Using longitudinal study data, we dynamically model how aging affects homeostasis in both mice and humans. We operationalize homeostasis as a multivariate mean-reverting stochastic process. We hypothesize that biomarkers have stable equilibrium values, but that deviations from equilibrium of each biomarker affects other biomarkers through an interaction network - this precludes univariate analysis. We therefore looked for age-related changes to homeostasis using dynamic network stability analysis, which transforms observed biomarker data into independent "natural" variables and determines their associated recovery rates. Most natural variables remained near equilibrium and were essentially constant in time. A small number of natural variables were unable to equilibrate due to a gradual drift with age in their homeostatic equilibrium, i.e. allostasis. This drift caused them to accumulate over the lifespan course and makes them natural aging variables. Their rate of accumulation was correlated with risk of adverse outcomes: death or dementia onset. We call this tendency for aging organisms to drift towards an equilibrium position of ever-worsening health "mallostasis". We demonstrate that the effects of mallostasis on observed biomarkers are spread out through the interaction network. This could provide a redundancy mechanism to preserve functioning until multi-system dysfunction emerges at advanced ages. | Make paid
Objective: To describe the HPV-Automated Visual Evaluation (PAVE) Study, an international, multi-centric study designed to evaluate a novel cervical screen-triage-treat strategy for resource-limited settings as part of a global strategy to reduce cervical cancer burden. The PAVE strategy involves: 1) screening with self-sampled HPV testing; 2) triage of HPV-positive participants with a combination of extended genotyping and visual evaluation of the cervix assisted by deep-learning-based automated visual evaluation (AVE); and 3) treatment with thermal ablation or excision (Large Loop Excision of the Transformation Zone). The PAVE study has two phases: efficacy (2023-2024) and effectiveness (planned to begin in 2024-2025). The efficacy phase aims to refine and validate the screen-triage portion of the protocol. The effectiveness phase will examine acceptability and feasibility of the PAVE strategy into clinical practice, cost-effectiveness, and health communication within the PAVE sites. Study design: Phase 1 Efficacy: Around 100,000 nonpregnant women, aged 25-49 years, without prior hysterectomy, and irrespective of HIV status, are being screened at nine study sites in resource-limited settings. Eligible and consenting participants perform self-collection of vaginal specimens for HPV testing using a FLOQSwab (Copan). Swabs are transported dry and undergo testing for HPV using a newly-redesigned isothermal DNA amplification HPV test (ScreenFire HPV RS), which has been designed to provide HPV genotyping by hierarchical risk groups: HPV16, else HPV18/45, else HPV31/33/35/52/58, else HPV39/51/56/59/68. HPV-negative individuals are considered negative for precancer/cancer and do not undergo further testing. HPV-positive individuals undergo pelvic examination with collection of cervical images and targeted biopsies of all acetowhite areas or endocervical sampling in the absence of visible lesions. Accuracy of histology diagnosis is evaluated across all sites. Cervical images are used to refine a deep learning AVE algorithm that classifies images as normal, indeterminate, or precancer+. AVE classifications are validated against the histologic endpoint of high-grade precancer determined by biopsy. The combination of HPV genotype and AVE classification is used to generate a risk score that corresponds to the risk of precancer (lower, medium, high, highest). During the efficacy phase, clinicians and patients within the PAVE sites will receive HPV testing results but not AVE results or risk scores. Treatment during the efficacy phase will be performed per local standard of care: positive Visual Inspection with Acetic Acid impression, high-grade colposcopic impression or CIN2+ on colposcopic biopsy, HPV positivity, or HPV 16,18/45 positivity. Follow up of triage negative patients and post treatment will follow standard of care protocols. The sensitivity of the PAVE strategy for detection of precancer will be compared to current SOC at a given level of specificity. Phase 2 Effectiveness: The AVE software will be downloaded to the new dedicated image analysis and thermal ablation devices (Liger Iris) into which the HPV genotype information can be entered to provide risk HPV-AVE risk scores for precancer to clinicians in real time. The effectiveness phase will examine clinician use of the PAVE strategy in practice, including feasibility and acceptability for clinicians and patients, cost-effectiveness, and health communication within the PAVE sites. Conclusion: The goal of the PAVE study is to validate a screen-triage-treat protocol using novel biomarkers to provide an accurate, feasible, cost-effective strategy for cervical cancer prevention in resource-limited settings. If validated, implementation of PAVE at larger scale can be encouraged. | Make paid
