High PPI Research Articles

NetCore: a network propagation approach using node coreness.

We present NetCore, a novel network propagation approach based on node coreness, for phenotype–genotype associations and module identification. NetCore addresses the node degree bias in PPI networks by using node coreness in the random walk with restart procedure, and achieves improved re-ranking of genes after propagation. Furthermore, NetCore implements a semi-supervised approach to identify phenotype-associated network modules, which anchors the identification of novel candidate genes at known genes associated with the phenotype. We evaluated NetCore on gene sets from 11 different GWAS traits and showed improved performance compared to the standard degree-based network propagation using cross-validation. Furthermore, we applied NetCore to identify disease genes and modules for Schizophrenia GWAS data and pan-cancer mutation data. We compared the novel approach to existing network propagation approaches and showed the benefits of using NetCore in comparison to those. We provide an easy-to-use implementation, together with a high confidence PPI network extracted from ConsensusPathDB, which can be applied to various types of genomics data in order to obtain a re-ranking of genes and functionally relevant network modules.

A new method to fabricate the cathode by cyclic voltammetric electrodeposition for electro-Fenton application

To develop a stable and efficient cathode applied in electro-Fenton is indispensable. In current study, the carbon felt (CF) was modified by the cyclic voltammetric (CV) electrodeposited anthraquinone 2-sulfonate (AQS) and polypyrrole (PPy). The newly fabricated CF/AQS/PPy cathode by CV electrodeposition method was applied in electro-Fenton, which showed higher stability and efficiency compared with that of the traditional potentiostatic electrodeposited (TPED) method. The yield of the electro-generated H2O2 and the degradation efficiencies of the target pollutant (RhB) in electro-Fenton with the newly fabricated cathode were around 10 times and 5 times higher than those of the unmodified CF cathode respectively. Recyclability evaluation showed that the degradation efficiency kept a good stability and could reach 100% within 1 h reaction time. The significantly enhanced performance and stability were attributed to the reduced charge transfer resistance (Rct) of the fabricated CF/AQS/PPy cathode decorated by the high conductive PPy and catalytic activity of AQS for oxygen reduction. The modification could result in an elevated extent of oxygen reduction to generate more O2•-, which subsequently combined with the protons to produce H2O2, the indispensable reactant to form reactive OH• in the Fenton’s process. The quenching experiment and EPR determination further confirmed the existence of OH• and O2•- free radicals in electro-Fenton equipped with the newly fabricated cathode.

Clopidogrel response in ischemic stroke patients: Is polymorphism or gender more important? Results of the CRISP study

Clopidogrel (CLP) is a second generation thienopyridine drug commonly used in secondary prevention of ischemic stroke (IS). Its antiplatelet response maybe variable due to genetic and non-genetic factors. Adipokines may affect platelet aggregation through ADP mediated platelet signalling. However, the combined effect of CYP genetic variants and adipokines on antiplatelet response of clopidogrel is unclear. Patients of IS/Transient ischemic attack (TIAs) within 3 months were prospectively screened following clopidogrel treatment. Major exclusions were cardioembolic and non atherosclerotic strokes. Antiplatelet effect of clopidogrel along with adipokine (Leptin and adiponectin) levels and genotyping of CYP, P2Y12 gene were investigated. Rare genetic variants were confirmed by DNA sequencing. 204 patients with ischemic stroke/TIAs were screened and 163 were recruited. 85 (52.1%) patients were poor responders to clopidogrel. Antiplatelet response to clopidogrel was weaker in females [Median 8.0 (IQR: 3.0–14.0)] compared to males [Median 5.0 (IQR: 2.0–10.0)]. In female subgroup analysis, association was found among high leptin levels and PPI (+) usage in poor responders. None of the genetic variants (CYP2C19*2,*3,*4*, CYP2C9*3, CYP2B6 and P2Y12) were found to influence the antiplatelet effects (p > 0.05). On multivariable logistic regression, a poor clopidogrel response was associated with female gender (Adjusted OR 2.55, 95% CI: 1.05–6.18) and PPI usage (Adjusted OR 2.42, 95% CI: 1.09–5.34). Despite a high prevalence of clopidogrel resistance in the North Indian stroke patients, female gender rather than genetic polymorphisms of CYP and P2Y12 genes may influence its antiplatelet effect. Further research may ascertain the role of gender on clopidogrel response.

