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STUDY OBJECTIVE: Most 911 calls result in ambulance transport to an emergency department. In some cases, transport is refused or deemed unnecessary. The frequency of pediatric non-transport is unknown. Our primary objective was to describe the proportion of pediatric EMS activations resulting in non-transport. Our secondary objective was to identify patient, community, and EMS agency factors associated with pediatric non-transport. METHODS: We conducted a cross-sectional study using 2019 data from the National EMS Information System registry. We compared non-transport rates for children (< 18 y/o), adults (18 – 60 y/o) and elderly (>60 y/o) patients. We then used generalized estimating equations to identify factors associated with pediatric non-transport while accounting for geographical clustering. RESULTS: There were 21,931,490 EMS activations, including 1,403,454 pediatric 911 responses. 30% of pediatric 911 responses resulted in non-transport. Non-transport was less likely for adults (19%, OR 0.54 [0.54, 0.55]) and elderly patients (13%, OR 0.35 [0.35, 0.36]). The most common pediatric non-transport dispositions were: refused evaluation/care, and treated/released. Non-transport was associated with: pulmonary (aOR 3.84 [3.30, 4.48]) and musculoskeletal chief complaints (aOR 3.75 [3.22, 4.36]). Non-transport was more likely for: rural EMS calls (aOR 1.28 [1.24, 1.32]); calls classified by EMS as Lower Acuity (aOR 7.88 [5.98, 10.38]); and Tribal EMS agencies (aOR 3.49 [3.09, 3.94]). CONCLUSION: Almost one-third of pediatric 911 activations result in non-transport. Although very few children have been included in pilots of alternate transport processes to date, non-transport is actually more common in children than adults. More work is needed to understand better the patient safety and economic implications of this practice.

Background Antenatal and neonatal viral exposure may put the developing brain at risk for abnormal neurodevelopment. A clinical follow-up program was created in the Congenital Infection Program at Children’s National Hospital to follow infants with in utero or early life exposure to SARS-CoV-2. The aim of this study was to determine if infants with early SARS-CoV-2 exposure have abnormal neurodevelopment in infancy. Methods We performed a retrospective review of all infants evaluated in the follow-up program between 3/2020 – 11/2021. Demographic details, SARS-CoV-2 infection/testing data, pregnancy/birth data, and specialty consult and NICU records were extracted from infants’ medical charts. Infants were divided into 3 SARS-CoV-2 exposure groups: 1) antenatal exposure to symptomatic mother, 2) antenatal exposure to asymptomatic mother, 3) neonatal infection. All infants received a neurologic exam and developmental screening with the Ages and Stages Questionnaire (ASQ) in 5 domains (Communication, Gross Motor, Fine Motor, Problem Solving, Personal-Social) during their evaluation. The ASQ accounts for prematurity. Outcomes of interest were an abnormal neurologic exam or ASQ scores close to or below suggested cut-offs. Multivariate analysis was used to study correlations between exposure group and neurodevelopmental outcomes. Results Thirty-five infants were seen for up to 3 outpatient visits. Most infants (83%) were exposed in utero – 16 to symptomatic mothers (Group 1) and 12 to asymptomatic mothers (Group 2); 1 chart did not have symptom data. Six were exposed only as a neonate (Group 3). Group 1 had abnormal neurologic exams at mean (SD) age 112 (24) days (Table 1) and ASQ scores close to or below cut-offs for all domains (Fig. 1) more frequently than Groups 2 or 3. Group 1 was more likely to score below any ASQ cutoff compared to Group 2 (P=.04); of the 5 domains, differences were significant for Fine Motor (P=.01) and Personal-Social (P=.02). Conclusion Early SARS-CoV-2 exposure may impact infant development, especially among those exposed in utero to a symptomatic mother. Vaccination and other precautions to reduce spread and symptoms may protect against early neurodevelopmental delays. Future work should prioritize longitudinal follow-up of children with early SARS-CoV-2 exposure. Disclosures All Authors: No reported disclosures.