Deep learning (DL)-based prediction of biological age in the developing human from a brain magnetic resonance image (MRI) (brain age) may have important diagnostic and therapeutic applications as a non-invasive biomarker of brain health, aging, and neurocognition. While previous deep learning tools for predicting brain age have shown promising capabilities using single-institution, cross-sectional datasets, our work aims to advance the field by leveraging multi-site, longitudinal data with externally validated and independently implementable code to facilitate clinical translation and utility. This builds on prior foundational efforts in brain age modeling to enable broader generalization and individual's longitudinal brain development. Here, we leveraged 32,851 T1-weighted MRI scans from healthy children and adolescents aged 3 to 30 from 16 multisite datasets to develop and evaluate several DL brain age frameworks, including a novel regression diffusion DL network (AgeDiffuse). In a multisite external validation (5 datasets), we found that AgeDiffuse outperformed conventional DL frameworks, with a mean absolute error (MAE) of 2.78 years (IQR:[1.2-3.9]). In a second, separate external validation (3 datasets), AgeDiffuse yielded an MAE of 1.97 years (IQR: [0.8-2.8]). We found that AgeDiffuse brain age predictions reflected age-related brain structure volume changes better than biological age (R2=0.48 vs R2=0.37). Finally, we found that longitudinal predicted brain age tracked closely with chronological age at the individual level. To enable independent validation and application, we made AgeDiffuse publicly available and usable for the research community. | Make paid
Electroencephalography (EEG) and magnetoencephalography (MEG) non-invasively measure human brain electrophysiology. They differ in nature; MEG offers better performance (higher spatial precision) whilst EEG (a wearable platform) is more practical. They are also complementary, with studies showing that concurrent MEG/EEG provides advantages over either modality alone, and consequently clinical guidelines for MEG in epilepsy recommend simultaneous acquisition of EEG. In recent years, new instrumentation, optically pumped magnetometers (OPMs), has had a significant impact on MEG, offering improved performance, lifespan compliance, and wearable sensors. Nevertheless, the ability to carry out simultaneous EEG/OPM-MEG remains critical. Here, we investigated whether simultaneous, wearable, whole-head EEG and OPM-MEG measurably degrades signal quality in either modality. We employed two tasks: a motor task known to modulate beta oscillations, and an eyes-open/eyes-closed task known to modulate alpha oscillations. In both, we characterised the performance of EEG alone, MEG alone, and concurrent EEG/OPM-MEG. Our results show that the SNR of the beta response was very similar, regardless of whether modalities were used individually or concurrently. Likewise, our alpha band recordings demonstrated that signal contrast was stable, regardless of the concurrent recording. These results combined suggest that there are no fundamental barriers to simultaneous wearable EEG/OPM-MEG, and consequently this technique is ripe for neuroscientific and clinical adoption. This will be particularly important in the clinical sphere where a direct comparison between simultaneous EEG and OPM-MEG recordings will facilitate interpretation of OPM-MEG data in patients. | Make paid
Objective: To identify the subset of the in vitro fertilization (IVF) population suitable for minimal monitoring by implementing a novel dosing regimen. Methods: A retrospective study conducted between April 2021 and August 2022. Eligible participants were aged 18 or older, had undergone IVF stimulation using an antagonist protocol, and were prescribed a combination of follitropin delta and human menopausal gonadotropin. The dosage was either based on a patient-specific dosing regimen developed by the ovo clinic utilizing weight and AMH levels (Group 1, n=356) or determined through clinical evaluation by the physician (Group 2, n=358). On day 6, ultrasound and serum hormone analyses were performed, with adjustments made solely to the menotropin dosage in necessary. Results: The study enrolled a total of 714 patients. In Group 1, 80,3% of patients were stimulated at maximal doses compared to 14,5% in Group 2. No cases of moderate or severe cases of ovarian hyperstimulation syndrome (OHSS) were recorded. The frequency of dose adjustments before day 10 was minimal. Patients treated with non-maximal doses according to the dosing regimen showed significantly fewer adjustments on day 6 compared to those treated according to physician's assessment (24.6% versus 46.9%, p<0.001). Among this subgroup, OHSS risk was observed in 30.4% of cases. Conclusion: Our innovative dosing regimen suggests that initial monitoring on day 10 would suffice for IVF patients with low ovarian reserve undergoing maximal stimulation. Keywords: In vitro fertilization; follitropin delta; HP-hMG; minimal monitoring; mixed protocol. | Make paid
Mitochondrial genomes co-evolve with the nuclear genome over evolutionary timescales and are shaped by selection in the female germline. Here, we investigate how mismatching between nuclear and mitochondrial ancestry impacts the somatic evolution of the mt-genome in different tissues throughout aging. We used ultra-sensitive Duplex Sequencing to profile ~2.5 million mt-genomes across five mitochondrial haplotypes and three tissues in young and aged mice, cataloging ~1.2 million mitochondrial somatic and ultra low frequency inherited mutations, of which 81,097 are unique. We identify haplotype-specific mutational patterns and several mutational hotspots, including at the Light Strand Origin of Replication, which consistently exhibits the highest mutation frequency. We show that rodents exhibit a distinct mitochondrial somatic mutational spectrum compared to primates with a surfeit of reactive oxygen species-associated G>T/C>A mutations, and that somatic mutations in protein coding genes exhibit signatures of negative selection. Lastly, we identify an extensive enrichment in somatic reversion mutations that "re-align" mito-nuclear ancestry within an organism's lifespan. Together, our findings demonstrate that mitochondrial genomes are a dynamically evolving subcellular population shaped by somatic mutation and selection throughout organismal lifetimes. | Make paid