66 The Use of Proton Pump Inhibitors in An Older Population in A Tertiary Hospital: A Patient Safety Issue?

Abstract Background PPIs form part of the most commonly prescribed medications in Ireland. There has been emerging concern regarding the risks associated with their chronic use. PPI use has been linked with clostridium difficile infection, pneumonia, hypomagnesaemia, nephrotoxicity, hyponatraemia as well as many other GI and non GI pathologies including dementia. Therefore there has been emerging concern regarding their chronic use. The aim of our audit was to identify the spot prevalence and appropriateness of PPI use for gastro-protection in an older population of medical inpatients in accordance with NICE 2014 PPI guidance “Management of dyspepsia in adults in primary care.” Methods We audited the prevalence of PPI use in medically admitted patients aged ≥65 years at our institution and the use of PPIs within this population. Patients' admission proforma, clinical notes, and drug kardex were reviewed. We collected: age, gender, past medical history, drug list, and laboratory results. This data was used to identify the prevalence and appropriateness of PPI use. Results The total number of medically admitted patients aged ≥65 years was 107. 52(48.5%) were prescribed PPIs. Of the 52, only 7(13.4%) had an appropriate indication: Five patients had concomitant prescription of low dose Aspirin ± clopidogrel and a documented history of gastritis/esophagitis/duodenitis. One patient had a hiatus hernia and gastro-esophageal reflux disease. One patient had chronic NSAID use due to arthritis. Subgroup analysis showed 46/52 were prescribed high dose PPI without indication. Conclusions Our audit confirms this showing that almost 50% of patients aged ≥ 65y admitted to our hospital have been prescribed PPIs. Furthermore, PPI prescriptions were only appropriate in 13.4%. In line with recent guidelines, NICE PPI guidance 2014 and AGA Best Practice Guidelines, our data shows there is scope to rationalise PPI use in older people with resultant cost savings and reduction in complications.

Metabotropic Glutamate Receptor 2 and Dopamine Receptor 2 Gene Expression Predict Sensorimotor Gating Response in the Genetically Heterogeneous NIH-HS Rat Strain.

Disruption of sensorimotor gating causes "flooding" of irrelevant sensory input and is considered a congenital trait in several neurodevelopmental disorders. Prepulse inhibition of acoustic startle response (PPI) is the operational measurement and has a high translational validity. Pharmacological studies in rodents have linked alterations in serotonin, dopamine and glutamate signalling to PPI disruption. How PPI response is associated with gene expression levels of these receptors is unknown. PPI response was assessed in 39 genetically heterogeneous National Institutes of Health-Heterogeneous Stock (NIH-HS) rats. Animals were classified as high, medium or low PPI. Expression levels of glutamate metabotropic receptor 2 (Grm2), dopamine receptor D2 (Drd2), dopamine receptor D1 (Drd1), serotonin receptor 1A (Htr1a), serotonin receptor 2A (Htr2a) and homer scaffolding protein 1 (Homer1) were investigated in prefrontal cortex (PFC) and striatum (STR). When comparing the two extreme phenotypes, only Drd2 in STR showed increased expression in the low PPI group. A multinomial model fitting all genes and all groups indicated that Grm2 in PFC, and Grm2 and Drd2 in the STR predicted PPI group. This was corroborated by a linear relationship of Grm2 with PPI in PFC, and Drd2 with PPI in STR. An interaction between levels of H3K27 trimethylation, associated with transcriptional repression, and PPI phenotype was observed for Drd2 in STR. Gene set enrichment analysis on a microarray dataset on Lewis rats confirmed enrichment of Drd2 in PFC in relation to PPI. These findings contribute to the understanding of the genetic substrate behind alterations in sensorimotor gating, relevant for its linkage to neurodevelopmental disorders.

