Somatic BrafV600E mutation in the cerebral endothelium induces brain arteriovenous malformations.

Current treatments of brain arteriovenous malformation (BAVM) are associated with considerable risks and at times incomplete efficacy. Therefore, a clinically consistent animal model of BAVM is urgently needed to investigate its underlying biological mechanisms and develop innovative treatment strategies. Notably, existing mouse models have limited utility due to heterogenous and untypical phenotypes of AVM lesions. Here we developed a novel mouse model of sporadic BAVM that is consistent with clinical manifestations in humans. Mice with BrafV600E mutations in brain ECs developed BAVM closely resembled that of human lesions. This strategy successfully induced BAVMs in mice across different age groups and within various brain regions. Pathological features of BAVM were primarily dilated blood vessels with reduced vascular wall stability, accompanied by spontaneous hemorrhage and neuroinflammation. Single-cell sequencing revealed differentially expressed genes that were related to the cytoskeleton, cell motility, and intercellular junctions. Early administration of Dabrafenib was found to be effective in slowing the progression of BAVMs; however, its efficacy in treating established BAVM lesions remained uncertain. Taken together, our proposed approach successfully induced BAVM that closely resembled human BAVM lesions in mice, rendering the model suitable for investigating the pathogenesis of BAVM and assessing potential therapeutic strategies.

From Bi-Level to One-Level: A Framework for Structural Attacks to Graph Anomaly Detection.

The success of graph neural networks stimulates the prosperity of graph mining and the corresponding downstream tasks including graph anomaly detection (GAD). However, it has been explored that those graph mining methods are vulnerable to structural manipulations on relational data. That is, the attacker can maliciously perturb the graph structures to assist the target nodes in evading anomaly detection. In this article, we explore the structural vulnerability of two typical GAD systems: unsupervised FeXtra-based GAD and supervised graph convolutional network (GCN)-based GAD. Specifically, structural poisoning attacks against GAD are formulated as complex bi-level optimization problems. Our first major contribution is then to transform the bi-level problem into one-level leveraging different regression methods. Furthermore, we propose a new way of utilizing gradient information to optimize the one-level optimization problem in the discrete domain. Comprehensive experiments demonstrate the effectiveness of our proposed attack algorithm BinarizedAttack .

A novel method for extraction of high purity and high production Phytophthora sojae oospores.

BACKGROUND: Phytophthora sojae, a soil-borne oomycete pathogen, has been a yield limiting factor for more than 60 years on soybean. The resurgence of P. sojae (Phytophthora sojae) is primarily ascribed to the durable oospores found in soil and remnants of the disease. P. sojae is capable of infesting at any growth periods of the soybean, and the succeed infestation of P. sojae is predominantly attributed to long-lived oospores present in soil. Comprehending the molecular mechanisms that drive oospores formation and their significance in infestation is the key for effective management of the disease. However, the existing challenges in isolating and extracting significant quantities of oospores pose limitations in investigating the sexual reproductive stages of P. sojae. RESULTS: The study focused on optimizing and refining the culture conditions and extraction process of P. sojae, resulting in establishment of an efficient and the dependable method for extraction. Novel optimized approach was yielded greater quantities of high-purity P. sojae oospores than traditional methods. The novel approach exceeds the traditional approaches with respect to viability, survival ability, germination rates of new oospores and the pathogenicity of oospores in potting experiments. CONCLUSION: The proposed method for extracting P. sojae oospores efficiently yielded a substantial quantity of highly pure, viable, and pathogenic oospores. The enhancements in oospores extraction techniques will promote the research on the sexual reproductive mechanisms of P. sojae and lead to the creation of innovative and effective approaches for managing oomycete diseases.

Summary of evidence on comprehensive healthcare for chemotherapy-induced peripheral neuropathy in cancer patients.

