Good Expansion Research Articles

Immune determinants of CAR-T cell expansion in solid tumor patients receiving GD2 CAR-T cell therapy

Chimeric antigen receptor Tcells (CAR-Ts) have remarkable efficacy in liquid tumors, but limited responses in solid tumors. We conducted a Phase I trial (NCT02107963) of GD2 CAR-Ts (GD2-CAR.OX40.28.z.iC9), demonstrating feasibility and safety of administration in children and young adults with osteosarcoma and neuroblastoma. Since CAR-T efficacy requires adequate CAR-T expansion, patients were grouped into good or poor expanders across dose levels. Patient samples were evaluated by multi-dimensional proteomic, transcriptomic, and epigenetic analyses. Tcell assessments identified naive Tcells in pre-treatment apheresis associated with good expansion, and exhausted Tcells in CAR-T products with poor expansion. Myeloid cell assessment identified CXCR3+ monocytes in pre-treatment apheresis associated with good expansion. Longitudinal analysis of post-treatment samples identified increased CXCR3- classical monocytes in all groups as CAR-T numbers waned. Together, our data uncover mediators of CAR-T biology and correlates of expansion that could be utilized to advance immunotherapies for solid tumor patients.

Lightweight polyethylene terephthalate bead foams with good interfacial adhesion and thermal insulation performance fabricated by supercritical carbon dioxide secondary foaming strategy

AbstractThis paper reported the novel supercritical carbon dioxide (scCO2) secondary foaming and molding strategy to prepare the thermal‐insulation polyethylene terephthalate (PET) bead foam part with good interfacial adhesion and high expansion ratio. The incorporation of porous structure could effectively enhance the blowing agent solubility and fabricate the system viscosity difference, which contributed to the expansion and further welding of the expanded PET beads. Under the optimum foaming conditions, PET bead foam parts with excellent comprehensive performance were successfully prepared by molding method in the confined space via scCO2 secondary foaming, and the corresponding welding mechanism of PET beads was further investigated. The obtained foam parts possessed good tensile and compressive properties, reaching 1.03 and 1.27 MPa (at 20% strain) respectively. Besides, the foam part exhibited the low thermal conductivity of 0.060 Wm−1 K−1, which confirmed the improvement of thermal insulation performance owing to the high expansion ratio.

Traffic Speed Prediction Method Based on Spatiotemporal Sampling and LSTM

Accurate prediction of traffic speed is crucial for traffic management and planning. In order to solve the problems of low prediction efficiency of previous traffic speed prediction models and easy neglect of spatiotemporal characteristics, a traffic speed prediction method based on spatiotemporal sampling and LSTM model is proposed based on the 24-hour driving dataset of 4,000 taxis in Shanghai, and draw speed heat maps in different regions at different times to visualize the spatiotemporal characteristics of traffic speed. Experimental results show that the model has high prediction accuracy and good expansion potential.

Calcified coronary left main disease treated with and without intravascular lithotripsy: a real word first description

Abstract Background Intravascular lithotripsy (IVL) is a promising balloon-based technique to treat calcified coronary lesions. The evidence of its use in LM disease is scarce and there are no studies reporting a comparison between IVL and conventional techniques for calcified lesions, especially in LM PCI that represented an exclusion criteria of the DISRUPT-CAD trials. Methods The aim of this study is to evaluate safety and efficacy of IVL to treat moderate-severe calcified LM disease from January 2018 to December 2022. We stratified our cohort into two groups 1) patients who underwent LM PCI with IVL treatment (bail-out or upfront) and 2) LM PCI with conventional techniques excluding IVL (cutting balloons, NC/OPN balloons, rotational atherectomy). Efficacy endpoint: device success and stent expansion evaluated either by intravascular imaging or angiographic criteria. Safety endpoint: peri-procedural complications (coronary dissection, perforation, no-slow flow, peri-procedural MI, pericardial effusion) and in hospital death or target vessel failure. Results 87 patients were enrolled, 43 (49.4%) underwent LM PCI with IVL (group A), while 44 (50.6%) were treated with conventional techniques (35 NC balloons, 7 RA, 2 cutting balloons). Intravascular imaging was performed in 69% of cases, the 2 groups were similar in terms of age (77.4±9.63, p=0.94), comorbidity, clinical presentation and angiographic characteristics. Both groups presented severe calcifications in terms of calcium length (11.9±10.3, p=0.87), arc (270° 144-350, p = 0.76, and thickness (1.3 ±0.7 p =0.99) assessed by intravascular imaging. IVUS calcium score was similar between 2 groups (1.53±0.7, p = 0.7). Target vessel was distal LM-proximal LAD in 56.6%. IVL most used balloon was 3.5mm (55%), followed by 4.00mm (38.2%). Impella CP was implanted to support 4 PCI and removed at the end of the procedure. Provisional stenting was performed in 55.1% of cases, while two-stents technique was used in 26.4% (mainly represented by DK-crush). Good stent expansion (>80%) was achieved in 85% of cases, with a certain prevalence for patients treated with IVL. Optimal stent expansion (>90%) was higher in patients treated with IVL (9 in group A vs 3 in group B), although it did not reach a statistically significative difference (p=0.06). No differences in terms of complications and peri-procedural myocardial infarction occurred between the two groups. Conclusions This is the first description of a comparison between IVL and conventional techniques in LM calcified PCI. IVL appeared to be safe and effective with good stent expansion and low rate of peri-procedural complications and in-hospital MACE. LM lesions treated with IVL appeared to reach greater stent expansion compared to other techniques, although it was not statistically significative. Certainly, further trials are warranted to establish longer term outcomes and the benefit of IVL over existing calcium-modification therapies.