Phenotypic analysis combined with tandem mass tags (TMT) labeling reveal the heterogeneity of strawberry stolon buds

BackgroundRamet propagation in strawberry (Fragaria × ananassa) is the most effective way in production. However, the lack of systematically phenotypic observations and high-throughput methods limits our ability to analyze the key factors regulating the heterogeneity in strawberry stolon buds.ResultsFrom observation, we found that the axillary bud located in the first node quickly stepped into dormancy (DSB), after several bract and leaf buds were differentiated. The stolon apical meristem (SAM) degenerated as the new ramet leaf buds (RLB), and the new active axillary stolon buds (ASB) differentiated continually after the differentiation of the first leaf. Using the tandem mass tags (TMT) labeling method, a total of 7271 strawberry proteins were identified. Between ASB and DSB, the spliceosome DEPs, such as Ser/Arg-rich (SR) and heterogeneous nuclear ribonucleoprotein particle (hnRNP), showed the highest enrichment and high PPI connectivity. This indicated that the differences in DEPs (e.g., SF-3A and PK) at the transcriptional level may be causing the differences between the physiological statuses of ASB and DSB. As expected, the photosynthetic pre-form RLB mainly differentiated from ASB and DSB judging by the DEP enrichment of photosynthesis. However, there are still other specialized features of DEPs between RLB and DSB and between ASB and DSB. The DEPs relative to DNA duplication [e.g., minichromosome maintenance protein (MCM 2, 3, 4, 7)], provide a strong hint of functional gene duplication leading the bud heterogeneity between RLB and DSB. In addition, the top fold change DEP of LSH 10-like might be involved in the degeneration of SAM into RLBs, based on its significant function in modulating the plant shoot initiation. As for RLB/ASB, the phenylpropanoid biosynthesis pathway probably regulates the ramet axillary bud specialization, and further promotes the differentiation of xylem when ASB develops into a new stolon [e.g., cinnamyl alcohol dehydrogenase 1 (CAD1) and phenylalanine ammonia-lyase 1 (PAL1)].ConclusionsBy using phenotypic observation combined with proteomic networks with different types of strawberry stolon buds, the definite dormancy phase of DSB was identified, and the biological pathways and gene networks that might be responsible for heterogeneity among different stolon buds in strawberry were also revealed.

1801 A Rare Case of Acute Esophageal Necrosis

INTRODUCTION: AEN is a rare disease with an incidence ranging from 0.01% to 0.28% of all upper GI endoscopies. AEN occurs in the setting of underlying critical illnesses. Upon review of the English literature, only 14 cases of AEN associated with DKA have been published over the past 50 years. CASE DESCRIPTION/METHODS: A 61 yo M with a PMH: HTN, HTN, GERD, ETOH abuse, and obesity presented to the hospital with severe SOB, worsening mid-back pain, and a 1.5 wk hx of GERD symptoms. T 97.8 F, BP 183/85, HR 141, RR 31/min. BG of 833 mg/dL, arterial blood gas (ABG) pH of 7.164, pCO2 of 11.1 mmHg, HCO3 of 4 mEq/L, and PO2 of 128 mmHg with an anion gap of 25, serum Beta-Hydroxybutyrate of 4.9 mmol/L, 2+ urine ketones. (WBC) of 30.2 K/uL, Hb 13.5 K+ 5.8, Cr: 2.7. Admitted for DKA on day 2 of his hospital stay he developed N/V and hematemesis. He denied melena. On day 3 he had hematemesis and complained of feeling that food was getting stuck in his mid-chest upon swallowing. On day 4 his Hb dropped from 12.8 to 10.7 g/dL and he began to complain of chest pain and discomfort. (EGD) showed severe necrotizing esophagitis along entire length of esophagus with normal stomach and duodenum. Patient was started on oral (PPI) therapy and oral sucralfate therapy. DKA resolved, anion gap closed, AKI resolved, WBC normalized, and he was weaned off the insulin infusion. He was discharged on hospital day 8 with 6 weeks of oral PPI and sucralfate therapy. DISCUSSION: The pathogenesis is hypothesized to be due to the distal portion of the esophagus being a watershed area due to lower levels of vascularization compared to the upper and middle portions. In one case series, 4 out of 16 cases (25%) of AEN occurred in the setting of diabetic ketoacidosis (DKA), and 14% of cases of DKA involved AEN. AEN is more likely to occur in men than women with a 4:1 ratio, and the ages of presentation ranged from 19-91 with a mean of 68 years. It is diagnosed by upper endoscopy which shows circumferential black necrosis in the distal third of the esophagus that may extend along the length of the esophagus into the upper third but will not extend into the gastric mucosa. Mortality is as high as 32% and the mortality specific to AEN is closer to 6%. Complications can include esophageal perforation, mediastinitis, and abscess formation in up to 6%. Late complications include esophageal strictures and stenoses which are seen in 10.2% of cases and appear as early as 7-12 days. AEN is typically managed with high dose PPI and sucralfate.

