Identification of potential therapeutic targets for breast cancer using Mendelian randomization analysis and drug target prediction.

Breast cancer stands as the foremost cause of cancer-related mortality among women, presenting a substantial economic impact on society. The limitations in current therapeutic options, coupled with poor patient tolerance, underscore the urgent need for novel treatments. Our study embarked on a genomic association exploration of breast cancer, leveraging whole-genome sequencing data from the Finngen database, complemented by expression quantitative trait loci (eQTL) insights from the eQTLGen and GTEx Consortiums. An initial investigation was conducted through summary-based Mendelian randomization (MR) to pinpoint primary eQTLs. Analysis of blood specimens revealed 103 eQTLs significantly correlated with breast cancer. Focusing our efforts, we identified 19 candidates with potential therapeutic significance. Further scrutiny via two-sample MR pinpointed UROD, LMO4, HORMAD1, and ZSWIM5 as promising targets for breast cancer therapy. Our research sheds light on new avenues for the treatment of breast cancer, highlighting the potential of genomic association studies in uncovering viable therapeutic targets.

A new charge transfer pathway in the MoSe2-WSe2 heterostructure under the conditions of B-excitons being resonantly pumped.

Most transition metal dichalcogenide (TMD) heterostructures (HSs) exhibit a type II band alignment, leading to a charge transfer process accompanied by the transfer of spin-valley polarization and spontaneous formation of interlayer excitons. This unique band structure facilitates achieving a longer exciton lifetime and extended spin-valley polarization lifetime. However, the mechanism of charge transfer in type II TMD HSs is not fully comprehended. Here, the ultrafast charge transfer process is studied in MoSe2-WSe2 HS via valley-solved broadband pump-probe spectroscopy. Under the conditions of B-excitons of WSe2 and MoSe2 being resonantly pumped, a new charge transfer pathway through the higher energy state associated with the B-exciton is found. Meanwhile, the holes (electrons) in the WSe2 (MoSe2) layer of MoSe2-WSe2 HS produce obvious spin-valley polarization even under the condition of B-exciton of WSe2 (MoSe2) being resonantly pumped, and the lifetime can reach tens of ps, which is in stark contrast to the absence of A-exciton spin-valley polarization in monolayer WSe2 (MoSe2) under the same pumping condition. The results deepen the insight into the charge transfer process in type II TMD HSs and show the great potential of TMD HSs in the application of spin-valley electronics devices.

Safety and immunogenicity of CoronaVac in healthy adults: A prospective observational multicenter real-world study in Henan Province, China.

Vaccination has emerged as the primar approach for managing the COVID-19 pandemic. Despite certain clinical trials reporting the safety and immunogenicity of CoronaVac, additional multicenter real-world studies are still necessary. In this study, we recruited 506 healthy volunteers who were not infected with COVID-19 or vaccinated. Each participant provided peripheral blood samples three times: prior to the first dose of vaccine, prior to the second dose, and 8 weeks following the second dose. Ultimately, 388 participants completed the entire follow-up process. No serious adverse events were observed among any of the participants. Within 1 week of vaccination, 13.4% of participants experienced systemic adverse reactions, with fatigue (5.93%) and dizziness (3.35%) being the most frequent. Although some clinical indicators, including creatinine, significantly changed after vaccination (p < 0.05), the mean of all altered indicators remained within the normal range. The positive rates of neutralizing antibodies (NAb), IgG, and IgM were 12.3%, 18.85%, and 5.24% prior to the second dose, respectively; and 57.99%, 86.34%, and 2.32% at 8 weeks following the second dose, respectively. Additionally, seven indicators, such as sex, age, and BMI, were significantly correlated with NAb (p < 0.05). Finally, a prediction model was developed based on age, monocytes, and alanine aminotransferase (ALT) with an AUC value of 87.56% in the train set and 80.71% in the test set. This study demonstrated that safety and immunogenicity of CoronaVac were good. The prediction model based on the baseline clinical characteristics prior to vaccination can help to develop more suitable vaccination strategies.

Association between sleep duration, depression and breast cancer in the United States: a national health and nutrition examination survey analysis 2009-2018.