Abstract 19038: Insights of Optical Coherence Tomography Into the Safety and Efficacy of Coronary Intravascular Lithotripsy for Calcified Nodule Modification During Percutaneous Coronary Intervention

Background: Among calcified lesions, nodular calcium is the most challenging subset to deal with during percutaneous coronary intervention (PCI), as there are limited options available for its modification. This study was done to assess the safety, efficacy and impact of coronary intravascular lithotripsy (IVL) on calcified nodule (CN) using optical coherence tomography (OCT). Methods: A total of 17 patients with 40 CN undergoing PCI using coronary intravascular lithotripsy were prospectively enrolled in the study. OCT parameters studied were pre-IVL minimum lumen area (MLA), calcium (Ca) score, number of CN, proximal and distal reference diameter, post-IVL gain in MLA, calcium fracture, major dissection, post-PCI minimum stent area (MSA), stent expansion, apposition, edge dissection and spherical index at CN. Spherical index was calculated by dividing the shortest and longest diameter at CN after stent placement. The primary safety endpoint was freedom from major adverse cardiovascular events (death, MI and target vessel revascularization) during hospitalisation and at 30 days. Primary efficacy endpoints were gain in MLA after stent placement and stent expansion. Results: Pre-IVL mean MLA at CN was 3.87±2.25mm 2 , Ca score was 3.94±0.24, Ca arc 190.59±54.02 o , Ca depth 0.97±0.31mm, Ca length 22.73±9.87mm and CN height-1.04±0.30 mm. All 17 (100%) patients developed Ca fractures, post-IVL MLA at CN was 5.20±2.31mm 2 , CN height 0.83±0.19mm and luminal gain at CN was 0.76 ± 1.71mm 2 . 10 (58.8%) patients developed fractures at base of CN and rest developed fractures at apex. Patients with fractures at base showed decrease in luminal area after IVL due to luminal shift of nodule, but all these patients had good stent expansion, likely due to Ca softening. Post-IVL OCT showed minor dissections in 5 (29.4%) and major in 3 (17.6%) patients. There was no perforation, slow flow or abrupt vessel closure. Stent expansion and MSA at CN was 107.12 ± 18.98% and 8.57±2.54 mm 2 respectively with spherical index of 0.83±0.12. All patients were free of MACE during hospitalization and at 30 days. Conclusion: Coronary intravascular lithotripsy is safe and effective for modification of coronary calcified nodules during percutaneous coronary intervention.

