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International evaluation of an AI system for breast cancer screening 期刊论文
NATURE, 2020, 577 (7788) : 89-+
作者:  McKinney, Scott Mayer;  Sieniek, Marcin;  Godbole, Varun;  Godwin, Jonathan;  Antropova, Natasha;  Ashrafian, Hutan;  Back, Trevor;  Chesus, Mary;  Corrado, Greg C.;  Darzi, Ara;  Etemadi, Mozziyar;  Garcia-Vicente, Florencia;  Gilbert, Fiona J.;  Halling-Brown, Mark;  Hassabis, Demis;  Jansen, Sunny;  Karthikesalingam, Alan;  Kelly, Christopher J.;  King, Dominic;  Ledsam, Joseph R.;  Melnick, David;  Mostofi, Hormuz;  Peng, Lily;  Reicher, Joshua Jay;  Romera-Paredes, Bernardino;  Sidebottom, Richard;  Suleyman, Mustafa;  Tse, Daniel;  Young, Kenneth C.;  De Fauw, Jeffrey;  Shetty, Shravya
收藏  |  浏览/下载:15/0  |  提交时间:2020/07/03

Screening mammography aims to identify breast cancer at earlier stages of the disease, when treatment can be more successful(1). Despite the existence of screening programmes worldwide, the interpretation of mammograms is affected by high rates of false positives and false negatives(2). Here we present an artificial intelligence (AI) system that is capable of surpassing human experts in breast cancer prediction. To assess its performance in the clinical setting, we curated a large representative dataset from the UK and a large enriched dataset from the USA. We show an absolute reduction of 5.7% and 1.2% (USA and UK) in false positives and 9.4% and 2.7% in false negatives. We provide evidence of the ability of the system to generalize from the UK to the USA. In an independent study of six radiologists, the AI system outperformed all of the human readers: the area under the receiver operating characteristic curve (AUC-ROC) for the AI system was greater than the AUC-ROC for the average radiologist by an absolute margin of 11.5%. We ran a simulation in which the AI system participated in the double-reading process that is used in the UK, and found that the AI system maintained non-inferior performance and reduced the workload of the second reader by 88%. This robust assessment of the AI system paves the way for clinical trials to improve the accuracy and efficiency of breast cancer screening.


  
Constraining an Ocean Model Under Getz Ice Shelf, Antarctica, Using A Gravity-Derived Bathymetry 期刊论文
GEOPHYSICAL RESEARCH LETTERS, 2020, 47 (13)
作者:  Millan, Romain;  St-Laurent, Pierre;  Rignot, Eric;  Morlighem, Mathieu;  Mouginot, Jeremie;  Scheuchl, Bernd
收藏  |  浏览/下载:9/0  |  提交时间:2020/06/01
glaciology  bathymetry  melt rates  ocean model  grounding line  getz ice shelf  
Insights into variation in meiosis from 31,228 human sperm genomes 期刊论文
NATURE, 2020, 583 (7815) : 259-+
作者:  Sakai, Akito;  Minami, Susumu;  Koretsune, Takashi;  Chen, Taishi;  Higo, Tomoya;  Wang, Yangming;  Nomoto, Takuya;  Hirayama, Motoaki;  Miwa, Shinji;  Nishio-Hamane, Daisuke;  Ishii, Fumiyuki;  Arita, Ryotaro;  Nakatsuji, Satoru
收藏  |  浏览/下载:26/0  |  提交时间:2020/07/03

Meiosis, although essential for reproduction, is also variable and error-prone: rates of chromosome crossover vary among gametes, between the sexes, and among humans of the same sex, and chromosome missegregation leads to abnormal chromosome numbers (aneuploidy)(1-8). To study diverse meiotic outcomes and how they covary across chromosomes, gametes and humans, we developed Sperm-seq, a way of simultaneously analysing the genomes of thousands of individual sperm. Here we analyse the genomes of 31,228 human gametes from 20 sperm donors, identifying 813,122 crossovers and 787 aneuploid chromosomes. Sperm donors had aneuploidy rates ranging from 0.01 to 0.05 aneuploidies per gamete  crossovers partially protected chromosomes from nondisjunction at the meiosis I cell division. Some chromosomes and donors underwent more-frequent nondisjunction during meiosis I, and others showed more meiosis II segregation failures. Sperm genomes also manifested manygenomic anomalies that could not be explained by simple nondisjunction. Diverse recombination phenotypes-from crossover rates to crossover location and separation, a measure of crossover interference-covaried strongly across individuals and cells. Our results can be incorporated with earlier observations into a unified model in which a core mechanism, the variable physical compaction of meiotic chromosomes, generates interindividual and cell-to-cell variation in diverse meiotic phenotypes.


