Banks and financial institutions taking part in providing mortgage loans for the Housing Authority Subsidised Sale Flats Scheme (SSFS) may offer a mortgage principal moratorium plan to the scheme’s mortgagors.

The authority today wrote to these institutions to confirm and agree that such a plan is applicable for SSFS flats.

Principal repayment may be deferred for a maximum 12-month period and the mortgage loan repayment period may be extended correspondingly by a maximum of 12 months.

The principal moratorium period may commence by December 31 this year at the latest.

The arrangement is applicable to the Home Ownership Scheme, the Private Sector Participation Scheme, the Buy or Rent Option Scheme, the Tenants Purchase Scheme and the Green Form Subsidised Home Ownership Scheme in the primary market and under the Secondary Market Scheme.

To encourage participating financial institutions to provide mortgage loans and better mortgage terms for SSFS flat purchasers, the authority provides a mortgage default guarantee for them.

It undertakes to meet the shortfall in repayment in the event of default by the borrowers under specified circumstances during the guarantee period.

Due to the requirements in the guarantee deed on the mortgage loan period and the monthly instalment amount, participating financial institutions may not be able to offer a mortgage principal moratorium plan to SSFS flat owners.

In light of the economic downturn arising from the COVID-19 outbreak, the authority confirmed today that a mortgage principal moratorium plan is applicable for SSFS flats.

The move will encourage participating financial institutions to offer such a plan to SSFS flat owners, reducing their burden of mortgage repayment.

The seasonally adjusted unemployment rate increased to 4.2% in the period between January and March, up from 3.7% for the period between December 2019 and February, the Census & Statistics Department announced today.

The underemployment rate also increased to 2.1% in the period.

Total employment dropped by 48,800 to 3,720,000 while the labour force fell by 20,800 to 3,882,200.

There were 134,100 unemployed people in the period, an increase of 28,100 from the period between December 2019 and February, and the number of underemployed people rose by 23,700 to 82,800.

Secretary for Labour & Welfare Dr Law Chi-kwong said that the labour market further deteriorated as the COVID-19 pandemic severely disrupted a wide range of economic activities.

The unemployment rate soared by 0.5 percentage point to 4.2% for the period, the highest in more than nine years, while the underemployment rate likewise surged 0.6 percentage point to 2.1%, the highest in nearly a decade, he said.

The year-on-year declines in total employment and labour force widened further to 3.6% and 2.2%, both the largest on record.

The combined unemployment rate of the consumption and tourism-related sectors of retail, accommodation and food services soared to 6.8%, the highest since the period between August and October in 2009 following the global financial crisis, while the underemployment rate rose to 3.9%, the highest since the period between June and August of 2003 following the onslaught of SARS.

Dr Law added the situation in food and beverage service activities was severe, with the unemployment and underemployment rates surging to 8.6% and 5.4%.

Meanwhile, the unemployment and underemployment rates of the construction sector went up drastically to 8.5% and 7.1% amid a visible slowdown in construction activities.

The unemployment and underemployment situation worsened visibly in the transportation and education sectors as well. Labour market conditions in most other sectors also saw deterioration of various degrees.

Dr Law said: "The labour market will continue to face significant pressure from the economic fallout arising from the pandemic in the near term.

“The Government has rolled out relief measures of unprecedented scale, including the one-off measures in the 2020-21 Budget and the two rounds of measures under the Anti-epidemic Fund totalling $287.5 billion, with a view to preserving the vitality of the economy and relieving people's financial burdens.

“Some specific measures, in particular the Employment Support Scheme and various types of support for specific sectors, should help keep workers in employment.

“The Government will closely monitor the developments, including the progress and effectiveness of the various relief measures.”

Sarah Tomasello
Jan 1, 2008; 21:19-25
Articles

Jennal L. Johnson
Jul 1, 2006; 19:148-153
Articles

Jul 1, 2002; 15:
Patient Information

Betsy B. Dokken
Jul 1, 2008; 21:160-165
From Research to Practice/Cardiovascular Disease and Diabetes

The 2020 honours and awards selection and appointment of Justices of the Peace (JPs) exercise will be postponed, as well as the announcement of the list of honours and awards and JP appointments, the Government announced today.

It decided to defer the exercise to accord top priority to the ongoing anti-epidemic work and implementation of measures to retain employment, support businesses and ease people's livelihood in the face of challenges arising from the COVID-19 epidemic.

The Honours List and JP appointments will be announced on October 1 instead of July 1 as in previous years, the Government added.