OBJECTIVE: Breast cancer is the most common cancer in women, threatening both physical and mental health. The epidemiological evidence for association between sleep duration, depression and breast cancer is inconsistent. The aim of this study was to determine the association between them and build machine-learning algorithms to predict breast cancer. METHODS: A total of 1,789 participants from the National Health and Nutrition Examination Survey (NHANES) were included in the study, and 263 breast cancer patients were identified. Sleep duration was collected using a standardized questionnaire, and the Nine-item Patient Health Questionnaire (PHQ-9) was used to assess depression. Logistic regression yielded multivariable-adjusted breast cancer odds ratios (OR) and 95% confidence intervals (CI) for sleep duration and depression. Then, six machine learning algorithms, including AdaBoost, random forest, Boost tree, artificial neural network, limit gradient enhancement and support vector machine, were used to predict the development of breast cancer and find out the best algorithm. RESULTS: Body mass index (BMI), race and smoking were statistically different between breast cancer and non-breast cancer groups. Participants with depression were associated with breast cancer (OR = 1.99, 95%CI: 1.55-3.51). Compared with 7-9h of sleep, the ORs for <7 and >9 h of sleep were 1.25 (95% CI: 0.85-1.37) and 1.05 (95% CI: 0.95-1.15), respectively. The AdaBoost model outperformed other machine learning algorithms and predicted well for breast cancer, with an area under curve (AUC) of 0.84 (95%CI: 0.81-0.87). CONCLUSIONS: No significant association was observed between sleep duration and breast cancer, and participants with depression were associated with an increased risk for breast cancer. This finding provides new clues into the relationship between breast cancer and depression and sleep duration, and provides potential evidence for subsequent studies of pathological mechanisms.

Prenatal MRI assessment of mediastinal shift angle as a feasible and effective risk stratification tool in isolated right-sided congenital diaphragmatic hernia.

OBJECTIVES: To develop a mediastinal shift angle (MSA) measurement method applicable to right-sided congenital diaphragmatic hernia (RCDH) in fetal MRI and to validate the predictive value of MSA in RCDH. METHODS: Twenty-seven fetuses with isolated RCDH and 53 controls were included in our study. MSA was measured on MRI axial image at the level of four-chamber view of the fetal heart. The angle between the sagittal midline landmark line and the left boundary landmark line touching tangentially the lateral wall of the left ventricle was used to quantify MSA for RCDH. Appropriate statistical analyses were performed to determine whether MSA can be regarded as a valid predictive tool for postnatal outcomes. Furthermore, predictive performance of MSA was compared with that of lung area to head circumference ratio (LHR), observed/expected LHR (O/E LHR), total fetal lung volume (TFLV), and observed/expected TFLV (O/E TFLV). RESULTS: MSA was significantly higher in the RCDH group than in the control group. MSA, LHR, O/E LHR, TFLV, and O/E TFLV were all correlated with postnatal survival, pulmonary hypertension (PH), and extracorporeal membrane oxygenation (ECMO) therapy (p < 0.05). Value of the AUC demonstrated good predictive performance of MSA for postnatal survival (0.901, 95%CI: (0.781-1.000)), PH (0.828, 95%CI: (0.661-0.994)), and ECMO therapy (0.813, 95%CI: (0.645-0.980)), which was similar to O/E TFLV but slightly better than TFLV, O/E LHR, and LHR. CONCLUSIONS: We developed a measurement method of MSA for RCDH for the first time and demonstrated that MSA could be used to predict postnatal survival, PH, and ECMO therapy in RCDH. CLINICAL RELEVANCE STATEMENT: Newly developed MRI assessment method of fetal MSA in RCDH offers a simple and effective risk stratification tool for patients with RCDH. KEY POINTS: • We developed a measurement method of mediastinal shift angle for right-sided congenital diaphragmatic hernia for the first time and demonstrated its feasibility and reproducibility. • Mediastinal shift angle can predict more prognostic information other than survival in right-sided congenital diaphragmatic hernia with good performance. • Mediastinal shift angle can be used as a simple and effective risk stratification tool in right-sided congenital diaphragmatic hernia to improve planning of postnatal management.

Spleen-dedicated stiffness measurement performed well to rule out high-risk varices in HBV-related hepatocellular carcinoma: Screening for high-risk varices in HCC.

