OmicsFootPrint: a framework to integrate and interpret multi-omics data using circular images and deep neural networks.

The OmicsFootPrint framework addresses the need for advanced multi-omics data analysis methodologies by transforming data into intuitive two-dimensional circular images and facilitating the interpretation of complex diseases. Utilizing Deep Neural Networks and incorporating the SHapley Additive exPlanations (SHAP) algorithm, the framework enhances model interpretability. Tested with The Cancer Genome Atlas (TCGA) data, OmicsFootPrint effectively classified lung and breast cancer subtypes, achieving high Area Under Curve (AUC) scores - 0.98±0.02 for lung cancer subtype differentiation, 0.83±0.07 for breast cancer PAM50 subtypes, and successfully distinguishe between invasive lobular and ductal carcinomas in breast cancer, showcasing its robustness. It also demonstrated notable performance in predicting drug responses in cancer cell lines, with a median AUC of 0.74, surpassing existing algorithms. Furthermore, its effectiveness persists even with reduced training sample sizes. OmicsFootPrint marks an enhancement in multi-omics research, offering a novel, efficient, and interpretable approach that contributes to a deeper understanding of disease mechanisms.

Bootstrapping for Estimating the Conservative Kill Ratio of the Surrogate to the Pathogen for Use in Thermal Process Validation at the Industrial Scale.

A surrogate is commonly used for process validations. The industry often uses the target log cycle reduction for the test (LCRTest) microorganism (surrogate) to be equal to the desired log cycle reduction for the target (LCRTarget) microorganism (pathogen). When the surrogate is too conservative with far greater resistance than the pathogen, the food may be overprocessed with quality and cost consequences. In aseptic processing, the Institute for Thermal Processing Specialists recommends using relative resistance (DTarget)/(DTest) to calculate LCRTest (product of LCRTarget and relative resistance). This method uses the mean values of DTarget and DTest and does not consider the estimating variability. We defined kill ratio (KR) as the inverse of relative resistance.The industry uses an extremely conservative KR of 1 in the validation of food processes for low-moisture foods, which ensures an adequate reduction of LCRTest, but can result in quality degradation. This study suggests an approach based on bootstrap sampling to determine conservative KR, leading to practical recommendations considering experimental and biological variability in food matrices. Previously collected thermal inactivation kinetics data of Salmonella spp. (target organism) and Enterococcus faecium (test organism) in Non-Fat Dried Milk (NFDM) and Whole Milk Powder (WMP) at 85, 90, and 95°C were used to calculate the mean KR. Bootstrapping was performed on mean inactivation rates to get a distribution of 1000 bootstrap KR values for each of the treatments. Based on minimum temperatures used in the industrial process and acceptable level of risk (e.g., 1, 5, or 10% of samples that would not achieve LCRTest), a conservative KR value can be estimated. Consistently, KR increased with temperature and KR for WMP was higher than NFDM. Food industries may use this framework based on the minimum processing temperature and acceptable level of risk for process validations to minimize quality degradation.

Effect of heat stress on the hypothalamic expression profile of water homeostasis-associated genes in low- and high-water efficient chicken lines.