Background Patients admitted to the pediatric intensive care unit (PICU) are frequently evaluated for bacterial infections and initiated on antibiotic regimens that include a MRSA-active agent even though invasive MRSA infections are rare in this population. The MRSA PCR nasal swab (MRSA-PCR) is a non-invasive test for MRSA colonization that has been shown within adult ICUs to have a high negative predictive value (NPV), making it a potentially valuable tool for antimicrobial stewardship. This study evaluated the performance of the MRSA-PCR in predicting invasive MRSA infection in critically ill pediatric patients. Methods A retrospective cohort study was performed in a 44-bed PICU from January 2013 to December 2018 when it was protocol for all admissions to be screened with a MRSA-PCR. Patients who had both a MRSA-PCR and cultures obtained to evaluate for invasive infection within seven days were included in the study. Invasive MRSA infection was defined by the isolation of MRSA from clinical cultures along with infectious signs and symptoms. A random sample comprising 55% of the patient population was evaluated. We calculated sensitivity, specificity, positive predictive value (PPV) and NPV of the MRSA-PCR for confirmed invasive MRSA infection. Results Of the 4,410 patients reviewed, 1,961 patients met inclusion criteria (45% female, mean age 7.4 yrs. [birth-19.9 yrs.]). MRSA-PCR was positive in 13.5% of patients. Invasive MRSA infection was identified in 25 patients (2 blood, 19 respiratory, 2 soft tissue, 1 pleural fluid, and 1 urine culture) equaling 1.2% of encounters and an incidence rate of 1.1 case per 1,000 patient days. The MRSA-PCR demonstrated a PPV of 8.7% and a NPV of 99.8% (see table). Conclusion The MRSA-PCR has a poor PPV but a very high NPV for invasive MRSA infection in critically ill pediatric patients, a result that is congruent with what has been reported in the adult literature. The high NPV of the MRSA-PCR in this vulnerable patient population makes it a potentially powerful tool for antimicrobial stewardship. Creation of protocols to guide antimicrobial selection based on MRSA-PCR results may lead to a significant reduction in unnecessary antibiotic exposure, drug level monitoring, and patient risk of renal injury or adverse reactions. Disclosures All Authors: No reported disclosures.

Children with in utero Zika virus (ZIKV) exposure without congenital Zika syndrome (CZS) are at risk for abnormal neurodevelopment. Preschool-age outcomes for children with antenatal ZIKV exposure have not yet been established.Children with in utero ZIKV exposure and non-exposed controls had neurodevelopmental evaluations at age 3-5 years in Sabanalarga, Colombia. Cases did not have CZS and were previously evaluated prenatally through age 18 months. Controls were born before ZIKV arrival to Colombia. Neurodevelopmental assessments included Pediatric Evaluation of Disability Inventory (PEDI-CAT), Behavior Rating Inventory of Executive Function (BRIEF-P), Bracken School Readiness Assessment (BSRA), and Movement Assessment Battery for Children (MABC). Family demographics and child medical history were recorded.Fifty-five ZIKV-exposed children were evaluated at mean age 3.6 years and 70 controls were evaluated at 5.2 years. Family demographics were similar between groups. BRIEF-P t-scores were higher for cases than controls in shift and flexibility domains. Cases had lower PEDI-CAT mobility t-scores compared to controls. There was no difference in MABC between groups. In 11% of cases and 1% of controls, parents reported child mood problems.Children with in utero ZIKV exposure without CZS may demonstrate emerging differences in executive function, mood, and adaptive mobility that require continued evaluation.Preschool neurodevelopmental outcome in children with in utero Zika virus exposure is not yet known, since the Zika virus epidemic occurred in 2015-2017 and these children are only now entering school age. This study finds that Colombian children with in utero Zika virus exposure without congenital Zika syndrome are overall developing well but may have emerging differences in executive function, behavior and mood, and adaptive mobility compared to children without in utero Zika virus exposure. Children with in utero Zika virus exposure require continued multi-domain longitudinal neurodevelopmental evaluation through school age.