The UK-based digital identity specialist managed to raise a bumper round during the peak of the COVID-19 pandemic, and is looking at ways to apply its technology to help combat the global crisis

(University of Southampton) Scientists have published highly detailed images of lab-grown neurons using Extreme Ultraviolet radiation that could aid the analysis of neurodegenerative diseases.

(University of South Florida (USF Health)) A new preclinical study by researchers at the University of South Florida Health (USF Health) Morsani College of Medicine and Johns Hopkins University School of Medicine offers promise of a specific treatment for NEC, a rare inflammatory bowel disease that is a leading cause of death in premature infants. The team found that inhibiting the inflammatory and blood-clotting molecule thrombin with targeted nanotherapy can protect against NEC-like injury in newborn mice.

Premises can still operate other licensed businesses which are not required to be suspended if they were operating more than one licensed business before the closure, the Food & Health Bureau said today.

The bureau made the statement in response to media enquiries on some anti-epidemic measures which were relaxed from today.

The statement noted that in accordance with the Prevention & Control of Disease (Requirements & Directions) (Business & Premises) Regulation, the Secretary for Food & Health has issued directions by notices in the Gazette that certain scheduled premises, namely karaoke establishments, clubs or nightclubs, party rooms and bathhouses, should remain closed until May 21.

These scheduled premises may still operate other licensed businesses if the operators have implemented all measures to effectively stop or avoid operation of businesses and offering services which are required to be suspended.

For example, premises originally operated as karaoke establishments and catering businesses can continue their catering business in accordance with the relevant directions if all karaoke operation and services are suspended.

The directions state that facilities, installations and equipment for karaoke activities are closed or properly sealed off and notices are posted in prominent locations at the entrances clearly indicating that only catering services but no karaoke services are provided in the premises.

Other scheduled premises operating more than one licensed business can adopt similar measures to operate other licensed businesses which are not required to be suspended, the bureau added.

Previous studies have shown that sphingosine kinase interacting protein (SKIP) inhibits sphingosine kinase (SK) function in fibroblasts. SK phosphorylates sphingosine producing the potent signaling molecule sphingosine-1-phosphate (S1P). SKIP gene (SPHKAP) expression is silenced by hypermethylation of its promoter in acute myeloid leukemia (AML). However, why SKIP activity is silenced in primary AML cells is unclear. Here, we investigated the consequences of SKIP down-regulation in AML primary cells and the effects of SKIP re-expression in leukemic cell lines. Using targeted ultra-HPLC-tandem MS (UPLC-MS/MS), we measured sphingolipids (including S1P and ceramides) in AML and control cells. Primary AML cells had significantly lower SK activity and intracellular S1P concentrations than control cells, and SKIP-transfected leukemia cell lines exhibited increased SK activity. These findings show that SKIP re-expression enhances SK activity in leukemia cells. Furthermore, other bioactive sphingolipids such as ceramide were also down-regulated in primary AML cells. Of note, SKIP re-expression in leukemia cells increased ceramide levels 2-fold, inactivated the key signaling protein extracellular signal-regulated kinase, and increased apoptosis following serum deprivation or chemotherapy. These results indicate that SKIP down-regulation in AML reduces SK activity and ceramide levels, an effect that ultimately inhibits apoptosis in leukemia cells. The findings of our study contrast with previous results indicating that SKIP inhibits SK function in fibroblasts and therefore challenge the notion that SKIP always inhibits SK activity.

The transcription factor forkhead box P3 (FOXP3) is a biomarker for regulatory T cells and can also be expressed in cancer cells, but its function in cancer appears to be divergent. The role of hepatocyte-expressed FOXP3 in hepatocellular carcinoma (HCC) is unknown. Here, we collected tumor samples and clinical information from 115 HCC patients and used five human cancer cell lines. We examined FOXP3 mRNA sequences for mutations, used a luciferase assay to assess promoter activities of FOXP3's target genes, and employed mouse tumor models to confirm in vitro results. We detected mutations in the FKH domain of FOXP3 mRNAs in 33% of the HCC tumor tissues, but in none of the adjacent nontumor tissues. None of the mutations occurred at high frequency, indicating that they occurred randomly. Notably, the mutations were not detected in the corresponding regions of FOXP3 genomic DNA, and many of them resulted in amino acid substitutions in the FKH region, altering FOXP3's subcellular localization. FOXP3 delocalization from the nucleus to the cytoplasm caused loss of transcriptional regulation of its target genes, inactivated its tumor-inhibitory capability, and changed cellular responses to histone deacetylase (HDAC) inhibitors. More complex FKH mutations appeared to be associated with worse prognosis in HCC patients. We conclude that mutations in the FKH domain of FOXP3 mRNA frequently occur in HCC and that these mutations are caused by errors in transcription and are not derived from genomic DNA mutations. Our results suggest that transcriptional mutagenesis of FOXP3 plays a role in HCC.