With climate change, selection for water efficiency and heat resilience are vitally important. We undertook this study to determine the effect of chronic cyclic heat stress (HS) on the hypothalamic expression profile of water homeostasis-associated markers in high (HWE)- and low (LWE)-water efficient chicken lines. HS significantly elevated core body temperatures of both lines. However, the amplitude was higher by 0.5-1°C in HWE compared to their LWE counterparts. HWE line drank significantly less water than LWE during both thermoneutral (TN) and HS conditions, and HS increased water intake in both lines with pronounced magnitude in LWE birds. HWE had better feed conversion ratio (FCR), water conversion ratio (WCR), and water to feed intake ratio. At the molecular level, the overall hypothalamic expression of aquaporins (AQP8 and AQP12), arginine vasopressin (AVP) and its related receptor AVP2R, angiotensinogen (AGT), angiotensin II receptor type 1 (AT1), and calbindin 2 (CALB2) were significantly lower; however, CALB1 mRNA and AQP2 protein levels were higher in HWE compared to LWE line. Compared to TN conditions, HS exposure significantly increased mRNA abundances of AQPs (8, 12), AVPR1a, natriuretic peptide A (NPPA), angiotensin I-converting enzyme (ACE), CALB1 and 2, and transient receptor potential cation channel subfamily V member 1 and 4 (TRPV1 and TRPV4) as well as the protein levels of AQP2, however it decreased that of AQP4 gene expression. A significant line by environment interaction was observed in several hypothalamic genes. Heat stress significantly upregulated AQP2 and SCT at mRNA levels and AQP1 and AQP3 at both mRNA and protein levels, but it downregulated that of AQP4 protein only in LWE birds. In HWE broilers, however, HS upregulated the hypothalamic expression of renin (REN) and AVPR1b genes and AQP5 proteins, but it downregulated that of AQP3 protein. The hypothalamic expression of AQP (5, 7, 10, and 11) genes was increased by HS in both chicken lines. In summary, this is the first report showing improvement of growth performances in HWE birds. The hypothalamic expression of several genes was affected in a line- and/or environment-dependent manner, revealing potential molecular signatures for water efficiency and/or heat tolerance in chickens.

Pericyte Control of Gene Expression in the Blood-Brain Barrier Endothelium: Implications for Alzheimer's Disease.

Background: A strong body of evidence suggests that cerebrovascular pathologies augment the onset and progression of Alzheimer's disease (AD). One distinctive aspect of this cerebrovascular dysfunction is the degeneration of brain pericytes-often overlooked supporting cells of blood-brain barrier endothelium. Objective: The current study investigates the influence of pericytes on gene and protein expressions in the blood-brain barrier endothelium, which is expected to facilitate the identification of pathophysiological pathways that are triggered by pericyte loss and lead to blood-brain barrier dysfunction in AD. Methods: Bioinformatics analysis was conducted on the RNA-Seq expression counts matrix (GSE144474), which compared solo-cultured human blood-brain barrier endothelial cells against endothelial cells co-cultured with human brain pericytes in a non-contact model. We constructed a similar cell culture model to verify protein expression using western blots. Results: The insulin resistance and ferroptosis pathways were found to be enriched. Western blots of the insulin receptor and heme oxygenase expressions were consistent with those observed in RNA-Seq data. Additionally, we observed more than 5-fold upregulation of several genes associated with neuroprotection, including insulin-like growth factor 2 and brain-derived neurotrophic factor. Conclusions: Results suggest that pericyte influence on blood-brain barrier endothelial gene expression confers protection from insulin resistance, iron accumulation, oxidative stress, and amyloid deposition. Since these are conditions associated with AD pathophysiology, they imply mechanisms by which pericyte degeneration could contribute to disease progression.

Integration of multiomics data shows down regulation of mismatch repair and tubulin pathways in triple-negative chemotherapy-resistant breast tumors.

BACKGROUND: Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype. Patients with TNBC are primarily treated with neoadjuvant chemotherapy (NAC). The response to NAC is prognostic, with reductions in overall survival and disease-free survival rates in those patients who do not achieve a pathological complete response (pCR). Based on this premise, we hypothesized that paired analysis of primary and residual TNBC tumors following NAC could identify unique biomarkers associated with post-NAC recurrence. METHODS AND RESULTS: We investigated 24 samples from 12 non-LAR TNBC patients with paired pre- and post-NAC data, including four patients with recurrence shortly after surgery (< 24 months) and eight who remained recurrence-free (> 48 months). These tumors were collected from a prospective NAC breast cancer study (BEAUTY) conducted at the Mayo Clinic. Differential expression analysis of pre-NAC biopsies showed minimal gene expression differences between early recurrent and nonrecurrent TNBC tumors; however, post-NAC samples demonstrated significant alterations in expression patterns in response to intervention. Topological-level differences associated with early recurrence were implicated in 251 gene sets, and an independent assessment of microarray gene expression data from the 9 paired non-LAR samples available in the NAC I-SPY1 trial confirmed 56 gene sets. Within these 56 gene sets, 113 genes were observed to be differentially expressed in the I-SPY1 and BEAUTY post-NAC studies. An independent (n = 392) breast cancer dataset with relapse-free survival (RFS) data was used to refine our gene list to a 17-gene signature. A threefold cross-validation analysis of the gene signature with the combined BEAUTY and I-SPY1 data yielded an average AUC of 0.88 for six machine-learning models. Due to the limited number of studies with pre- and post-NAC TNBC tumor data, further validation of the signature is needed. CONCLUSION: Analysis of multiomics data from post-NAC TNBC chemoresistant tumors showed down regulation of mismatch repair and tubulin pathways. Additionally, we identified a 17-gene signature in TNBC associated with post-NAC recurrence enriched with down-regulated immune genes.