Objectives Vosoritide is a C-type natriuretic peptide analog which binds its receptor on chondrocytes, leading to increased chondrocyte proliferation and differentiation via its inhibition of the ERK1/2-MAPK pathway. It was recently approved for increasing linear growth in children with achondroplasia. Our study aims to assess the safety and efficacy of vosoritide in children with genetic mutations in 6 categories: hypochondroplasia, Rasopathies (including Noonan syndrome), aggrecan deficiency, carriers of heterozygous NPR2 mutations, CNP deficiency, and SHOX deficiency. Methods This is a prospective, Phase II study with a goal N of 35 subjects. All subjects must have a documented genetic mutation in one of the 6 categories, be prepubertal between the ages of 3 and 11 for boys and 3 and 10 for girls, and have a height < -2.25 SD. Subjects are followed for a 6-month observation period to establish a baseline annualized growth velocity (AGV) and then receive daily subcutaneous vosoritide (15 mcg/kg/day) for 12 months. The primary outcomes are rate of AEs and change in AGV from baseline. Pharmacokinetic studies and pharmacodynamic studies, using cGMP production as a pharmacodynamic marker, are completed at Day 1 and Months 6 and 12. Results To date, 27 subjects have enrolled in the trial (20 hypochondroplasia, 3 Noonan, 2 NPR2, 2 Aggrecan). Median baseline height is -3.1 SD (IQR -3.6, -2.6). 14 subjects have initiated on vosoritide, and 10 completed 6 months of therapy. Median increase in AGV was 3.9 cm/yr (IQR 2.2, 4.6). The two subjects with NPR2 mutations had increased AGVs of 4.4 and 9.2 cm/yr. The two subjects with Noonan syndrome had an increase in AGV of 7.5 and 3.3 cm/yr. One subject with Noonan syndrome, a 4-year-old male, had previously been treated with growth hormone (GH) for 2 years. His AGV was 6.7 cm/yr while on GH, 4.1 cm/yr during the 6-month observation period, and 11.6 cm/year during the first 6 months of vosoritide treatment. There were no serious adverse events related to vosoritide treatment. One subject had a brief episode of syncope with her first injection which self-resolved, and she continued on therapy with no further incidents. PK parameters were similar to previously published parameters for vosoritide in children with achondroplasia. In preliminary data, vosoritide Cmax and AUC correlated strongly with peak increase in cGMP (r=0.70, p=0.01;r=0.84, p Conclusions This is the first clinical trial of vosoritide for children with genetic short stature who do not have achondroplasia. Vosoritide treatment may work as a precision therapy to improve growth in multiple genetic conditions which interact with the ERK1/2-MAPK pathway. Presentation: Monday, June 13, 2022 12:00 p.m. - 12:15 p.m.

A wide variety of techniques are used to assess the development of survey-based scales. The majority of these techniques focus on the quality of information characterized by the scale. Aside from very rudimentary measures such as response rates and sample sizes, very few empirical techniques are available to measure the quantity of information contained in a scale. This article conducts an exploratory empirical analysis to assess whether information entropy can be useful for measuring the quantity of information in a scale’s development. If the quantity of information in the scale significantly increases (decreases) with the addition of the survey item, researchers may consider retaining (discarding) that item in the scale. The study was conducted within the context of a natural experiment that occurred at a major amateur sporting event in 2018. Customer satisfaction was assessed using a survey whose core questions have been assessed repeatedly over time. The most recent survey contained a previously validated empathy scale, with two items contained in the base measure. Six additional items were added to this base empathy measure. The quantity of information provided (as measured by information entropy) is calculated for each set of scale items. Statistical analysis indicates that, when adding the behavioral, cognitive, and affective scales to the two-item base scale, the quantity of information available increased. However, most of the increase in information quantity was attributable to three survey items, one item from each of the behavioral, cognitive, and affective domains. These findings suggest that information entropy may indeed be a useful quality control tool for survey scale development.