Prostate cancer (PCa) cells heavily rely on an active androgen receptor (AR) pathway for their survival. Enzalutamide (MDV3100) is a second-generation antiandrogenic drug that was approved by the Food and Drug Administration in 2012 to treat patients with castration-resistant prostate cancer (CRPC). However, emergence of resistance against this drug is inevitable, and it has been a major challenge to develop interventions that help manage enzalutamide-resistant CRPC. Erythropoietin-producing human hepatocellular (Eph) receptors are targeted by ephrin protein ligands and have a broad range of functions. Increasing evidence indicates that this signaling pathway plays an important role in tumorigenesis. Overexpression of EPH receptor B4 (EPHB4) has been observed in multiple types of cancer, being closely associated with proliferation, invasion, and metastasis of tumors. Here, using RNA-Seq analyses of clinical and preclinical samples, along with several biochemical and molecular methods, we report that enzalutamide-resistant PCa requires an active EPHB4 pathway that supports drug resistance of this tumor type. Using a small kinase inhibitor and RNAi-based gene silencing to disrupt EPHB4 activity, we found that these disruptions re-sensitize enzalutamide-resistant PCa to the drug both in vitro and in vivo. Mechanistically, we found that EPHB4 stimulates the AR by inducing proto-oncogene c-Myc (c-Myc) expression. Taken together, these results provide critical insight into the mechanism of enzalutamide resistance in PCa, potentially offering a therapeutic avenue for enhancing the efficacy of enzalutamide to better manage this common malignancy.

Heterotrimeric G proteins are the core upstream elements that transduce and amplify the cellular signals from G protein–coupled receptors (GPCRs) to intracellular effectors. GPCRs are the largest family of membrane proteins encoded in the human genome and are the targets of about one-third of prescription medicines. However, to date, no single therapeutic agent exerts its effects via perturbing heterotrimeric G protein function, despite a plethora of evidence linking G protein malfunction to human disease. Several recent studies have brought to light that the Gq family–specific inhibitor FR900359 (FR) is unexpectedly efficacious in silencing the signaling of Gq oncoproteins, mutant Gq variants that mostly exist in the active state. These data not only raise the hope that researchers working in drug discovery may be able to potentially strike Gq oncoproteins from the list of undruggable targets, but also raise questions as to how FR achieves its therapeutic effect. Here, we place emphasis on these recent studies and explain why they expand our pharmacological armamentarium for targeting Gq protein oncogenes as well as broaden our mechanistic understanding of Gq protein oncogene function. We also highlight how this novel insight impacts the significance and utility of using G(q) proteins as targets in drug discovery efforts.

The Mycobacterium tuberculosis virulence factor EsxA and its chaperone EsxB are secreted as a heterodimer (EsxA:B) and are crucial for mycobacterial escape from phagosomes and cytosolic translocation. Current findings support the idea that for EsxA to interact with host membranes, EsxA must dissociate from EsxB at low pH. However, the molecular mechanism by which the EsxA:B heterodimer separates is not clear. In the present study, using liposome-leakage and cytotoxicity assays, LC-MS/MS–based proteomics, and CCF-4 FRET analysis, we obtained evidence that the Nα-acetylation of the Thr-2 residue on EsxA, a post-translational modification that is present in mycobacteria but absent in Escherichia coli, is required for the EsxA:B separation. Substitutions at Thr-2 that precluded Nα-acetylation inhibited the heterodimer separation and hence prevented EsxA from interacting with the host membrane, resulting in attenuated mycobacterial cytosolic translocation and virulence. Molecular dynamics simulations revealed that at low pH, the Nα-acetylated Thr-2 makes direct and frequent “bind-and-release” contacts with EsxB, which generates a force that pulls EsxB away from EsxA. In summary, our findings provide evidence that the Nα-acetylation at Thr-2 of EsxA facilitates dissociation of the EsxA:B heterodimer required for EsxA membrane permeabilization and mycobacterial cytosolic translocation and virulence.

