective, single-center, single-arm, and open-design study was performed to evaluate the feasibility and safety of transseptal transcatheter mitral valve replacement in the treatment of severe mitral regurgitation. Patients with symptomatic moderate-severe or severe mitral regurgitation at high-surgical risk and anatomically appropriate for the HighLife transseptal mitral valve replacement (TSMVR) system in West China Hospital, Sichuan University from December 2021 to August 2022 were enrolled. Four patients (1 male and 3 females) with severe mitral regurgitation were included, with a median age of 68.5 (64.0-77.0) years and a median Society of Thoracic Surgeons (STS) score of 8.1% (6.4%-8.9%). Technical success was achieved in all the patients. There was no residual mitral regurgitation, paravalvular leakage, or left ventricular outflow tract obstruction. Three major cardiovascular and cerebrovascular adverse events occurred within 30 days after the procedure, including ventricular tachycardia, iatrogenic atrial septal defect closure, and heart failure readmission. The current study preliminarily demonstrates that transcatheter mitral valve replacement using the HighLife system via the transseptal approach for severe mitral regurgitation is feasible and relatively safe.

[Study on the relationship between the age at natural menopause and postmenopausal metabolic syndrome]

To explore the relationship between the early or delayed age at natural menopause and metabolic syndrome (MS) in women. A total of 4 734 natural menopausal women who completed the baseline survey from November 2017 to January 2020 in the Guangzhou Middle-aged and Elderly Chronic Disease Prospective Cohort Study were selected in this cross-sectional study. Data on general demographic characteristics, disease history and female physiological health indicators were collected. Logistic regression model and restricted cubic spline curve were used to analyze the relationship between the age at natural menopause and MS. The results showed that the mean age of the subjects was (60±6) years old. The median (Q₁,Q₃) age at natural menopause was 50 (49, 52) years old, and the prevalence of MS was 14.8%(699/4 734). After adjusting for confounders, the age at natural menopause was closely related to MS in an approximate"U"shape. Compared with the group of normal age at natural menopause, the early age at menopause (OR=1.52, 95%CI: 1.12-2.06) and delayed age at menopause (OR=1.77, 95%CI: 1.36-2.30) had a higher risk of MS. In the group with time since menopause ≤6 years and 7-9 years, the risk of MS in the group with delayed age at menopause was 2.40 times (95%CI: 1.54-3.75) and 2.19 times (95%CI: 1.11-4.31) higher than that in the group with normal menopausal age, respectively. In conclusion, the early and delayed age at natural menopause increased the risk of MS. The increased risk of MS in delayed age at natural menopause mainly occurred within 10 years since menopause.

[Immunogenicity of group A+C meningococcal polysaccharide conjugate vaccine in infants: A phase Ⅲ clinical trial study]

Objective: To evaluate the immunogenicity of group A+C meningococcal polysaccharide conjugate vaccine in infants under 2 years old. Methods: From March 2017 to June 2018, 1 932 healthy infants in Biyang County, Henan Province, who were not vaccinated with meningococcal meningitis vaccine and whose axillary temperature was ≤37.0 ℃, were recruited as participants. The 3 months and 6-11 months old infants were allocated to the experiment group and the control group in a ratio of 1∶1. Infants aged 12-23 months were allocated to the 1-dose group, the 2-dose group and the control group in a ratio of 1∶1∶1, with 276 infants in each group. The infants in the experiment group were intramuscularly injected with freeze-dried group A+C meningococcal polysaccharide conjugate vaccine to be evaluated, and infants in the control group received intramuscular injection of commercially available freeze-dried group A+C meningococcal conjugate vaccine. The venous blood of infants was collected 30 days before the first dose and after the last dose of inoculation, and the antibody seroconversion of each group was determined and compared. Results: The completion rate of immunogenicity study was 95.2% (1 839/1 932). Before inoculation, there was no statistical difference in the geometric mean titer and positive rate of group A+C antibodies between the experiment group and the control group in 3 months and 6-11 months old infants (all P values >0.05). The geometric mean titers and positive rate of group A antibodies in the 1-dose group were higher than those in the control group (all P values <0.05), but there was no statistical difference between the 2-dose group and the control group (all P values >0.05) in infants aged 12-23 months. After inoculation, the differences (95%CI) in the positive conversion rate of group A+C antibodies between the experiment group and the control group were -0.12% (-6.01%-5.77%) and 0.82% (-4.23%-5.86%) in the 3 months old infants. At the age of 6-11 months, the differences were 6.75% (1.71%-11.79%) and -4.32% (-8.73%-0.08%), respectively. At the age of 12-23 months, the differences were 1.02% (-3.80%-5.83%) and -4.40% (-7.79%- -1.01%) in the 2-dose group and -7.22% (-12.90%- -1.54%) and -18.61% (-23.75%- -13.46%) in the 1-dose group, respectively. The geometric mean titers of group A+C antibodies in the 3 months old infants were 48.50 and 63.12, respectively, which had no significant difference from the control group (43.02 and 57.99, respectively) (both P values <0.05). The geometric mean titers of group A+C antibodies in the 6-11 months and 12-23 months old infants were 84.09 and 92.51 (2-dose group), which were higher than those in the corresponding control group (43.10 and 61.83, respectively) (all P values <0.001). Conclusion: Group A+C meningococcal conjugate vaccine has good immunogenicity in infants under 2 years old.

Tracking the 2022 Hunga Tonga-Hunga Ha'apai Aerosol Cloud in the Upper and Middle Stratosphere Using Space-Based Observations

On 15 January 2022, the submarine Hunga Tonga volcanic eruption lofted materials high into the upper stratosphere, reaching a record-breaking altitude of ∼58 km, unprecedented in the satellite observations era. Within two weeks, the bulk of the injected material circulated the globe between 20-30 km altitude, as observed by satellite instruments. We estimate that the stratospheric aerosol optical depth (sAOD) is the largest since the Pinatubo eruption and is at least twice as great as the sAOD after the 2015 Calbubo eruption despite the similar SO₂ injection from that eruption. We use space-based observations to monitor the Hunga-Tonga volcanic plume evolution and transport at different altitudes as it circulates the globe. While the main aerosol layer remains trapped in the tropical pipe, small parts have already made it to both the northern and southern hemisphere poles by April, which is almost certain to influence this year's ozone hole.

Search for New Physics in Electronic Recoil Data from XENONnT

We report on a blinded analysis of low-energy electronic recoil data from the first science run of the XENONnT dark matter experiment. Novel subsystems and the increased 5.9 ton liquid xenon target reduced the background in the (1, 30) keV search region to (15.8±1.3)  events/(ton×year×keV), the lowest ever achieved in a dark matter detector and ∼5 times lower than in XENON1T. With an exposure of 1.16 ton-years, we observe no excess above background and set stringent new limits on solar axions, an enhanced neutrino magnetic moment, and bosonic dark matter.

Photodynamic therapy in a pleural cavity using monte carlo simulations with 2D/3D Graphical Visualization

Cancer therapy using Photodynamic Therapy (PDT) has been investigated for some time [1,2] and now it is a growing area of interest in clinical trials [3]. Monte Carlo (MC) simulations were used for early laboratory studies [4,5] for analysis in PDT. Various improvements in the MC method have advanced the field in recent years.