577 Randomized Controlled Trial (RCT) of Over-the-Scope Clip (OTSC) as Initial Endoscopic Treatment of Severe Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB)

INTRODUCTION: Recurrent GI bleeding from peptic ulcers (PUB's) & Dieulafoy's lesions is common in high risk patients. In our recent RCT, patients treated with Standard Hemostasis- RX (e.g. hemoclips &/or multipolar probe with epinephrine pre-injection) for severe NVUGIB had a 30 day rebleed rate of 26.3 % (Gastro 2017;152:1310). OTSC obliterates arterial flow underneath stigmata of hemorrhage (SRH) of PUB's more effectively than Standard RX & residual blood flow correlates with rebleed risk (DDW 2019). No one has reported an RCT of OTSC as primary, initial treatment compared to current Standard RX. Therefore, we performed this RCT. METHODS: The RCT was conducted at 2 academic medical centers after IRB approvals & Clinicaltrials.gov registration (NCT03065465). After informed consent for emergency endoscopy (EGD), patients & their caregivers (general GI, ICU & primary care) were blinded as to EGD Rx & the latter MD's made all management decisions about medical treatment, RBC transfusions, or ordering repeat EGD or angiography (IR) for rebleeding. Patients who met clinical & EGD criteria for PUB's or UGI Dieulafoy's lesions (with major SRH or spots with arterial blood flow) were randomized in a 1:1 allocation to either Standard RX (as described in above RCT) or OTSC. All patients received high dose PPI's after randomization & were followed prospectively for 30 days. Clinical outcomes data were collected on standard forms, de-identified, entered onto computer files, managed with SAS, & analyzed by a biostatistician (JG). RESULTS: 49 RCT patients were well matched in demographics, risk factors, lesion type & SRH (Table 1). In contrast, the proportion of patients with 30 day rebleeding was significantly higher with Standard RX - 28% (7/25) - compared to OTSC Rx – 4.2% (1/24) - P = 0.0285 by Chi square (P = 0.022 by log rank test – See Figure 1). The OTSC rebleed rate was 85% lower than Standard group (Relative Risk 0.149 with 95% confidence intervals of 0.006, 0.863). The number needed to treat (NNT) was 4.2. See Table 2 for other outcomes. CONCLUSION: In patients with severe UGI bleeding from PUB's or Dieulafoy's lesions, primary endoscopic treatment with a large over the scope hemoclip resulted in significantly lower rates of rebleeding & severe complications, & fewer RBC transfusions than standard endoscopic hemostasis. Results appear to relate OTSC's superior ability to obliterate arterial blood flow underneath SRH & thereby reduce lesion rebleeding.