Senescence classification is an acknowledged challenge within the field, as markers are cell-type and context dependent. Currently, multiple morphological and immunofluorescence markers are required for senescent cell identification. However, emerging scRNA-seq datasets have enabled increased understanding of the heterogeneity of senescence. Here we present SenPred, a machine-learning pipeline which can identify senescence based on single-cell transcriptomics. Using scRNA-seq of both 2D and 3D deeply senescent fibroblasts, the model predicts intra-experimental and inter-experimental fibroblast senescence to a high degree of accuracy (>99% true positives). We position this as a proof-of-concept study, with the goal of building a holistic model to detect multiple senescent subtypes. Importantly, utilising scRNA-seq datasets from deeply senescent fibroblasts grown in 3D refines our ML model leading to improved detection of senescent cells in vivo. This has allowed for detection of an in vivo senescent cell burden, which could have broader implications for the treatment of age-related morbidities. | Make paid
This cross-sectional study aimed to investigate the control of hypertension and its association with cognitive impairment in Chinese adults aged 45-80 years. Using cross-sectional surveys conducted in Shanghai and Guizhou from 2019-2021, 9,688 eligible subjects were eventually included. After analyzing the data using statistical methods such as unconditional logistic regression and restricted cubic splines (RCS), we found that severe blood pressure was positively associated with the risk of cognitive impairment. There was no significant association between mild/moderate BP and the risk of cognitive impairment. Moreover, diastolic blood pressure was significantly positively correlated with cognitive impairment. The restricted cubic spline model (RCS) results showed that the associations with cognitive impairment seem to be U-shaped for SBP and linear for DBP. In conclusion, this study shows that uncontrolled hypertension is an independent risk factor for cognitive impairment and that the risk of cognitive impairment increases as diastolic blood pressures continue continues to rise. | Make paid
Ectopic expression of OCT4, SOX2, KLF4 and MYC (OSKM) transforms differentiated cells into induced pluripotent stem cells. To refine our mechanistic understanding of reprogramming, especially during the early stages, we profiled chromatin accessibility and gene expression at single-cell resolution across a densely sampled time course of human fibroblast reprogramming. Using neural networks that map DNA sequence to ATAC-seq profiles at base-resolution, we annotated cell-state-specific predictive transcription factor (TF) motif syntax in regulatory elements, inferred affinity- and concentration-dependent dynamics of Tn5-bias corrected TF footprints, linked peaks to putative target genes, and elucidated rewiring of TF-to-gene cis-regulatory networks. Our models reveal that early in reprogramming, OSK, at supraphysiological concentrations, rapidly open transient regulatory elements by occupying non-canonical low-affinity binding sites. As OSK concentration falls, the accessibility of these transient elements decays as a function of motif affinity. We find that these OSK-dependent transient elements sequester the somatic TF AP-1. This redistribution is strongly associated with the silencing of fibroblast-specific genes within individual nuclei. Together, our integrated single-cell resource and models reveal insights into the cis-regulatory code of reprogramming at unprecedented resolution, connect TF stoichiometry and motif syntax to diversification of cell fate trajectories, and provide new perspectives on the dynamics and role of transient regulatory elements in somatic silencing. | Make paid
R (resistance) proteins, such as intracellular NLRs (nucleotide-binding leucine-rich repeat receptors), are integral components of the plant innate immune system. Host responses following R protein activation include the generation of reactive oxygen species, sustained increases in cytosolic Ca2+, transcriptional reprogramming and, typically, rapid host cell death at sites of pathogen infection, which together ultimately lead to pathogen growth restriction. To assess the activity of R proteins, agroinfiltration-mediated transient gene expression assays have been widely used in Nicotiana species (e.g., N. benthamiana). In these transient assays, host cell death is often chosen as an indicator of R protein activity from the host responses mentioned above, in part because of the ease of experimentation. However, the extent to which host cell death is a proxy for disease resistance signaling has long been debated, as host cell death and pathogen growth restriction can be uncoupled in several cases. To assess the disease resistance activity of R proteins, bacterial growth assays have been employed in combination with transient R gene expression in N. benthamiana. Bacterial growth assays, however, require multiple experimental procedures, including agroinfiltration, pathogen infection and bacterial counts, which hinders high-throughput studies of R gene-mediated disease resistance. Here, we report a simple plate reader-based assay to assess R gene-mediated disease resistance activity against PVX (Potato virus X) that expresses YFP (PVX-YFP). Unlike bacterial pathogens, PVX proliferation in N. benthamiana is not restricted by the intrinsic activity of the EDS1 signaling pathway as previously shown by virus-induced NbEDS1 gene silencing and as we consistently show in this study using a Nbeds1 gene knockout mutant. This feature would increase the sensitivity of the assay, allowing it to capture a weak-to-moderate disease resistance activity of R proteins, as the contribution of basal immunity to PVX via the NbEDS1 pathway is negligible. Using this assay, we show that a non-cell death-inducing mutant of the R protein of RBA1 (Response to HopBA1), which lacks 2',3'-cAMP/cGMP synthetase activity but retains NADase activity, confers PVX resistance in an EDS1 signaling pathway-dependent manner. | Make paid