Impact of selective licensing schemes for private rental housing on mental health and social outcomes in Greater London, England: a natural experiment study.

OBJECTIVES: To assess primary impact of selective Licensing (SL), an area-based intervention in the private rented housing market, on individual self-reported anxiety and neighbourhood mental health (MHI-Mental Healthcare Index) and secondary impacts on antisocial behaviour (ASB), population turnover and self-reported well-being. DESIGN: Difference-in-difference (DiD) was used to evaluate effects of SL schemes initiated 2012-2018. 921 intervention areas (lower super output areas) were matched 3:1 using propensity scores derived from sociodemographic and housing variables (N=3.684 including controls). Average treatment effect on treated (ATT) was calculated for multiple time period DiD in area-level analyses. Canonical DiD was used for individual-level analysis by year of treatment initiation while adjusting for age, sex, native birth and occupational class. SETTING: Intervention neighbourhoods and control areas in Greater London, UK, 2011-2019. PARTICIPANTS: We sampled 4474 respondents renting privately in intervention areas (N=17 347 including controls) in Annual Population Survey and obtained area-level MHI population data. INTERVENTIONS: Private landlords in SL areas must obtain a licence from the local authority, allow inspection and maintain minimum housing standards. RESULTS: ATT after 5 years was significantly lower for MHI (-7.5%, 95% CI -5.6% to -8.8%) than controls. Antidepressant treatment days per population reduced by -5.4% (95% CI -3.7% to -7.3), mental health benefit receipt by -9.6% (95% CI -14% to -5.5%) and proportion with depression by -12% (95% CI -7.7% to -16.3%). ASB reduced by -15% (95% CI -21% to -8.2%). Population turnover increased by 26.5% (95% CI 22.1% to 30.8%). Sensitivity analysis suggests overlap with effects of London 2012 Olympic regeneration. No clear patterns were observed for self-reported anxiety. CONCLUSIONS: We found associations between SL and reductions in area-based mental healthcare outcomes and ASB, while population turnover increased. A national evaluation of SL is feasible and necessary.

Luminal androgen receptor breast cancer subtype and investigation of the microenvironment and neoadjuvant chemotherapy response.

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype with low overall survival rates and high molecular heterogeneity; therefore, few targeted therapies are available. The luminal androgen receptor (LAR) is the most consistently identified TNBC subtype, but the clinical utility has yet to be established. Here, we constructed a novel genomic classifier, LAR-Sig, that distinguishes the LAR subtype from other TNBC subtypes and provide evidence that it is a clinically distinct disease. A meta-analysis of seven TNBC datasets (n = 1086 samples) from neoadjuvant clinical trials demonstrated that LAR patients have significantly reduced response (pCR) rates than non-LAR TNBC patients (odds ratio = 2.11, 95% CI: 1.33, 2.89). Moreover, deconvolution of the tumor microenvironment confirmed an enrichment of luminal epithelium corresponding with a decrease in basal and myoepithelium in LAR TNBC tumors. Increased immunosuppression in LAR patients may lead to a decreased presence of cycling T-cells and plasma cells. While, an increased presence of myofibroblast-like cancer-associated cells may impede drug delivery and treatment. In summary, the lower levels of tumor infiltrating lymphocytes (TILs), reduced immune activity in the micro-environment, and lower pCR rates after NAC, suggest that new therapeutic strategies for the LAR TNBC subtype need to be developed.

Positive relationship of rectal temperature at fixed timed artificial insemination on pregnancy outcomes in beef cattle.