OBJECTIVE: This paper aims to provide an evidence-based summary of the most effective strategies for comprehensive healthcare of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients. METHOD: Following the "6S" model, relevant evidence on CIPN management was collected from reputable evidence-based resource websites and databases nationally and internationally. The included articles were evaluated for methodological quality, and evidence was extracted using the Australian JBI Evidence-based Health Care Center's literature evaluation standard (2016 edition). RESULTS: A total of 60 articles were included in this study, comprising 2 guidelines, 5 expert consensus statements, and 53 systematic reviews. The findings of these articles were summarized across 7 dimensions, including risk factor screening, assessment, diagnosis, prevention, treatment, management, and health education, resulting in the identification of 42 relevant pieces of evidence. CONCLUSIONS: This study provides a comprehensive synthesis of evidence-based recommendations for managing CIPN in cancer patients, offering guidance for healthcare professionals engaged in clinical practice. However, when implementing these recommendations, it is crucial to consider the individual patient's clinical circumstances, preferences, and expert judgment, ensuring feasibility and applicability in real-world clinical settings.

Successful treatment of Purpureocillium lilacinum pulmonary infection with isavuconazole: A case report.

BACKGROUND: Purpureocillium lilacinum (P. lilacinum) is a saprophytic fungus widespread in soil and vegetation. As a causative agent, it is very rarely detected in humans, most commonly in the skin. CASE SUMMARY: In this article, we reported the case of a 72-year-old patient with chronic lymphocytic leukemia who was admitted with cough and fever. Computed tomography revealed an infection in the right lower lobe. Bronchoalveolar lavage fluid culture and metagenomic next-generation sequencing were ultimately confirmed to have a pulmonary infection with P. lilacinum. She was eventually discharged with good outcomes after treatment with isavuconazole. CONCLUSION: Pulmonary infection with P. lilacinum was exceedingly rare. While currently there are no definitive therapeutic agents, there are reports of high resistance to amphotericin B and fluconazole and good sensitivity to second-generation triazoles. The present report is the first known use of isavuconazole for pulmonary P. lilacinum infection. It provides new evidence for the characterization and treatment of clinical P. lilacinum lung infections.

[Two kinds of percutaneous endoscopic lumbar decompression in the treatment of single level lumbar lateral recess stenosis].