mRNA translation relies on identifying translation initiation sites (TISs) in mRNAs. Alternative TISs are prevalent across plant transcriptomes, but the mechanisms for their recognition are unclear. Using ribosome profiling and machine learning, we developed models for predicting alternative TISs in Arabidopsis thaliana and tomato (Solanum lycopersicum). Distinct feature sets were predictive of AUG and non-AUG TISs in 5' untranslated regions and coding sequences, including a novel CU-rich sequence that promoted plant TIS activity, a translational enhancer found across dicots and monocots and also in humans and viruses. Our results elucidate the mechanistic and evolutionary basis of TIS recognition, whereby cis-regulatory RNA signatures affect start site selection. The TIS prediction model provides global estimates of TISs to discover neglected protein-coding genes across plant genomes. The prevalence of cis-regulatory signatures across eukaryotes and viruses suggests their broad, critical roles in reprogramming the translational landscape in the plant-virus arms race. | Make paid
This study utilized multivariate ANOVA analysis to investigate age-related microstructural changes in the brain tissues driven primarily by myelin, iron, and water content. Voxel-wise analyses were performed on gray matter (GM) and white matter (WM), in addition to region of interest (ROI) analyses. The multivariate approach identified brain regions showing coordinated alterations in multiple tissue properties and demonstrated bidirectional correlations between age and all examined modalities in various brain regions, including the caudate nucleus, putamen, insula, cerebellum, lingual gyri, hippocampus, and olfactory bulb. The multivariate model was more sensitive than univariate analyses as evidenced by detecting a larger number of significant voxels within clusters in the supplementary motor area, frontal cortex, hippocampus, amygdala, occipital cortex, and cerebellum bilaterally. The examination of normalized, smoothed, and z-transformed maps within the ROIs revealed age-dependent differences in myelin, iron, and water content. These findings contribute to our understanding of age-related brain differences and provide insights into the underlying mechanisms of aging. The study emphasizes the importance of multivariate analysis for detecting subtle microstructural changes associated with aging that may motivate interventions to mitigate cognitive decline in older adults. | Make paid
Introduction: to study the characteristics of the anamnestic history, the clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and evaluate their impact on the prognosis of the disease. Material and methods : the study included patients aged 60 years or older, survivors of acute myocardial infarction and registered in the database of the Hospital Universitario de los Andes in Merida , Venezuela (n=410). During the 2013-2018 study, a five-year prospective observation of patients with an assessment of their vital status was conducted. For the statistical processing of the data obtained, the Statistica V10.0 application package (StatSoft Inc.) was used. Results: the analysis showed that 90% of the patients had a history of comorbid pathology. The presence of an atypical manifestation of myocardial infarction lengthened the prehospital stage of medical care for patients who were late in seeking medical attention (120 [49; 311.5] minutes), as well as the longest time until the first medical contact (26.5 [20; 40] minutes (p = 0.005)). One-fifth of patients were treated for acute MI in complementary hospitals, where the level of in-hospital mortality among elderly patients reached 65.7%, three times higher than the same figure in specialized cardiology departments (19, 7%, p< 0.001). Conclusion: The main factors influencing long-term post-infarction in elderly patients were isolated systolic arterial hypertension, diabetes mellitus, renal dysfunction, previous myocardial infarction and acute stroke. | Make paid
Deep learning (DL)-based prediction of biological age in the developing human from a brain magnetic resonance image (MRI) (brain age) may have important diagnostic and therapeutic applications as a non-invasive biomarker of brain health, aging, and neurocognition. While previous deep learning tools for predicting brain age have shown promising capabilities using single-institution, cross-sectional datasets, our work aims to advance the field by leveraging multi-site, longitudinal data with externally validated and independently implementable code to facilitate clinical translation and utility. This builds on prior foundational efforts in brain age modeling to enable broader generalization and individual's longitudinal brain development. Here, we leveraged 32,851 T1-weighted MRI scans from healthy children and adolescents aged 3 to 30 from 16 multisite datasets to develop and evaluate several DL brain age frameworks, including a novel regression diffusion DL network (AgeDiffuse). In a multisite external validation (5 datasets), we found that AgeDiffuse outperformed conventional DL frameworks, with a mean absolute error (MAE) of 2.78 years (IQR:[1.2-3.9]). In a second, separate external validation (3 datasets), AgeDiffuse yielded an MAE of 1.97 years (IQR: [0.8-2.8]). We found that AgeDiffuse brain age predictions reflected age-related brain structure volume changes better than biological age (R2=0.48 vs R2=0.37). Finally, we found that longitudinal predicted brain age tracked closely with chronological age at the individual level. To enable independent validation and application, we made AgeDiffuse publicly available and usable for the research community. | Make paid
