Non-invasive determination of critical dissolved oxygen thresholds for stress physiology in fish using triple-oxygen stable isotopes and aquatic respirometry.

Understanding the critical thresholds of dissolved oxygen (O2) that trigger adaptive physiological responses in aquatic organisms is long hampered by a lack of robust, non-lethal or non-invasive methodologies. The isotope fractionation of triple O2 isotopes (18O/17O/16O) during respiration is linked to the amount of oxygen utilised, offering a potential avenue for new insights. Our experimental research involved measuring the oxygen isotope fractionation of dissolved O2 in closed-system aquatic respirometry experiments with wild sticklebacks (Gasterosteus aculeatus). These fish were either naturally adapted or experimentally acclimated to hypoxic and normoxic conditions. The aim was to observe their oxygen usage and isotope fractionation in response to increasingly severe hypoxia. Initial observations revealed a progressive 18O enrichment from the preferential uptake of 16O to a dissolved oxygen threshold of 3-5 mg O2 L-1, followed by an apparent reversal in oxygen isotope fractionation, which is mixing of 16O and 17O with the remaining O2 pool across all populations and indicative of a systematic change in oxygen metabolism among the fish. Unexpectedly, sticklebacks adapted to hypoxia but acclimated to normoxia exhibited stronger oxygen isotope fractionation compared to those adapted to normoxia and acclimated to hypoxia, contradicting the hypothesis that hypoxia adaptation would lead to reduced isotope discrimination due to more efficient oxygen uptake. These preliminary experimental results highlight the novel potential of using dissolved O2 isotopes as a non-invasive, non-lethal method to quantitatively assess metabolic thresholds in aquatic organisms. This approach could significantly improve our understanding of the critical oxygen responses and adaptation mechanisms in fish and other aquatic organisms across different oxygen environments, marking a significant step forward in aquatic ecological and physiological research.

Survival of different caries managements in children with autism and unaffected peers: a retrospective cohort study.

AIM: Dental caries is a common oral disease in children with special needs such as those with autism spectrum disorders (ASDs). The aim is to assess whether the type and survival of three caries management, conventional resin restorations (CR), ART technique (ART) and SDF application without caries removal (SDF), in primary teeth carried out at the Pediatric Dentistry Department of San Paolo Hospital (University of Milan) differed between children with ASDs and unaffected peers. METHODS: Data from a convenience sample of children with and without ASDs, who have received dental care for caries in primary teeth from January 2019 to June 2022, were analysed. Medical history, age, sex, teeth treated, and type of treatment were collected from dental charts. Data on success and minor and major failures of each treatment were also collected. Two survival analysis were performed, one considering both major and minor failures, a second considering only major failures. Cox Proportional Hazards multivariate logistic models were run to assess factors associated with failures. The statistical significance was set at 5% (p< 0.05). CONCLUSION: In children with autism, the different techniques for approaching caries lesions seem to have the same probability of success. Therefore, the choice of treatment should be patient-oriented rather than lesion-oriented. In unaffected children, the gold standard always seems to be traditional restorative treatment.

Epigenetic regulation by hypoxia, N-acetylcysteine and hydrogen sulphide of the fetal vasculature in growth restricted offspring: A study in humans and chicken embryos.