OBJECTIVE: To prospectively compare the clinical efficacy and radiographic outcomes between interlaminar percutaneous endoscopic lumbar decompression(IL-PELD) and transforaminar percutaneous endoscopic lumbar decompression(TF-PELD) in the treatment of single-segment lumbar lateral recess stenosis. METHODS: From April 2018 to July 2021, 85 patients with single-segment lumbar lateral recess stenosis underment percutaneous endoscopic lumbar decompression.There were 44 males and 41 females, aged from 49 to 81 years old with an average of (65.5±8.3) years old, duration of lumbar lateral recess stenosis ranging from 3 to 83 months with an average of (26.7±16.5) months. They were divided into IL-PELD group and TF-PELD group according to the different operation methods. There were 47 patients in the IL-PELD group, including 28 males and 19 females aged from 50 to 80 yeaes old with an average age was (66.7±9.3) years old. The disease duration ranged from 3 to 65 months with an average of (25.7±15.0) months. There were 38 patients in the TF-PELD group, including 16 males and 22 females, aged from 51 to 78 years old with an average of(64.1±7.6) years old. The disease duration ranged from 4 to 73 months with an average of (27.9±18.3) months The operation time, intraoperative blood loss, intraoperative fluoroscopy, hospitalization day and complications of the two groups were recorded. Visual analogue scale (VAS) to evaluate low back pain and lower limb pain, Oswestry disability index(ODI) to evaluate lumbar function in preoperative and postoperative period(1month, 6 months and last follow-up)were recorded. the sagittal diameter of the lateral recess of the responsible intervertebral space in preoperative and 1 week after the operation were recorded. RESULTS: The operation was successfully completed in both groups without serious complications such as vascular injury, dural sac tear and nerve injury. The operation time in IL-PED group(69.3±19.3)min was significantly longer than that in TF-PELD group(57.5±14.5)min (P<0.05). There was no significant difference in the intraoperative blood loss between the two groups (P>0.05). The number of intraoperative fluoroscopy in TF-PELD group (8.8±2.6)times was significantly higher than that in IL-PED group(4.8±1.2)times (P<0.05). The hospitalization days of the two groups were not statistically significant (P>0.05). VAS for low back and lower extremity pain and ODI were (5.1±2.2), (6.9±1.3) scores and (71.4±12.6) % in IL-PELD group, and (4.7±1.8), (6.9±1.3) scores and (68.4±13.9)% in TF-PELD group. In the IL-PELD group, the VAS of low back pain was (2.4±1.5), (1.6±0.8), (1.4±0.9) scores, and the VAS of lower extremity pain was (3.0±1.2), (1.6±0.7), (1.5±1.0) scores, ODI was (32.6±11.9) %, (17.4±6.5) %, (19.3±9.3)%;In TF-PELD group, the VAS of low back pain was (2.6±1.4), (1.5±0.6), (1.4±1.0) scores, and the VAS of lower extremity pain was (2.8±1.2), (1.6±0.6), (1.5±1.2) scores, The ODI was (32.0±11.2) %, (15.0±6.1) %, and (20.0±11.3) %. The VAS and ODI of the two groups at each time point after operation were significantly improved compared with those before operation (P<0.05), but there was no statistically significant difference between the groups (P>0.05), and there was no statistically significant difference in the interaction between different time points and groups (P>0.05). At 1 week after operation, the sagittal diameter of lateral recess in both groups was significantly increased compared with that before operation (P<0.05), but there was no significant difference between the two groups at each time point (P>0.05). According to the modified Macnab criteria, IL-PELD group was rated as excellent in 24 cases, good in 19 cases and fair in 4 cases. In TF-PELD group the results were excellent in 19 cases, good in 15 cases, fair in 3 cases and poor in 1 case. There was no significant difference between the two groups (P>0.05). CONCLUSION: IL-PELD and TF-PELD can expand the lateral recess in the treatment of single level lumbar lateral recess stenosis, and have achieved good clinical effects.

Unified Strategy Enables the Collective Syntheses of Structurally Diverse Indole Alkaloids.

Natural products and their analogues are significant sources of therapeutic lead compounds. However, synthetic strategies for generating large collections of these molecules remain a significant challenge. The most difficult step in their synthesis is the design of a common intermediate that can be easily transformed into natural products belonging to different families. This study demonstrates the evolution of synthetic tactics designed to assemble the functionalized piperidines present in indole alkaloids from a common intermediate. More importantly, we also report a previously unknown Ir- and Er-catalyzed dehydrogenative spirocyclization reaction that enables direct access to spirocyclic oxindole alkaloids. As a practical application, the asymmetric total syntheses of 29 natural alkaloids belonging to different families were accomplished by following a uniform synthetic route. The proposed methodology extends the capability of the iridium-catalyzed dehydrogenative coupling reaction to the realm of indole-alkaloid synthesis and provides new opportunities for the efficient preparation of natural product-like molecules.

In vitro and vivo anti-tumor activity and mechanisms of the new cryptotanshinone derivative 11 against hepatocellular carcinoma.

Global burden of hepatocellular carcinoma (HCC) is increasing. Chemotherapy and immunotherapy are the prevailing options for therapy. Developing new therapeutic strategies for HCC patients is still highly desirable. Recent studies demonstrate that cryptotanshinone is capable of inhibiting tumor growth in HCC and induces antitumor immunity in vitro. In our previous research, we discovered a new cryptotanshinone derivative 11 as an effective immunoregulatory enzyme indoleamine 2, 3-dioxygenase 1 (IDO1) inhibitor. This study aims to evaluate its in vitro and in vivo antitumor activity against hepatocellular carcinoma. 11 displayed robust anti-proliferative activity against HCC cell lines and promoted apoptosis of HCC cell line through the mitochondrial-mediated apoptotic pathway. In H22 tumor-bearing mice models, 11 exhibited significant in vivo anti-tumor activity with different administration routes. And no obvious toxicity was observed. RNA-seq analysis demonstrated the differential expressed genes and alteration of key pathways associated with immune responses after administration of 11. Up-regulation of anti-tumor cytokines and down-regulation of cytokines that promote tumor growth were indicated and further validated. Our study demonstrates that 11 exhibits promising anti-tumor activity both in vitro and in vivo against hepatocellular carcinoma cancer. It is a lead compound for HCC immunotherapy and is worthy for further development.