Changes in Ukraine’s foreign trade as a reflection of its progress in integration with the European Union

The study aims to assess changes in the ability of Ukrainian goods to compete in the EU market. It reflects Ukraine’s progress towards EU integration in the run-up to Russia’s attack on Ukraine. Using foreign trade measures, including international specialisation, we show the specifics of Ukraine’s integration into the EU. By estimating the level and changes in the market shares of Ukraine’s commodity groups in the EU market, we show its progress in penetrating this market compared to non-EU countries. On the one hand, the geographical structure of Ukraine’s foreign trade changed radically between 2010 and 2021. On the other hand, more minor changes in the commodity structure of exports and Ukraine’s international specialisation were accompanied byan increased market share of Ukraine’s exports in the EU market. It reflected an improvement in the ability of Ukrainian goods to compete, thus fulfilling one of Ukraine’s accession criteria. Calculated on the basis of market shares, the increase in the ability of Ukrainian goods to compete is confirmed by estimates of export competitiveness indicators: the Balassa index of revealedcomparative advantages and the Lafay index. Levels and changes in the three indicators varied between commodity groups. The increase in the market shares of three commodity groups (raw materials, so-called “other manufactured goods” (medium and low technology) and food products) was accompanied by significant and increasing levels of export competitiveness indicators. The decline in the market shares of other commodity groups was accompanied by low and declining levels of export specialisation indicators. Thus, Ukraine’s integration into the EU has so far been based on the expansion of competitive and competitive-enhancing goods, in the production of which Ukraine specialises.

Processing and characterization of porous composites based on CaAl4O7/CaZrO3

According to previous research, CaAl4O7/CaZrO3 composites present good refractoriness, mechanical resistance and low thermal expansion coefficient (good thermal shock resistance), characteristics that insulating materials and lightweight structural components require. In this work, porous ceramics based on CaAl4O7/CaZrO3 were prepared from commercial powder combinations of m-ZrO2, Al(OH)3 and CaCO3. The powder mixture was processed by high-energy milling at different times (from 3 to 24 h). Different composites were obtained by solid state sintering at 1400 °C. The reaction was studied using thermal analysis techniques (TG-DTA), and the crystalline phases were analyzed by X-ray diffraction (XRD) and the Rietveld method. The resulting composites were also characterized. CaAl4O7 and CaZrO3 were the main phases present in these composites, with c-ZrO2 as secondary phase, and some scarce m-ZrO2. Porosity values varied from 54 to 59%, and flexural strengths ranged from 16.5 to 23.6 MPa. The increasing milling time produced an effective particle size reduction that accelerated the reactivity of the starting mixtures and reduced the grain size. The composite obtained by 24 h milling and sintered at 1400 °C (ACZ2414) presented the highest flexural strength and the lowest coefficient of linear thermal expansion. The mean thermal expansion coefficient of CaAl4O7/CaZrO3 composites was ca. 6 10−6 °C −1. This indicated that it is possible to manufacture ceramic bodies with expansion properties comparable to those of mullite, making it a suitable for insulation.

Self-healing properties and improvement methods of mortar cracks in marine corrosive environments

The crack healing of marine concrete is of great significance to ensure its durability. The crack self-healing performances of ordinary concrete and self-healing concrete under the curing of tap water or seawater has been tested. The results show that seawater has a certain promoting effect on the self-healing of cracks, especially on the surface healing effect. The healing products under the autogenous healing or seawater curing are mainly hydrated products and their carbonized products, and the quantity is small, making it difficult to meet the requirements of water plugging. By introducing aluminum ions into the cracks, layered double hydroxides can be formed in situ with divalent metal ions in the alkaline environment of the cracks, greatly improving the healing speed and efficiency of the cracks. The formed layered double hydroxides can not only combine many water molecules to produce good volume expansion, but also adsorb and fix corrosive ions. In addition, the formation of layered double hydroxides will consume a large amount of hydroxide ions, which will also improve the chemical conditions of the crack solution to a certain extent, and provide the possibility to enhance the application of microbial technology in cement-based materials. The research results provide a reference for the development of marine self-healing concrete.

Calcium evaluation using coronary computed tomography in combination with optical coherence tomography.

Optical coherence tomography (OCT) can assess calcium thickness, a key factor for predicting good stent expansion; however, it underestimates coronary calcium severity due to its penetration limitation. This study aimed to evaluate computed tomography (CT) and OCT images to assess calcification. We investigated 25 left anterior descending arteries of 25 patients, using coronary CT and OCT, and assessed their calcification. Of the 25 vessels, 1811 pairs of CT and OCT cross-sectional images were co-registered. Of the 1811 cross-sectional CT images, calcification was not detectable in 256 (14.1%) of the corresponding OCT images due to limited penetration. In the 1555 OCT calcium-detectable images, the maximum calcium thickness was not detectable in 763 (49.1%) images compared to the CT images. In CT images of slices corresponding to undetected calcium in OCT images, the angle, thickness, and maximum density of calcium were significantly smaller compared to slices corresponding to detected calcium in OCT. Calcium with an undetectable maximum thickness in the corresponding OCT image had a significantly greater calcium angle, thickness, and density than calcium with a detectable maximum thickness. There was an excellent correlation between CT and OCT with respect to calcium angle ( R= 0.82, P < 0.001). The calcium thickness on the OCT image had a stronger correlation with the maximum density on the corresponding CT image (R = 0.73, P < 0.001) than with the calcium thickness on the CT image (R = 0.61, P < 0.001). Cross-sectional CT imaging allows for pre-procedural assessment of calcium morphology and severity and could complement the lack of information on calcium severity in OCT-guided percutaneous coronary intervention.