BACKGROUND: Esophagogastroduodenoscopy (EGD) is required to screen for high-risk varices (HRV) in patients with hepatocellular carcinoma (HCC), especially since overall survival rates have dramatically improved with new systemic therapies. AIM: To assess the Baveno VI and Baveno VII algorithms' ability to rule out HRV in hepatitis B virus (HBV)-related HCC METHODS: We prospectively enrolled consecutive patients with HBV related, compensated cirrhosis and newly diagnosed HCC who underwent liver stiffness measurement, spleen stiffness measurement (SSM) using a 100-Hz shear wave frequency, and EGD. RESULTS: From September 2021 to August 2023, we enrolled 219 patients with HCC, with 107 (48.9%) Barcelona Clinic Liver Cancer (BCLC) A, 28 (12.8%) BCLC B and 84 (38.3%) BCLC C, respectively. HRV prevalence was 28.8% (63/219). Baveno VI criteria safely (HRV missing rate, 3.2%) avoided 27.4% unnecessary EGDs, while the Baveno VII algorithm avoided 49.3% with HRV missing rate at 7.9% (5/63). The SSM ≤40 kPa avoided 47.5% of EGDs safely (HRV missing rate, 4.8%), significantly better than the Baveno VI criteria (p < 0.001) and comparable to the Baveno VII algorithm (p = 0.390). The SSM ≤40 kPa safely avoided EGDs in patient subgroups within Milan criteria, with portal vein tumour thrombosis or BCLC B/C or candidates for systemic therapy. CONCLUSIONS: We validated that the SSM ≤40 kPa using a 100-Hz probe could safely eliminate more unnecessary EGDs than the Baveno VI criteria in patients with HBV-related HCC. However, the efficacy of the Baveno VII algorithm in patients with HCC requires further investigation.

Excitonic Effect Drives Ultrafast Transition in Two-Dimensional Transition Metal Dichalcogenides.

Two-dimensional (2D) transition metal dichalcogenides (TMDCs) are ideal platforms for exploring excitonic physics because of the tightly bound excitons. In this work, we observed the onset of band-edge exciton formation in monolayer MoS2 (WS2) and bilayer MoS2-WS2 by measuring the transient optical response upon excitation with ultrashort laser pulses. In addition to wavelength dependence on excitation under nonresonant excitation, we found that the onset of band-edge exciton formation in monolayer MoS2 (WS2) pumped in the exciton state is significantly faster than that with pumping in the nonexciton state, which could be attributed to the effective transition between exciton states induced by the excitonic effect. Besides, the onset of band-edge exciton formation in van der Waals heterostructures is similar to that for monolayer TMDCs regardless of charge transfer at the interface. Our work contributes to a better understanding of exciton dynamics in 2D TMDCs, providing a solid basis of the rational design of the 2D optoelectronic applications based on TMDCs.

A deep-learning pipeline to diagnose pediatric intussusception and assess severity during ultrasound scanning: a multicenter retrospective-prospective study.

Ileocolic intussusception is one of the common acute abdomens in children and is first diagnosed urgently using ultrasound. Manual diagnosis requires extensive experience and skill, and identifying surgical indications in assessing the disease severity is more challenging. We aimed to develop a real-time lesion visualization deep-learning pipeline to solve this problem. This multicenter retrospective-prospective study used 14,085 images in 8736 consecutive patients (median age, eight months) with ileocolic intussusception who underwent ultrasound at six hospitals to train, validate, and test the deep-learning pipeline. Subsequently, the algorithm was validated in an internal image test set and an external video dataset. Furthermore, the performances of junior, intermediate, senior, and junior sonographers with AI-assistance were prospectively compared in 242 volunteers using the DeLong test. This tool recognized 1,086 images with three ileocolic intussusception signs with an average of the area under the receiver operating characteristic curve (average-AUC) of 0.972. It diagnosed 184 patients with no intussusception, nonsurgical intussusception, and surgical intussusception in 184 ultrasound videos with an average-AUC of 0.956. In the prospective pilot study using 242 volunteers, junior sonographers' performances were significantly improved with AI-assistance (average-AUC: 0.966 vs. 0.857, P < 0.001; median scanning-time: 9.46 min vs. 3.66 min, P < 0.001), which were comparable to those of senior sonographers (average-AUC: 0.966 vs. 0.973, P = 0.600). Thus, here, we report that the deep-learning pipeline that guides lesions in real-time and is interpretable during ultrasound scanning could assist sonographers in improving the accuracy and efficiency of diagnosing intussusception and identifying surgical indications.