The overarching aim was to examine the relationship of rectal temperature at fixed time artificial insemination (FTAI) on pregnancy outcomes in a typical breeding season with expected pregnancy rates approaching 50% using Bos indicus and Bos taurus cattle. This represents a continuum of steps to test the hypothesis that elevated body temperature at or around insemination is functionally important to maximize pregnancy outcomes. Rectal temperature of Bos indicus cattle at FTAI ranged from 37.0 to 40.9 °C; 60.6% were hyperthermic. Positive factors impacting pregnancy outcomes were rectal temperature at FTAI, body condition, and estrus patch scores. Rectal temperature at FTAI was positively associated with pregnancy outcomes (P < 0.0001); per each 1 °C increase pregnancy odds increased 1.9 times (95% CI: 1.4 to 2.6). Highest pregnancy outcomes occurred with rectal temperatures exceeding 40 °C (P = 0.0004). Rectal temperature before FTAI in Bos taurus cattle ranged from 37.8 to 41.8 °C; 43.3% were hyperthermic. Factors impacting pregnancy were rectal temperature at FTAI, estrus activity, parity, and ambient conditions on day of FTAI. Rectal temperature of Bos taurus cattle at FTAI was positively associated with pregnancy (P = 0.0286); odds increased 1.45 times (95% CI: 1.0 to 2.0) per each 1 °C increase. Highest pregnancy outcomes occurred with rectal temperatures at FTAI exceeding 40 °C (P = 0.057). Moreover, positive relationship of rectal temperature at FTAI to pregnancy persisted in estrual females (71.25% of total; P = 0.0408; OR 1.5; 95% CI: 1.0 to 2.2). Mindful that 1) elevated temperatures observed in Bos indicus and Bos taurus cattle directly promote meiotic resumption of the oocyte in vitro and that 2) in vivo hyperthermia alters intrafollicular components which others have shown to potentiate ovulation and promote meiotic resumption, it is biologically plausible that an acute elevation in body temperature at or around time of insemination is functionally important to maximize pregnancy outcomes.

Reproductive efficiency remains a major challenge for beef producers with 35% to 55% of females failing to become pregnant after a single insemination. While basis for failure is multi-factorial, heightened estrus activity matters for pregnancy outcomes, even when synchronizing ovulation for fixed time artificial insemination. Body temperature increases of 1.5 °C+ are common during estrus. We hypothesize that higher estrous-associated temperatures (HEAT) at/near insemination are functionally important to maximize pregnancy outcomes. Elevated temperatures equivalent to what is observed in females exhibiting HEAT have been shown to induce oocyte meiotic resumption. An acute episode of hyperthermia after the LH surge alters intrafollicular components known to potentiate ovulation and affect the oocyte. Effort to examine the relationship of rectal temperature at fixed time artificial insemination with pregnancy outcomes in a breeding season with expected pregnancy rates >50% represents a next step in the continuum of hypothesis testing. The positive relationship of rectal temperature at insemination with pregnancy outcomes that was discovered adds to foundational knowledge. Because the degree of hyperthermia is related to highest pregnancy outcomes, a case is made for HEAT to be biologically and functionally important to maximize pregnancy outcomes in cattle.

Pharmacologically induced weight loss is associated with distinct gut microbiome changes in obese rats.

BACKGROUND: Obesity, metabolic disease and some psychiatric conditions are associated with changes to relative abundance of bacterial species and specific genes in the faecal microbiome. Little is known about the impact of pharmacologically induced weight loss on distinct microbiome species and their respective gene programs in obese individuals. METHODOLOGY: Using shotgun metagenomics, the composition of the microbiome was obtained for two cohorts of obese female Wistar rats (n = 10-12, total of 82) maintained on a high fat diet before and after a 42-day treatment with a panel of four investigatory or approved anti-obesity drugs (tacrolimus/FK506, bupropion, naltrexone and sibutramine), alone or in combination. RESULTS: Only sibutramine treatment induced consistent weight loss and improved glycaemic control in the obese rats. Weight loss was associated with reduced food intake and changes to the faecal microbiome in multiple microbial taxa, genes, and pathways. These include increased ß-diversity, increased relative abundance of multiple Bacteroides species, increased Bacteroides/Firmicutes ratio and changes to abundance of genes and species associated with obesity-induced inflammation, particularly those encoding components of the flagellum and its assembly. CONCLUSIONS: Sibutramine-induced weight loss in obese rats is associated with improved metabolic health, and changes to the faecal microbiome consistent with a reduction in obesity-induced bacterially-driven inflammation.