Synthesis and application of a halogen-free epoxy resin flame retardant curing agent

In this study, the intermediate of SPDPC flame retardant curing agent was successfully synthesized through the reaction between phosphorus oxychloride and pentaerythritol under the catalysis of 4-dimethylaminopyridine. Using 1,2-propylenediamine and the prepared SPDPC, a novel phosphorus and nitrogen flame retardant curing agent named poly1,2-propylenediamine pentaerythritol diphosphate (PDS) was successfully synthesized. The target product was subjected to characterization using infrared spectroscopy, mass spectrometry, hydrogen NMR spectroscopy and thermogravimetric analysis. The molecular structure of the product was determined and its decomposition temperature curve obtained, leading to the conclusion that it could be cured at high temperatures. DDS was selected as the curing agent for epoxy E-51, the specific curing conditions were obtained by DSC test. Subsequently, E-51, DDS and PDS were mixed for high temperature curing resulting in obtaining test spline of PDS-E-51 flame retardant composite material. Then, the flame retardancy and mechanical properties of the spline were tested. It was observed that pure EP cured by DDS had an LOI of only 19.5%, indicating its flammability. However, upon addition of PDS as a flame retardant, the LOI significantly increased with 20 parts resulting in an LOI of 29.7%. The addition of 25 parts results in an increase in limiting oxygen index to 30.3%, while the tensile strength and impact strength are measured at 38.27 MPa and 5.087 kJ/m2 respectively. The CCT test shows that the addition of PDS can significantly reduce the HHR and THR of the system. CCT digital photos show that the addition of PDS can make the combustion residue of the system expand obviously, showing a good expansion and flame retardant effect. TG-FTIR gas phase infrared absorption indicates that the addition of PDS can reduce the concentration of combustible gas in the combustion process. Test results indicate that the mechanical properties of PDS-E-51 flame retardant composites experience a certain degree of decline, but with increasing amounts of PDS curing agent added, their flame retardancy is significantly enhanced.

Vibration control for large space truss structure assembly using a distributed adaptive neural network approach

The vibration suppression problem of the large space truss structure during on-orbit assembly process is investigated in this paper, and a distributed adaptive neural network control approach is proposed to solve this problem. The dynamic modeling process of large space truss structure assembly is firstly developed. It can be used to describe the dynamic characteristics of the incrementally increasing space structure. To achieve the vibration suppression during on-orbit assembly, a distributed control approach is then proposed. The controller is designed for each assembly substructure, and a coordination term is added into the controller to reduce the interactions between the assembled substructures, and the distributed control system is therefore formed along with the assembly proceeds. The distributed controller is then redesigned using neural networks, to compensate the effect of the modeling uncertainties and the system parameter variation in the assembly process. It also could be noted that the dependence of controller design on dynamic models is then reduced. The simulation results demonstrate that the vibration is effectively suppressed, and the dynamic performance of the closed-loop system is improved. The controller designed based on the proposed dynamic model has good expansibility, and the control system also has robustness to external disturbance, and good fault tolerance when controller fails.

Utilization of waste glass with natural pozzolan in the production of self-glazed glass-ceramic materials