Purpose This study sought to determine the feasibility of using phonetic complexity manipulations as a way to systematically assess articulatory deficits in talkers with progressive dysarthria due to Parkinson's disease (PD). Method Articulatory kinematics were recorded using three-dimensional electromagnetic articulography from 15 talkers with PD (58–84 years old) and 15 healthy controls (55–80 years old) while they produced target words embedded in a carrier phrase. Majority of the talkers with PD exhibited a relatively mild dysarthria. For stimuli selection, phonetic complexity was calculated for a variety of words using the framework proposed by Kent (1992) , and six words representative of low, medium, and high phonetic complexity were selected as targets. Jaw, posterior tongue, and anterior tongue kinematic measures that were used to test for phonetic complexity effects included movement speed, cumulative path distance, movement range, movement duration, and spatiotemporal variability. Results Significantly smaller movements and slower movement speeds were evident in talkers with PD, predominantly for words with high phonetic complexity. The effect sizes of between-groups differences were larger for several jaw kinematic measures than those of the tongue. Discussion and Conclusion Findings suggest that systematic manipulations of phonetic complexity can support the detection of articulatory deficits in talkers with PD. Phonetic complexity should therefore be leveraged for the assessment of articulatory performance in talkers with progressive dysarthria. Future work will be directed toward linking speech kinematic and auditory–perceptual measures to determine the clinical significance of the current findings.

Patients with hematologic malignancies relapsing after allogeneic blood or marrow transplantation (BMT) have limited response to conventional salvage therapies, with an expected 1-year overall survival (OS) of

Adoptive T cell immunotherapy has been used to restore immunity against multiple viral targets in immunocompromised patients after bone-marrow transplantation and has been proposed as a strategy for preventing coronavirus 2019 (COVID-19) in this population. Ideally, expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-virus-specific T cells (CSTs) should demonstrate marked cell expansion, T cell specificity, and CD8+ T cell skewing prior to adoptive transfer. However, current methodologies using IL-4 + IL-7 result in suboptimal specificity, especially in CD8

Hematopoietic stem cell transplantation (HSCT) can be curative for sickle cell disease (SCD). SCD patients with cerebrovascular disease are often referred for HSCT. The objective of this study was to describe neurologic outcomes after HSCT in patients with pre-existing SCD and cerebrovascular comorbidity. Patients with SCD treated with HSCT at a single center between 1996 and 2019 were identified. Patients with cerebral ischemia and/or vasculopathy before undergoing HSCT were included. Patients with graft failure were excluded. The cohort was divided into 3 groups: symptomatic stroke, vasculopathy without symptomatic stroke, and isolated silent cerebral infarction (SCI). Magnetic resonance imaging/angiography and neurologic assessments pre- and post-HSCT were analyzed to assess outcomes. In a cohort of 44 patients, there were 25 with symptomatic infarction, 10 with vasculopathy, and 9 with isolated SCI. Post-HSCT ischemic injury (2 symptomatic strokes, 2 SCIs) was identified in 4 patients, all with previous symptomatic infarction. Within this group (n = 25), the post-HSCT incidence of subsequent symptomatic infarction was 1.6 events/100 patient-years, and SCIs occurred at a rate of 2.2 events/100 patient-years. No patient had progression of vasculopathy post-HSCT. Our data show a low incidence of new ischemic injury after successful HSCT for SCD. Patients with a history of both symptomatic stroke and vasculopathy are at greatest risk for post-HSCT ischemic injury.