  
Liquid flow and control without solid walls 期刊论文
NATURE, 2020, 581 (7806) : 58-+
作者:  Hellmuth, Susanne;  Stemmann, Olaf
收藏  |  浏览/下载:40/0  |  提交时间:2020/07/03

Wall-free liquid channels surrounded by an immiscible magnetic liquid can be used to create liquid circuitry or to transport human blood without damaging the blood cells by moving permanent magnets.


When miniaturizing fluidic circuitry, the solid walls of the fluid channels become increasingly important(1) because they limit the flow rates achievable for a given pressure drop, and they are prone to fouling(2). Approaches for reducing the wall interactions include hydrophobic coatings(3), liquid-infused porous surfaces(4-6), nanoparticle surfactant jamming(7), changes to surface electronic structure(8), electrowetting(9,10), surface tension pinning(11,12) and use of atomically flat channels(13). A better solution may be to avoid the solid walls altogether. Droplet microfluidics and sheath flow achieve this but require continuous flow of the central liquid and the surrounding liquid(1,14). Here we demonstrate an approach in which aqueous liquid channels are surrounded by an immiscible magnetic liquid, both of which are stabilized by a quadrupolar magnetic field. This creates self-healing, non-clogging, anti-fouling and near-frictionless liquid-in-liquid fluidic channels. Manipulation of the field provides flow control, such as valving, splitting, merging and pumping. The latter is achieved by moving permanent magnets that have no physical contact with the liquid channel. We show that this magnetostaltic pumping method can be used to transport whole human blood with very little damage due to shear forces. Haemolysis (rupture of blood cells) is reduced by an order of magnitude compared with traditional peristaltic pumping, in which blood is mechanically squeezed through a plastic tube. Our liquid-in-liquid approach provides new ways to transport delicate liquids, particularly when scaling channels down to the micrometre scale, with no need for high pressures, and could also be used for microfluidic circuitry.


  
A lower X-gate in TASK channels traps inhibitors within the vestibule 期刊论文
NATURE, 2020
作者:  Chen, Tao;  Nomura, Kinya;  Wang, Xiaolin;  Sohrabi, Reza;  Xu, Jin;  Yao, Lingya;  Paasch, Bradley C.;  Ma, Li;  Kremer, James;  Cheng, Yuti;  Zhang, Li;  Wang, Nian;  Wang, Ertao;  Xin, Xiu-Fang;  He, Sheng Yang
收藏  |  浏览/下载:35/0  |  提交时间:2020/07/03

TWIK-related acid-sensitive potassium (TASK) channels-members of the two pore domain potassium (K-2P) channel family-are found in neurons(1), cardiomyocytes(2-4) and vascular smooth muscle cells(5), where they are involved in the regulation of heart rate(6), pulmonary artery tone(5,7), sleep/wake cycles(8) and responses to volatile anaesthetics(8-11). K-2P channels regulate the resting membrane potential, providing background K+ currents controlled by numerous physiological stimuli(12-15). Unlike other K-2P channels, TASK channels are able to bind inhibitors with high affinity, exceptional selectivity and very slow compound washout rates. As such, these channels are attractive drug targets, and TASK-1 inhibitors are currently in clinical trials for obstructive sleep apnoea and atrial fibrillation(16). In general, potassium channels have an intramembrane vestibule with a selectivity filter situated above and a gate with four parallel helices located below  however, the K-2P channels studied so far all lack a lower gate. Here we present the X-ray crystal structure of TASK-1, and show that it contains a lower gate-which we designate as an '  X-gate'  -created by interaction of the two crossed C-terminal M4 transmembrane helices at the vestibule entrance. This structure is formed by six residues ((VLRFMT248)-V-243) that are essential for responses to volatile anaesthetics(10), neurotransmitters(13) and G-protein-coupled receptors(13). Mutations within the X-gate and the surrounding regions markedly affect both the channel-open probability and the activation of the channel by anaesthetics. Structures of TASK-1 bound to two high-affinity inhibitors show that both compounds bind below the selectivity filter and are trapped in the vestibule by the X-gate, which explains their exceptionally low washout rates. The presence of the X-gate in TASK channels explains many aspects of their physiological and pharmacological behaviour, which will be beneficial for the future development and optimization of TASK modulators for the treatment of heart, lung and sleep disorders.