Comparative Bioequivalence and Food Effect of Two Formulations of 30-mg Nifedipine Controlled-Release Tablets in Healthy Chinese Adults.

Nifedipine is a potent antihypertensive medication classified as a dihydropyridine calcium channel blocker. The objective of this trial was to assess the bioequivalence of a 30-mg nifedipine controlled-release tablet and a reference drug in a cohort of healthy Chinese individuals. Two independent open-label, randomized, single-dose, crossover studies were conducted, 1 under fasting conditions (N = 44, with 1 participant dropping out midway) and the other under fed conditions (N = 44, with 4 participants dropping out midway). Plasma concentrations of nifedipine were determined using liquid chromatography-mass spectrometry, and pharmacokinetic (PK) parameters were calculated using noncompartmental analysis with Phoenix WinNonlin 8.0 software. In both fasting and fed studies, reasonable bioequivalence was observed for the PK parameters of both the test product and the reference drug. A good safety profile was demonstrated for both the test product and reference drug, with no serious adverse events reported, and both were similarly well tolerated. An important observation with food coadministration was that systemic exposure to nifedipine (based on area under the curve, AUC0-∞) was reduced by approximately 12%. The bioequivalence of the test product and reference drug under fasting/fed conditions in healthy subjects in China was demonstrated by the study results.

[Effect and complication among different kinds of spinal endoscopic surgery for lumbar disc herniation].

OBJECTIVE: To compare clinical efficacy and complication rate of percutaneous endoscopic transforaminal discectomy(PETD),percutaneous endoscopic interlaminar discectomy (PEID) and unilateral biportal endoscopic (UBE) in treating single-segment lumbar disc herniation(LDH). METHODS: From October 2019 to August 2021,121 LDH patients with single-segment treated by spinal endoscopy were retrospectively analyzed and divided into three groups. In PETD group,there were 48 patients,including 19 males and 29 females,aged from 18 to 72 years old with an average of (44.0±13.9) years old;3 patients with L3,4 segments,27 patients with L4,5 segments,and 18 patients with L5S1 segments. In PEID group,there were 43 patients,including 23 males and 20 females,aged from 20 to 69 years old with an average of (40.1±12.1) years old;1 patient with L3,4 segments,15 patients with L4,5 segments,and 27 patients with L5S1 segments. In UBE group,there were 30 patients,including 12 males and 18 females,aged from 29 to 72 years old with an average of (41.2±15.0) years old;1 patient with L3,4 segments,18 patients with L4,5 segments,and 11 patients with L5S1 segments. Operation time,blood loss,fluoroscopy times and complications among three groups were observed and compared. Before opertaion,3 months after operation and at the latest follow-up,visual analogue scale (VAS) was used to evaluate low back pain and lower extremity pain,Oswestry disfunction index (ODI) was used to evaluate lumbar function,and modified MacNab was used to evaluate clinical efficacy at the latest follow-up. RESULTS: All patients were performed endoscopic spinal surgery completly and were followed up for at least 12 months. One patient occurred dural sac rupture both in PETD and PEID group,and dural sac rupture was small,and there was no obvious discomfort after operation. Two patients were occurred intraoperative rupture of dural sac in UBE group. One patient was occurred cerebrospinal fluid leakage after operation,and was improved after rest in supine position and fluid rehydration. One patient without no significant postoperative discomfort. (1)There were no significant difference in operating time,blood loss and hospital stay between PETD and PEID group (P>0.05),while UBE group was higher than those of PETD and PEID group (P<0.05). There was no statistical significance in fluoroscopy times between PEID and UBE group (P>0.05),but PETD group was higher than that of PEID and UBE group (P<0.05). (2)VAS of low back pain at 3 months after operation in UBE group was higher than that in PETD and PEID group (P<0.05),but there was no significant difference between PETD and PEID group (P>0.05). At the latest follow-up,there was no significant difference in VAS of low back pain among three groups (P>0.05). (3)Lower extremity pain of VAS and ODI among 3 groups after operation were significantly improved at all time points compared with those before opertaion(P<0.05),and there were no statistical significance between groups (P>0.05),and there were no statistical significance in interaction between different time points and operation groups (P>0.05). (4) At the latest follow-up,according to the modified MacNab standard,the results of PETD group were excellent in 27 patients,good in 16 patients,moderate in 4 patients,poor in 1 patient;in PEID group,27 patients got excellent result,12 good,3 moderate,and 1 poor;in UBE group,16 patients got excellent,10 good,2 moderate,and 2 poor. There was no significant difference among three groups (χ2=0.308,P>0.05). Recurrence of lumbar disc herniation occurred in 1 patient among each three groups,symptoms were improved in 2 patients after symptomatic treatment,and 1 patient was treated in other hospitals. CONCLUSION: PETD,PEID and UBE techniques could achieve good early clinical effects in treating lumbar disc herniation with similar complication rates. Both of PETD and PEID are single-channel minimally invasive surgery,with mild intraoperative tissue damage and quick postoperative recovery; while intraoperative fluoroscopy of PETD was relatively more frequent, and PEID was more suitable for L5S1 segment;UBE is a two-channel surgery,in which the intraoperative soft tissue damage is more severe,but exposure is broad,which is more suitable for complex cases.