Investigation Into the Effect of COVID-19 Infection on Length of Hospital Stay and Mortality in Patients With Rheumatoid Arthritis.

Background SARS-CoV-2 (COVID-19) is a positive-stranded ribonucleic acid (RNA) virus of the coronavirus family, which has resulted in one of the most serious pandemics, with more than 14 million cases confirmed globally. Rheumatoid arthritis (RA) is estimated to be prevalent in 0.5-1% of the U.S. population. So far, there has been little evidence of COVID-19 infection and its propensity to result in increased mortality or length of hospital stay in patients with RA. To contribute to this body of literature, this study will assess the degree to which COVID-19 is associated with increased mortality and length of hospital stay in patients with RA while also taking into account these patients' comorbidities. Methods Our retrospective study included 14,180 patients (age >18, median 58, range 18-90) who tested positive for COVID-19 or were assumed to have COVID-19 infection from January 1st, 2020, through July 31st, 2020. Patients were grouped based on the diagnosis of RA and COVID-19 infection versus those without RA. Patients who were diagnosed with systemic lupus erythematosus (SLE), chronic obstructive pulmonary disease, and hypertension were excluded. Covariates included age, body mass index (BMI), race, sex, maximum C-reactive protein value, maximum D-dimer value, and comorbid diabetes mellitus. Outcome measures were length of hospital stay (LOS), in-hospital mortality, intensive care unit (ICU) admission, ICU LOS, mechanical ventilation, time on mechanical ventilation, and discharge to hospice. The logistic regression model was used to estimate the probability of in-hospital mortality, ICU admission, placement on mechanical ventilation, discharge to hospice, and in-hospital mortality related to home anti-inflammatory use when comparing patients with RA and COVID-19 infection to COVID-19 infected patients without RA. Results Of the total 14,180 patients (males 57.1%, females 42.9%), 159 patients (1.1%), had a diagnosis of RA. There was no significant association between RA and hospital LOS, ICU admission, ICU LOS, LOS on mechanical ventilation, or discharge to hospice among those infected with COVID-19. Yet, RA was associated with higher mortality (OR: 1.65; 95% CI: 1.07-2.53; p=0.02) and placement on mechanical ventilation (OR: 1.82; 95% CI: 1.22-2.71; p<0.01) amidst patients infected with COVID-19. Conclusion This study suggests that patients with RA and COVID-19 have a significantly increased likelihood of in-hospital mortality and placement on mechanical ventilation. While challenging to realize in a pandemic situation, large studies nationwide are necessary to improve our understanding of COVID-19 infection in patients diagnosed with RA.

Estrogen receptor beta repurposes EZH2 to suppress oncogenic NFκB/p65 signaling in triple negative breast cancer.

Triple Negative Breast Cancer (TNBC) accounts for 15-20% of all breast cancer cases, yet is responsible for a disproportionately high percentage of breast cancer mortalities. Thus, there is an urgent need to identify novel biomarkers and therapeutic targets based on the molecular events driving TNBC pathobiology. Estrogen receptor beta (ERß) is known to elicit anti-cancer effects in TNBC, however its mechanisms of action remain elusive. Here, we report the expression profiles of ERß and its association with clinicopathological features and patient outcomes in the largest cohort of TNBC to date. In this cohort, ERß was expressed in approximately 18% of TNBCs, and expression of ERß was associated with favorable clinicopathological features, but correlated with different overall survival outcomes according to menopausal status. Mechanistically, ERß formed a co-repressor complex involving enhancer of zeste homologue 2/polycomb repressive complex 2 (EZH2/PRC2) that functioned to suppress oncogenic NFκB/RELA (p65) activity. Importantly, p65 was shown to be required for formation of this complex and for ERß-mediated suppression of TNBC. Our findings indicate that ERß+ tumors exhibit different characteristics compared to ERß- tumors and demonstrate that ERß functions as a molecular switch for EZH2, repurposing it for tumor suppressive activities and repression of oncogenic p65 signaling.