Iron deficiency (ID) and iron deficiency with anaemia (IDA) are serious global health problems that disproportionately affect women aged 15-49 years. Although food fortification is one of the most effective and sustainable ways to combat nutritional deficiencies, iron remains one of the most difficult micronutrients to fortify, given its tendency to react strongly with food constituents. Therefore, it is important to assess the sensory properties of foods fortified with iron to determine the acceptability and palatability in target populations. We aimed to determine the palatability and acceptability of an novel iron and zinc enriched powder fortified in tap water by conducting sensory evaluations in 35 women of reproductive age using a 9-point hedonic scale, where participants rated the sensory properties of six samples containing different amounts of the active or placebo. We found significant differences between samples reconstituted at 1g/L, 2g/L, and 3g/L for sensory properties, including overall taste. Participants were found to be more willing to drink the mineral-enriched powder when prepared at the lowest concentration (1g/L) compared to higher concentrations. Our results provide important insight on sensory qualities of a novel formulation of an iron and zinc -enriched powder for at-home fortification, and indicate consumer acceptability in reproductive aged women, a key group at risk for ID/IDA. If found to improve iron status, novel treatments like this product will contribute to global efforts to develop safe, acceptable and sustainable interventions for ID and IDA. | Make paid
Background The COVID-19 pandemic has affected millions of people globally with major health, social and economic consequences, prompting development of vaccines for use in the general population. However, vaccination uptake is lower in some groups, including in pregnant women, because of concerns regarding vaccine safety. There is evidence of increased risk of adverse pregnancy and neonatal outcomes associated with SARS-CoV-2 infection, but fear of vaccine-associated adverse events on the baby both in short and longer term is one of the main drivers of low uptake for this group. Other vaccines commonly used in pregnancy include influenza and pertussis. These both have reportedly higher uptake compared with COVID-19 vaccination, which may be because they are perceived to be safer. In this study, we will undertake an independent evaluation of the uptake, effectiveness and safety of COVID-19 vaccinations in pregnant women using the QResearch primary care database in England. Objectives A. To determine COVID-19 vaccine uptake in pregnant women compared to uptake of influenza and pertussis vaccinations. B. To estimate COVID-19 vaccine effectiveness in pregnant women by evaluating the risk of severe COVID-19 outcomes following vaccination. C. To assess the safety of COVID-19 vaccination in pregnancy by evaluating the risks of adverse pregnancy and perinatal outcomes and adverse events of special interest for vaccine safety after COVID-19 vaccination compared with influenza and pertussis vaccinations. Methods This population-based study uses the QResearch database of primary health care records, linked to individual-level data on hospital admissions, mortality, COVID-19 vaccination, SARS-CoV-2 testing data and congenital anomalies. We will include women aged 16 to 49 years with at least one pregnancy during the study period of 30th December 2020 to the latest date available. Babies born during the study period will be identified and linked to the mothers record, where possible. We will describe vaccine uptake in pregnant women by trimester and population subgroups defined by demographics and other characteristics. Cox proportional hazards multivariable regression will be used to identify factors associated with vaccine uptake. The effectiveness of COVID-19 vaccines in pregnant women will be assessed using time varying Royston-Palmar regression analyses to determine unadjusted and adjusted hazard ratios for the occurrence of severe COVID-19 outcomes after each vaccine dose compared with unvaccinated individuals. For the safety analysis, we will we use logistic regression analyses to determine unadjusted and adjusted odds ratios for the occurrence of maternal (e.g. miscarriage, ectopic pregnancy and gestational diabetes) and perinatal outcomes (e.g. stillbirth, small for gestational age and congenital anomalies) by vaccination status compared to unvaccinated individuals. For the adverse events of special interest for vaccine safety (e.g. venous thromboembolism, myocarditis and Guillain Barre syndrome), we will use time varying Royston-Palmar regression analyses to determine unadjusted and adjusted hazard ratios for the occurrence of each outcome by vaccination status to unvaccinated individuals. Ethics and dissemination QResearch is a Research Ethics Approved Research Database with ongoing approval from the East Midlands Multi-Centre Research Ethics Committee (Ref: 18/EM/0400). This study was approved by the QResearch Scientific Committee on 9th June 2022. This research protocol has been developed with support from a patient and public involvement panel, who will continue to provide input throughout the duration of the study. Research findings will be submitted to pre-print servers such as MedRxIv, academic publication and disseminated more broadly through media releases and community groups and conference presentations. | Make paid
HIV incidence in eastern and southern Africa has historically been concentrated among girls and women aged 15-24 years. As new cases decline with HIV interventions, population-level infection dynamics may shift by age and gender. Here, we integrated population-based surveillance of 38,749 participants in the Rakai Community Cohort Study and longitudinal deep sequence viral phylogenetics to assess how HIV incidence and population groups driving transmission have changed from 2003 to 2018 in Uganda. We observed 1,117 individuals in the incidence cohort and 1,978 individuals in the transmission cohort. HIV viral suppression increased more rapidly in women than men, however incidence declined more slowly in women than men. We found that age-specific transmission flows shifted, while HIV transmission to girls and women (aged 15-24 years) from older men declined by about one third, transmission to women (aged 25-34 years) from men that were 0-6 years older increased by half in 2003 to 2018. Based on changes in transmission flows, we estimated that closing the gender gap in viral suppression could have reduced HIV incidence in women by half in 2018. This study suggests that HIV programs to increase HIV suppression in men are critical to reduce incidence in women, close gender gaps in infection burden and improve men's health in Africa. | Make paid