Material radiopurity control in the XENONnT experiment

The selection of low-radioactive construction materials is of the utmost importance for rare-event searches and thus critical to the XENONnT experiment. Results of an extensive radioassay program are reported, in which material samples have been screened with gamma-ray spectroscopy, mass spectrometry, and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{222}$$\end{document}222Rn emanation measurements. Furthermore, the cleanliness procedures applied to remove or mitigate surface contamination of detector materials are described. Screening results, used as inputs for a XENONnT Monte Carlo simulation, predict a reduction of materials background (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\sim $$\end{document}∼17%) with respect to its predecessor XENON1T. Through radon emanation measurements, the expected \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{222}$$\end{document}222Rn activity concentration in XENONnT is determined to be 4.2 (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{+0.5}_{-0.7}$$\end{document}-0.7+0.5) \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\upmu $$\end{document}μBq/kg, a factor three lower with respect to XENON1T. This radon concentration will be further suppressed by means of the novel radon distillation system.

[Outcomes and prognosis of radical surgery in patients with stageⅠb2 and Ⅱa2 cervical squamous cell carcinoma]

Objective: To evaluate the survival, complications and prognostic factors in patients with stageⅠb2 and Ⅱa2 cervical squamous cell carcinoma treated by primarily radical surgery with or without postoperative adjuvant therapy. Methods: The clinical and pathological data of patients with stageⅠb2 and Ⅱa2 cervical squamous cell carcinoma treated in the Cancer Hospital of the University of Chinese Academy of Sciences from January 2015 to January 2018 were retrospectively analyzed. All patients underwent Querleu-Morrow classification (Q-M classification) C2 radical surgery, including extensive hysterectomy+pelvic lymphadenectomy with or without adjuvant therapy based on postoperative risk factors. Survival rate was calculated by Kaplan-Meier method and survival curve was drawn. Univariate analysis was performed by using the log-rank test to analyze the clinicopathological factors related to the prognosis of patients. Multivariate analysis was performed by using Cox regression method to analyze independent risk factors affecting survival prognosis. Results: (1) The median age of 643 patients with cervical squamous cell carcinoma was 50 years old (45-58 years old). Clinical stage: 260 cases (40.4%, 260/643) of stage Ⅰb2, 383 cases (59.6%, 383/643) of stage Ⅱa2. (2) Among 643 cases underwent Q-M classification C2 surgery, 574 cases (89.3%, 574/643) of them received adjuvant therapy and 184 cases (28.6%, 184/643) of them had grade 3-4 complications after treatment, including 134 cases (20.8%, 134/643) early complications and 66 cases (10.3%, 66/643) late complications. The incidence of grade 3-4 complications in 574 patients received postoperative adjuvant therapy was 30.1% (173/574), which was significantly different from that in 69 patients who received surgery alone (15.9%, 11/69; χ²=6.08, P=0.014). (3) All 643 cases were followed up, and the median follow-up time was 40 months (3-76 months). During the follow-up period, 117 cases (18.2%, 117/643) recurred, including 45 cases (7.0%, 45/643) of local recurrence, 54 cases (8.4%, 54/643) of distant metastasis, and 18 cases (2.8%, 18/643) of local recurrence and distant metastasis. The 5-year progression-free survival (PFS) and 5-year overall survival (OS) rates of patients with stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma were 79.9% and 85.5%, respectively. Univariate analysis showed that pelvic lymph node metastasis, para-aortic lymph node metastasis, deep stromal infiltration, and lymph-vascular space invasion were significantly associated with 5-year PFS in patients with stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma (all P<0.05). The maximum diameter of tumor, pelvic lymph node metastasis and para-aortic lymph node metastasis were significantly associated with the 5-year OS of cervical squamous cell carcinoma in stages Ⅰb2 and Ⅱa2 (all P<0.05). Multivariate analysis showed that pelvic lymph node metastasis and para-aortic lymph node metastasis were independent factors affecting 5-year PFS and 5-year OS in patients with stage Ⅰb2 and Ⅱa2 cervical squamous cell carcinoma (all P<0.01). Conclusion: Radical surgery is a feasible and effective primary treatment for stagesⅠb2 and Ⅱa2 cervical squamous cell carcinoma, with a high 5-year survival rate and an acceptable complication rate.

[Primary ovarian squamous cell carcinoma: clinicopathological features and prognostic analysis of fifteen cases]

Objective: To assess the clinical features and treatment outcomes in patients with primary ovarian squamous cell carcinoma (POSCC). Methods: Fifteen patients with primary ovarian squamous cell carcinoma diagnosed from January 2009 to December 2018 in Cancer Hospital of the University of Chinese Academy of Sciences were collected. The expression of p16, hMLH1, hMSH2, hMSH6 and PMS2 in POSCC was detected by immunohistochemistry, and the status of high-risk human papillomavirus (HPV) by RNAscope test. Results: Squamous cell carcinoma with different degrees of differentiation was found in 15 cases, including three cases with high differentiation and 12 cases with medium to low differentiation. There were four cases with in situ squamous cell carcinoma, four cases with teratoma, one case with endometrial carcinoma/atypical hyperplasia, and one case with endometriosis. p16 was expressed in five cases (5/15), indicating coexisting high-risk HPV infection. There was no high-risk HPV infection in the remaining 10 cases, and p16 staining was negative. There was no deficient mismatch repair protein in all cases. The overall survival time (P=0.038) and progression free survival (P=0.045) of patients with high-risk HPV infection were longer than those without HPV infection. Conclusions: POSCC is more commonly noted in postmenopausal women and often occurs unilaterally. Elevated serological indexes CA125 and SCC are the most common finding. Morphologically, the tumors show variable degrees of differentiation, but the current data suggest that the degree of differentiation cannot be used as an independent prognostic index. High-risk HPV infection may be associated with the occurrence of POSCC, and that the prognosis of POSCC patients with HPV infection is better than that of patients without infection.

Atoms to fibers: Identifying novel processing methods in the synthesis of pitch-based carbon fibers

Understanding and optimizing the key mechanisms used in the synthesis of pitch-based carbon fibers (CFs) are challenging, because unlike polyacrylonitrile-based CFs, the feedstock for pitch-based CFs is chemically heterogeneous, resulting in complex fabrication leading to inconsistency in the final properties. In this work, we use molecular dynamics simulations to explore the processing and chemical phase space through a framework of CF models to identify their effects on elastic performance. The results are in excellent agreement with experiments. We find that density, followed by alignment, and functionality of the molecular constituents dictate the CF mechanical properties more strongly than their size and shape. Last, we propose a previously unexplored fabrication route for high-modulus CFs. Unlike graphitization, this results in increased sp³ fraction, achieved via generating high-density CFs. In addition, the high sp³ fraction leads to the fabrication of CFs with isometric compressive and tensile moduli, enabling their potential applications for compressive loading.