228 Potentially Inappropriate Prescribing in Community Nursing Units: Prevalence and Potential for Optimisation

Abstract Background It is well researched that individuals in long-term care (LTC) are prescribed a greater number of medications, the leading risk factor for inappropriate prescribing, and are thus at greater risk of adverse drug reactions as a result. Many tools with explicit criteria are described in the literature for assessing potentially inappropriate prescribing (PIP) in the general geriatric population, but few have been developed to examine prescribing in LTC. Methods This was a point prevalence observational study of patients aged >65 years residing in three HSE-run LTC facilities in Cork. Demographic characteristics, medical diagnoses and medication regimes at time of admission (TOA) to LTC, and time of data collection were recorded and reviewed using STOPPFrail and NORGEP-NH criteria. Results 98 patients met the inclusion criteria, with 66% being female. The median age was 83 years (IQR 77-88 years), and median length of stay was 31 months (IQR 14-53 months). The median number of medications per person on admission was 8 (IQR 6-11), which increased to 9 (IQR 7-11) at time of review (TOR)(p<0.001). PIP was found in 70 (84.3%) patients at TOA, and 79(80.6%) at TOR using STOPPFrail, and was recorded as 81 (97.6%) at TOA, and 95(96.9%) at TOR using NORGEP-NH. Among the STOPPFrail criteria most commonly implicated were continuous use of nutritional supplements and high dose PPI therapy. With NORGEP, the most commonly implicated were use of antidepressants and antihypertensives. There was an increase in number of patients prescribed benzodiazepines, z-drugs, anti-depressants and anti-psychotics from TOA to TOR, while statins were prescribed less often at TOR (p<0.001). Conclusion Potentially inappropriate prescribing is highly prevalent in older residents of community hospitals using validated prescribing indicators. Criteria such as those used in this study could be used to highlight potentially inappropriate or futile medications in older, vulnerable patients. Regular medication review is recommended to facilitate deprescribing of such medications.

High Effective of 14-Day High-Dose PPI- Bismuth-Containing Quadruple Therapy with Probiotics Supplement for Helicobacter Pylori Eradication: A Double Blinded-Randomized Placebo-Controlled Study.

Background: Helicobacter pylori (H. pylori) infection is important risk factors for chronic gastritis, peptic ulcer and gastric cancer. Bismuth-containing quadruple therapy has recently been the first-line regimen recommended in many European countries but has limited efficacy in ASEAN especially Thailand. This study was aim to evaluate efficacy of high dose PPI Bismuth-containing quadruple therapy with probiotics supplement for H. pylori eradication. Methods:In this double-blind randomized placebo-controlled study, H. pylori infected patients were randomized to receive 7-or 14-day high dose PPI- bismuth-containing quadruple therapy with or without probiotics supplement. Probiotic was 37.5 mg Lactobacillus reuteri (Biogaia®) in tablet twice daily. CYP2C19 genotyping and antibiotic susceptibility tests were also done. H. pylori eradication was defined as a negative 13C-urea breath test at least 4 weeks after treatment. Results:100 subjects were enrolled (72 females, 28 males, mean age=54 years). Antibiotic resistance was 15.6% for clarithromycin, 34.1% for metronidazole. CYP2C19 genotyping was performed in both group and revealed 13%, 50% and 37% for poor, intermediate and rapid metabolizers, respectively. Overall eradication rates of 7-day and 14-day regimens with probiotic were 68% and 96%; P value=0.027. The eradication rate for all patients with poor and rapid metabolizers were 100% with 14-day regimen. 14-day regimen with probiotics can provide 100% eradication with clarithromycin resistance, metronidazole resistance or dual clarithromycin and metronidazole resistance group. Furthermore, the incidence of nausea and vomiting, abdominal discomfort, and bitter taste were significantly lower in patients with probiotics group compared with placebo (6%vs.26%, P=0.002,OR=0.126,95% CI=0.03-0.53; 4%vs.18.0%, P=0.017, OR= 0.155,95% CI=0.03-0.81 and 4%vs.26%, P= 0.001,OR= 0.08, 95%CI= 0.016-0.41, respectively). Conclusions:The 14-day high dose PPI- bismuth-containing quadruple therapy with probiotic can provide an excellent cure rate for H. pylori infection as first line treatment irrespective of CYP2C19 and antibiotic resistance pattern. Adding probiotic also significantly reduced treatment-related adverse events and improve the patients’ compliance.

P‐11.17: A Combining Arc Design Scheme for Large TV Panel with Low PPI

Great success have been achieved in special‐shaped panel with high PPI and small size for their aesthetic appearance. However huge progress in arc design of relatively large TV panel has not been made yet. In this paper we tried different arc design scheme in a 70 PPI LCD panel and established an effective method to evaluate the smoothness of arc corner. In accordance of the calculation and the survey results we put forward a new combining arc design scheme for TV panel with relatively low PPI.