Fetal growth restriction (FGR) is a common outcome in human suboptimal gestation and is related to prenatal origins of cardiovascular dysfunction in offspring. Despite this, therapy of human translational potential has not been identified. Using human umbilical and placental vessels and the chicken embryo model, we combined cellular, molecular, and functional studies to determine whether N-acetylcysteine (NAC) and hydrogen sulphide (H2S) protect cardiovascular function in growth-restricted unborn offspring. In human umbilical and placental arteries from control or FGR pregnancy and in vessels from near-term chicken embryos incubated under normoxic or hypoxic conditions, we determined the expression of the H2S gene CTH (i.e. cystathionine γ-lyase) (via quantitative PCR), the production of H2S (enzymatic activity), the DNA methylation profile (pyrosequencing) and vasodilator reactivity (wire myography) in the presence and absence of NAC treatment. The data show that FGR and hypoxia increased CTH expression in the embryonic/fetal vasculature in both species. NAC treatment increased aortic CTH expression and H2S production and enhanced third-order femoral artery dilator responses to the H2S donor sodium hydrosulphide in chicken embryos. NAC treatment also restored impaired endothelial relaxation in human third-to-fourth order chorionic arteries from FGR pregnancies and in third-order femoral arteries from hypoxic chicken embryos. This NAC-induced protection against endothelial dysfunction in hypoxic chicken embryos was mediated via nitric oxide independent mechanisms. Both developmental hypoxia and NAC promoted vascular changes in CTH DNA and NOS3 methylation patterns in chicken embryos. Combined, therefore, the data support that the effects of NAC and H2S offer a powerful mechanism of human translational potential against fetal cardiovascular dysfunction in complicated pregnancy. KEY POINTS: Gestation complicated by chronic fetal hypoxia and fetal growth restriction (FGR) increases a prenatal origin of cardiovascular disease in offspring, increasing interest in antenatal therapy to prevent against a fetal origin of cardiovascular dysfunction. We investigated the effects between N-acetylcysteine (NAC) and hydrogen sulphide (H2S) in the vasculature in FGR human pregnancy and in chronically hypoxic chicken embryos. Combining cellular, molecular, epigenetic and functional studies, we show that the vascular expression and synthesis of H2S is enhanced in hypoxic and FGR unborn offspring in both species and this acts to protect their vasculature. Therefore, the NAC/H2S pathway offers a powerful therapeutic mechanism of human translational potential against fetal cardiovascular dysfunction in complicated pregnancy.

Thiophene-Functionalized Cadmium(II)-Based Metal-Organic Frameworks for CO2 Adsorption with Gate-Opening Effect, Separation, and Catalytic Conversion.

Two new porous three-dimensional cadmium(II) metal-organic frameworks (MOFs) containing thiophene-appended carboxylate acid ligands, formulated as [Cd(L1)(4,4'-Bipy)]n.2n(DMF) (1) and [Cd(L2)(4,4'-Bipy)]n.2n(DMF) (2) [where L1 = 5-{(thiophen-2-ylmethyl)amino}isophthalate, L2 = 5-{(thiophen-3-ylmethyl)amino}isophthalate, 4,4'-Bipy = 4,4'-bipyridine, and DMF = N,N'-dimethylformamide] have been synthesized and structurally characterized. The gas adsorption analysis of the activated MOFs shows that they specifically capture CO2 (uptake amount 4.36 mmol/g under 1 bar at 195 K) over N2 and CH4. Moreover, both MOFs show a gate-opening-closing phenomenon, which features the S-shaped isotherms with impressive hysteretic desorption during the CO2 adsorption-desorption process at 195 K. Ideal adsorbed solution theory (IAST) calculations of these MOFs displayed that the obtained selectivity values for CO2/CH4 (50:50) and CO2/N2 (15:85) are approximately 8.6-23 and 93-565, respectively. Configurational bias Monte Carlo simulation was performed to understand the mechanism behind the better CO2 adsorption by these MOFs. Catalytic activity of the MOFs for the CO2 fixation reactions with different epoxides to form cyclic carbonates were tested. These MOFs demonstrated a significantly high conversion (94-99%) of epichlorohydrin to the corresponding cyclic carbonate within 8 h of reaction time at 1 bar of CO2 pressure, at 70 °C, and they can be reused up to five cycles without losing considerably their activity.

Validation of the HemoCue Hb 801 portable haemoglobin analyser for fish blood.