Abstract Significant self-glazed glass-ceramic was obtained from a natural pozzolan and external glass cullet. Natural pozzolan with/without glass cullet was fused to glass melt that quenched in water to glass frits. The dried glass frits were pulverized (&lt;0.083 mm) and then shaped in a stainless mold. The thermal behavior of the glasses shows a widening of the crystallization temperature with the incorporation of the glass cullet between ∼800 and 950°C. Sintering of the shaped glass powder at 1,050°C/2 h lead to the crystallization of augite, enstatite, cristobalite, and hematite. The microcrystalline structure shows massive texture with pores in-between; however, at high magnification regular euhedral to subhedral crystals in submicron to nearly submicron size was developed in the glassy matrix and their microanalysis indicates the dominant augite. The density of the glass-ceramic samples decreases from 2,706 to 2,539 kg/m3 with the incorporation of glass wastes. The sample surfaces show, through force electron microscopy, the fineness and smoothness of the grains with the incorporation of the glassy portion. The microhardness values were between 6.43 and 6.11 GPa. The coefficient of thermal expansion increased from 32.87 (25–300°C) to 66.89 (25–500°C) × 10−7°C−1. The chemical resistance of samples in water (0.0002–0.0016) is better than in an acidic medium (0.0011–0.0017). These glass-ceramic enjoy good density, hardness, and thermal expansion and can be used in the ceramic industry and cladding walls and floors.

Engineering T cell receptor fusion proteins using nonviral CRISPR/Cas9 genome editing for cancer immunotherapy.

Manufacture of chimeric antigen receptor (CAR)-T cells usually involves the use of viral delivery systems to achieve high transgene expression. However, it can be costly and may result in random integration of the CAR into the genome, creating several disadvantages including variation in transgene expression, functional gene silencing and potential oncogenic transformation. Here, we optimized the method of nonviral, CRISPR/Cas9 genome editing using large donor DNA delivery, knocked-in an anti-tumor single chain variable fragment (scFv) into the N-terminus of CD3ε and efficiently generated fusion protein (FP) T cells. These cells displayed FP integration within the TCR/CD3 complex, lower variability in gene expression compared to CAR-T cells and good cell expansion after transfection. CD3ε FP T cells were predominantly CD8+ effector memory T cells, and exhibited anti-tumor activity in vitro and in vivo. Dual targeting FP T cells were also generated through the incorporation of scFvs into other CD3 subunits and CD28. Compared to viral-based methods, this method serves as an alternative and versatile way of generating T cells with tumor-targeting receptors for cancer immunotherapy.

Development and performance test of an expansive particle temporary plugging agent

Addressing the problems found in some wells in the carbonate reservoirs of Tahe and Shunbei blocks, such as wide natural fractures and large leakage, an efficient temporary plugging agent is developed to effectively seal up large fractures and leaky wells without affecting the flow path after acid fracturing. The temporary plugging agent is prepared by crosslinking an organic zirconium crosslinker with starch-grafted polyacrylamide. Among the materials, starch-grafted polyacrylamide shows good viscoelasticity, water absorption, expansion, and degradable properties; an organic zirconium crosslinker can improve the sealing effect. The temporary plugging agents produced from the two-boast have good performance in water absorption and expansion, temporary plugging pressure, and degradability. Experimental tests evaluated the developed expansive particle temporary plugging agent’s performance. According to the results, the particle size of the temporary plugging agent can expand 4 times larger; its final degradation under formation conditions reaches 99%. A larger plugging agent particle size and a higher concentration of the plugging agent can increase the plugging pressure. The plugging pressure can be as high as 15.5 MPa at a 5% concentration of the plugging agent with a particle size of 2 mm, which fully meets the needs of temporary plugging fracturing on site.

Effect of sodium sulfate and gypsum on performances of expansive grouting material with aluminum as expansion agent

In order to compensate the shrinkage of cement-based grout after hardening, volume expansion was produced by adding sodium sulfate or gypsum into aluminum powder blended grouting materials to enhance the expansion and strength. It was found that the addition of sodium sulfate or gypsum not only improved the expansive performances, but also enhanced the strength of specimens by increasing the amount of hydration products. When the water-cement ratio was fixed at 0.40 and aluminum powder content was at 0.5 wt‰, with the increase of sodium sulfate content, the volume expansion was accelerated, and the expansion rate gradually increased. The compressive strengths at 3d and 28d were the best at 0.5 wt%, especially the 28d compressive strength was increased by 14.7%. With the increase of gypsum content, the starting time of expansion was delayed, but the expansion rate was increased. The 3d compressive strength first increased and then decreased, and the 28d compressive strength was increased by 59.8% with 4 wt% gypsum. The mechanisms were that sodium sulfate increased the pH value of the slurry, while gypsum promoted the formation of ettringite (AFt), which caused different effects on the gas generation characteristics of aluminum powder. The results indicated that the optimum contents of sodium sulfate and gypsum in this aluminum powder blended grouting material were 0.5 wt% and 4 wt%, respectively, which had highest compressive strength and good expansion behaviors.