Room temperature energy-efficient spin-orbit torque switching in two-dimensional van der Waals Fe3GeTe2 induced by topological insulators.

Two-dimensional (2D) ferromagnetic materials with unique magnetic properties have great potential for next-generation spintronic devices with high flexibility, easy controllability, and high heretointegrability. However, realizing magnetic switching with low power consumption at room temperature is challenging. Here, we demonstrate the room-temperature spin-orbit torque (SOT) driven magnetization switching in an all-van der Waals (vdW) heterostructure using an optimized epitaxial growth approach. The topological insulator Bi2Te3 not only raises the Curie temperature of Fe3GeTe2 (FGT) through interfacial exchange coupling but also works as a spin current source allowing the FGT to switch at a low current density of ~2.2×106 A/cm2. The SOT efficiency is ~2.69, measured at room temperature. The temperature and thickness-dependent SOT efficiency prove that the larger SOT in our system mainly originates from the nontrivial topological origin of the heterostructure. Our experiments enable an all-vdW SOT structure and provides a solid foundation for the implementation of room-temperature all-vdW spintronic devices in the future.

Combining deep learning and intelligent biometry to extract ultrasound standard planes and assess early gestational weeks.

OBJECTIVES: To develop and validate a fully automated AI system to extract standard planes, assess early gestational weeks, and compare the performance of the developed system to sonographers. METHODS: In this three-center retrospective study, 214 consecutive pregnant women that underwent transvaginal ultrasounds between January and December 2018 were selected. Their ultrasound videos were automatically split into 38,941 frames using a particular program. First, an optimal deep-learning classifier was selected to extract the standard planes with key anatomical structures from the ultrasound frames. Second, an optimal segmentation model was selected to outline gestational sacs. Third, novel biometry was used to measure, select the largest gestational sac in the same video, and assess gestational weeks automatically. Finally, an independent test set was used to compare the performance of the system with that of sonographers. The outcomes were analyzed using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and mean similarity between two samples (mDice). RESULTS: The standard planes were extracted with an AUC of 0.975, a sensitivity of 0.961, and a specificity of 0.979. The gestational sacs' contours were segmented with a mDice of 0.974 (error less than 2 pixels). The comparison showed that the relative error of the tool in assessing gestational weeks was 12.44% and 6.92% lower and faster (min, 0.17 vs. 16.6 and 12.63) than that of the intermediate and senior sonographers, respectively. CONCLUSIONS: This proposed end-to-end tool allows automatic assessment of gestational weeks in early pregnancy and may reduce manual analysis time and measurement errors. CLINICAL RELEVANCE STATEMENT: The fully automated tool achieved high accuracy showing its potential to optimize the increasingly scarce resources of sonographers. Explainable predictions can assist in their confidence in assessing gestational weeks and provide a reliable basis for managing early pregnancy cases. KEY POINTS: • The end-to-end pipeline enabled automatic identification of the standard plane containing the gestational sac in an ultrasound video, as well as segmentation of the sac contour, automatic multi-angle measurements, and the selection of the sac with the largest mean internal diameter to calculate the early gestational week. • This fully automated tool combining deep learning and intelligent biometry may assist the sonographer in assessing the early gestational week, increasing accuracy and reducing the analyzing time, thereby reducing observer dependence.

The Role of Polaronic States on the Spin Dynamics in Solution-Processed Two-Dimensional Layered Perovskite with Different Layer Thickness.

2D lead halide perovskites (LHPs) show strong excitonic and spin-orbit coupling effects, generating a facile spin injection. Besides, they possess a polaron character due to the soft crystal lattice, which can prolong the spin lifetime, making them favorable materials for spintronic applications. Here, the spin dynamics of 2D PEA2 PbI4 (MAPbI3 )n -l thin films with different layers by temperature- and pump fluence-dependent circularly polarization-resolved transient absorption (TA) measurements is studied. These results indicate that the spin depolarization mechanism is gradually converted from the Maialle-Silva-Sham (MSS) mechanism to the polaronic states protection mechanism with the layer number increasing from = 1 to 3, which is determined by the interplay between the strength of Coulomb exchange interaction and the strength of polaronic effect. While for ≥ 4, the Elliot-Yafet (EY) impurities mechanism is proposed, in which the formed polaronic states with free charge carriers no longer play the protective role.