Type 2 diabetes mellitus (T2DM) is characterized by impaired glucose-stimulated insulin secretion and increased peripheral insulin resistance. Unremitting endoplasmic reticulum (ER) stress can lead to beta-cell apoptosis and has been linked to type 2 diabetes. Although many studies have attempted to link ER stress and T2DM, the specific effects of ER stress on beta-cell function remain incompletely understood. To determine the interrelationship between ER stress and beta-cell function, here we treated insulin-secreting INS-1(832/13) cells or isolated mouse islets with the ER stress–inducer tunicamycin (TM). TM induced ER stress as expected, as evidenced by activation of the unfolded protein response. Beta cells treated with TM also exhibited concomitant alterations in their electrical activity and cytosolic free Ca2+ oscillations. As ER stress is known to reduce ER Ca2+ levels, we tested the hypothesis that the observed increase in Ca2+ oscillations occurred because of reduced ER Ca2+ levels and, in turn, increased store-operated Ca2+ entry. TM-induced cytosolic Ca2+ and membrane electrical oscillations were acutely inhibited by YM58483, which blocks store-operated Ca2+ channels. Significantly, TM-treated cells secreted increased insulin under conditions normally associated with only minimal release, e.g. 5 mm glucose, and YM58483 blocked this secretion. Taken together, these results support a critical role for ER Ca2+ depletion–activated Ca2+ current in mediating Ca2+-induced insulin secretion in response to ER stress.

Fabry disease is a heritable lipid disorder caused by the low activity of α-galactosidase A and characterized by the systemic accumulation of globotriaosylceramide (Gb3). Recent studies have reported a structural heterogeneity of Gb3 in Fabry disease, including Gb3 isoforms with different fatty acids and Gb3 analogs with modifications on the sphingosine moiety. However, Gb3 assays are often performed only on the selected Gb3 isoforms. To precisely determine the total Gb3 concentration, here we established two methods for determining both Gb3 isoforms and analogs. One was the deacylation method, involving Gb3 treatment with sphingolipid ceramide N-deacylase, followed by an assay of the deacylated products, globotriaosylsphingosine (lyso-Gb3) and its analogs, by ultra-performance LC coupled to tandem MS (UPLC-MS/MS). The other method was a direct assay established in the present study for 37 Gb3 isoforms and analogs/isoforms by UPLC-MS/MS. Gb3s from the organs of symptomatic animals of a Fabry disease mouse model were mainly Gb3 isoforms and two Gb3 analogs, such as Gb3(+18) containing the lyso-Gb3(+18) moiety and Gb3(−2) containing the lyso-Gb3(−2) moiety. The total concentrations and Gb3 analog distributions determined by the two methods were comparable. Gb3(+18) levels were high in the kidneys (24% of total Gb3) and the liver (13%), and we observed Gb3(−2) in the heart (10%) and the kidneys (5%). These results indicate organ-specific expression of Gb3 analogs, insights that may lead to a deeper understanding of the pathophysiology of Fabry disease.

Bacterial type VII secretion systems secrete a wide range of extracellular proteins that play important roles in bacterial viability and in interactions of pathogenic mycobacteria with their hosts. Mycobacterial type VII secretion systems consist of five subtypes, ESX-1–5, and have four substrate classes, namely, Esx, PE, PPE, and Esp proteins. At least some of these substrates are secreted as heterodimers. Each ESX system mediates the secretion of a specific set of Esx, PE, and PPE proteins, raising the question of how these substrates are recognized in a system-specific fashion. For the PE/PPE heterodimers, it has been shown that they interact with their cognate EspG chaperone and that this chaperone determines the designated secretion pathway. However, both structural and pulldown analyses have suggested that EspG cannot interact with the Esx proteins. Therefore, the determining factor for system specificity of the Esx proteins remains unknown. Here, we investigated the secretion specificity of the ESX-1 substrate pair EsxB_1/EsxA_1 in Mycobacterium marinum. Although this substrate pair was hardly secreted when homologously expressed, it was secreted when co-expressed together with the PE35/PPE68_1 pair, indicating that this pair could stimulate secretion of the EsxB_1/EsxA_1 pair. Surprisingly, co-expression of EsxB_1/EsxA_1 with a modified PE35/PPE68_1 version that carried the EspG5 chaperone-binding domain, previously shown to redirect this substrate pair to the ESX-5 system, also resulted in redirection and co-secretion of the Esx pair via ESX-5. Our results suggest a secretion model in which PE35/PPE68_1 determines the system-specific secretion of EsxB_1/EsxA_1.

(American Association for the Advancement of Science) A one-hour exercise designed to increase feelings of social belonging administered during the first year of college appears to significantly improve the lives and careers of black students up to 11 years later, psychologists report.

Vladimir Dragović and Irina Goryuchkina
Bull. Amer. Math. Soc. 57 (2020), 293-299.
Abstract, references and article information

A 53-year-old building on Fa Yuen Street near Prince Edward, like most of the buildings in Yau Tsim Mong District, was in poor condition two years ago. Walls, both inside and out, were worn down, staircases were broken, and with electrical installation panels exposed on the outside. 