Printing Air-Stable High-Tc Molecular Magnet with Tunable Magnetic Interaction

High-T_c molecular magnets have amassed much promise; however, the long-standing obstacle for its practical applications is the inaccessibility of high-temperature molecular magnets showing dynamic and nonvolatile magnetization control. In addition, its functional durability is prone to degradation in oxygen and heat. Here, we introduce a rapid prototyping and stabilizing strategy for high T_c (360 K) molecular magnets with precise spatial control in geometry. The printed molecular magnets are thermally stable up to 400 K and air-stable for over 300 days, a significant improvement in its lifetime and durability. X-ray magnetic circular dichroism and computational modeling reveal the water ligands controlling magnetic exchange interaction of molecular magnets. The molecular magnets also show dynamical and reversible tunability of magnetic exchange interactions, enabling a colossal working temperature window of 86 K (from 258 to 344 K). This study provides a pathway to flexible, lightweight, and durable molecular magnetic devices through additive manufacturing.

Mechanism of cadmium tolerance in Salicornia europaea at optimum levels of NaCl

Many saline-alkali soils around the world are polluted by the heavy metal Cd, restricting the development of agriculture and ecology in those regions. The halophyte Salicornia europaea L. is capable of growing healthily in Cd-contaminated saline-alkali soil, suggesting that the species is tolerant to stress caused by both salt and heavy metals. In this study, the mechanism of Cd tolerance in this species was explored under 200 mM NaCl. Flame spectrophotometric assays for ions content and spectrophotometric for organic soluble substances, antioxidant enzyme activity, phytochelatins (PCs) content and phytochelatin synthase (PCS) activity, the photosynthetic parameters by portable photosynthesis measurement system, genes expression by qRT-PCR analysis were carried out. Cd treatment significantly decreased the dry weight, photosynthetic rate, K⁺ , Zn²⁺ , and Fe^2+/3+ content, while significantly increasing Na⁺ and Cd⁺ , soluble organic matter, and reactive oxygen species (ROS) levels. Compared with Cd treatment at 0 mM NaCl, Cd treatment at 200 mM NaCl significantly increased dry weight and photosynthetic rate while significantly decreasing ROS content through increased antioxidant enzyme activity. When exposed to Cd stress, treatment with 200 mM NaCl significantly increased PCs content and PCS activity and up-regulated the expression of the phytochelatin synthase genes CDA1 and PCS1 were, thereby increasing resistance to Cd. NaCl treatment increases the tolerance of S. europaea to the heavy metal Cd by growing rapidly, reducing the quantity of Cd²⁺ from entering the plant shoots, increasing the levels of PCs that chelate Cd²⁺ , thereby reducing its toxicity.

Evaluation of the Accuracy of Six Simple Screening Tools for Sarcopenia in Schizophrenic Patients

OBJECTIVES

Our objective was to evaluate if SARC-F, SARC-CalF, SARC-F-EBM, calf circumference (CC), mid-upper-arm circumference (MUAC) and Ishii test can be used to accurately screen for sarcopenia in schizophrenic patients.

METHOD

We enrolled schizophrenic patients aged 50 or older, who were regularly taking antipsychotic medications, at two mental health centres. Bioimpedance-based muscle-mass was analysed with an InBody 770 instrument, while muscle strength was measured with a digital grip-strength dynamometer. The physical performance of the patients was gauged from their gait speed over 6 m. Standard AWGS2019 diagnostic criteria were used, and the accuracies of the six screening methods were indicated by the sensitivity, negative predictive value (NPV), and area under receiver operating characteristic curve (AUC).

RESULTS

A total of 339 stable schizophrenic patients were enrolled. The overall prevalence of sarcopenia was 53.1%, and the prevalence was 55.6% and 47.66%, respectively, for males and females. The prevalence of sarcopenia obesity in the total population was 16.22%, and that of males and females was 18.97% and 10.28%, respectively. The SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test sensitivity/NPV in screening for sarcopenia were 41.86%/0.52, 79.07%/0.7, 28.68%/0.51, 78.3%/0.71, 76.74%/0.7, 89.92%/0.84, respectively, in males and 45.1%/0.59, 94.12%/0.91, 54.9%/0.7, 92.16%/60.91, 74.51%/0.77, 96.08%/0.94, respectively, in females. In males, the AUCs of the SARC-F, SARC-CalF, SARC-F-EBM, CC, MUAC and Ishii test were 0.601 (95%CI, 0.528-0.673), 0.754 (95%CI,0.69-0.817), 0.657 (95%CI,0.588-0.727), 0.8 (95%CI, 0.744-0.856), 0.781 (95%CI, 0.721-0.84) and 0.88 (95%CI, 0.837-0.922), respectively, and in females, they were 0.587(95%CI,0.479-0.696), 0.794 (95%CI,0.709-0.878), 0.799 (95%CI,0.71-0.888), 0.893 (95%CI, 0.833-0.953), 0.843 (95%CI, 0.772-0.915) and 0.855 (95%CI, 0.784-0.926), respectively.

CONCLUSION

The prevalence of sarcopenia in schizophrenic patients is high. Clinical doctors should screen for sarcopenia in schizophrenic patients and provide timely interventions to reduce the occurrence of adverse events. The above six tools can be used as screening tools, and the Ishii test is the most suitable for screening.

Association between the Severity of Sarcopenia and Pneumonia in Patients with Stable Schizophrenia: A Prospective Study

OBJECTIVES

This study investigates the associations between the severity of sarcopenia and pneumonia in patients with stable schizophrenia.

MATERIALS AND METHODS

This is a prospective study that includes patients from the rehabilitation wards of two mental health centres in western China, who were diagnosed with stable schizophrenia. Baseline data were collected from these patients between September 1 and September 30, 2020, while patients' data associated with pneumonia, diagnosed and treated by clinicians, were collected between October 2020 and October 2021. The severity of sarcopenia was diagnosed according to the diagnostic criteria defined by the Asian Working Group for Sarcopenia (AWGS) 2019. The association between the severity of sarcopenia and pneumonia in patients with schizophrenia was analyzed with the use of logistic regression analysis.

RESULTS

Three hundred and thirty-five patients with stable schizophrenia were enrolled in the prospective study, among whom 242 (72.24%) were≥60 years old, and 229 (68.36%) were males. Among the patients with stable schizophrenia, 130 (38.8%) were diagnosed with non-severe sarcopenia, whereas 47 (14.0%) had severe sarcopenia. Eighty-two (24.5%) of patients with schizophrenia fought pneumonia. Our study showed that the severe sarcopenia group had the highest incidence of pneumonia, followed by the non-severe sarcopenia group (severe sarcopenia vs. non-severe sarcopenia vs. normal, 38.3% vs. 28.46% vs. 17.09%, p=0.005). Compared with the normal group, the non-severe sarcopenia group (OR=1.93, 95%CI: 1.1-3.389) and the severe sarcopenia group (OR=3.011, 95%CI: 1.467-6.183) had a higher risk of pneumonia. We further adjusted the potential confounders such as sex, smoking history, chronic obstructive pulmonary disease (COPD), Patient Health Questionnaire (PHQ-9) score, and benzhexol and confirmed that only the severe sarcopenia group had an increased risk of pneumonia (OR=2.366, 95%CI: 1.078-5.191).