Organocatalytic Atroposelective Construction of Axially Chiral Compounds Containing Benzimidazole and Quinoline Rings.

An organocatalytic atroposelective strategy for the construction of axially chiral compounds containing benzimidazole and quinoline rings is described. The enantioselective heteroannulation reaction of 2-alkynylbenzimidazoles with ortho-aminophenylketones proceeded smoothly in the presence of chiral phosphoric acid to provide axially chiral heterobiaryls with good yields and enantioselectivities. This is the first example of the combination of benzimidazole and quinoline rings at the 2- and 3-positions, respectively, into axially chiral heterobiaryls by this new strategy.

One-pot synthesis of multisubstituted propenylbenzenes from benzyl chlorides through relay catalysis of palladium.

A strategy for the synthesis of multisubstituted propenylbenzenes using benzyl chlorides as starting materials is described. The palladium-catalyzed allylative dearomatization and the subsequent Wagner-Meerwein rearrangement as well as the olefin isomerization proceeded smoothly under mild conditions to produce propenylation products in good yields with high regioselectivity. Control experiments and cyclic voltammetry analysis suggest that Bu3SnCl, a by-product generated in the first step of allylative dearomatization, plays an essential role in the third step of olefin isomerization in the presence of a Brønsted acid.

Outstanding feasibility of spleen stiffness measurement by 100-Hz vibration-controlled transient elastography.

This novel spleen-dedicated FibroScan has high success rate and is easy to operate. The spleen stiffness is correlated with liver stiffness, which reflects the liver fibrosis stage. However, whether SSM is able to reflect the severity of liver disease warrants further observation.

Salen-based porous aromatic frameworks with multi-active sites as anode materials for lithium-ion batteries.

Porous organic polymers are considered as excellent candidates for the electrode materials in rechargeable battery due to their desirable properties including porosity, customizable structure, and intrinsic chemical stability. Herein a Salen-based porous aromatic framework (Zn/Salen-PAF) is synthesized through a metal directed method and further used as efficient anode materialfor lithium-ion battery. Attributing to the stable functional skeleton, Zn/Salen-PAF delivers a reversible capacity of 631 mAh·g-1 at 50 mA·g-1, a high-rate capability of 157 mAh·g-1 at 20.0 A·g-1 and a long-term cycling capacity of 218 mAh·g-1 at 5.0 A·g-1 even after 2000 cycles. Compared to the Salen-PAF without metal ions, Zn/Salen-PAF possesses better electrical conductivity and more active sites. X-ray photoelectron spectroscopy (XPS) investigation indicates that the coordination of Zn2+ with N2O2 unit not only improves the conjugation of the framework but also contributes to the in situ cross-sectional oxidation of the ligand during reaction, which results in the electron redistribution of oxygen atom and the formation of CO bonds.

Nanosecond pulse effectively ablated hepatocellular carcinoma with alterations in the gut microbiome and serum metabolites.

Background: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death in the world. Nanosecond pulsed electric fields (nsPEFs) have emerged as a new treatment for cancer. This study aims to identify the effectiveness of nsPEFs in the treatment of HCC and analyze the alterations in the gut microbiome and serum metabonomics after ablation. Methods: C57BL/6 mice were randomly divided into three groups: healthy control mice (n = 10), HCC mice (n = 10), and nsPEF-treated HCC mice (n = 23). Hep1-6 cell lines were used to establish the HCC model in situ. Histopathological staining was performed on tumor tissues. The gut microbiome was analyzed by 16S rRNA sequencing. Serum metabolites were analyzed by liquid chromatography-mass spectrometry (LC-MS) metabolomic analysis. Spearman's correlation analysis was carried out to analyze the correlation between the gut microbiome and serum metabonomics. Results: The fluorescence image showed that nsPEFs were significantly effective. Histopathological staining identified nuclear pyknosis and cell necrosis in the nsPEF group. The expression of CD34, PCNA, and VEGF decreased significantly in the nsPEF group. Compared with normal mice, the gut microbiome diversity of HCC mice was increased. Eight genera including Alistipes and Muribaculaceae were enriched in the HCC group. Inversely, these genera decreased in the nsPEF group. LC-MS analysis confirmed that there were significant differences in serum metabolism among the three groups. Correlation analysis showed crucial relationships between the gut microbiome and serum metabolites that are involved in nsPEF ablation of HCC. Conclusion: As a new minimally invasive treatment for tumor ablation, nsPEFs have an excellent ablation effect. The alterations in the gut microbiome and serum metabolites may participate in the prognosis of HCC ablation.