AStruct: detection of allele-specific RNA secondary structure in structuromic probing data.

BACKGROUND: Uncovering functional genetic variants from an allele-specific perspective is of paramount importance in advancing our understanding of gene regulation and genetic diseases. Recently, various allele-specific events, such as allele-specific gene expression, allele-specific methylation, and allele-specific binding, have been explored on a genome-wide scale due to the development of high-throughput sequencing methods. RNA secondary structure, which plays a crucial role in multiple RNA-associated processes like RNA modification, translation and splicing, has emerged as an essential focus of relevant research. However, tools to identify genetic variants associated with allele-specific RNA secondary structures are still lacking. RESULTS: Here, we develop a computational tool called 'AStruct' that enables us to detect allele-specific RNA secondary structure (ASRS) from RT-stop based structuromic probing data. AStruct shows robust performance in both simulated datasets and public icSHAPE datasets. We reveal that single nucleotide polymorphisms (SNPs) with higher AStruct scores are enriched in coding regions and tend to be functional. These SNPs are highly conservative, have the potential to disrupt sites involved in m6A modification or protein binding, and are frequently associated with disease. CONCLUSIONS: AStruct is a tool dedicated to invoke allele-specific RNA secondary structure events at heterozygous SNPs in RT-stop based structuromic probing data. It utilizes allelic variants, base pairing and RT-stop information under different cell conditions to detect dynamic and functional ASRS. Compared to sequence-based tools, AStruct considers dynamic cell conditions and outperforms in detecting functional variants. AStruct is implemented in JAVA and is freely accessible at: https://github.com/canceromics/AStruct .

Construction and evaluation of a cloud follow-up platform for gynecological patients receiving chemotherapy.