CONCLUSIONS

We have demonstrated that severe sarcopenia was associated with pneumonia in patients diagnosed with stable schizophrenia.

Screening and Understanding Li Adsorption on Two-Dimensional Metallic Materials by Learning Physics and Physics-Simplified Learning

Understanding and broad screening Li interaction energetics with surfaces are key to the development of materials for a wide range of applications including Li-based electrochemical capacitors, Li sensors, Li separation membranes, and Li-ion batteries. In this work, we build a high-throughput screening scheme to screen Li adsorption energetics on 2D metallic materials. First, density functional theory and graph convolution networks are utilized to calculate the minimum Li adsorption energies for some 2D metallic materials. The data is then used to find a dependence of the minimum Li adsorption energies on the sum of ionization potential, work function of the 2D metal, and coupling energy between Li⁺ and substrate, and the dependence is used to screen all 2D metallic materials. Physics-simplified learning by splitting the property into different contributions and learning or calculating each component is shown to have higher accuracy and transferability for machine learning of complex materials properties.

Laser-Induced Cooperative Transition in Molecular Electronic Crystal

The competing and non-equilibrium phase transitions, involving dynamic tunability of cooperative electronic and magnetic states in strongly correlated materials, show great promise in quantum sensing and information technology. To date, the stabilization of transient states is still in the preliminary stage, particularly with respect to molecular electronic solids. Here, a dynamic and cooperative phase in potassium-7,7,8,8-tetracyanoquinodimethane (K-TCNQ) with the control of pulsed electromagnetic excitation is demonstrated. Simultaneous dynamic and coherent lattice perturbation with 8 ns pulsed laser (532 nm, 15 MW cm^-2 , 10 Hz) in such a molecular electronic crystal initiates a stable long-lived (over 400 days) conducting paramagnetic state (≈42 Ωcm), showing the charge-spin bistability over a broad temperature range from 2 to 360 K. Comprehensive noise spectroscopy, in situ high-pressure measurements, electron spin resonance (ESR), theoretical model, and scanning tunneling microscopy/spectroscopy (STM/STS) studies provide further evidence that such a transition is cooperative, requiring a dedicated charge-spin-lattice decoupling to activate and subsequently stabilize nonequilibrium phase. The cooperativity triggered by ultrahigh-strain-rate (above 10⁶ s^{- 1} ) pulsed excitation offers a collective control toward the generation and stabilization of strongly correlated electronic and magnetic orders in molecular electronic solids and offers unique electro-magnetic phases with technological promises.

What is an appropriate caesarean delivery rate for China: a multicentre survey

Objective

To assess the current status of caesarean delivery (CD) in China, propose reference CD rates for China overall, and by regions, investigate the main indications for CDs and identify possible areas for safe reduction.

Design

A multicentre cross‐sectional study.

Setting

A total of 94 hospitals across 23 provinces in China.

Population

A total of 73 977 randomly selected deliveries.

Methods

We used a modified Robson classification to characterise CDs in subgroups and by regions, and the World Health Organization (WHO) C‐Model to calculate reference CD rates.

Main outcome measures

CD rates in China.

Results

In 2015–2016, the overall CD rate in China was 38.9% (95% CI 38.6–39.3%). Considering the obstetric characteristics of the population, the multivariable model‐based reference CD rate was estimated at 28.5% (95% CI 28.3–28.8%). Accordingly, an absolute reduction of 10.4% (or 26.7% relative reduction) may be considered. The CD rate varied substantially by region. Previous CD was the most common indication in all regions, accounting for 38.2% of all CDs, followed by maternal request (9.8%), labour dystocia (8.3%), fetal distress (7.7%) and malpresentation (7.6%). Overall, 12.7% of women had prelabour CDs, contributing to 32.8% of the total CDs.

Conclusions

Nearly 39% of births were delivered by caesarean in China but a reduction of this rate by a quarter may be considered attainable. Repeat CD contributed more than one‐third of the total CDs. Given the large variation in maternal characteristics, region‐specific or even hospital‐specific reference CD rates are needed for precision management of CD.

Tweetable abstract

The caesarean rate in 2015–2016 in China was 38.9%, whereas the reference rate was 28.5%.

The caesarean rate in 2015–2016 in China was 38.9%, whereas the reference rate was 28.5%.

Linked article This article is commented on by M Varner, p. 148 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16953.

P14.76 Bevacizumab (BEV) alone or in combination with chemotherapy in recurrent Glioblastoma Multiforme (GBM): A real world experience

BACKGROUND

Patients with glioblastoma multiforme (GBM) have a median survival of about 14 months. In recurrent GBM no active intervention has shown improvement in survival. Clinical trials has shown that bevacizumab (BEV) alone or in combination with chemotherapy is associated with better progression free survival (PFS). The current study aims to assess efficacy of BEV in real-world setting.

MATERIAL AND METHODS

Population-based retrospective cohort study patients with recurrent GBM diagnosed in the province of Saskatchewan during 2008–2018 and received BEV alone or in combination with chemotherapy were evaluated. Survival was compared with historic control.

RESULTS

43 eligible patients with GBM treated with BEV with or without chemotherapy. 25 patients were treated with Bev alone and 18 patients treated with chemotherapy+ BEV. Median age of the patients were noted to be 53 years. 28 male, and 15 female. 80% of patients treated with single agent BEV had a performance status of either 2 or 3 compared to 33% of patient treated with BEV+ chemotherapy.

Median PFS was 4.6 months with 95% CI 2.9–6.9. Median Overall survival (OS) from the time of diagnosis was 17.5 month. Median OS from the time of start of BEV was 5.4 months with 95% CI 3.4–6.8. Partial response (PR) was noted in 3 patients (7%) with stable disease (SD) in 6 patients (14%). 33 (77%) had progressive disease (PD). We were unable to confirm response status in one patient (2%). No statistically significant difference in response rate for patients treated with BEV and BEV+ Chemotherapy. From the start of Bev to the best response, 11 patients (30.56%) noted decrease in the dose of steroids, 14 patients (38.89%) dose remained unchanged. 7 patients (19.44%) required increase in the dose of steroids. 4 patients (11.11%) were not on steroids. For 7 patients we did not have the information on use of steroids. PFS was better for patients treated with chemotherapy + BEV with median PFS of 6.9 months, 95% CI 3.2- 22.3 verses BEV alone with median PFS 3.53 months 95% CI 1.4–5.3, P-value 0.0449. The Cox regression model for PFS to test comparing Bev with chemotherapy vs. Bev alone with the co-variables of sex, age, and ECOG performance status (PS). The model showed that patient with higher ECOG PS were noted to have inferior PFS with a Hazard ratio of 1.92 95% CI 1.09–3.37. P value of 0.2. Patient treated with BEV+ chemo had better PFS with a HR of 6.44 95% CI 1.86–22.28. P value of 0.003.

CONCLUSION

Retrospective real world study confirms that, patients with recurrent GBM, treatment with BEV is associated with similar PFS as reported in literature. Our study showed similar overall survival from the diagnosis compared to historic control. However the Median OS from Start of BEV was noted to be inferior to what is reported in EORTC EH1.3. Better ECOG performance status is associated with better PFS. Higher number of patients with ECOG 2 and 3 received BEV alone.