But with the help of various subsidy schemes launched by the Government and Urban Renewal Authority, older buildings are being given a new lease of life. The schemes include Operation Building Bright 2.0 (OBB 2.0), the Fire Safety Improvement Works Subsidy Scheme (FSWS) and the Lift Modernisation Subsidy Scheme (LIMSS).
 

Helping hand

Octogenarian owner-occupiers Leung Ting-lam and Chu Lai-chun have lived in this building on Fa Yuen Street for more than two decades. They welcome the improvements, which include a new metal gate and lift.

“Modernising the lift was done so quickly. It only took a few months and that was the most satisfying part,” said Mr Leung. Ms Chu agreed that the lift no longer breaks down so regularly.

It cost $800,000 just to modernise the lift. Add to that the other repair and maintenance works, and the total cost exceeded $3 million. Those who own a flat had to shoulder tens of thousands of dollars in the 10-storey building containing 19 units.

For seniors on a fixed income, it is not easy to cover the full cost of repair works. With the government subsidies, they no longer have to worry about the financial burden of upgrading their buildings on their own.

Popular services

The lift modernisation work under the LIMSS is assisted by the Electrical & Mechanical Services Department. The department’s Assistant Director Raymond Poon said the subsidy can cover up to 60% of the total cost of the works - plus a consultation fee - with a cap of $500,000 per lift for eligible buildings.

For elderly owner-occupiers, they can receive the full cost of relevant works capped at $50,000 per domestic unit.

Up until August 1, the department received around 1,171 applications for the scheme involving nearly 5,000 lifts in the first round of applications. This far exceeded the quota of 1,400 lifts set for the round, a response Mr Poon described as overwhelming.

Apart from the LIMSS, owner-occupiers can also apply for OBB 2.0 and other schemes to cover maintenance costs.

In one 58-year-old Hung Hom building, residents had to spend more than $800,000 to paint the common areas, replace above-ground drainage pipework and other structural upgrades.

The building’s owners’ corporation has applied for several funding schemes to get some financial relief, including OBB 2.0. Under this scheme, elderly recipients can receive the full cost of the work, subject to a cap of $50,000. Other owner-occupiers can receive 80%, capped at $40,000.

As of August, the owners or owners’ corporations of 479 Category One buildings were prepared to carry out the prescribed inspection and repair works for the common areas of their buildings under OBB 2.0. They can do so on a voluntary basis to comply with the Mandatory Building Inspection Scheme (MBIS) statutory notices.

These buildings are in 13 districts. Among them, Yau Tsim Mong has the largest number of applications, followed by Kowloon City and Sham Shui Po.

More help ahead

In the future, another $3 billion will be injected into OBB 2.0. This means a total of $6 billion will be used to benefit 5,000 buildings.

Development Bureau Principal Assistant Secretary Jasmine Choi said they have received feedback from the community which hopes the operation will eventually allow younger buildings to join the rehabilitation schemes.

Upon review, buildings between 40 and 49 years old with an outstanding MBIS statutory notice not yet complied with will be accepted in the next round of applications.

Apart from these younger structures, OBB 2.0 will also accept buildings aged 50 and older, even if they do not have an outstanding notice.

Problems might occur when using SAS Enterprise Guide with dual monitors. For example, it might appear there is a performance problem with the query builder or other task, or it might appear that code or a task is hung, or

(University of Helsinki) Mutations in white blood cells can contribute to abnormal immune profile after hematopoietic stem cell transplantation.

(University of Illinois at Urbana-Champaign, News Bureau) University of Illinois classics professor Clara Bosak-Schroeder writes about how the ancient Greeks thought about natural resources and how it is relevant to responding to climate change today.

(Bentham Science Publishers) Using a nationally representative sample, the researchers explored racial/ethnic variation in the link between educational attainment and heart disease among American adults.

(Keck School of Medicine of USC) A new USC study suggests that temporarily suppressing the body's immune system during the early stages of COVID-19 could help a patient avoid severe symptoms. That's because the research shows that an interaction between the body's two main lines of defense may be causing the immune system to go into overdrive in some patients.

(University of Colorado at Boulder) What can researchers do when their mathematical models of the spread of infectious diseases don't match real-world data? One research team is working on a solution.

(University of California - Davis) In the tropical atmosphere, cold air rises due to an overlooked effect -- the lightness of water vapor. This effect helps to stabilize tropical climates, and the impacts of a warming climate would be much worse without it.

(University of Maryland) Many historians have claimed the Justinianic Plague (c. 541-750 CE) killed half of the population of Byzantine (Eastern Roman) Empire. New historical research and mathematical modeling challenge the death rate and severity of this first plague pandemic, named for Emperor Justinian I.