The X-ray crystal structure of the potassium channel TASK-1 reveals the presence of an X-gate, which traps small-molecule inhibitors in the intramembrane vestibule and explains their low washout rates from the channel.


  
Olfactory sniffing signals consciousness in unresponsive patients with brain injuries 期刊论文
NATURE, 2020
作者:  Hellmuth, Susanne;  Gomez-H, Laura;  Pendas, Alberto M.;  Stemmann, Olaf
收藏  |  浏览/下载:10/0  |  提交时间:2020/07/03

After severe brain injury, it can be difficult to determine the state of consciousness of a patient, to determine whether the patient is unresponsive or perhaps minimally conscious(1), and to predict whether they will recover. These diagnoses and prognoses are crucial, as they determine therapeutic strategies such as pain management, and can underlie end-of-life decisions(2,3). Nevertheless, there is an error rate of up to 40% in determining the state of consciousness in patients with brain injuries(4,5). Olfaction relies on brain structures that are involved in the basic mechanisms of arousal(6), and we therefore hypothesized that it may serve as a biomarker for consciousness(7). Here we use a non-verbal non-task-dependent measure known as the sniff response(8-11) to determine consciousness in patients with brain injuries. By measuring odorant-dependent sniffing, we gain a sensitive measure of olfactory function(10-15). We measured the sniff response repeatedly over time in patients with severe brain injuries and found that sniff responses significantly discriminated between unresponsive and minimally conscious states at the group level. Notably, at the single-patient level, if an unresponsive patient had a sniff response, this assured future regaining of consciousness. In addition, olfactory sniff responses were associated with long-term survival rates. These results highlight the importance of olfaction in human brain function, and provide an accessible tool that signals consciousness and recovery in patients with brain injuries.


Odorant-dependent sniff responses predicted the long-term survival rates of patients with severe brain injury, and discriminated between individuals who were unresponsive and in minimally conscious states.


  
Massively parallel coherent laser ranging using a soliton microcomb 期刊论文
NATURE, 2020, 581 (7807) : 164-+
作者:  Casanova, Emmanuelle;  Knowles, Timothy D. J.;  Bayliss, Alex;  Dunne, Julie;  Baranski, Marek Z.;  Denaire, Anthony;  Lefranc, Philippe;  di Lernia, Savino;  Roffet-Salque, Melanie;  Smyth, Jessica;  Barclay, Alistair;  Gillard, Toby;  Classen, Erich;  Coles, Bryony;  Ilett, Michael;  Jeunesse, Christian;  Krueger, Marta;  Marciniak, Arkadiusz;  Minnitt, Steve;  Rotunno, Rocco;  van de Velde, Pieter;  van Wijk, Ivo;  Cotton, Jonathan;  Daykin, Andy;  Evershed, Richard P.
收藏  |  浏览/下载:46/0  |  提交时间:2020/07/03