High-Pressure-Sintering-Induced Microstructural Engineering for an Ultimate Phonon Scattering of Thermoelectric Half-Heusler Compounds

Thermal management is of vital importance in various modern technologies such as portable electronics, photovoltaics, and thermoelectric devices. Impeding phonon transport remains one of the most challenging tasks for improving the thermoelectric performance of certain materials such as half-Heusler compounds. Herein, a significant reduction of lattice thermal conductivity (κ_L ) is achieved by applying a pressure of ≈1 GPa to sinter a broad range of half-Heusler compounds. Contrasting with the common sintering pressure of less than 100 MPa, the gigapascal-level pressure enables densification at a lower temperature, thus greatly modifying the structural characteristics for an intensified phonon scattering. A maximum κ_L reduction of ≈83% is realized for HfCoSb from 14 to 2.5 W m^-1 K^-1 at 300 K with more than 95% relative density. The realized low κ_L originates from a remarkable grain-size refinement to below 100 nm together with the abundant in-grain defects, as determined by microscopy investigations. This work uncovers the phonon transport properties of half-Heusler compounds under unconventional microstructures, thus showing the potential of high-pressure compaction in advancing the performance of thermoelectric materials.

MiR-4429 suppresses the malignant development of ovarian cancer by targeting YOD1

OBJECTIVE

The purpose of this study was to assess the clinical significance of microRNA-4429 (miR-4429) in the development and prognosis of ovarian cancer, and to explore the regulatory role of miR-4429 in migratory potential of ovarian cancer cells.

PATIENTS AND METHODS

MiR-4429 levels in paired ovarian cancer species and paracancerous ones were examined. Then, the relationship between miR-4429 level and clinical features of ovarian cancer patients was analyzed. Potential influences of miR-4429 on migratory potentials in CAOV3 and SKOV3 cells were explored by transwell assay. After that, the interaction between miR-4429 and its downstream gene YOD1, and their involvement in the malignant development of ovarian cancer were finally demonstrated through Luciferase assay and rescue experiments.

RESULTS

The results revealed that miR-4429 was downregulated in ovarian cancer tissues and cell lines. Its level was significantly correlated with rates of lymphatic metastasis (p=0.018) and distant metastasis (p=0.012) but not with age, tumor size, and tumor stage in ovarian cancer patients. Survival analysis uncovered that a low level of miR-4429 was unfavorable to PFS and OS in ovarian cancer patients. Besides, the overexpression of miR-4429 inhibited migratory potential in CAOV3 cells, and conversely, the knockdown of miR-4429 in SKOV3 cells obtained the opposite result. Moreover, YOD1 was proved to be the downstream gene binding to miR-4429. It was highly expressed in ovarian cancer tissues and negatively regulated by miR-4429. Rescue experiments finally identified that YOD1 was responsible for migratory potential changes in ovarian cancer cells regulated by miR-4429.

CONCLUSIONS

MiR-4429 is downregulated in ovarian cancer tissues, and its level is closely linked to metastasis and prognosis in ovarian cancer patients. By negatively regulating YOD1 level, miR-4429 suppresses the malignant development of ovarian cancer.

Neuroprotective effect of DUSP14 overexpression against isoflurane-induced inflammatory response, pyroptosis and cognitive impairment in aged rats through inhibiting the NLRP3 inflammasome

OBJECTIVE

Postoperative cognitive dysfunction (POCD) is a common complication after general anesthesia in the elderly people. Dual-specificity phosphatase 14 (DUSP14, also known as MKP6) has been implicated in the pathogenesis of various inflammatory diseases. However, the exact role and mechanism of DUSP14 in POCD remains unclear.

MATERIALS AND METHODS

An isoflurane exposure induced POCD aged rat model was successfully constructed. The pathological changes of hippocampal tissues of aged rats were detected by Nissl staining. Evaluation of learning and memory abilities in aged rats was measured using Morris water maze task test. The DUSP14 level was detected by immunohistochemistry (IHC) assay, quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot, respectively. Levels of brain injury markers [S-100β and neuron specific enolase (NSE)] and inflammatory cytokines [interleukin (IL)-1β (tumor necrosis factor (TNF)-α and IL-6] were detected using Enzyme Linked Immunosorbent Assay (ELISA) or qRT-PCR. The apoptosis of hippocampal nerve cells was assessed by Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. Western blot assay was used to measure the expression of proteins related to apoptosis, pyroptosis and NOD-like receptor family pyrin domain-containing 3 (NLRP3)-Caspase-1 pathway.

RESULTS

Isoflurane exposure led to brain injury, inflammatory response, cognitive dysfunction in aged rats and decreased the expression of DUSP14. Overexpression of DUSP14 could inhibit apoptosis, inflammation, pyroptosis, brain tissue damage, and improve cognitive dysfunction of aged rats after isoflurane anesthesia. Further mechanism studies revealed that DUSP14 may play a neuroprotective effect on POCD by regulating NLRP3 inflammasome-mediated pyroptosis.

CONCLUSIONS

DUSP14 may effectively protect against isoflurane-induced neuro-inflammation, brain damage and cognitive dysfunction, indicating that DUSP14 may be a potential predictor and therapeutic target for POCD.

222 Rn emanation measurements for the XENON1T experiment

The selection of low-radioactive construction materials is of utmost importance for the success of low-energy rare event search experiments. Besides radioactive contaminants in the bulk, the emanation of radioactive radon atoms from material surfaces attains increasing relevance in the effort to further reduce the background of such experiments. In this work, we present the 222 Rn emanation measurements performed for the XENON1T dark matter experiment. Together with the bulk impurity screening campaign, the results enabled us to select the radio-purest construction materials, targeting a 222 Rn activity concentration of 10 μ Bq / kg in 3.2 t of xenon. The knowledge of the distribution of the 222 Rn sources allowed us to selectively eliminate problematic components in the course of the experiment. The predictions from the emanation measurements were compared to data of the 222 Rn activity concentration in XENON1T. The final 222 Rn activity concentration of ( 4.5 ± 0.1 ) μ Bq / kg in the target of XENON1T is the lowest ever achieved in a xenon dark matter experiment.

Long noncoding RNA SLC30A10 promotes colorectal tumor proliferation and migration via miR-21c/APC axis

OBJECTIVE

Colorectal cancer is a common malignancy and a common cause of tumor-related death. Long non-coding RNAs (lncRNAs) have become an important regulatory factor and tissue specific biomarker for a variety of cancers, including colorectal cancer. Recent evidence indicates that the novel lncRNA SLC30A10 plays an important role in tumor progression and metastasis. However, its role and molecular mechanisms in colorectal cancer are unclear.

PATIENTS AND METHODS

SLC30A10 expression was detected in 12 colorectal cancer and adjacent normal tissues by quantitative reverse transcription PCR. Insights into the underlying mechanisms of competitive endogenous RNAs (ceRNAs) were determined by transwell assay, CCK8 assay, and luciferase assay.