Haemoglobin concentration ([Hb]) assessment in fish blood has become a routine parameter to measure the health and welfare status of the animals. The original method (haemoglobincyanide method, best known as the Drabkin method) for measuring Hb in human and animals is not well suited for work outside of a laboratory setting. It is relatively time consuming, contains hazardous cyanide elements, and requires specific laboratory material. As an alternative to the Drabkin method, portable analysers have been developed for human blood, but they need to be first validated for fish blood before being used in experiments. In this study, the performance of the new HemoCue Hb 801 portable haemoglobin analyser was compared to the validated Drabkin method to determine [Hb] in three fish species. Hb readings between the two methods were not different for any of the species tested (rainbow trout, Onchorynchus mykiss, Atlantic wolffish, Anarhichas lupus, and Nile tilapia, Oreochromis niloticus). Therefore, this new portable device can be readily used to measure Hb in fish blood. Unlike the previous model from HemoCue, the Hb 201+, this device does not need an incubation time or a correction factor, representing a major gain of time and precision.

Risk of venous thromboembolism in relation to high physical activity level in men over 27 year follow up.

Venous thromboembolism (VTE) is the third most common type of cardiovascular disease. An association between high level of physical activity (PA) and the onset of VTE has been found in some, but not all previous studies. We aim to study the association between PA-level and VTE in a cohort of men with updated data on PA levels at four occasions. We used data from the Uppsala Longitudinal Study of Adult Men (ULSAM) study initiated in 1970, a study of men at age 50 years (n = 2,294 at baseline) examined on leisure time PA by questionnaire and traditional cardiovascular risk factors. Examinations were repeated at ages 60, 70, and 77, and follow-up was completed after a median time of 33 years. Cox regression analysis with hazard ratios (HRs) using updated covariates for PA and risk factors was performed on the association of PA levels with incident VTE, with adjustments for established cardiovascular risk factors (systolic blood pressure, LDL- and HDL-cholesterol, BMI, diabetes, and smoking). Totally 186 men experienced a VTE during follow-up of 68,263 person-years at risk. Individuals with the highest PA level had an increased relative risk of VTE, adjusted HR, 2.22 (95% CI 1.05-4.67), when compared to individuals with the lowest level of PA. In this cohort of men with a follow-up of 27 years, the risk of VTE was increased at the highest PA level. Findings indicate that there could be an increased VTE risk with higher PA level including strenuous activities.

Hematological and anthelminthic responses of tambaqui (Colossoma macropomum) supplemented with Artrhospira platensis and Chlorella vulgaris.

The present study evaluated the hematological, antiparasitic and growth responses in tambaqui (Colossoma macropomum) fed with diets supplemented with the microalgae Arthrospira platensis and Chlorella vulgaris (0%; 10% A. platensis; 10% C. vulgaris; and 5% A. platensis+5% C. vulgaris). Tambaqui (n=60, 62.57 ± 8.76 g) were fed for 20 days with experimental diets. Blood samples collection was done to determine hematological parameters, and gills were removed to identify and count monogenetic parasites. Supplementation with A. platensis 10% reduced red blood cells count, in consequence mean corpuscular volume and mean hemoglobin concentration increased. Total leukocyte, monocyte, eosinophil, and basophil counts reduced with the use of A. platensis. Higher monocytes, eosinophil, and basophil numbers in tambaqui fed with diet supplemented with 10% C. vulgaris were observed and may have been due to the presence of immunostimulants in this microalga composition. Reduction on total cholesterol in tambaqui that received both microalgae (A. platensis 5%+C. vulgaris 5%) may indicate that combined supplementation presented greater benefits to the health for C. macropomum than separately. Both microalgae were efficient against monogenetic parasites of tambaqui. Thus, the dietary use of the microalgae A. platensis and C. vulgaris provided immunostimulant and antiparasitic efficacy in C. macropomum.

Revisiting Perdeck's massive avian migration experiments debunks alternative social interpretations.