Background This study investigated the clinical implication of TNK2 expression in esophageal cancer patients’ cancer tissue samples. Methods The expression of TNK2 in esophageal cancer tissues and para‐carcinoma tissue was assessed with immunohistochemistry and Western blot analysis; besides, the proteins of CDC42, EGFR, and Akt were also analyzed. Then, Kaplan‐Meier survival curves of TNK2 protein expression level were assayed with 184 esophageal cancer patients from TCGA database. Moreover, with multiple linear regression analysis, we detected the correlations of TNK2 expression associated with tumor differentiation degree and metastasis status. Results It revealed that TNK2 was highly expressed in the cytoplasm of esophageal cancer tissues compared with para‐carcinoma tissue; besides, the proteins of CDC42, EGFR, and Akt were also up‐regulated in different levels of esophageal cancer tissues. However, there was no significant difference of the overall survival time of TNK2 protein expression in 184 esophageal cancer patients from TCGA database (p = 0.37). But, in the included study samples of our study, there was positive coefficience between TNK2 protein expression and differentiation degree in esophageal cancer with multiple linear regression analysis [R = 0.928, 95% confidence interval (0.085‐0.12)]. Conclusion Our results indicated that TNK2 was a potential diagnostic marker and promoted esophageal cancer progression through activating EGFR‐AKT signaling., The dependent linear equation was TNK2=0.103 + 0.042 (differentiation degree) ‐ 0.026 (metastasis status) with Multiple linear regression analysis, the coefficient of regression (R) was 0.928 of differentiation degree, ‐0.25 for status of metastasis, 95% confidence interval (0.085~0.12), p

Objective: To quantify the use of the interprofessional team member (ITM) domain of entrustable professional activities (EPAs) by North Dakota pharmacists across practice sites, roles in practice, and by preceptor status. Methods: Survey methods were used to characterize the self-reported frequency with which pharmacists undertake core EPAs and supporting tasks in the ITM domain. The survey was administered to registered pharmacists practicing in North Dakota (n=990) during the fall of 2018, of which 457 (46.1%) responded. After eliminating responses with incomplete or missing information, 119 responses were available for analysis. Results: For the overall EPA ITM domain, “Collaborate as a member of an interprofessional team population” pharmacists reported performing these activities an average (mean) of 3.3 times per month (SD=2.3). Within this domain, the highest reported example activity was “Use setting appropriate communication skills when interacting with others” (mean=4.1, SD 1.8), followed by “Communicate a patient’s medication-related problem(s) to another health professional” (mean=3.3, SD 2.0), and “Contribute medication-related expertise to the team’s work” (mean=3.1, SD=2.2). ITM domain and supporting example activities were performed at a greater rate in hospitals, community health centers and long-term-care facilities. For most items, preceptors reported a greater use of activities, than did non-preceptors. Conclusions: North Dakota pharmacists currently complete tasks outlined in the ITM domain of the EPAs, although their contributions are varied by task, role, and preceptor status.

Osteogenesis imperfecta (OI) is a genetic connective tissue disorder characterized by compromised skeletal integrity, altered microarchitecture, and bone fragility. Current OI treatment strategies focus on bone antiresorptives and surgical intervention with limited effectiveness, and thus identifying alternative therapeutic options remains critical. Muscle is an important stimulus for bone formation. Myostatin, a TGF-β superfamily myokine, acts through ActRIIB to negatively regulate muscle growth. Recent studies demonstrated the potential benefit of myostatin inhibition with the soluble ActRIIB fusion protein on skeletal properties, although various OI mouse models exhibited variable skeletal responses. The genetic and clinical heterogeneity associated with OI, the lack of specificity of the ActRIIB decoy molecule for myostatin alone, and adverse events in human clinical trials further the need to clarify myostatin's therapeutic potential and role in skeletal integrity. In this study, we determined musculoskeletal outcomes of genetic myostatin deficiency and postnatal pharmacological myostatin inhibition by a monoclonal anti-myostatin antibody (Regn647) in the G610C mouse, a model of mild-moderate type I/IV human OI. In the postnatal study, 5-week-old wild-type and +/G610C male and female littermates were treated with Regn647 or a control antibody for 11 weeks or for 7 weeks followed by a 4-week treatment holiday. Inhibition of myostatin, whether genetically or pharmacologically, increased muscle mass regardless of OI genotype, although to varying degrees. Genetic myostatin deficiency increased hindlimb muscle weights by 6.9% to 34.4%, whereas pharmacological inhibition increased them by 13.5% to 29.6%. Female +/mstn +/G610C (Dbl.Het) mice tended to have similar trabecular and cortical bone parameters as Wt showing reversal of +/G610C characteristics but with minimal effect of +/mstn occurring in male mice. Pharmacologic myostatin inhibition failed to improve skeletal bone properties of male or female +/G610C mice, although skeletal microarchitectural and biomechanical improvements were observed in male wild-type mice. Four-week treatment holiday did not alter skeletal outcomes. © 2020 American Society for Bone and Mineral Research (ASBMR).