Coherent ranging, also known as frequency-modulated continuous-wave (FMCW) laser-based light detection and ranging (lidar)(1) is used for long-range three-dimensional distance and velocimetry in autonomous driving(2,3). FMCW lidar maps distance to frequency(4,5) using frequency-chirped waveforms and simultaneously measures the Doppler shift of the reflected laser light, similar to sonar or radar(6,7) and coherent detection prevents interference from sunlight and other lidar systems. However, coherent ranging has a lower acquisition speed and requires precisely chirped(8) and highly coherent(5) laser sources, hindering widespread use of the lidar system and impeding parallelization, compared to modern time-of-flight ranging systems that use arrays of individual lasers. Here we demonstrate a massively parallel coherent lidar scheme using an ultra-low-loss photonic chip-based soliton microcomb(9). By fast chirping of the pump laser in the soliton existence range(10) of a microcomb with amplitudes of up to several gigahertz and a sweep rate of up to ten megahertz, a rapid frequency change occurs in the underlying carrier waveform of the soliton pulse stream, but the pulse-to-pulse repetition rate of the soliton pulse stream is retained. As a result, the chirp from a single narrow-linewidth pump laser is transferred to all spectral comb teeth of the soliton at once, thus enabling parallelism in the FMCW lidar. Using this approach we generate 30 distinct channels, demonstrating both parallel distance and velocity measurements at an equivalent rate of three megapixels per second, with the potential to improve sampling rates beyond 150 megapixels per second and to increase the image refresh rate of the FMCW lidar by up to two orders of magnitude without deterioration of eye safety. This approach, when combined with photonic phase arrays(11) based on nanophotonic gratings(12), provides a technological basis for compact, massively parallel and ultrahigh-frame-rate coherent lidar systems.


  
The mutational landscape of normal human endometrial epithelium 期刊论文
NATURE, 2020, 580 (7805) : 640-+
作者:  Rogelj, Joeri;  Forster, Piers M.;  Kriegler, Elmar;  Smith, Christopher J.;  Seferian, Roland
收藏  |  浏览/下载:13/0  |  提交时间:2020/07/03

All normal somatic cells are thought to acquire mutations, but understanding of the rates, patterns, causes and consequences of somatic mutations in normal cells is limited. The uterine endometrium adopts multiple physiological states over a lifetime and is lined by a gland-forming epithelium(1,2). Here, using whole-genome sequencing, we show that normal human endometrial glands are clonal cell populations with total mutation burdens that increase at about 29 base substitutions per year and that are many-fold lower than those of endometrial cancers. Normal endometrial glands frequently carry '  driver'  mutations in cancer genes, the burden of which increases with age and decreases with parity. Cell clones with drivers often originate during the first decades of life and subsequently progressively colonize the epithelial lining of the endometrium. Our results show that mutational landscapes differ markedly between normal tissues-perhaps shaped by differences in their structure and physiology-and indicate that the procession of neoplastic change that leads to endometrial cancer is initiated early in life.


Whole-genome sequencing of normal human endometrial glands shows that most are clonal cell populations and frequently carry cancer driver mutations that occur early in life, and that parity has a protective effect.


  
Measuring and forecasting progress towards the education-related SDG targets 期刊论文
NATURE, 2020, 580 (7805) : 636-+
作者:  Hindell, Mark A.;  Reisinger, Ryan R.;  Ropert-Coudert, Yan;  Huckstadt, Luis A.;  Trathan, Philip N.;  Bornemann, Horst;  Charrassin, Jean-Benoit;  Chown, Steven L.;  Costa, Daniel P.;  Danis, Bruno;  Lea, Mary-Anne;  Thompson, David;  Torres, Leigh G.;  Van de Putte, Anton P.
收藏  |  浏览/下载:17/0  |  提交时间:2020/07/03

Education is a key dimension of well-being and a crucial indicator of development(1-4). The Sustainable Development Goals (SDGs) prioritize progress in education, with a new focus on inequality(5-7). Here we model the within-country distribution of years of schooling, and use this model to explore educational inequality since 1970 and to forecast progress towards the education-related 2030 SDG targets. We show that although the world is largely on track to achieve near-universal primary education by 2030, substantial challenges remain in the completion rates for secondary and tertiary education. Globally, the gender gap in schooling had nearly closed by 2018 but gender disparities remained acute in parts of sub-Saharan Africa, and North Africa and the Middle East. It is predicted that, by 2030, females will have achieved significantly higher educational attainment than males in 18 countries. Inequality in education reached a peak globally in 2017 and is projected to decrease steadily up to 2030. The distributions and inequality metrics presented here represent a framework that can be used to track the progress of each country towards the SDG targets and the level of inequality over time. Reducing educational inequality is one way to promote a fairer distribution of human capital and the development of more equitable human societies.


Great progress toward the education-related SDG targets has been made  however, global estimates of within-country distributions of education reveal gender disparities and high levels of total inequality in many parts of the world.