(American Association for the Advancement of Science) Ice sheet losses from Greenland and Antarctica have outpaced snow accumulation and contributed approximately 14 millimeters to sea level rise over 16 years (2003 to 2019), a new analysis of data from NASA's laser-shooting satellites has revealed.

(European Geosciences Union) A new declaration endorsed by EGU and other international geoscience societies affirms the commitment of the Earth, planetary and space science community to support and promote scientific knowledge and research for the benefit of humanity.

Climate change could mean mosquitoes that can carry diseases like dengue, zika and yellow fever become established in southern Europe within 10 years.

(Crime and Justice Research Alliance) A new study evaluated the effects of legalizing cannabis on police officers' law enforcement efforts in Washington. The study found that officers in that state, although not supportive of recriminalization, had a variety of concerns, from worries about the effect on youth to increases in impaired driving. The study can inform other states' efforts to address legalization.

The Lady of Dancehall, D'Angel, says although her COVID-19 Relief Concert did not meet its US$200,000 target, she is overwhelmed by the support. The event, held via Instagram Live last Friday, saw performances from the likes of Beenie Man, G...

He's celebrating 10 years of dancing both competitively and in the street, and the co-founder of Unruly Skankaz, Devon Brown, says he is looking to expand the brand. The once three-member male dance group has grown to five, he told THE WEEKEND...

The COVID-19 pandemic has created a disruptive new normal for all of us, including thousands of urban and rural poor. Let's emerge into a place where the vulnerable are not so affected by social inequality, and rise together to create a world that'...

"It felt like prison." Those are the exact words of Jermaine who returned to the island yesterday after he was stranded on a cruise ship for 56 days in South Hampton, United Kingdom. "Bwoy we are out of prison ... it was rough mentally. They...

Fabry disease is a heritable lipid disorder caused by the low activity of α-galactosidase A and characterized by the systemic accumulation of globotriaosylceramide (Gb3). Recent studies have reported a structural heterogeneity of Gb3 in Fabry disease, including Gb3 isoforms with different fatty acids and Gb3 analogs with modifications on the sphingosine moiety. However, Gb3 assays are often performed only on the selected Gb3 isoforms. To precisely determine the total Gb3 concentration, here we established two methods for determining both Gb3 isoforms and analogs. One was the deacylation method, involving Gb3 treatment with sphingolipid ceramide N-deacylase, followed by an assay of the deacylated products, globotriaosylsphingosine (lyso-Gb3) and its analogs, by ultra-performance LC coupled to tandem MS (UPLC-MS/MS). The other method was a direct assay established in the present study for 37 Gb3 isoforms and analogs/isoforms by UPLC-MS/MS. Gb3s from the organs of symptomatic animals of a Fabry disease mouse model were mainly Gb3 isoforms and two Gb3 analogs, such as Gb3(+18) containing the lyso-Gb3(+18) moiety and Gb3(−2) containing the lyso-Gb3(−2) moiety. The total concentrations and Gb3 analog distributions determined by the two methods were comparable. Gb3(+18) levels were high in the kidneys (24% of total Gb3) and the liver (13%), and we observed Gb3(−2) in the heart (10%) and the kidneys (5%). These results indicate organ-specific expression of Gb3 analogs, insights that may lead to a deeper understanding of the pathophysiology of Fabry disease.

Liye Chen
May 1, 2020; 19:871-883
Research

Chia-Feng Tsai
May 1, 2020; 19:828-838
Research

¹⁸F-PI-2620 is a positron emission tomography (PET) tracer with high binding affinity for aggregated tau, a key pathologic feature of Alzheimer’s disease (AD) and other neurodegenerative disorders. Preclinically, ¹⁸F-PI-2620 binds to both, 3R and 4R tau isoforms. The purpose of this first-in-human study was to evaluate the ability of ¹⁸F-PI-2620 to detect tau pathology in AD patients using PET imaging, as well as to assess its safety and tolerability of this new tau PET tracer. Methods: Participants with clinical diagnosis of probable AD and healthy controls (HC) underwent dynamic ¹⁸F-PI-2620 PET imaging for 180 min. ¹⁸F-PI-2620 binding was assessed visually and quantitatively using Distribution Volume Ratios (DVR) estimated from non-invasive tracer kinetics and standardized uptake value ratios (SUVR) measured at different time points post-injection (p.i.) with the cerebellar cortex as the reference region. Time-activity curves and SUVR were assessed in AD and HC, as well as DVR and SUVR correlations and effect size (Cohen’s d) over time. Results: ¹⁸F-PI-2620 showed peak brain uptake around 5 min p.i. and fast wash-out in non-target regions. In AD subjects, focal asymmetric uptake was evident in temporal and parietal lobes, precuneus, and posterior cingulate cortex. DVR and SUVR in these regions were significantly higher in AD compared to HC. Very low background signal was observed in HC. ¹⁸F-PI-2620 administration was safe and well tolerated. SUVR time activity curves in most regions and subjects achieved a secular equilibrium after 40 min p.i.. A strong correlation (R² > 0.93) was found between non-invasive DVR and SUVR for all imaging windows starting >30 min p.i.. Similar effect sizes between AD and HC groups were obtained across the different imaging windows. ¹⁸F-PI-2620 uptake in neocortical regions was significantly correlated with the degree of cognitive impairment. Conclusion: Initial clinical data obtained in AD and HC demonstrate the high image quality with excellent signal-to-noise of ¹⁸F-PI-2620 PET for imaging tau deposition in AD subjects. Non-invasive quantification using DVR and SUVR for 30 min imaging windows between 30-90 min p.i., e.g. 45-75 min, provides robust and significant discrimination between AD and HC subjects. ¹⁸F-PI-2620 uptake in expected regions is highly correlated to neurocognitive performance.