Analysis of Core Loss Characteristics of Linear Phase-Shifting Transformer

Linear phase-shifting transformer, as a new type of phase-shifting transformer, has the advantages of shifting phase at any angle, good expansibility, and easy modularization compared with the traditional core column phase-shifting transformer. To calculate the output performance such as the efficiency of linear phase-shifting transformer, the loss of linear phase-shifting transformer should be studied. The loss of linear phase-shifting transformer includes copper loss and core loss. Among them, the core loss has an important impact on linear phase-shifting transformer performance parameters such as efficiency and temperature rise, but there is a lack of relevant research at present. In this paper, based on the traditional separation model of ferromagnetic materials, a calculation method for linear phase-shifting transformer core loss is proposed. In this method, the loss coefficient of the linear phase-shifting transformer iron loss model is calculated by the least square method based on the calculation and analysis of the magnetic field law of the core by the time-step finite element method, and the loss coefficient is further modified by considering the influence of local hysteresis loop, non-sinusoidal magnetic field, and harmonic magnetic field. The linear phase-shifting transformer model based on finite element field-road coupling simulation is established, a low-power experimental prototype is designed, and a multi-stack inverter system platform is built. The theoretical calculation is verified by simulation and experiment. Simulation and experimental results demonstrate the accuracy of the core loss calculation method presented in this paper.

Whatever Happened to the Affluent Society? Or, the Dynamics of Consumer-Driven Capitalism Revealed

Abstract: This article is an exploration of the ways in which affluence undermines itself, based on a reexamination of two influential books: John Kenneth Galbraith’s Affluent Society (1958) and Tibor Scotivsky’s Joyless Economy (1976). Galbraith’s book offered blueprints for the reform of both the American economy and the discipline of economics based on his understanding that the affluent society was driven increasingly by the consumer rather than the producer. The essay explores the strengths and weaknesses of Galbraith’s analysis based on an account of the course of American public policy in the decades since he wrote. He had advocated for an expansion of public goods; what emerged instead was an expansion of transfer payments. Scitovsky’s account of consumer behavior sought to explain why rising income led to dissatisfied—joyless—consumers. Expanding on his approach, I identify the dynamic of consumer demand that acts to undermine the condition of affluence itself.

Examining safety and durable disease remission in R/R B-ALL after autologous CD19-directed CAR T cells produced by novel PRIMCAR manufacture platform.

7026 Background: CD19 chimeric antigen receptor (CAR) T cell therapy has shown promising efficacy in the r/r B-ALL. However, the life-threatening side effect and disease relapse limited its wide application. To overcome these limitations, we established a novel PrimeCAR platform (PRIMCAR) and reported the preliminary safety and effectiveness data of MC-1-50 CAR-T cells before (Shiqi Li, et al. J Clin Oncol 2022; 40 [suppl 16]. Abstract 7008). Here, we present updated data. Methods: In this Phase I /II study (NCT04271410), MC-1-50 CAR T cells were manufactured by the PRIMCAR platform, which reduces manufacture periods to about 2 days. Patients (pts) received single-dose of MC-1-50 at dose ranged 1-5×105 CAR+/kg (Level 1, 1×105 CAR+/kg; Level 2, 2×105 CAR+/kg; Level 3, 3×105 CAR+/kg; Level 4, 5×105 CAR+/kg). Pts were pre-conditioned with fludarabine (25-30 mg/m2) and cyclophosphamide (200-300 mg/m2) daily for 3 days. Toxicity was graded by CTCAE, CRS and ICANS were graded by ASTCT criteria. Results: 19 pts with r/r B-ALL were infused. Disease characteristics and outcomes are shown in the table. No DLTs were reported. 18 pts (94.7%) experienced CRS, including 10 (52.6%) at grade 1, 7 (36.8%) at grade 2, 1 (5.3%) at grade 3, and no ≥ 4 CRS were observed. Three pts (15.8%) experienced ICANS, including 2 (10.5%) at grade 1, 1(5.3%) at grade 2, and no ≥ 3 ICANS occurred. All patients achieved CR/CRi (BM MRD-) in the first month. All patients received no other anti-tumor therapy until relapse was confirmed. The median DOR was not reached. 6 patients confirmed relapse, including 4 were CD19 negative and 2 were CD19 positive but with CD19 gene mutation at the time of relapse. All patients in 4 dose levels had good CAR-T expansion and exhibited long persistence features. Only 3 patients experienced the loss of CAR-T. Conclusions: Treatment of r/r B-ALL at a very low dose resulted in excellent safety profiles while exhibiting a high and durable efficacy. That makes this PRIMCAR platform potential for outpatient administration in the future. Clinical trial information: NCT04271410 . [Table: see text]