  
AIM2 inflammasome surveillance of DNA damage shapes neurodevelopment 期刊论文
NATURE, 2020, 580 (7805) : 647-+
作者:  Okada, Tatsuaki;  Fukuhara, Tetsuya;  Tanaka, Satoshi;  Taguchi, Makoto;  Arai, Takehiko;  Senshu, Hiroki;  Sakatani, Naoya;  Shimaki, Yuri;  Demura, Hirohide;  Ogawa, Yoshiko;  Suko, Kentaro;  Sekiguchi, Tomohiko;  Kouyama, Toru;  Takita, Jun;  Matsunaga, Tsuneo;  Imamura, Takeshi;  Wada, Takehiko;  Hasegawa, Sunao;  Helbert, Joern;  Mueller, Thomas G.;  Hagermann, Axel;  Biele, Jens;  Grott, Matthias;  Hamm, Maximilian;  Delbo, Marco;  Hirata, Naru;  Hirata, Naoyuki;  Yamamoto, Yukio;  Sugita, Seiji;  Namiki, Noriyuki;  Kitazato, Kohei;  Arakawa, Masahiko;  Tachibana, Shogo;  Ikeda, Hitoshi;  Ishiguro, Masateru;  Wada, Koji;  Honda, Chikatoshi;  Honda, Rie;  Ishihara, Yoshiaki;  Matsumoto, Koji;  Matsuoka, Moe;  Michikami, Tatsuhiro;  Miura, Akira;  Morota, Tomokatsu;  Noda, Hirotomo;  Noguchi, Rina;  Ogawa, Kazunori;  Shirai, Kei;  Tatsumi, Eri;  Yabuta, Hikaru;  Yokota, Yasuhiro;  Yamada, Manabu;  Abe, Masanao;  Hayakawa, Masahiko;  Iwata, Takahiro;  Ozaki, Masanobu;  Yano, Hajime;  Hosoda, Satoshi;  Mori, Osamu;  Sawada, Hirotaka;  Shimada, Takanobu;  Takeuchi, Hiroshi;  Tsukizaki, Ryudo;  Fujii, Atsushi;  Hirose, Chikako;  Kikuchi, Shota;  Mimasu, Yuya;  Ogawa, Naoko;  Ono, Go;  Takahashi, Tadateru;  Takei, Yuto;  Yamaguchi, Tomohiro;  Yoshikawa, Kent;  Terui, Fuyuto;  Saiki, Takanao;  Nakazawa, Satoru;  Yoshikawa, Makoto;  Watanabe, Seiichiro;  Tsuda, Yuichi
收藏  |  浏览/下载:17/0  |  提交时间:2020/07/03

The sensing of DNA damage by the AIM2 inflammasome promotes the death of central nervous system cells and is required for normal brain development.


Neurodevelopment is characterized by rapid rates of neural cell proliferation and differentiation followed by massive cell death in which more than half of all recently generated brain cells are pruned back. Large amounts of DNA damage, cellular debris, and by-products of cellular stress are generated during these neurodevelopmental events, all of which can potentially activate immune signalling. How the immune response to this collateral damage influences brain maturation and function remains unknown. Here we show that the AIM2 inflammasome contributes to normal brain development and that disruption of this immune sensor of genotoxic stress leads to behavioural abnormalities. During infection, activation of the AIM2 inflammasome in response to double-stranded DNA damage triggers the production of cytokines as well as a gasdermin-D-mediated form of cell death known as pyroptosis(1-4). We observe pronounced AIM2 inflammasome activation in neurodevelopment and find that defects in this sensor of DNA damage result in anxiety-related behaviours in mice. Furthermore, we show that the AIM2 inflammasome contributes to central nervous system (CNS) homeostasis specifically through its regulation of gasdermin-D, and not via its involvement in the production of the cytokines IL-1 and/or IL-18. Consistent with a role for this sensor of genomic stress in the purging of genetically compromised CNS cells, we find that defective AIM2 inflammasome signalling results in decreased neural cell death both in response to DNA damage-inducing agents and during neurodevelopment. Moreover, mutations in AIM2 lead to excessive accumulation of DNA damage in neurons as well as an increase in the number of neurons that incorporate into the adult brain. Our findings identify the inflammasome as a crucial player in establishing a properly formed CNS through its role in the removal of genetically compromised cells.