Whether avian migrants can adapt to their changing world depends on the relative importance of genetic and environmental variation for the timing and direction of migration. In the classic series of field experiments on avian migration, A. C. Perdeck discovered that translocated juveniles failed to reach goal areas, whereas translocated adults performed 'true-goal navigation'. His translocations of > 14 000 common starlings (Sturnus vulgaris) suggested that genetic mechanisms guide juveniles into a population-specific direction, i.e. 'vector navigation'. However, alternative explanations involving social learning after release in juveniles could not be excluded. By adding historical data from translocation sites, data that was unavailable in Perdeck's days, and by integrated analyses including the original data, we could not explain juvenile migrations from possible social information upon release. Despite their highly social behaviour, our findings are consistent with the idea that juvenile starlings follow inherited information and independently reach their winter quarters. Similar to more solitarily migrating songbirds, starlings would require genetic change to adjust the migration route in response to global change.

Unveiling the influence of end-capped acceptors modification on photovoltaic properties of non-fullerene fused ring compounds: a DFT/TD-DFT study.

Herein, unique A-D-A configuration-based molecules (NBD1-NBD7) were designed from the reference compound (NBR) by utilizing the end-capped acceptor modification approach. Various electron-withdrawing units -F, -Cl, -CN, -NO2, -CF3, -HSO3, and -COOCH3, were incorporated into terminals of reference compound to designed NBD1-NBD7, respectively. A theoretical investigation employing the density functional theory (DFT) and time-dependent DFT (TD-DFT) was performed at B3LYP/6-311G(d,p) level. To reveal diverse opto-electronic and photovoltaic properties, the frontier molecular orbitals (FMOs), absorption maxima (λ max), density of states (DOS), exciton binding energy (E b), open-circuit voltage (V oc) and transition density matrix (TDM) analyses were executed at the same functional. Moreover, the global reactivity parameters (GRPs) were calculated using the HOMO-LUMO energy gaps from the FMOs. Significant results were obtained for the designed molecules (NBD1-NBD7) as compared to NBR. They showed lesser energy band gaps (2.024-2.157 eV) as compared to the NBR reference (2.147 eV). The tailored molecules also demonstrated bathochromic shifts in the chloroform (671.087-717.164 nm) and gas phases (623.251-653.404 nm) as compared to NBR compound (674.189 and 626.178 nm, respectively). From the photovoltaic perspectives, they showed promising results (2.024-2.157 V). Furthermore, the existence of intramolecular charge transfer (ICT) in the designed compounds was depicted via their DOS and TDM graphical plots. Among all the investigated molecules, NBD4 was disclosed as the excellent candidate for solar cell applications owing to its favorable properties such as the least band gap (2.024 eV), red-shifted λ max in the chloroform (717.164 nm) and gas (653.404 nm) phases as well as the minimal E b (0.126 eV). This is due to the presence of highly electronegative -NO2 unit at the terminal of electron withdrawing acceptor moiety, which leads to increased conjugation and enhanced the intramolecular charge transfer (ICT) rate. The obtained insights suggested that the designed molecules could be considered as promising materials for potential applications in the realm of OSCs.

Advancing nursing education through wearable electronic devices: A scoping review.

AIM: To examine the incorporation of wearable electronic devices in the education of undergraduate nursing students. BACKGROUND: The advancement of technology has influenced nursing education and will continue to do so in the future. Wearable technologies are electronic devices that can be worn as an accessory and expand the possibilities in nursing education with increased engagement in the learning process. DESIGN: A scoping review was conducted following JBI and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: The search was performed on August 25th, 2023, in the databases: MEDLINE via PubMed, ISI Web of Science, ERIC, EBSCOhost CINAHL, EBSCOhost Academic Search Premier, EBSCOhost Health Source Nursing, EMBASE, Scopus, BVShost LILACS and ProQuest. Literature that examined the application of wearable electronic devices in the education of undergraduate nursing students was included. RESULTS: This scoping review study included a total of 21 records published between 2014 and 2023. The analysis showed that smart glasses are the most common wearable electronic device used in nursing education, followed by smartwatches. The devices provide an opportunity for competencies development, especially when applied in the simulation environment, such as physical examination and medication administration. Wearable technologies are potentially useful and feasible as learning tools in nursing education, increasing nursing students' motivation, confidence and satisfaction. CONCLUSIONS: In the technological revolution, educators must consider the potential of innovative teaching strategies, such as wearable electronic devices, to advance nursing education. Wearables can contribute to developing competencies required for the professionalism of undergraduate nursing students.