RESULTS

SLC30A10 was down-regulated in colorectal cancer tissues and cell lines, and its low expression was positively correlated with colorectal cancer progression and metastasis. Functionally, SLC30A10 depletion promotes cell proliferation and migration in colorectal cancer cells, while SLC30A10 overexpression has the opposite effect. Bioinformatics prediction and luciferase assay indicated that miR-21c is a direct target of SLC30A10, which plays the role of ceRNA in regulating colorectal cancer metastasis. In addition, miR-21c specifically targets APC gene.

CONCLUSIONS

Our findings suggest that reduced expression of SLC30A10 is associated with aggressive tumor phenotypes and poor patient outcomes in colorectal cancer. SLC30A10 inhibits colorectal cancer progression and metastasis by acting as a ceRNA for miR-21c to regulate APC expression, suggesting that SLC30A10 may serve as a potential prognostic biomarker and anti-metastatic therapeutic target for colorectal cancer.

Dislocations at coalescence boundaries in heteroepitaxial GaN/sapphire studied after the epitaxial layer has completely coalesced

We have performed cross-sectional scanning capacitance microscopy (SCM), cathodoluminescence (CL) microscopy in the scanning electron microscope (SEM) and transmission electron microscopy (TEM) all on the same few-micron region of a GaN/sapphire sample. To achieve this, it was necessary to develop a process flow which allowed the same features viewed in a cleaved cross-section to be traced from one microscope to the next and to adapt the focused ion beam preparation of the TEM lamella to allow preparation of a site-specific sample on a pre-cleaved cross-section. Growth of our GaN/sapphire samples involved coalescence of three-dimensional islands to form a continuous film. Highly doped marker layers were included in the sample so that coalescence boundaries formed late in the film growth process could be identified in SCM and CL. Using TEM, we then identified one or more dislocations associated with each of several such late-coalescing boundaries. In contrast, previous studies have addressed coalescence boundaries formed earlier in the growth process and have shown that early-stage island coalescence does not lead to dislocation formation.

Long non-coding RNA LINC00665 promotes metastasis of breast cancer cells by triggering EMT

OBJECTIVE

In recent years, studies have found that abnormally expressed long non-coding RNA (lncRNA) is closely associated with the progression of breast cancer (BCa). Some lncRNAs have been identified to be involved in the regulation of BCa cell invasion and metastasis. In this research, LINC00665 was found to be abnormally expressed in BCa tissues and cells, and its regulatory effects on invasion and metastasis of BCa were explored. The aim of this study was to investigate the expression characteristics of LINC00665 in BCa, and its regulatory role in BCa progression.

PATIENTS AND METHODS

LINC00665 expressions in BCa tissue samples and normal ones were collected from GEPIA database. The expression of LINC00665 in BCa tissues and cell lines was further confirmed by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). After knockdown of LINC00665 expression in BCa cells by transfection of small interfering RNA, cell migration and invasion abilities were examined by cell wound healing and transwell assay. Expressions of epithelial-mesenchymal transition (EMT)-related markers in BCa cells were examined using qRT-PCR and Western blot.

RESULTS

LINC00665 was highly expressed in BCa tissues and cell lines, and the high expression of LINC00665 could be used to predict a poor prognosis of BCa patients. In addition, the results of in vitro cell experiments showed that the migration and invasion ability of BCa cells were remarkably attenuated after downregulation of LINC00665. At the same time, qRT-PCR and Western blot results revealed that downregulation of LINC00665 was able to inhibit the expressions of EMT-related genes in BCa cells.

CONCLUSIONS

LINC00665 is highly expressed in BCa tissues and cell lines, which could predict poor prognosis of BCa patients. In addition, LINC00665 may promote the malignant metastasis of BCa cells by affecting the EMT process.

Search for Coherent Elastic Scattering of Solar ^{8}B Neutrinos in the XENON1T Dark Matter Experiment

We report on a search for nuclear recoil signals from solar ^{8}B neutrinos elastically scattering off xenon nuclei in XENON1T data, lowering the energy threshold from 2.6 to 1.6  keV. We develop a variety of novel techniques to limit the resulting increase in backgrounds near the threshold. No significant ^{8}B neutrinolike excess is found in an exposure of 0.6  t×y. For the first time, we use the nondetection of solar neutrinos to constrain the light yield from 1-2 keV nuclear recoils in liquid xenon, as well as nonstandard neutrino-quark interactions. Finally, we improve upon world-leading constraints on dark matter-nucleus interactions for dark matter masses between 3 and 11  GeV c^{-2} by as much as an order of magnitude.

Emerging Magnetic Interactions in van der Waals Heterostructures

Vertical van der Waals (vdWs) heterostructures based on layered materials are attracting interest as a new class of quantum materials, where interfacial charge-transfer coupling can give rise to fascinating strongly correlated phenomena. Transition metal chalcogenides are a particularly exciting material family, including ferromagnetic semiconductors, multiferroics, and superconductors. Here, we report the growth of an organic-inorganic heterostructure by intercalating molecular electron donating bis(ethylenedithio)tetrathiafulvalene into (Li,Fe)OHFeSe, a layered material in which the superconducting ground state results from the intercalation of hydroxide layer. Molecular intercalation in this heterostructure induces a transformation from a paramagnetic to spin-glass-like state that is sensitive to the stoichiometry of molecular donor and an applied magnetic field. Besides, electron-donating molecules reduce the electrical resistivity in the heterostructure and modify its response to laser illumination. This hybrid heterostructure provides a promising platform to study emerging magnetic and electronic behaviors in strongly correlated layered materials.

Genetic polymorphisms and cardiovascular outcomes in Chinese patients undergoing PCI and treated with clopidogrel and aspirin

Background

Genetic polymorphisms of key proteins involved in clopidogrel absorption, metabolism, and action may contribute to variability in platelet inhibition in patients undergoing percutaneous coronary intervention (PCI), but their impacts on cardiovascular outcomes remain unclear.

Purpose

To examine the associations between genetic polymorphisms and cardiovascular outcomes in Chinese patients undergoing PCI and treated with clopidogrel and aspirin.

Methods

This prospective cohort study consecutively enrolled 2,453 post-PCI patients treated with clopidogrel and aspirin. Adenosine diphosphate-induced platelet aggregation was measured by light transmission aggregometry. A total of 40 single nucleotide polymorphisms (SNPs) of 18 genes selected according to published studies were investigated using an improved multiplex ligation detection reaction technique. The primary outcome was major adverse cardiovascular event (MACE), the composite of cardiovascular death, non-fatal myocardial infarction (MI), and ischemic stroke within one year after PCI.

Results

We restricted the analyses to the first 1,452 patients who had finished one-year follow-up and complete data on genotyping and platelet aggregation. 44 (3.03%) patients suffered MACE. Among the 40 SNPs, only the A-allele carriers of CYP2C19*2 had a significant higher risk of MACE (adjusted HR 2.05; 95% CI, 1.01–4.19; p=0.048) and platelet aggregation than non-A-carriers after adjusting age, sex, MI presentation, and left ventricular ejection fraction. CYP2C19*3, CYP2B6 rs3745274, and PEAR1 rs12041331 variants were also significantly associated with platelet aggregation (all p&lt;0.05) but not with MACE at 1 year.