Introduction: A new pattern of response, so-called hyper-progressive disease (HPD), is emerging during treatment with immune checkpoint inhibitors (ICI). Our aim was to investigate the prevalence of such phenomenon and to assess its association with clinical variables and metabolic parameters by ¹⁸F-fludeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT). Methods: Data from 50 patients (34 male, 16 female, median age 73) with non-small cell lung carcinoma (NSCLC) and treated with ICI were prospectively collected. All patients underwent contrast-enhanced CT, ¹⁸F-FDG PET/CT, and complete peripheral blood sample at baseline before ICI. HPD was defined according to clinical and radiologic criteria. Because of the rapid disease progression or worsening of clinic conditions, radiologic response assessment was available for 46 patients. OS were analyzed using the Kaplan–Meier method and the log-rank test. A Cox proportional hazards regression analysis was used to evaluate factors independently associated with OS. Median follow-up was 12.4 months (9.7-15.2 months). Results: We identified the following response categories: 10 cases as complete/partial response (CR/PR), 17 cases with stable disease (SD), 5 patients with progressive disease (PD), and 14 with HPD. Among metabolic parameters we observed a statistically significant association between HPD status and tumor burden, expressed by both MTV (756.1ml for HPD vs 475.6ml for non-HPD, P = 0.011) and TLG (287.3 for HPD vs 62.1 for non-HPD, P = 0.042). Among clinical variables, 12/14 patients (85.7%) within the HPD group compared with 8/32 patients (25%) in the non-HDP group had more than two metastatic sites (p<0.001). In addition, the derived neutrophil-to-lymphocyte ratio (dNLR) and platelet counts was significantly associated with HPD status (P = 0.038, P = 0.025, respectively). Survival analysis showed a median OS of 4 months for HPD group compared with 15 months within non-HPD patients (P = 0.003). Likewise, median OS was significantly different when we considered all the response categories: CR/PR, SD, PD, and HPD (P = 0.001). Finally, Multivariate analysis identified MTV and dNLR as independent predictors for OS. Conclusion: Our results suggest that the use of ICI might represent a concern in patients with high metabolic tumor burden and inflammatory indexes at baseline. However Additional studies are needed.

Purpose: To determine the effect of smooth filter and partial volume correction (PVC) method on measured prostate-specific membrane antigen (PSMA) activity in small metastatic lesions and to determine the impact of these changes on the molecular imaging (mi) PSMA scoring. Materials & Methods: Men with biochemical recurrence of prostate cancer with negative CT and bone scintigraphy were referred for ¹⁸F-DCFPyL PET/CT. Examinations were performed on one of 2 PET/CT scanners (GE Discovery 610 or Siemens mCT40). All suspected tumor sites were manually contoured on co-registered CT and PET images, and each was assigned a miPSMA score as per the PROMISE criteria. The PVC factors were calculated for every lesion using the anatomical CT and then applied to the unsmoothed PET images. The miPSMA scores, with and without the corrections, were compared, and a simplified "rule of thumb" (RoT) correction factor (CF) was derived for lesions at various sizes (<4mm, 4-7mm, 7-9mm, 9-12mm). This was then applied to the original dataset and miPSMA scores obtained using the RoT CF were compared to those found using the actual corrections. Results: There were 75 men (median age, 69 years; median serum PSA of 3.69 ug/L) with 232 metastatic nodes < 12 mm in diameter (mean lesion volume of 313.5 ± 309.6 mm³). Mean SUV_max before and after correction was 11.0 ± 9.3 and 28.5 ± 22.8, respectively (p<0.00001). The mean CF for lesions <4mm (n = 22), 4-7mm (n = 140), 7-9mm (n = 50), 9-12 mm (n = 20) was 4 (range: 2.5-6.4), 2.8 (range: 1.6-4.9), 2.3 (range: 1.6-3.3) and 1.8 (range 1.4-2.4), respectively. Overall miPSMA scores were concordant between the corrected dataset and RoT in 205/232 lesions (88.4%). Conclusion: There is a significant effect of smooth filter and partial volume correction on measured PSMA activity in small nodal metastases, impacting the miPSMA score.