Neratinib and Ado-Trastuzumab-Emtansine for Pre-treated and Untreated HER2-positive Breast Cancer Brain Metastases: Translational Breast Cancer Research Consortium Trial 022.

PURPOSE: Treatment options for HER2-positive breast cancer brain metastases (BCBM) remain limited. We previously reported central nervous system (CNS) activity for neratinib and neratinib-capecitabine. Preclinical data suggest that neratinib may overcome resistance to ado-trastuzumab-emtansine (T-DM1) when given in combination. In TBCRC 022's cohort 4, we examined the efficacy of neratinib plus T-DM1 in patients with HER2-positive BCBM. PATIENTS AND METHODS: In this multicenter, phase II study, patients with measurable HER2-positive BCBM received neratinib 160 mg daily plus T-DM1 3.6 mg/kg intravenously every 21 days in three parallel-enrolling cohorts (cohort 4A-previously untreated BCBM, cohorts 4B and 4C- BCBM progressing after local CNS-directed therapy without [4B] and with [4C] prior exposure to T-DM1). Cycle 1 diarrheal prophylaxis was required. The primary endpoint was the Response Assessment in Neuro-Oncology-Brain Metastases (RANO-BM) by cohort. Overall survival (OS) and toxicity were also assessed. RESULTS: Between 2018-2021, 6, 17, and 21 patients enrolled to cohorts 4A, 4B, and 4C. Enrollment was stopped prematurely for slow accrual. The CNS objective response rate in cohorts 4A, 4B, and 4C was 33.3% (95% confidence interval [CI]: 4.3-77.7%), 35.3% (95% CI: 14.2-61.7%), and 28.6% (95% CI: 11.3-52.2%), respectively; 38.1-50% experienced stable disease for ≥6 months or response. Diarrhea was the most common grade 3 toxicity (22.7%). Median OS was 30.2 months (cohort 4A; 95% CI: 21.9, not reached [NR]), 23.3 months (cohort 4B; 95% CI: 17.6, NR), and 20.9 months (cohort 4C; 95% CI: 14.9, NR). CONCLUSION: We observed Intracranial activity for neratinib plus T-DM1, including those with prior T-DM1 exposure, suggesting synergistic effects with neratinib. Our data provide additional evidence for neratinib-based combinations in patients with HER2-positive BCBM, even those who are heavily pre-treated.

MDMA-assisted brief cognitive behavioral conjoint therapy for PTSD: Study protocol for a pilot study.

Background: Posttraumatic Stress Disorder (PTSD) impacts both individual and relational functioning. Veteran couples are at increased risk of relationship distress due to military stressors such as deployment, family reintegration, and traumatic stress. Although both Cognitive-Behavioral Conjoint Therapy (CBCT) and its brief version (bCBCT) consistently have large effects on reducing PTSD symptoms, these treatments have more variable effects on relational outcomes. Given the impact of relationship functioning on the overall health of veterans, improving the effect of PTSD treatments on relationship functioning is an essential area of research. One promising path is the role of MDMA (3,4-methylenedioxymethamphetamine)-assisted therapy in augmenting the relational impact of established therapeutic interventions such as bCBCT. Method/Design: This is a single site, open-label study assessing the preliminary efficacy, safety, and acceptability of MDMA-assisted therapy in combination with bCBCT in 8 veterans with PTSD and their intimate partners (N = 16). Therapy teams trained in bCBCT and MDMA-assisted therapy will deliver bCBCT combined with two MDMA sessions and two couple emotion focused integration sessions. PTSD symptom severity and relationship functioning outcomes will be evaluated. Conclusion: This is the first study to examine the efficacy of MDMA-assisted bCBCT for improving PTSD and relationship functioning among a sample of U.S. military veterans and their partners. This project could provide an opportunity to pilot a scalable model of treating PTSD within the Veterans Affairs healthcare system and leverage the benefits of MDMA for veterans with PTSD, as well as the downstream benefits to their partner on both individual and relationship functioning. ClinicalTrials.gov Identifier: NCT05979844.