BACKGROUND: Patient follow-up is an essential component of hospital management. In the current information era, the patient follow-up scheme is expected to be replaced by Internet technology. This study constructed a cloud follow-up platform for gynecological chemotherapy patients and assessed its cost-effectiveness and patients' feedback. METHODS: A total of 2,538 patients were followed up using a cloud follow-up system between January and October 2021. Prior to this, 690 patients were followed manually via telephone calls. Patients' characteristics, follow-up rate, satisfaction, and session duration were compared between the cloud follow-up and manual follow-up groups. In addition, the read rate of health education materials in the cloud follow-up group was analyzed. RESULTS: General information, including age, education attainment, cancer stage, and disease category, and follow-up rate (cloud: 6,957/7,614, 91.4%; manual: 1,869/2,070, 90.3%; P = 0.13) did not significantly differ between the two groups. The follow-up satisfaction of the cloud follow-up patients was significantly better than that of the manual follow-up group (cloud: 7,192/7,614, 94.5%; manual: 1,532/2,070, 74.0%; P<0.001). The time spent on the follow-up was approximately 1.2 h for 100 patients in the cloud follow-up group and 10.5 h in the manual follow-up group. Multivariate analysis indicated that the cloud follow-up group had significantly greater follow-up satisfaction (odds ratio: 2.239, 95% CI: 1.237 ~ 5.219). Additionally, the average follow-up duration of the cloud follow-up group decreased by 9.287 h (coefficient: -9.287, 95% CI: -1.439~-0.165). The read rate of health education materials was 72.9% in the cloud follow-up group. CONCLUSIONS: The follow-up effect of the cloud follow-up group was not inferior to that of the manual follow-up group. The cloud follow-up was more effective for prevention and control requirements in the post-epidemic era. Cloud follow-up can save medical resources, improve cost-effectiveness, provide sufficient health education resources for patients, and improve their satisfaction.

TSCRE: a comprehensive database for tumor-specific cis-regulatory elements.

Cis-regulatory elements (CREs) and super cis-regulatory elements (SCREs) are non-coding DNA regions which influence the transcription of nearby genes and play critical roles in development. Dysregulated CRE and SCRE activities have been reported to alter the expression of oncogenes and tumor suppressors, thereby regulating cancer hallmarks. To address the strong need for a comprehensive catalogue of dysregulated CREs and SCREs in human cancers, we present TSCRE (http://tscre.zsqylab.com/), an open resource providing tumor-specific and cell type-specific CREs and SCREs derived from the re-analysis of publicly available histone modification profiles. Currently, TSCRE contains 1 864 941 dysregulated CREs and 68 253 dysregulated SCREs identified from 1366 human patient samples spanning 17 different cancer types and 9 histone marks. Over 95% of these elements have been validated in public resources. TSCRE offers comprehensive annotations for each element, including associated genes, expression patterns, clinical prognosis, somatic mutations, transcript factor binding sites, cancer-type specificity, and drug response. Additionally, TSCRE integrates pathway and transcript factor enrichment analyses for each study, enabling in-depth functional and mechanistic investigations. Furthermore, TSCRE provides an interactive interface for users to explore any CRE and SCRE of interest. We believe TSCRE will be a highly valuable platform for the community to discover candidate cancer biomarkers.

Oral cancer cell to endothelial cell communication via exosomal miR-21/RMND5A pathway.

Required for meiotic nuclear division 5 homolog A (RMND5A), a novel ubiquitin E3 Ligase, has been reported to correlate with poor prognosis of several cancers. However, its role in endothelial cells has not been reported. In this study, overexpression of RMND5A in human umbilical vein endothelial cells (HUVECs) was performed via lentiviral infection, followed by MTT, would healing and tube formation assay as well as signaling analysis. Moreover, crosstalk between HUVECs and oral squamous cell carcinoma (OSCC) cells was investigated by indirect co-culture with condition medium or tumor cell derived exosomes. Our results showed that overexpression of RMND5A reduced the proliferation, migration and tube formation ability of HUVECs by inhibiting the activation of ERK and NF-κB pathway. Interestingly, OSCC cells can inhibit RMND5A expression of endothelial cells via exosomal miR-21. In summary, our present study unveils that OSCC cells can activate endothelial cells via exosomal miR-21/RMND5A pathway to promote angiogenesis, which may provide novel therapeutic targets for the treatment of OSCC.

Refining the 8th edition TNM classification for EBV related nasopharyngeal carcinoma.