Rapid Discovery and Detection of Haemaphysalis longicornis through the Use of Passive Surveillance and Collaboration: Building a State Tick-Surveillance Network.

Between March 2019 and February 2020, Asian long-horned ticks (Haemaphysalis longicornis Neumann, 1901) were discovered and collected for the first time in one middle and seven eastern Tennessee counties, facilitated by a newly developed passive and collaborative tick-surveillance network. Network collaborators included federal, state, county, university, and private resource personnel working with companion animals, livestock, and wildlife. Specimens were collected primarily from dogs and cattle, with initial detections of female adult stage ticks by stakeholders associated with parasitology positions (e.g., entomologists and veterinary parasitologists). Initial county tick detections were confirmed with morphological and molecular identifications, and then screened for the presence of animal-associated pathogens (Anaplasma marginale, Babesia species, Ehrlichia species, and Theileria orientalis), for which all tests were negative. Herein, we describe the identification and confirmation of these tick specimens as well as other results of the surveillance collaboration.

An Interesting Presentation of Testosterone-Induced Arterial Thrombosis.

Testosterone replacement therapy (TRT) is an industry on the rise in large part due to an increase in direct-to-customer advertising targeting middle-aged men with non-specific symptoms. The biggest problem with unnecessary prescribing is that testosterone therapy is not without side effects. One of the more common adverse effects is erythrocytosis with subsequent thrombosis. It was originally postulated that thrombosis seen in patients on TRT was solely related to increasing in hemoglobin however, new studies demonstrate increasing episodes of thrombosis unrelated to hemoglobin or hematocrit. We report the case of a 38-year-old white male presenting to the clinic with infarction of bilateral feet and digits due to testosterone-induced thrombosis of dermal and epidermal arteries. Laboratory workup including vasculitis panel was negative and complete blood count (CBC) was within appropriate parameters. He was treated with anticoagulation, pain control, and vasodilatory therapy with subsequent improvement of symptoms. There have been many reported cases of testosterone-induced thrombosis of the venous system with occasional involvement of the renal arteries. However, cases involving thrombosis of dermal or epidermal arteries due to testosterone supplementation have never been reported. It could be beneficial to screen potential patients requiring TRT for hypercoagulable states such as Factor V Leiden and lupus anticoagulant.

Characteristics and Spatially Defined Immune (micro)landscapes of Early-stage PD-L1-positive Triple-negative Breast Cancer.

PURPOSE: Programmed death ligand 1 [PD-(L)1]-targeted therapies have shown modest survival benefit in triple-negative breast cancer (TNBC). PD-L1+ microenvironments in TNBC are not well characterized and may inform combinatorial immune therapies. Herein, we characterized clinicopathologic features, RNA-based immune signatures, and spatially defined protein-based tumor-immune microenvironments (TIME) in early-stage PD-L1+ and PD-L1- TNBC. EXPERIMENTAL DESIGN: From a large cohort of chemotherapy-naïve TNBC, clinicopathologic features, deconvoluted RNA immune signatures, and intraepithelial and stromal TIME (Nanostring GeoMX) were identified in subsets of PD-L1+ and PD-L1- TNBC, as defined by FDA-approved PD-L1 companion assays. RESULTS: 228 of 499 (46%) TNBC were PD-L1+ (SP142: ≥1% immune cells-positive). Using PD-L1 22C3, 46% had combined positive score (CPS) ≥ 1 and 16% had CPS ≥10. PD-L1+ TNBC were higher grade with higher tumor-infiltrating lymphocytes (TIL; P < 0.05). PD-L1 was not associated with improved survival following adjustment for TILs and other variables. RNA profiles of PD-L1+ TNBC had increased dendritic cell, macrophage, and T/B cell subset features; and decreased myeloid-derived suppressor cells. PD-L1+ stromal and intraepithelial TIMEs were highly enriched in IDO-1, HLA-DR, CD40, and CD163 compared with PD-L1-TIME, with spatially specific alterations in CTLA-4, Stimulator of Interferon Genes (STING), and fibronectin. Macrophage- and antigen presentation-related proteins correlated most strongly with PD-L1 protein. CONCLUSIONS: In this early-stage TNBC cohort, nearly 50% were PD-L1+ (SP142 companion assay) while 16% were PD-L1+ with the 22C3 companion assay. PD-L1+ TNBC had specific myeloid-derived and lymphoid features. Spatially defined PD-L1+ TIME were enriched in several clinically actionable immune proteins. These data may inform future studies on combinatorial immunotherapies for patients with PD-L1+ TNBC.See related commentary by Symmans, p. 5446.