28‐2: A Novel Local Dimming algorithm with HDR for VR system based on GPU

As the screen of VR is very close to human eye and the optical lens has amplification effect, VR needs high PPI to meet people's visual requirements. High PPI panel with side‐emitting LED backlight is difficult to realize high contrast ratio(CR). Local Dimming based on direct‐illumination LED can not only save backlight power consumption but also improve the CR of the VR system. The point spread function(PSF) of LED plays an important role in Local Dimming technology. However traditional PSF always adopts approximate calculation method with low accuracy, which causes luminance distortion. In this paper, a method of PSF measurement and data processing was proposed. It can describe the spread strength and range of one single block LED actually. One improved LCD compensation algorithm was demonstrated in this paper. The light leakage characteristic of liquid crystal was considered. It can keep the hue consistent. The proposed Local Dimming method has low distortion and high dynamic contrast range. This paper also presents a method for implementing Local Dimming algorithm by GPU, which can display Local Dimming effect in real time of VR system with high frame rate.

67‐3: Unique Belt Plane Source Evaporation Techniques for the Mass Production of 2250ppi AMOLED and 77” QD OLED TV

The AMOLED has a limitation in ppi(pixel per inch) resolution due to the shadow phenomenon in doing evaporation deposition process and the QD‐OLED TV device has a limitation in substrate size due to the glass bending during evaporation deposition process. Using the plane source evaporation deposition, the AMOLED resolution can be improved up to 2250ppi and the blue organic film of 12G size glass can be deposited uniformly. The mass production of very high ppi AMOLED and 77” QD‐OLED TV will be realized by unique belt plane source evaporator which can supply the continuous plane source evaporation process.

P‐30: Novel Driving Circuit Designs and Driving Methods for Organic Light Emitting Diode (OLED) Display

The paper presents three novel solutions for driving OLED displays including Distributive‐Driving, Prime‐Bridge, and the combination thereof. Distributive‐Driving re‐arranges the source and gate channel numbers on the back plane without changing the OLED fine metal mask (FMM) pattern, thereby increasing charging time, reducing fan‐out area, etc. Prime‐Bridge enables the sharing of the driving circuit by multiple subpixels and thus, can reduce the total number of thin‐film transistors (TFTs) and capacitors as well as the gate line number without sacrificing the charging time of each subpixel and the frame rate. By combining Distributive‐Driving and Prime‐Bridge, the driving circuit area can be increased in both horizontal and vertical directions, which is good for high PPI backplane design and can reduce BOM cost with higher yield.

SUN-LB057 An Interesting Case of Multiple Pancreatic Neuroendocrine Tumour: Normoglycaemic Glucagonoma and Concurrent Gastrinoma

Background: Pancreatic neuro-endocrine tumours (pNETs) are rare tumours, constituting less than 5% of pancreatic tumours. Of these cases, only an estimated 6% present with functional secretion of more than one hormone. Clinical Case: A 72-year-old woman was admitted to the acute frailty ward with symptoms of generalized weakness, fatigue and reduced exercise tolerance with shortness of breath on exertion. She reported unintentional weight loss of 16 kg in the preceding 3 months and widespread migratory rash with epidermal breakdown in the lower legs that was resistant to antibiotic therapy. Initial investigations on admission revealed severe anaemia with a haemoglobin (Hb) of 51 g/L that was refractory to blood transfusion, prompting gastroscopy that showed erosive gastritis. CT/MRI scans revealed a 24 mm solid arterial-enhancing mass lesion in the uncinate process of the pancreas, highly suggestive of a neuroendocrine tumour (NET). Histopathological examination of a skin biopsy showed intraepithelial vacuolisation of the cells in the upper epidermis, neutrophilic infiltration with psoriasiform hyperplasia and confluent parakeratosis; typical features of necrolytic migratory erythema (NME). Fasting serum gut hormone profile prior to omeprazole therapy was consistent with multiple functioning NET with elevated serum glucagon level (>500 pmol/L) and hypergastrinaemia (274 pmol/L). Fasting serum glucose level was 4.5 mmol/L and serum albumin was 24 g/L. Elevated serum fasting serum glucagon and gastrin levels strongly supported diagnosis of neuroendocrine tumour resulting in normoglycaemic glucagonoma syndrome (NME, weight loss without diabetes mellitus) and Zollinger-Ellison syndrome (anaemia and hyperchlorhydria). The rash resolved rapidly less than a week after commencing medical management with octreotide, a somatostatin receptor analogue. She was also commenced on high dose PPI therapy. Somatostatin receptor scintigraphy was performed that confirmed a somatostatin-avid primary tumour in the pancreas without distant metastases. Surveillance will include blood glucose monitoring, interval rescanning with CT abdomen and pelvis with contrast and octreotide scan to assess for metastases. Surgical resection of the tumour will be considered as the patient's performance status improves. Conclusion: We report a rare case of a patient diagnosed with a multiple functioning pNET. The clinician must always consider unconventional rashes as dermatological manifestations of systemic disease. A normal fasting serum glucose level is not a reliable exclusion criterion of glucagonoma syndrome due to functioning insulin secretion from beta pancreatic islet cells. Isolated measurement of fasting serum gastrin level is not appropriate for diagnosis of Zollinger-Ellison syndrome in patients treated with proton pump inhibitors or histamine receptor antagonists. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