Oral Fungal Alterations in Patients with COVID-19 and Recovered Patients.

The oral bacteriome, gut bacteriome, and gut mycobiome are associated with coronavirus disease 2019 (COVID-19). However, the oral fungal microbiota in COVID-19 remains unclear. This article aims to characterize the oral mycobiome in COVID-19 and recovered patients. Tongue coating specimens of 71 COVID-19 patients, 36 suspected cases (SCs), 22 recovered COVID-19 patients, 36 SCs who recovered, and 132 controls from Henan are collected and analyzed using internal transcribed spacer sequencing. The richness of oral fungi is increased in COVID-19 versus controls, and beta diversity analysis reveals separate fungal communities for COVID-19 and control. The ratio of Ascomycota and Basidiomycota is higher in COVID-19, and the opportunistic pathogens, including the genera Candida, Saccharomyces, and Simplicillium, are increased in COVID-19. The classifier based on two fungal biomarkers is constructed and can distinguish COVID-19 patients from controls in the training, testing, and independent cohorts. Importantly, the classifier successfully diagnoses SCs with positive specific severe acute respiratory syndrome coronavirus 2 immunoglobulin G antibodies as COVID-19 patients. The correlation between distinct fungi and bacteria in COVID-19 and control groups is depicted. These data suggest that the oral mycobiome may play a role in COVID-19.

Bioinspired artificial spider silk photocatalyst for the high-efficiency capture and inactivation of bacteria aerosols.

Bioaerosol can cause the spread of disease, and therefore, capture and inactivation of bioaerosols is desirable. However, filtration systems can easily become blocked, and are often unable to inactivate the bioaerosol once it is captured. Herein, we reported a bioinspired artificial spider silk (ASS) photocatalyst, consisting of a periodic spindle structure of TiO2 on nylon fiber that can efficiently capture and concentrate airborne bacteria, followed by photocatalytic inactivation in situ, without a power-supply exhaust system. The ASS photocatalyst exhibits a higher capture capacity than the nylon fiber substrate and a photocatalytic inactivation efficiency of 99.99% obtained under 4 h irradiation. We found that the capture capacity of the ASS photocatalyst can be mainly attributed to the synergistic effects of hydrophilicity, Laplace pressure differences caused by the size of the spindle knots and surface energy gradients induced by surface roughness. The bacteria captured by the ASS photocatalyst are inactivated by photocatalysis within droplets or at the air/photocatalyst interfaces. This strategy paves the way for constructing materials for bioaerosol purification.

Combined model with acoustic radiation force impulse to rule out high-risk varices in HBV-related cirrhosis with viral suppression.

AIMS: To prospectively evaluate the performance of spleen stiffness measurement (SSM) and liver stiffness measurement (LSM) via acoustic radiation force impulse (ARFI) imaging combined with platelet counts (PLT) in ruling out HRV in HBV-related cirrhotic patients with viral suppression. METHODS: Patients with cirrhosis enrolled between June 2020-March 2022 were divided into a derivation cohort and validation cohort. LSM and SSM ARFI-based, and esophagogastroduodenoscopy (EGD) were performed at enrollment. RESULTS: In the derivation cohort, overall, 236 HBV-related cirrhotic patients with maintained viral suppression were enrolled, and the prevalence of HRV was 19.5% (46/236). With the aim of identifying HRV, the most accurate LSM and SSM cut-offs were chosen of 1.46 m/s and 2.28 m/s, respectively. The combined model (LSM<1.46 m/s and PLT>150 × 109/L strategy combined with SSM ≤ 2.28 m/s) can spare 38.6% of EGDs and 4.3% of HRV cases were misclassified. In the validation cohort, we analysed 323 HBV-related cirrhotic patients with maintained viral suppression and validated the combined model can spare 33.4% (108/323) of EGD, and the HRV missed rate was 3.4%. CONCLUSIONS: A non-invasive prediction model combining LSM<1.46 m/s and PLT>150 × 109/L strategy with SSM ≤ 2.28 m/s exhibited excellent performance in ruling out HRV and avoided a significantly large number (38.6% vs 33.4%) of unnecessary EGDs in HBV-related cirrhotic patients with viral suppression.