Extended post-exercise hyperthermia in athletes with a spinal cord injury.

OBJECTIVES: Determine the extent and underlying causes of post-exercise hyperthermia in athletes with a spinal cord injury following exercise. DESIGN: Observational. METHODS: Thirty-one males (8 with tetraplegia [TP; C5-C8], 7 with high paraplegia [HP; T1-T5], 8 with low paraplegia [LP; T6-L1] and 8 able-bodied [AB]), recovered in 35°C/50%RH for 45min after 30-min of exercise at a metabolic heat production (Hprod) of 4.0W/kg (AB vs TP) or 6.0W/kg (AB vs HP vs LP). Esophageal (Tes), gastrointestinal (Tgi) and skin temperatures, Hprod, local sweat rate (LSR) and mean arterial pressure were measured. RESULTS: TP maintained a higher Tes (38.05°C [95% CI: 37.83°C, 38.28°C], AB: 36.77°C [36.56°C, 36.98°C], p<0.001) and Tgi (TP: 38.36°C [38.15°C, 38.58°C], AB: 37.26°C [37.04°C, 37.47°C], p<0.001), with peak values observed 45min post-exercise. Core temperatures all declined in HP, LP and AB, but HP maintained a higher Tes than AB (p=0.030), and higher Tgi than LP and AB (p=0.019). No differences in post-exercise Hprod were observed between TP and AB (p=0.264), or HP, LP and AB (p=0.124). Evaporative heat loss was estimated to be zero in TP, while back LSR was greater in HP than LP (p=0.009). Minimal dry heat loss occurred in SCI groups (TP: 9W/m2 [6, 12], HP: 4W/m2 [1, 6], LP: 2W/m2 [0, 5]). CONCLUSIONS: Substantial post-exercise hyperthermia is evident in TP (∼1.4°C hotter than AB after 45min of post-exercise recovery) due to minimal evaporation. HP have delayed post-exercise thermoregulatory recovery whereas LP respond similarly to AB.

Chronic Lymphocytic Leukemia of the Aortic Valve: A Case Report.

Chronic lymphocytic leukemia (CLL) is characterized by the chronic accumulation of mature B-cell lymphocytes in the bone marrow. CLL accounts for approximately one-quarter of new leukemia cases each year and is the most common leukemia in Western countries. Most notably, this leukemia involves the lymph nodes, spleen, and liver, whereas non-lymphoid tissue is seldom associated with CLL infiltration. A large percentage of patients are asymptomatic at presentation; however, for those who are symptomatic, lymphadenopathy is the most common presenting complaint. This is the case of a 75-year-old Caucasian male with CLL on ibrutinib who presented with chest pressure and worsening shortness of breath. The patient underwent cardiac catheterization, which revealed demonstrable aortic stenosis. His aortic valve was subsequently replaced, and tissue was sent for histochemical analysis. Stains were positive for CD20, BCL2, CD5, and CD23, compatible with the CLL of the valve. To be able to investigate those with a known leukemic disease in patients with valvular disease would be beneficial to clinicians as CLL can present in atypical locations.

Using Esterase Selectivity to Determine the In Vivo Duration of Systemic Availability and Abolish Systemic Side Effects of Topical ß-Blockers.