Reworking the Tao-Mo Exchange-Correlation Functional. III. Improved Deorbitalization Strategy and Faithful Deorbitalization.

We present a deorbitalization of the recent simplified, regularized Tao-Mo exchange functional ( J. Chem. Phys. 2023, 159, 214102) that is faithful to the parent functional. That is a major gain relative to our earlier deorbitalization which did poorly on molecular heats of formation ( J. Chem. Phys. 2023, 159, 214103). The improvement arises from augmentation of the Mejía-Rodríguez and Trickey deorbitalization strategy ( Phys. Rev. A 2017, 96, 052512) to use a smoothed replacement for the reduced density Laplacian (conventionally denoted q) obtained from that Laplacian itself. The augmentation also rationalizes the improvement obtained from the cutoff of q < 0 that was poorly understood at the time of the previous paper. The new scheme yields deorbitalized chemical region indicators that are much closer to those from the parent, orbital-dependent functional than were obtainable from the previous deorbitalization. It also replicates the good 3d elemental magnetization of the parent functional reasonably well.

Barriers and Opportunities for Tribal Access to Public Health Data to Advance Health Equity.

Public health authorities (PHAs), including Tribal nations, have the right and responsibility to protect and promote the health of their citizens. Although Tribal nations have the same need and legal authority to access public health data as any other PHA, significant legal challenges continue to impede Tribal data access.

Compassionate care through the eyes of patients and physicians: An interview study.

BACKGROUND: Although compassion is a crucial element of physicians' professional performance and high-quality care, research shows it often remains an unmet need of patients. Understanding patients' and physicians' perspectives on compassionate care may provide insights that can be used to foster physicians' ability to respond to patients' compassion needs. Therefore, this study aims to understand how both patients and physicians experience the concept and practice of compassionate care. METHODS: We conducted semi-structured interviews with eight patients and ten resident physicians at a University Medical Center in the Netherlands. Using thematic analysis, we separately coded patient and resident transcripts to identify themes capturing their experiences of compassionate care. This study was part of a larger project to develop an educational intervention to improve compassion in residents. RESULTS: For both patients and residents, we identified four themes encompassing compassionate care: being there, empathizing, actions to relieve patients' suffering, and connection. For residents, a fifth theme was professional fulfillment (resulting from compassionate care). Although patients and residents both emphasized the importance of compassionate care, patients did not always perceive the physician-patient encounter as compassionate. According to residents, high workloads and time pressures hindered their ability to provide compassionate care. DISCUSSION AND CONCLUSION: Patients and residents have similar and varying understandings of compassionate care at the same time. Understanding these differences can aid compassion in medical practice. Based on the findings, three topics are suggested to improve compassion in residents: (1) train residents how to ask for patients' compassion needs, (2) address residents' limiting beliefs about the concept and practice of compassion, and (3) acknowledge the art and science of medicine cannot be separated.

Quantifiable and reproducible phenotypic assessment of a constitutive knockout mouse model for congenital nephrotic syndrome of the Finnish type.