Age and elevated intraocular pressure (IOP) are the two primary risk factors for glaucoma, an optic neuropathy that is the most common cause of irreversible blindness. In most people, IOP is tightly regulated over a lifetime by the conventional outflow tissues. However, the mechanistic contributions of age to conventional outflow dysregulation, elevated IOP and glaucoma are unknown. To address this gap in knowledge, we studied how age affects the morphology, biomechanical properties and function of conventional outflow tissues in C57BL/6 mice, which have an outflow system similar to humans. As reported in humans, we observed that IOP in mice was maintained within a tight range over their lifespan. Remarkably, despite a constellation of age-related changes to the conventional outflow tissues that would be expected to hinder aqueous drainage and impair homeostatic function (decreased cellularity, increased pigment accumulation, increased cellular senescence and increased stiffness), outflow facility, a measure of conventional outflow tissue fluid conductivity, was stable with age. We concluded that the murine conventional outflow system has significant functional reserve in healthy eyes. However, these age-related changes, when combined with other underlying factors, such as genetic susceptibility, are expected to increase risk for ocular hypertension and glaucoma. | Make paid
Inhibition of the nutrient-responsive mTOR (mammalian target of rapamycin) signalling pathway including the key downstream effector S6 kinase 1 (S6K1) extends lifespan and improves healthspan in mice. However, the underlying mechanisms contributing to the broad range of age-related benefits observed with loss of S6K1 signalling are unclear. Cellular senescence is a stable growth arrest accompanied by an inflammatory phenotype (termed the senescence-associated secretory phenotype, or SASP). While both cellular senescence and SASP-mediated chronic inflammation contribute to age-related pathology, the specific role of S6K1 signalling in these processes has not been determined. Here, focussing on mouse liver, a key target tissue for the beneficial metabolic effects of loss of S6K1 signalling, we show that S6K1 deletion does not reduce senescence but ameliorates inflammation and immune cell infiltration in aged livers. Using human and mouse models of senescence, we demonstrated that reduced inflammation is a liver-intrinsic effect associated with S6K deletion. Furthermore, gene expression analysis suggested that downregulated cGAS/STING and IRF3 activation might mediate the impaired SASP observed upon S6K deletion. Using a hepatic oncogene induced senescence model, we showed in vivo that S6K1 deletion results in reduced IRF3 activation, impaired production of cytokines such as IL1b and reduced immune infiltration. Overall, deletion of S6K reduces inflammation in the liver suggesting that suppression of the inflammatory SASP by loss of S6K could contribute to explain the beneficial effects of inhibiting this pathway on healthspan and lifespan. | Make paid
Cell reprogramming to pluripotency applied to the study of cancer has identified transformation and pluripotency as two independent and incompatible cell fates. A detailed knowledge of the relationship between transformation and reprogramming could lead to the identification of new vulnerabilities and therapeutic targets in cancer. Here, we explore this interplay and find that OSKM expression limits tumor cell growth by inducing apoptosis and senescence. We identify Oct4 and Klf4 as the main individual reprogramming factors responsible for this effect. Mechanistically, the induction of cell cycle inhibitor p21 downstream of the reprogramming factors acts as mediator of cell death and senescence. Using a variety of in vivo systems, including allografts, orthotopic transplantation and KRAS-driven lung cancer mouse models, we demonstrate that OSKM expression impairs tumor growth and reduces tumor burden. | Make paid
Biological aging is a multifactorial process involving complex interactions of cellular and biochemical processes that is reflected in omic profiles. Using common clinical laboratory measures in ~30,000 individuals from the MGB-Biobank, we developed a robust, predictive biological aging phenotype, EMRAge, that balances clinical biomarkers with overall mortality risk and can be broadly recapitulated across EMRs. We then applied elastic-net regression to model EMRAge with DNA-methylation (DNAm) and multiple omics, generating DNAmEMRAge and OMICmAge, respectively. Both biomarkers demonstrated strong associations with chronic diseases and mortality that outperform current biomarkers across our discovery (MGB-ABC, n=3,451) and validation (TruDiagnostic, n=12,666) cohorts. Through the use of epigenetic biomarker proxies, OMICmAge has the unique advantage of expanding the predictive search space to include epigenomic, proteomic, metabolomic, and clinical data while distilling this in a measure with DNAm alone, providing opportunities to identify clinically-relevant interconnections central to the aging process. | Make paid