For disorders of the skin, eyes, ears, and respiratory tract, topical drugs, delivered directly to the target organ, are a therapeutic option. Compared with systemic oral therapy, the benefits of topical treatments include a faster onset of action, circumventing the liver first pass drug metabolism, and reducing systemic side effects. Nevertheless, some systemic absorption still occurs for many topical agents resulting in systemic side effects. One way to prevent these would be to develop drugs that are instantly degraded upon entry into the bloodstream by serum esterases. Because topical ß-blockers are used in glaucoma and infantile hemeangioma and cause systemic side effects, the ß-adrenoceptor system was used to test this hypothesis. Purified liver esterase reduced the apparent affinity of esmolol, an ester-containing ß-blocker used in clinical emergencies, for the human ß-adrenoceptors in a concentration and time-dependent manner. However, purified serum esterase had no effect on esmolol. Novel ester-containing ß-blockers were synthesized and several were sensitive to both liver and serum esterases. Despite good in vitro affinity, one such compound, methyl 2-(3-chloro-4-(3-((2-(3-(3-chlorophenyl)ureido)ethyl)amino)-2-hydroxypropoxy)phenyl)acetate, had no effect on heart rate when injected intravenously into rats, even at 10 times the equipotent dose of esmolol and betaxolol that caused short and sustained reductions in heart rate, respectively. Thus, ester-based drugs, sensitive to serum esterases, offer a mechanism for developing topical agents that are truly devoid of systemic side effects. Furthermore, differential susceptibility to liver and serum esterases degradation may also allow the duration of systemic availability for other drugs to be fine-tuned.

Frequency of MicroRNA Response Elements Identifies Pathologically Relevant Signaling Pathways in Triple-Negative Breast Cancer.

Complex interactions between mRNAs and microRNAs influence cellular functions. The mRNA-microRNA interactions also determine the post-transcriptional availability of mRNAs and unbound microRNAs. MicroRNAs binds to one or more microRNA response elements (MREs) located on the 3'UTR of mRNAs. In this study, we leveraged MREs and their frequencies in cancer and matched normal tissues to obtain insights into disease-specific interactions between mRNAs and microRNAs. We developed a bioinformatics method "ReMIx" that utilizes RNA sequencing (RNA-Seq) data to quantify MRE frequencies across the transcriptome. We applied ReMIx to triple-negative (TN) breast cancer tumor-normal adjacent pairs and identified MREs specific to TN tumors. ReMIx identified candidate mRNAs and microRNAs in the MAPK signaling cascade. Further analysis of MAPK gene regulatory networks revealed microRNA partners that influence and modulate MAPK signaling. In conclusion, we demonstrate a novel method of using MREs in the identification of functionally relevant mRNA-microRNA interactions in TN breast cancer.

Sire contribution to pregnancy loss in different periods of embryonic and fetal development of beef cows.

The objective was to evaluate the effect of service sire on pregnancy results during different periods of embryonic and fetal development. Angus cows (n = 658) were timed artificially inseminated (TAI) on day 0 after synchronization of estrus using one of eight Angus sires. Estrus expression prior to TAI was evaluated using estrus breeding indicators. Blood samples were collected on days 0, 24 and 31 for quantification of circulating pregnancy-associated glycoprotein (PAG). Pregnancy was diagnosed at day 24 based on blood-based test, and on days 31 and 60 by transrectal ultrasonography to determine early embryonic mortality (EEM; between days 24 and 31) and late embryonic/early fetal mortality (LEM; between days 31 and 60). Sires were retrospectively classified according to the amount of pregnancy loss in each evaluated interval. Overall EEM was 5.54%, with values ranging from 1.8 to 11.7% among sires, whereas LEM was 6.7% with values ranging from 2.3 to 12.6% among sires. Individual sires had different phenotypes in regard to pregnancy loss during different developmental periods, indicating the importance of evaluating multiple milestones of embryonic development when classifying sire fertility. No difference (P ≥ 0.05) was observed in serum concentrations of PAG in cows bred with sires of different phenotypes. Pregnancy rate by sire was also influenced by estrus expression. Sires with a greater number of cows pregnant without estrus expression, had similar incidence of early (P = 0.71) but greater incidence of late embryonic mortality (P = 0.05). These results are significant to characterize sire contribution to pregnancy maintenance and establishment in beef cows and to serve as basis of studies to identify markers to improve sire fertility evaluation.