Bone is the most common site of distant metastatic spread in prostate adenocarcinoma. Prostate-specific membrane antigen uptake has been described in both benign and malignant bone lesions, which can lead to false-positive findings on ⁶⁸Ga-prostate-specific membrane antigen-11 positron emission tomography (⁶⁸Ga-PSMA-11 PET). The purpose of this study was to evaluate the diagnostic accuracy of ⁶⁸Ga-PSMA-11 PET for osseous prostate cancer metastases and improve bone uptake interpretation using semi-quantitative metrics. METHODS: 56 prostate cancer patients (18 pre-prostatectomy, 38 biochemical recurrence) who underwent ⁶⁸Ga-PSMA-11 PET/MRI or PET/CT examinations with osseous PSMA-ligand uptake were included in the study. Medical records were reviewed retrospectively by board-certified nuclear radiologists to determine true or false positivity based on a composite endpoint. For each avid osseous lesion, biological volume, size, PSMA-RADS rating, maximum standardized uptake value (SUV_max), and ratio of lesion SUV_max to liver, blood pool, and background bone SUV_max were measured. Differences between benign and malignant lesions were evaluated for statistical significance, and cut-off values for these parameters were determined to maximize diagnostic accuracy. RESULTS: Among 56 participants, 13 patients (22.8%) had false-positive osseous ⁶⁸Ga-PSMA-11 findings and 43 patients (76.8%) had true-positive osseous ⁶⁸Ga-PSMA-11 findings. Twenty-two patients (39%) had 1 osseous lesion, 18 (32%) had 2-4 lesions, and 16 (29%) had 5 or more lesions. Cut-off values resulting in statistically significant (p<0.005) differences between benign and malignant lesions were: PSMA-RADS ≥4, SUV_max ≥4.1, SUV_max ratio of lesion to blood pool ≥2.11, to liver ≥0.55, and to bone ≥4.4. These measurements corresponded to lesion-based ⁶⁸Ga-PSMA-11 PET lesion detection rate for malignancy of 80%, 93%, 89%, 21%, 89%, and a specificity of 73%, 73%, 73%, 93%, 60%, respectively. CONCLUSION: PSMA-RADS rating, SUV_max, and SUV_max ratio of lesion to blood pool can help differentiate benign from malignant lesions on ⁶⁸Ga-PSMA-11 PET. SUV_max ratio to blood pool above 2.2 is a reasonable parameter to support image interpretation and presented superior lesion detection rate and specificity when compared to visual interpretation by PSMA RADS. These parameters hold clinical value by improving diagnostic accuracy for metastatic prostate cancer on ⁶⁸Ga-PSMA-11 PET/MRI and PET/CT.

It was hypothesized that the brain β-amyloid buildup curve plateaus at an early symptomatic Alzheimer's disease (AD) stage. Atrophy-related partial volume effects (PVEs) degrade signal in hot-spot imaging techniques, such as amyloid positron emission tomography (PET). This longitudinal analysis of amyloid-sensitive PET data investigated the shape of the β-amyloid curve in AD applying PVE correction (PVEC). We analyzed baseline and 2-year follow-up data of 216 symptomatic individuals on the AD continuum (positive amyloid status) enrolled in Alzheimer's Disease Neuroimaging Initiative (17 AD dementia, 199 mild cognitive impairment), including 18F-florbetapir PET, magnetic resonance imaging and mini mental state examination (MMSE) scores. For PVEC, the modified Müller-Gärtner method was performed. Compared to non-PVE-corrected data, PVE-corrected data yielded significantly higher regional and composite standardized uptake value ratio (SUVR) changes over time (P=0.0002 for composite SUVRs). Longitudinal SUVR changes in relation to MMSE decreases showed a significantly higher slope of the regression line in the PVE-corrected as compared to the non-PVE-corrected PET data (F=7.1, P=0.008). These PVEC results indicate that the β-amyloid buildup curve does not plateau at an early symptomatic disease stage. A further evaluation of the impact of PVEC on the in-vivo characterization of time-dependent AD pathology, including the reliable assessment and comparison of other amyloid tracers, is warranted.