高分辨率平板电脑产品中彩膜曝光基台色斑不良的改善

高分辨率平板电脑产品中彩膜曝光基台色斑不良的改善

High-performance all-solid-state supercapacitor derived from PPy coated carbonized silk fabric

Polypyrrole (PPy) has attracted renewed interest as a promising electrode material for supercapacitors. However, excellent gravimetric capacitance with the low areal capacitance of PPy composite electrodes is ascribed to the small mass loading, limiting the practical application for high energy systems. Herein, based on advantages of carbonized silk fabric (CSF) with large accessible area and hierarchically porous interconnected structure, a composite electrode with high PPy mass loading of 16.02 mg cm−2 (CSF/PPy) was prepared by electro-depositing PPy on the framework of CSF. The CSF/PPy composite electrode displays an outstanding areal capacitance of 4040 mF cm−2 at 2 mA cm−2 and a good cycling stability (88.6% capacitance retention after 1500 cycles). In addition, the prepared CSF/PPy were used as electrodes to fabricate the all-solid symmetric supercapacitor, achieving excellent areal specific capacitances of 666.78 mF cm−2 and volumetric capacitance of 15.29 F cm−3 at the current density of 2 mA cm−2. Moreover, the all-solid supercapacitor exhibits higher energy density of 6.88 mWh cm−3 at a power density of 0.04 W cm−3, which is higher than most of PPy-coated supercapacitors. Importantly, the carbonized fabrics have a promising application to be treated as porous carbon substrates to enhance active material mass loading for improvement of energy storage performance.

Water soluble Ln(III)-based metallopolymer with AIE-active and ACQ-effect lanthanide behaviors for detection of nanomolar pyrophosphate

In this study, a polymerizable terpyridine 2-(4-(4-(4-vinylbenzyloxy)phenyl)-6-(pyridin-2-yl)pyridin-2-yl)pyridine was synthesized, with N-(2-hydroxyethyl)acrylamide (HEAA) used to obtain an amphipathic polymer (Poly) through free radical polymerization. Then, Poly was coordinated with LnCl3 or Ln(ABM)3(H2O)2 (ABM = 4,4,4-trifluoro-1-phenylbutane-1,3-dione; Ln = Eu or Gd) in an equimolar ratio and a series of terpyridine-based Ln(III)-metallopolymer Poly-Eu or Poly-Eu-ABM obtained. The results strongly suggested that Poly-Eu exhibited aggregation-induced lanthanide emission. In contrast, after the introduction of a secondary sensitizer, ABM to Poly-Eu, aggregation-caused quenching effects were observed in Poly-Eu-ABM. In addition, both Poly-Eu and Poly-Eu-ABM were applied as fluorescence sensors to selectively detect pyrophosphate (PPi) among a series of different anions and the detection limit found to be at the nanomolar scale. Furthermore, high PPi sensitivity and selectively, low toxicity, and water solubility of this metallopolymer matrix Poly-Eu-ABM were used to detect PPi in living cells.