Angiosarcoma is an aggressive soft-tissue sarcoma with a poor prognosis. Chemotherapy for this cancer typically employs paclitaxel, one of the taxanes (genotoxic drugs), although it has a limited effect due to chemoresistance for prolonged treatment. Here we examine a new angiosarcoma treatment approach that combines chemotherapeutic and senolytic agents. We first find that the chemotherapeutic drugs, cisplatin and paclitaxel, efficiently induce cellular senescence of angiosarcoma cells. Subsequent treatment with a senolytic agent, ABT-263, eliminates senescent cells through the activation of the apoptotic pathway. In addition, expression analysis indicates that senescence-associated secretory phenotype (SASP) genes are activated in senescent angiosarcoma cells and that ABT-263 treatment eliminates senescent cells expressing genes in the type-I interferon (IFN-I) pathway. Moreover, we show that cisplatin treatment alone requires a high dose to remove angiosarcoma cells, whereas a lower dose of cisplatin is sufficient to induce senescence, followed by the elimination of senescent cells by senolytic treatment. This study sheds light on a potential therapeutic strategy against angiosarcoma by combining a relatively low dose of cisplatin with the ABT-263 senolytic agent, which can help ease the deleterious side effects of chemotherapy. | Make paid
Human healthy and pathological aging is linked to a steady decline in brain resting state activity and connectivity measures. The neurophysiological mechanisms underlying these changes remain poorly understood. Making use of recent developments in normative modeling and availability of in vivo maps for various neurochemical systems, we test in the UK Biobank cohort (N=25,917) if and how age- and Parkinson's disease related resting state changes in commonly applied local and global activity and connectivity measures co-localize with underlying neurotransmitter systems. We find the distributions of several major neurotransmitter systems including serotonergic, dopaminergic, noradrenergic and glutamatergic neurotransmission to explain age-related changes as observed across functional activity and connectivity measures. Co-localization patterns in Parkinson's disease deviate from normative aging trajectories for these, as well as for cholinergic and GABAergic neurotransmission. The deviation from normal co-localization of brain function and GABAa correlates with disease duration. These findings provide new insights into molecular mechanisms underlying age- and Parkinson's related brain functional changes. Combining normative modeling and neurotransmitter mapping may aid future research and drug development through deeper understanding of neurophysiological mechanisms underlying specific clinical conditions. | Make paid
ABSTRACT Objectives To determine whether raising the minimum legal sales age of tobacco (MLSA) to 20 or above is associated with reduced prevalence of smoking compared to an MLSA set at 18 or below through systematic review. Design Following a pre-registered protocol on PROSPERO (ref: CRD42022347604), six databases were searched for studies that assessed the association between MLSAs of 20 and above and tobacco smoking or tobacco sales. Assessments on e-cigarettes were excluded. Two reviewers independently extracted study data and used ROBINS-I to assess the risk of bias. Narrative methods were used to synthesise findings. Setting Global, with no language restrictions. Subjects Children and young people aged 11-20. Main outcome measures Current cigarette smoking and cigarette sales. Results 19 studies were reviewed, from which 26 effect estimates were extracted. All studies evaluated Tobacco 21 laws in the United States. Just under half of estimates found a statistically significant association with reduced current cigarette smoking or sales, just over half found no statistically significant association and one estimate found an association with increased cigarette smoking. The positive association appeared to be stronger for older age groups, those from a Hispanic/Latinx background and those with lower education. The degree of study bias was variable. Conclusions There is evidence that raising the MLSA for tobacco to 21 reduces cigarette sales and current cigarette smoking amongst those aged 11-20. It may have the potential to reduce health inequalities. Further research beyond the United States would support generalisability to other settings. | Make paid
Background Squamous cell carcinoma of the anus (SCCA) annual incidence among sexual minority men (SMM) with and without HIV is 85/100,000 and 19/100,000 persons, respectively, which is significantly higher than the overall incidence (2/100,000). Since SCCA tumours average [≥]30 mm at diagnosis, we assessed the accuracy of individuals to self-detect anal abnormalities. Methods The study enrolled 714 SMM and transgender women (SMM/TW), aged 25 to 81 years, in Chicago, Illinois and Houston, Texas during 2020-2022. Individuals were taught the anal self- and companion examinations (ASE/ACE). Then, a clinician performed a digital anal rectal examination (DARE) before participants conducted the ASE or ACE. Accuracy was measured along with factors associated with ASE/ACE and DARE concordance. Findings The median age was 40 years (interquartile range, 32-54), 36.8% were living with HIV, and 47.0%, 23.4%, and 23.0% were non-Hispanic white, non-Hispanic Black, and Hispanic. Clinicians detected 245 individuals with abnormalities (median diameter 3 mm). Sensitivity and specificity of the ASE/ACE was 59.6% (95%CI 53.5-65.7%) and 80.2% (95%CI 76.6-83.8%), respectively. Overall concordance was 0.73 (95% CI 0.70-0.76) between ASE/ACE and DARE and increased with increasing anal canal lesion size (p=0.02). However, concordance was lower for participants aged [≥]55 years (compared to 25-34 years) and when the ASE/ACE trainer was a lay person rather than a clinician. Interpretation SMM/TW who complete an ASE or ACE are likely to detect SCCA at an early stage when malignant lesions are much smaller than the current median dimension at presentation of [≥]30 mm. Funding National Cancer Institute | Make paid