The AJCC/UICC TNM classification describes anatomic extent of tumor progression and guides treatment decisions. Our comprehensive analysis of 8,834 newly diagnosed patients with non-metastatic Epstein-Barr virus related nasopharyngeal carcinoma (NPC) from six Chinese centers indicates certain limitations in the current staging system. The 8th edition of the AJCC/UICC TNM classification inadequately differentiates patient outcomes, particularly between T2 and T3 categories and within the N classification. We propose reclassifying cases of T3 NPC with early skull-base invasion as T2, and elevating N1-N2 cases with grade 3 image-identified extranodal extension (ENE) to N3. Additionally, we suggest combining T2N0 with T1N0 into a single stage IA. For de novo metastatic (M1) NPC, we propose subdivisions of M1a, defined by 1-3 metastatic lesions without liver involvement, and M1b, characterized by >3 metastatic lesions or liver involvement. This proposal better reflects responses of NPC patients to the up-to-date treatments and their evolving risk profiles.

Causalized convergent cross-mapping and its approximate equivalence with directed information in causality analysis.

Convergent cross-mapping (CCM) has attracted increased attention recently due to its capability to detect causality in nonseparable systems under deterministic settings, which may not be covered by the traditional Granger causality. From an information-theoretic perspective, causality is often characterized as the directed information (DI) flowing from one side to the other. As information is essentially nondeterministic, a natural question is: does CCM measure DI flow? Here, we first causalize CCM so that it aligns with the presumption in causality analysis-the future values of one process cannot influence the past of the other, and then establish and validate the approximate equivalence of causalized CCM (cCCM) and DI under Gaussian variables through both theoretical derivations and fMRI-based brain network causality analysis. Our simulation result indicates that, in general, cCCM tends to be more robust than DI in causality detection. The underlying argument is that DI relies heavily on probability estimation, which is sensitive to data size as well as digitization procedures; cCCM, on the other hand, gets around this problem through geometric cross-mapping between the manifolds involved. Overall, our analysis demonstrates that cross-mapping provides an alternative way to evaluate DI and is potentially an effective technique for identifying both linear and nonlinear causal coupling in brain neural networks and other settings, either random or deterministic, or both.

Concomitant Thoracic Spinal Dural Arteriovenous Fistula and Spinal Cavernous Malformation.

Both spinal dural arteriovenous fistula (SDAVF) and spinal cavernous malformation (SCM) are uncommon vascular malformations. To our knowledge, such a case of SDAVF concomitant with SCM has not been reported. We encountered a case of a 55-year-old man who had weakness and numbness in both lower extremities. Magnetic resonance imaging showed a round-shape lesion identified as a cavernous malformation in the middle segment of the thoracic spine, with spinal edema and obvious flow voids. Diagnostic angiography revealed an SDAVF fed by the right T7 radicular artery with venous drainage. The intramedullary venous hypertension due to fistula was suspected of inducing the formation of SCM. This case may provide new insight into the pathogenesis of SCM.

Understanding adsorption behavior of Polysorbate-20 to sterile filters in therapeutic proteins final filtration process.

Surfactants are commonly used in the therapeutic protein manufacturing process as stabilizer. Polysorbate-20 (PS-20) is one of the most commonly used surfactants to mitigate protein aggregation in the therapeutic protein formulation. It has been observed that polysorbate can be adsorbed by sterile filters during the final filtration process, which poses risk of uneven distribution and potentially reduced polysorbate concentration in final products. In this study, we evaluated the PS-20 adsorption behavior using commonly used sterilizing-grade microfiltration (MF) membranes via a customized filtration set-up. The effect of membrane properties, including the membrane materials, modification, and layer configuration were studied. In addition, the effect of PS-20 concentration was evaluated and the PS-20 adsorption amount by each type of membranes was determined quantitatively and showed good agreement with the in-process adsorption results. Finally, the selection of sterile filters and strategy of pre-flush are discussed for ensuring accurate PS-20 content in the final therapeutic protein drug product.