Background: Entrustable Professional Activities (EPAs) are a list of professional tasks that pharmacy educational organizations support, and accreditation organizations encourage, for assessment by colleges and schools of pharmacy. Objective: This manuscript evaluates the perceived frequency of performing EPAs in the population health promoter (PHP) domain among pharmacists practicing in North Dakota. Methods: This survey evaluated the self-reported EPA activities of registered pharmacists living and practicing in North Dakota. For EPAs and supporting tasks in the 6 domains (including the PHP domain), respondents were asked to self-report the number of times during the last 30 days that they perform the task, using a 6 point response scale (0, 1, 2, 3, 4, 5 or more times). there were 990 pharmacists surveyed, and 457 (46.1%) of pharmacists responded. Results: Within the PHP domain, pharmacists reported performing “Minimize adverse drug events and medication errors” most frequently (mean=3.4, SD=2.0), followed by “Ensure that patients have been immunized against vaccine-preventable diseases” (mean=2.3, SD 2.3), “Maximize the appropriate use of medications in a population” (mean=2.2, SD 2.3), and “Identify patients at risk for prevalent diseases in a population” (mean=1.3, SD=1.9). In these Core EPAs PHP domains, the clinical pharmacists reported the highest level, followed by pharmacy managers and staff pharmacists. Conclusions: Pharmacists in North Dakota currently perform some population health promoter activities, but not at a consistent and high level. Most of the health prevention activities were medication-related and oriented towards individual patients (micro-level), rather than at a community (population-based) macro-level.

The four-parameter logistic model is often used to describe dose-response functions in many toxicological studies. In this study, under the four-parameter logistic model, optimal designs to estimate the EDp are studied. The EDp is the dose achieving p% of the expected difference between the maximum and the minimum responses. C-optimal design works the best for estimating the EDp, but the best performance is only guaranteed when the goal is for estimating a single EDp. If the c-optimal design for studying a specific EDp is used for studying different EDp values, it may work poorly. This paper shows that the c-optimal design for estimating the EDp truly depends on the value of p under the 4-parameter logistic model. We present a robust c-optimal design that works well for the change in the value of p, so that the design can be used effectively for studying multiple EDp values. In addition, this paper presents a two-stage robust c-optimal design for estimating multiple EDp that is not substantially affected by the mis-specified nominal parameter values.