Quantifying the kinetics with which memory T cell populations are generated and maintained is essential for identifying the determinants of the duration of immunity. The quality and persistence of circulating CD4+ effector memory (TEM) and central memory (TCM) T cells in mice appear to shift with age, but it is unclear whether these changes are driven by the aging host environment, by cell age effects, or both. Here we address these issues by combining DNA labelling methods, an established fate-mapping system, and mathematical models. Together these allow us to quantify the dynamics of both young and established circulating memory CD4+ T cell subsets, within both young and old mice. We find strong evidence that cell-age effects dominate host-age effects, and that clones become more quiescent and more persistent the longer they reside within the TCM and TEM pools. This behaviour will lead to an increasingly long-tailed distribution of clone sizes as an individual ages. Therefore, the age structure of CD4+ TCM and TEM clones can explain bulk changes in their dynamics and persistence across the lifespan. | Make paid
Triple-Negative Breast Cancer (TNBC) has profound unmet medical need globally for its devastating clinical outcome associated with rapid metastasis and lack of targeted therapies. Recently, lipid metabolic reprogramming has emerged as a major driver of breast cancer metastasis. Here, we unveil a strong association between the heightened expression of fatty acid metabolic enzyme, acyl-CoA synthetase 4 (ACSL4) and TNBC, which is primarily attributed by the selective absence of progesterone receptor (PR). Loss of ACSL4 function, either through genetic ablation or pharmacological inhibition significantly reduces metastatic potential of TNBC. Global transcriptome analysis reveals that ACSL4 activity markedly influences the gene expression pattern associated with TNBC migration. Mechanistically, ACSL4 alters fatty acid oxidation (FAO) and cellular acetyl-CoA levels, leading to the hyper- acetylation of particularly H3K27Ac and H3K9Ac marks resulting in overexpression of SNAIL during the course of TNBC metastatic spread to lymph node and lungs. Further, human TNBC metastasis exhibits positive correlation between ACSL4 and SNAIL expression. Altogether, our findings provide new molecular insights regarding the intricate interplay between metabolic alterations and epigenetic modifications, intertwined to orchestrate TNBC metastasis and posit a rational understanding for the development of ACSL4 inhibitors as a targeted therapy against TNBC. | Make paid
Bacteria have developed a wide range of strategies to respond to stress, one of which is the rapid large-scale reorganization of their nucleoid, which is often associated with a major reprogramming of the gene expression profile. Nucleoid associated proteins (NAPs) are believed to be major actors in this process, but the molecular mechanisms underlying stress-induced nucleoid remodeling remain poorly understood. Here, using the radiation resistant bacterium, D. radiodurans, as a model, and advanced fluorescence microscopy approaches, we examined the changes in nucleoid morphology and compaction induced by either entry into stationary phase or exposure to UV-C light, and characterized the associated changes in abundance and dynamics of the major NAP in D. radiodurans, the heat-unstable (HU) protein. While both types of stress induced a similar macroscopic rearrangement of the nucleoid into a more compact structure, HU diffusion was significantly reduced in stationary phase cells, but was instead dramatically increased following exposure to UV-C, suggesting that the underlying mechanisms of remodeling are distinct. Furthermore, a detailed comparison of the cellular response to sublethal and lethal doses of UV-C light revealed that UV-induced nucleoid remodeling involves a rapid nucleoid condensation step associated with increased HU diffusion and abundance, followed by a slower decompaction phase to restore normal nucleoid morphology and HU dynamics, before cell growth and division can resume. Together, these findings shed light on the diversity and complexity of stressed-induced nucleoid remodeling processes in bacteria. | Make paid
The role of sleep in systemic aging remains poorly understood, despite sleep's essential function in preserving overall health and the prevalence of reduced sleep quality in modern society. Although reduced sleep correlates with an elevated risk of age-related diseases in humans, the mechanisms underlying this are unclear. In this study, we established a link between sleep and aging by demonstrating that disrupting sleep in C57BL/6 mice drives cellular senescence in the visceral adipose tissue. Sleep disruption also led to increased oxidative stress and DNA damage, both recognized triggers for senescence induction. Cellular senescence is implicated in numerous age-related conditions which are associated with insufficient sleep, such as cardiovascular disease, type 2 diabetes, and chronic inflammation. Our findings identify an accumulation of senescent cells in the adipose tissue, which serves as a potential target through which disturbed sleep accelerates the aging process and elevates the risk of age-related diseases. | Make paid
Ribosomal DNA (rDNA) genes encode the structural RNAs of the ribosome and are present in hundreds of copies in mammalian genomes. Age-linked DNA hypermethylation throughout the rDNA constitutes a robust methylation clock that accurately reports age, yet the consequences of hypermethylation on rDNA function are unknown. We confirmed that pervasive hypermethylation of rDNA occurs during mammalian aging and senescence while rDNA copy number remains stable. We found that DNA methylation is exclusively found on the promoters and gene bodies of inactive rDNA. To model the effects of age-linked methylation on rDNA function, we directed de novo DNA methylation to the rDNA promoter or gene body with a nuclease-dead Cas9 (dCas9) DNA methyltransferase fusion enzyme in human cells. Hypermethylation at each target site had no detectable effect on rRNA transcription, nucleolar morphology, or cellular growth rate. Instead, human UBF and Pol I remain bound to rDNA promoters in the presence of increased DNA methylation. These data suggest that promoter methylation is not sufficient to impair transcription of the human rDNA and imply that the human rDNA transcription machinery may be resilient to age-linked rDNA hypermethylation. | Make paid