Conclusion

About 54.2% of Chinese patients with PCI were A-allele carriers of CYP2C19*2, who face a two-fold higher risk of MACE than non-A-allele carriers in Chinese patients after PCI. It would help identify low clopidogrel responders and optimize antiplatelet therapy before drug administration.

Figure 1

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Funding of China

Sex differences in diastolic blood pressure changes with age using 24-hour ABPM in 30,513 patients

Background

We have previously shown, using 24-hour ABPM monitoring, that diastolic blood pressure (DBP) in a large referral population, containing both males and females, increases until age 42 years, following which DBP falls progressively. This occurs in the hypertensive population some 13 years sooner than previous general population studies. There is conflicting emerging data on sex differences in the lifelong trajectory of both systolic and diastolic blood pressure.

Purpose

To examine sex-specific patterns of diastolic blood pressure throughout the lifespan of patients referred for 24-hour ABPMs.

Methods

Our database was searched for all 24-hour ABPMs. We used the average 24-hour SBP and DBP for this analysis. Scatter grams were produced for age versus systolic BP (SBP) and DBP for both males and females. Second order polynomial regression was performed on the DBP scatter grams for both genders and their inflection points calculated. The inflection point is the age at which the DBP on the polynomial curve where the slope changes from positive to negative. This, inflection point, corresponds to the age at which DBP begins to decrease. The DBP polynomial curves for males and females were then superimposed to show any gender differences.

Results

There were 30,513 24-hour analysable ABPMs over 24 years, representing 97% of all ABPMs. There were 15,913 females aged 60.8±14.6 years (range 15–97 years) and 14,600 males aged 58.8±14.2 years (range 15–100 years). As can be seen from the charts below, in females DBP begins to fall at a very early age of 22.3 years, whereas in males the diastolic BP begins to fall at 46.5 years.

Conclusions

There are significant sex differences in the changes in DBP with increasing age. For the first 35 years DBP is higher in women, thereafter DBP is lower in females and only intersects again much later in life at 95 years. The significance of this sex difference is unclear but may explain the increased prevalence of systolic hypertension in elderly females.

Figure 1

Funding Acknowledgement

Type of funding source: None

A joint analysis strategy reveals genetic changes associated with artificial selection between egg-type and meat-type ducks

Egg-type ducks and meat-type ducks are predominantly commercial or indigenous and have been subjected to artificial directional selection. These two duck types differ substantially in body shape, production performance and reproductivity. However, the genetic changes associated with phenotypic differences remain unclear. Here, we compared the two duck types at the genomic and transcriptomic levels. We identified a large number of SNPs and genes in genomic divergent regions in terms of F_ST and θπ values. The corresponding genes were mainly enriched in embryonic development function and metabolic pathway. RNA-seq analysis also revealed differential gene expression in the liver and gonads. The differentially expressed genes were functionally associated with signal transmission and substance metabolism respectively. Furthermore, we found that seven genes were related to differentiation between the two types by both g genome and transcriptome analysis and were plausible candidate genes. These genes were annotated to GO categories of cell development and disease immunity. These findings will enable a better understanding of the artificial selection history of meat and egg ducks and provide a valuable resource for future research on the breeding of these two lineages.

Effects of rosuvastatin on neuronal apoptosis in cerebral ischemic stroke rats via Sirt1/NF-kappa B signaling pathway

OBJECTIVE

To investigate the effects of rosuvastatin on nerve cell apoptosis in rats with cerebral ischemic stroke through Sirt1/NF-κB pathway.

MATERIALS AND METHODS

30 model rats were divided into three groups: normal group, stroke group (rats with cerebral ischemic stroke) and stroke+RVT group (cerebral ischemic stroke rats treated with rosuvastatin). The expression of Sirt1/NF-κB, areas of stroke infarction, cell cycles, as well as apoptosis situation in different groups were detected by Western Blot, immunohistochemistry, histomorphological observation, triphenyl tetrazolium chloride (TTC) staining and flow cytometry as well as immunofluorescent staining.

RESULTS

Optical microscope observation showed cells in normal group presented complete and clear cellular hierarchical structure, regular cell arrangement, bluish violet cell nucleus and pink cytoplasm. No damage or necrosis was observed under normal condition. In stroke group, the boundary line between cytoplasm and nucleus was blurry and some apoptosis bodies were also observed. However, after rosuvastatin treatment, necrosis disappeared in stroke+RVT group. Western Blot analysis showed that the expression of SIRT1 decreased and NF-κB elevated in stroke group compared with those in normal group (p<0.05). However, rosuvastatin could reverse the effects of stroke on SIRT1 and NF-κB (p<0.05). The results of immunohistochemistry and immunofluorescent staining also confirmed our findings in SIRT1 and NF-κB expression after stroke. The areas of cerebral infarction increased significantly in stroke group and this effect could also be reversed by rosuvastatin treatment (p<0.05). Besides, cell cycle detection also showed that rosuvastatin treatment could inhibit the shortening of G1, S as well as G2 periods in cell cycles after stoke (p<0.05).

CONCLUSIONS

Rosuvastatin may have great effects on improving cerebral infarction condition in rats with cerebral ischemic stroke. The mechanisms may be through Sirt1/ NF-κB pathway, thereby reducing the apoptosis rate and improving cell cycle of brain cells.

Chikungunya virus antagonizes cGAS-STING mediated type-I interferon responses by degrading cGAS

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus known to cause epidemics resulting in predominantly symptomatic infections, which in rare cases cause long term debilitating arthritis and arthralgia. Significant progress has been made in understanding the roles of canonical RNA sensing pathways in the host recognition of CHIKV; however, less is known regarding antagonism of CHIKV by cytosolic DNA sensing pathways like that of cyclic GMP-AMP synthase (cGAS) and Stimulator of Interferon Genes (STING). With the use of cGAS or STING null cells we demonstrate that the pathway restricts CHIKV replication in fibroblasts and immune cells. We show that DNA accumulates in the cytoplasm of infected cells and that CHIKV blocks DNA dependent IFN-β transcription. This antagonism of DNA sensing is via an early autophagy-mediated degradation of cGAS and expression of the CHIKV capsid protein is sufficient to induce cGAS degradation. Furthermore, we identify an interaction of CHIKV nsP1 with STING and map the interaction to 23 residues in the cytosolic loop of the adaptor protein. This interaction stabilizes the viral protein and increases the level of palmitoylated nsP1 in cells. Together, this work supports previous publications highlighting the relevance of the cGAS-STING pathway in the early detection of (+)ssRNA viruses and provides direct evidence that CHIKV interacts with and antagonizes cGAS-STING signaling.

MiR-210 inhibits apoptosis of vascular endothelial cells via JAK-STAT in arteriosclerosis obliterans

OBJECTIVE

To investigate the effect of micro ribonucleic acid (miR)-210 on the apoptosis of vascular endothelial cells in arteriosclerosis obliterans (ASO) through the Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathway.