Unusual Case of Acquired Gastroduodenal Fistula Due to Methotrexate

Gastroduodenal fistulas are quite rare, with an incidence of 0.02%, most forming at the lesser curvature of the gastric antrum and the duodenal bulb. The most common etiology of acquired fistula formation is peptic ulcer disease. Methotrexate, even at low doses, can be a cause of gastrointestinal mucosal injuries, though the incidence of complications such as fistulas and perforations are less than 0.1% in rheumatoid arthritis patients. As gastroenterologists increase their usage of methotrexate as adjuvant therapy for inflammatory bowel disease, such complications are important to recognize. A 71 year old female with a history of rheumatoid arthritis on methotrexate presented to our hospital with epigastric pain, anorexia and weight loss. Patient reported starting methotrexate several months prior. For the past 2 months, she had increased epigastric pain and a 30 pound weight loss. She had an albumin of 1.9 and while hemoglobin was 7.0 on admission, patient denied any hematochezia or melena. Patient denied taking any NSAIDs or steroids for at least the last 3 months. She denied ever having an EGD or colonoscopy. An EGD was performed on hospital day 2 which revealed grade D esophagitis, severe gastritis with erosions, as well as a large cratered non-bleeding ulcer in the duodenal bulb. Adjacent to the pylorus, there was an additional opening into the duodenal bulb/duodenal sweep. The gastroscope was able to traverse through this opening into the duodenal bulb. She had follow up imaging which revealed distorted anatomy. Patient was discharged on day 3 and methotrexate was discontinued with high dose PPI initiated. Patient was scheduled to see gastrointestinal surgery for further evaluation, though the patient was subsequently lost to follow up. Gastrointestinal mucosal injuries such as erosions and ulcers caused by low dose methotrexate can occur in patients with rheumatologic or inflammatory bowel disease. One could advocate using a PPI or H2 blocker in patients on long term methotrexate to reduce GI side effects. While some may argue against this because of decreased renal clearance of methotrexate with PPI usage, this has only been reported with high dose methotrexate in treating malignancy. Due to the increasing frequency of patients taking methotrexate, gastroenterologists will need to have a better recognition of the gastrointestinal side effects in this subset of patients.

A Case of Low Grade Astrocytoma Induced Progressive Episodic Intractable Nausea and Vomiting

Chronic nausea and emesis, which may serve a protective function, pose a diagnostic challenge with a broad differential and contribute to numerous health care visits each year. We present a case of chronic intermittent nausea/emesis due to a brain mass without classic neurologic findings. A 36 year-old male presented with 3 months of intermittent episodes consisting of: relentless nausea, up to 10 bouts of forceful emesis a day, and PO intolerance. Episodes would last 2-3 days and occur once every 6 to 8 weeks with asymptomatic intervals between episodes. He denied preceding events, food triggers, and other related symptoms. He was taking lisinopril and aspirin and denied over the counter supplements. He remained afebrile and hemodynamically stable. Physical exam noted active emesis and non-peritoneal left quadrant pain. CBC, CMP, TSH, lipase were within normal limits. Urine drug screen and EtOH level were negative. CT abdomen/pelvis and right upper quadrant ultrasound were unremarkable. EGD revealed a small hiatal hernia with LA grade B esophagitis, chronic active gastritis, no food retention, and no evidence of obstruction. A trial of high dose PPI was unsuccessful. Subsequent imaging of the brain revealed a 1.6cm right posterior high frontal cortical mass without mass effect that was suspected to be benign; therefore, plan was for conservative management. However, in the following months, the patient had progression of symptoms with episodes increasing to once every 4 weeks and lasting 1-2 weeks. An elective sub-total resection of the mass was performed. Pathology demonstrated a diffuse grade II astrocytoma. The patient reported complete symptom resolutions at his 3-month follow up exam. The most common symptoms associated with brain masses are headache and neurologic deficits. However, nausea/vomiting are the initial presenting symptoms in up to 13% of cases. Nausea/emesis are typically the result of increased intracranial pressure, mass effect, involvement of the posterior fossa leading to gastroparesis, or involvement of the area postrema at the chemoreceptor trigger zone. However, lesions involving the higher cortical centers (such as the frontal lobe) can also lead to nausea and emesis. We highlight a rare case of a frontal astrocytoma initially presenting with unexplained nausea/emesis with resolution of symptoms following resection. It is important to consider the extra-intestinal etiologies for common gastrointestinal symptoms.3085_A Figure 1. MRI Brain Horizontal3085_B Figure 2. MRI Brain Sagittal