Development Strategy and Existing Qualities of Honeybee in Beekeepers Group Badung Regency-Bali

The cultivation of local honeybees is one of the new alternative jobs for the local community in Badung Regency, Bali to survive their life during Covid-19. This research aims to identify and determine of development strategy and to evaluate the quality existing of honeybees. The total sample was used 50 respondents consisting of 22 members of beekeepers of the “Sarining Trigona Pertiwi” group, 4 samples from local government, 4 from related institution government, and 20 local people. The SWOT method is used to formulate appropriate strategies and IE matrix is to analyze the condition of the honeybee-tourism strategy. The results of the analysis showed that internal factors have a total value of 3.20, with the highest factor being strategic partners in product innovation development. External factor analysis has a total value of 2.88 with the highest factor being increasingly diverse product diversification. Based on the IE matrix, tourism in quadrant IV shows the potential development of honeybees in Badung Regency, Bali is in a position to grow and develop with the appropriate intensive and integrated strategy. Based on the SWOT matrix were obtained strategies to conduct socialization of the cultivation program, having a research program regularly, developing products based on consumer demand, collaborating with cooperatives and Banks in credit services, conducting marketing and good market expansion, making SOP in the process, manufacture and storage of products, government policies on reforestation and forest area protection, human resource training, preparing market analysis and strategies, alternative food sources for the honeybees, and increasing product development. However, the qualities of Tetragonula laevicep honeybees produced by the beekeeper of “Sarining Trigona Pertiwi” are still lower than Indonesia National Standard (SNI) therefore; need to increase the quality in the future.

P39 MANAGEMENT OF A CASE OF LAST REMAINING PATENT VESSEL

Abstract A 72–year–old hypertensive, dyslipidemic and smoker (20 cig/day) gentleman was admitted to the emergency department for pulmonary edema. Past medical history included COPD, anterior MI treated with PCI and stenting of proximal LAD 5 years back, recent TIA. He was admitted to cardiac intensive care unit and treated with CPAP, IV furosemide and norepinephrine. Echocardiogram showed severe ventricular dysfunction (LVEF 20%) and severe functional mitral regurgitation; lab tests pointed out mild troponin elevation (50 ng/L) and high levels of BNP (1300 pg/mL). After stabilization, he underwent coronary angiography: in–stent CTO of LAD, critical stenosis of distal LM and ostio–proximal LCX (last remaining patent vessel, LRPV); hypoplastic RCA. At the end of angiography, new episode of pulmonary edema that required treatment with inotropes, CPAP and diuretics. Considering hemodynamic instability and high surgical risk (combined STS 37%), the Heart Team decided to proceed to PCI with mechanical circulatory support with Impella CP. From left radial access we achieved advancement of JR4 guiding catheter with guide extension in right common iliac artery. We performed angiography and then put a coronary guidewire in superficial femoral artery to facilitate right femoral access (angio–guided). From this femoral access we implanted Impella CP device. From left radial access we performed PCI: cannulation with JL 3 guiding catheter, wiring with Sion Blue ES guidewire, pre–dilatation with NC balloons until 3.0 mm diameter, stenting of LM–LCX with 1 DES 4.0/32 mm, post–dilatation with NC balloons (4.5 and 5.0 mm diameter). Good angiographic result; IVUS examination revealed good expansion and apposition of stent. Femoral access was closed with 2 Perclose Proglide. Patient was then monitored in cardiac intensive care unit, with clinical improvement and without complications. 10 days after PCI the patient, asymptomatic, was discharged. The echocardiogram displayed betterment of contractile function (LVEF 28%) and of mitral regurgitation (now moderate). At 4–month follow–up visit, patient is paucisymptomatic (NYHA class II), without angina episodes, with good quality of life in guideline–directed optimal medical therapy. Critical disease of LRPV is a severe condition, with unpredictable evolution and poor prognosis. PCI of LRPV in HFrEF patients is an high–risk PCI scenario in which mechanical circulatory support with Impella can prove to be essential.