// Jianjun Liu 1,* , Mingxue Su 2,* , Jing Wang 3,* , Gan Zhang 1 , Jing Zhou 1 , Anqing Zhang 1 , Zixue Ren 1 , Xucai Zheng 1 , Shikai Hong 1 , Shengying Wang 1 and Rongxin Zhang 1 1 Department of Head - Neck and Thoracic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China 2 Department of Infectious Disease Epidemiology, Lu’an People’s Hospital, Lu’an, China 3 Department of Urologic Surgery, Anhui Provincial Cancer Hospital, West branch of Anhui Province Hospital, Hefei, China * These authors have contributed equally to this work Correspondence to: Rongxin Zhang, email: // Shengying Wang, email: // Keywords : neoadjuvant radiotherapy; gastric cancer; survival analysis; SEER Received : August 23, 2016 Accepted : October 05, 2016 Published : October 11, 2016 Abstract Although local advanced gastric cancer (AGC) could benefit from neoadjuvant radiotherapy (NRT), there are few studies evaluating patients’ survival after NRT. In current study, we aimed to investigate the value of prognostic factors in AGC patients after NRT and to evaluate whether post-therapy pathological characteristics were predictive factors in these patients. We retrospectively analyzed AGC patients who underwent NRT from Surveillance, Epidemiology, and End Results (SEER) Database. The patients’ clinical and post-therapy pathological characteristics were analyzed. The best cutoff points for continuous variables were identified by X-tile. The discrimination of risk factors were compared by receiver operating characteristic (ROC) curve. As a result, 1,429 AGC patients were included into this study. In the multivariate analysis, the lymph nodes status and histology grade were significant risk factors for DSS (disease special survival). Then, we propose a novel Grade-lymph node Ratio (G-R) staging system for the AGC patients’ survival prognosis. Clearly, the new G-R staging system has a more-accurate 3-year and 5-year DSS prediction than the AJCC staging system ( p = 0.001, 0.007, respectively). In conclusions, the current large, general population-based study demonstrated that the G-R staging system resulting in more-accurate DSS prediction. It could be regarded as a reliable classification for AGC patients after NRT in future.

In order to improve the accuracy of multi-target tracking, a feasible dada fusion system is proposed for radar and infrared sensor used together, to overcome the defects both small detection range and no distance measurement for infrared sensor, and to avoid the problem of large error in measurement information of single sensor. Rader and infrared dada fusion can achieve complementary information. An optimal weighted fusion method for measurement of radar and infrared sensors is derived, and an interactive multi-model PHD nonlinear filtering algorithm is used to improve the accuracy of target tracking. The computer simulation results show that the integrated system and multi-sensor measurement fusion method can improve the accuracy of target state estimation. It is of great practical significance to solve the problem of target tracking estimation of heterogeneous multi-sensor.

Hyperspectral image visualization is an important research aspect in hyperspectral image fusion. This paper compared four typically used hyperspectral image visualization methods: method based on bilateral filter, method based on Principal Component Analysis (PCA), method based on independent component analysis (ICA) and method based on optimization. Fusion framework and scheme are explained briefly. Two sets of images obtained by AVIRIS and ROSIS sensors are used in our experiments, and four statistical assessment parameters, namely variance, entropy, average gradient and fusion factor are adopted to comparatively analyze the fusion results. The comparison results show that the effects of bilateral filter method, PCA method and optimization method are similar, and they are superior to ICA method.

Essential meiotic endonuclease 1 homolog 1 (EME1) is a key DNA repair protein that participates in the recognition and repair of DNA double-strand breaks. Deficiency of the EME1 gene can lead to spontaneous genomic instability and thus contribute to tumorgenesis. We hypothesized that the exon variants of EME1 confer genetic susceptibility to breast cancer. In a case-control study of 748 breast cancer patients and 778 normal controls, we analyzed the association between two exon variants of EME1 (i.e.,Ile350Thr: rs12450550T > C and Glu69Asp: rs3760413T > G) and breast cancer risk. We found that compared to the common Ile/Ile genotype, the Thr variant genotypes (Thr/Ile + Thr/Thr) conferred a 1.47-fold increased risk of breast cancer (OR=1.47, 95% CI=1.13-1.92). The variant Ile350Thr was also associated with early onset of breast cancer (r = -0.116, P = 0.002). The mean age of onset was 44.4 years for Thr/Thr genotype carriers and 46.5 years for Thr/Ile genotype carriers, which was significantly lower than that (49.4 years) for Ile/Ile genotype carriers (P = 0.006). Moreover, no significant association was observed between the Glu69Asp variant and breast cancer risk. Our findings suggest that the EME1 variant Ile350Thr contributes to an increased risk and early onset of breast cancer.