Steroid-resistant nephrotic syndrome (SRNS) is the second most frequent cause of childhood chronic kidney disease. Congenital nephrotic syndrome of the Finnish type (CNF) (MIM# 256300) is caused by biallelic variants in the gene NPHS1, encoding nephrin, an integral component of the kidney filtration barrier. No causal treatments exist, and children inevitably require kidney replacement therapy. In preparation for gene replacement therapy (GRT) in CNF, we established a quantifiable and reproducible phenotypic assessment of the nephrin-deficient CNF mouse model: 129/Sv-Nphs1tm1Rkl/J. We assessed the phenotypic spectrum of homozygous mice (Nphs1tm1Rkl/Nphs1tm1Rkl) compared to heterozygous controls (Nphs1tm1Rkl/Nphs1WT) by the following parameters: 1. cohort survival, 2. podocyte foot process (FP) density per glomerular basement membrane (GBM) using transmission electron microscopy, 3. tubular microcysts in brightfield microscopy, and 4. urinary albumin/creatinine ratios. Nphs1tm1Rkl/Nphs1tm1Rkl mice exhibited: 1. perinatal lethality with median survival of 1 day, 2. FP effacement with median FP density of 1.00 FP/µm GBM (2.12 FP/µm in controls), 3. tubular dilation with 65 microcysts per section (6.5 in controls), and 4. increased albumin/creatinine ratio of 238 g/g (4.1 g/g in controls). We here established four quantifiable phenotyping features of a CNF mouse model to facilitate future GRT studies by enabling sensitive detection of phenotypic improvements.

Recovery and encapsulation of Dunaliella salina ß-carotene through a novel sustainable approach: Sequential application of an ionic liquid as naturally-derived solvent and emulsifier.

Dunaliella salina is a promising source of ß-carotene, widely employed in the food industry. This study aimed to evaluate the sequential application of the Ionic Liquid (IL) cholinium oleate as an extraction solvent for D. salina ß-carotene recovery and, sequentially, as emulsifier for emulsion-based products obtained therefrom. The IL was evaluated regarding its ability to permeabilize the cells and recover ß-carotene at different temperatures (25-65 °C) and IL concentrations (0-46%). The use of the IL as solvent greatly improved ß-carotene recovery (>84%). The IL already present in the obtained extracts loaded with recovered ß-carotene was sequentially used as emulsifier in the production of nanoemulsions (NE). NE presented a ß-carotene entrapment efficiency of 100% and were kinetically stable for 30 days and presented droplet size, size distribution, and ζ-potential of 220 nm, 0.21, and -67 mV, respectively. These results indicate that using IL sequential as solvent and emulsifier has potential applications in the food industry.

Baseline tumor-infiltrating lymphocyte patterns and response to immune checkpoint inhibition in metastatic cutaneous melanoma.

INTRODUCTION: The presence of tumor-infiltrating lymphocytes (TILs) in melanoma has been linked to survival. Their predictive capability for immune checkpoint inhibition (ICI) response remains uncertain. Therefore, we investigated the association between treatment response and TILs in the largest cohort to date and analyzed if this association was independent of known clinical predictors. METHODS: In this multicenter cohort study, patients who received first-line anti-PD1 ± anti-CTLA4 for advanced melanoma were identified. TILs were scored on hematoxylin and eosin (H&E) slides of primary melanoma and pre-treatment metastases using the validated TILs-WG, Clark and MIA score. The primary outcome was objective response rate (ORR), with progression free survival and overall survival being secondary outcomes. Univariable and multivariable logistic regression and Cox proportional hazard were performed, adjusting for known clinical predictors. RESULTS: Metastatic melanoma specimens were available for 650 patients and primary specimens for 565 patients. No association was found in primary melanoma specimens. In metastatic specimens, a 10-point increase in the TILs-WG score was associated with a higher probability of response (aOR 1.17, 95 % CI 1.07-1.28), increased PFS (HR 0.93, 95 % CI 0.87-0.996), and OS (HR 0.94, 95 % CI 0.89-0.99). When categorized, patients in the highest tertile TILs-WG score (15-100 %) compared to the lowest tertile (0 %) had a longer median PFS (13.1 vs. 7.3 months, p = 0.04) and OS (49.4 vs. 19.5 months, p = 0.003). Similar results were noted using the MIA and Clark scores. CONCLUSION: In advanced melanoma patients, TIL patterns on H&E slides of pre-treatment metastases, regardless of measurement method, are independently associated with ICI response. TILs are easily scored on readily available H&Es, facilitating the use of this biomarker in clinical practice.