PATIENTS AND METHODS

In the present work, the vascular endothelial cells in ASO patients were selected as objects of study, the cell lines with miR-210 interference and overexpression were constructed with the Crisp/Case9 technique for subsequent experiments as experimental group, and the aortic endothelial cells of a healthy human were used as control group. First, the changes in the transcriptional and translational levels of such genes as JAK2 and STAT3 in the JAK-STAT signaling pathway in cell lines with miR-210 interference and overexpression were detected via fluorescence quantitative Polymerase Chain Reaction (qPCR) and Western blotting. The changes in the transcriptional and translational levels of nitric oxide synthase (NOS) in cells were detected in experimental group and control group to clarify the regulatory effect of miR-210 on the JAK-STAT signaling pathway. At the same time, the cell proliferation in experimental group and control group was observed via methyl thiazolyl tetrazolium (MTT) assay and the apoptosis rate was detected in both groups via flow cytometry.

RESULTS

The results of fluorescence qPCR and Western blotting revealed that the expression level of miR-210 was significantly increased in cells of ASO patients compared with that in aortic endothelial cells of healthy human with a significant difference (p<0.05). At the same time, the inhibition on miR-210 could significantly reduce the transcriptional and translational levels of JAK2, STAT3, and NOS, block the JAK-STAT signaling pathway, suppress the cell proliferation, and promote apoptosis. The overexpression of miR-210 could markedly increase the transcriptional and translational levels of JAK2, STAT3, and NOS, activate the JAK-STAT signaling pathway, promote the cell proliferation, and suppress the apoptosis.

CONCLUSIONS

MiR-210 can be involved in the apoptosis process of vascular endothelial cells in ASO through the JAK-STAT signaling pathway.

[ Ⅲ ]

Objective: The aim of this study was to evaluate the safety and immunogenicity of the first domestic ACYW135 meningococcal conjugate vaccine and a control vaccine named AC group meningococcal conjugate vaccine for 3 months (90-119 days) infants. Methods: From February 2017 to June 2018, a randomized, blinded, and similar vaccine-controlled clinical trial design was adopted at the Henan Vaccine Clinical Research Base. The subjects were 3 months old healthy infants, a total of 720, based on a 1∶1 ratio. The random allocation table for entry was randomly assigned to the experimental group and the control group. According to the 3, 4, and 5 month-old vaccination procedures, the subjects were vaccinated with test vaccine (ACYW135 group meningococcal conjugate vaccine) and control vaccine (group A group C meningococcal polysaccharide conjugate vaccine), of which 720 were given the first dose, 696 were given the second dose (test group: 346; control group: 350), and 692 were given the third dose (test group: 344; Control group: 348). Results: The overall adverse reaction rate of the test vaccine was 21.90% (230 cases), which was lower than the 32.04% (339 cases) of the control vaccine (P<0.001). The incidence of systemic adverse reactions was 19.52% (205 cases), which was lower than that of the control vaccine (27.69%) (293 cases) (P<0.001). The local adverse reaction rate was 3.04% (32 cases), which was lower than the control group (7.84%) (83 cases) (P<0.001). The graded adverse reaction test vaccine was 0.57% (6 cases), which was lower than the control group of 2.36% (25 cases) (P<0.001). The positive conversion rate of anti-bacterial serum antibodies showed that there was no significant difference between the test vaccine group A (91.42%), C (88.76%) and the control vaccine (92.92%) (87.02%) (P>0.05). Group Y and W135 was 88.17% (298 cases), 99.41% (336 cases), respectively. The GMT results showed that the test vaccine group A was 56.24, the control vaccine was 57.43 (P>0.05); the group C test vaccine (43.53) was higher than the control group (27.28) (P<0.001). The group Y and W135 are 89.22 and 140.66, respectively. Among them, the proportion of the group C GMT antibody ≥ 1∶128 for test vaccine (31.07%, 105 cases) was higher than the control vaccine (16.22%, 55 cases) (P<0.001). Conclusion: ACYW135 group meningococcal conjugate vaccine has more safety and immunogenicity after application to 3 month old infants.

Comparison of the efficacy and safety of the EC-T (epirubicin/cyclophosphamide followed by docetaxel) and TCb (docetaxel/carboplatin) neoadjuvant regimens in early TOP2A-normal stage II-III breast cancer

This study aimed to compare the efficacy and safety of the EC-T (4 cycles of epirubicin 90 mg/m2 + cyclophosphamide 600 mg/m2, followed by 4 cycles of docetaxel 75 mg/m2) and TCb (6 cycles of docetaxel 75 mg/m2, intravenous drip (ID), day 1 + carboplatin AUC 6, ID, day 1) neoadjuvant regimens in patients with TOP2A-normal stage II-III breast cancer. This study analyzed 280 patients enrolled from three studies registered with ClinicalTrials.gov (NCT03140553, NCT03154749, NCT03507465) with early TOP2A-normal stage II-III breast cancer who received neoadjuvant chemotherapy, including 100 patients who received the EC-T regimen and 180 patients who received the TCb regimen. The primary endpoint was the ratio of RCB 0/1 (residual cancer burden 0/1) after neoadjuvant chemotherapy. The secondary endpoint was the safety of the two groups. There was no significant difference in the ratio of RCB 0/1 between the two groups (23% vs. 23.9%, p=0.614). Among the triple-negative breast cancer patients, the efficacy did not differ between the two groups (40% vs. 32%, p=0.52). Among the lymph node metastasis patients, the efficacy of the EC-T group was significantly better than that of the TCb group (14% vs. 2.6%, p=0.03). Regarding the side effects, the incidence of grade 3/4 anemia was higher in the EC-T group than in the TCb group (21.0% vs. 8.33%, p=0.002), while the incidence of grade 3/4 neutropenia was higher in the EC-T group than in the TCb group (17% vs. 14.44%, p=0.570), and the incidence of grade 3/4 thrombocytopenia was low in each group (EC-T group: 6 % and TCb group: 7.22%, p=0.697). In the EC-T group, grade 3/4 nausea and vomiting occurred in 5 patients. The EC-T group showed a higher rate of grade 3/4 myalgia than the TCb group (7% and 4.44%, respectively, p=0.363). To conclude, the TCb regimen can be used as an alternative regimen for TOP2A-normal stage II-III breast cancer patients in neoadjuvant chemotherapy. However, in patients with node-positive tumors, EC-T is still recommended. Though no difference of grade 3/4 thrombocytopenia in two groups, grade 4 thrombocytopenia caused by the carboplatin-containing regimen should be taken seriously.

[Application of tracheotomy in the treatment of severe cases of COVID-19]

Objective: To discuss the the effects, indications and protective measures of tracheotomy for severe cases of coronavirus disease 2019 (COVID-19) patients. Methods: A retrospectively analysis was conducted to explore the clinical data of COVID-19 patients who received tracheotomy in February to March 2020, and descriptive statistics were used to analyze the indication of tracheotomy, particularity of intraoperative treatment and protective measures. Results: A total of 4 cases were included in this article. All patients were successfully operated. One case had postoperative incision continuous bleeding, there were not other complications and nosocomial infection among the medical staff. The patient's condition was relieved in different degrees after the operation, who remained hospitalized. Conclusion: Tracheotomy for severe cases of COVID-19 can achieve certain curative effect, but the occurrence of tracheotomy related complications and nosocomial infection should be effectively controlled, and the risk benefit ratio of tracheotomy should be carefully weighed before surgery.