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Wavefront shaping for deep tissue imaging

October 28, 2024
ID
12273

Transcript

  • 00:00I'm gonna introduce the next
  • 00:01speaker, Li Ying Guan, so
  • 00:03who graduated from Tsinghua University
  • 00:05and got her PhD in
  • 00:06statistics from Stanford.
  • 00:08And, right after that, she
  • 00:09joined, the department of biostatistics
  • 00:12here at the Yale School
  • 00:13of Public Health.
  • 00:15She,
  • 00:16her research focuses on
  • 00:18robust predictive modeling and
  • 00:20uncertainty quantification,
  • 00:22model development for complex data,
  • 00:24including multiomics data, single cell
  • 00:26data,
  • 00:27and to apply modern statistical
  • 00:29ideas and machine learning approaches
  • 00:31for improved data driven immunological
  • 00:33discoveries.
  • 00:34Welcome.
  • 00:37Thank you, John. Thank you,
  • 00:39everyone.
  • 00:40I'm really excited to share
  • 00:42my, one of my recent
  • 00:44work, with the audience here
  • 00:46and which is also a
  • 00:48good example of how I
  • 00:49apply the combined, model machine
  • 00:51learning,
  • 00:52in data driven in logical
  • 00:54research.
  • 00:58Thanks.
  • 01:01So, today, I'm gonna talk
  • 01:02about how we utilize longitudinal
  • 01:05multi arms data to conduct
  • 01:07unsupervised,
  • 01:08disease
  • 01:09subtype
  • 01:10discovery. The data we're using
  • 01:12is from this impact cohort.
  • 01:14So, in this cohort, like,
  • 01:16we generalize the data for
  • 01:18more than a thousand hospitalized
  • 01:20COVID nineteen patients and the
  • 01:21collected longitudinal samples,
  • 01:23during their hospitalization
  • 01:25on,
  • 01:26PBMC and the insert transomics,
  • 01:28serum protein, plasma protein tablets,
  • 01:31large, body of data, as
  • 01:32well as antibody, viral loads,
  • 01:34and others.
  • 01:36Along with this, deep immunofield
  • 01:38typing, we also collected a
  • 01:39lot of clinical measures,
  • 01:41both from a prior to,
  • 01:43infection or during acute infection,
  • 01:45as well as a one
  • 01:46year follow-up after discharge,
  • 01:49on their post acute recovery
  • 01:51based on, self reported patient
  • 01:53survey.
  • 01:55So this rich, data resource
  • 01:57actually, is very valuable and
  • 01:59allows us to reliably
  • 02:01identify or confirm immunosignatures
  • 02:04associated with the primary clinical
  • 02:06endpoints such as acute disease
  • 02:07severity,
  • 02:08measuring primarily based on risk
  • 02:10for status. For example, like,
  • 02:12previously we'll have done a
  • 02:13per assay,
  • 02:15immunosertial
  • 02:15identification
  • 02:16as well as an integrated
  • 02:18manner saying what are the
  • 02:20multi omics programs or cascade
  • 02:22associated with, mortality or their
  • 02:24severity.
  • 02:27One thing is, although this
  • 02:29is very meaningful, like, to
  • 02:30identify the immune correlates with
  • 02:32a particular,
  • 02:33clinical endpoint. We know that
  • 02:34patient are very heterogeneous.
  • 02:36If we look at their
  • 02:37clinical characterization,
  • 02:40in panel a, it is
  • 02:41like the primary clinical endpoint
  • 02:42will have been considered in
  • 02:44a lot of our previous,
  • 02:45analysis
  • 02:46is called something called a
  • 02:47clinical tragedy group, which is,
  • 02:51disease group,
  • 02:52defined by our clinical team
  • 02:54based on longitudinal response data
  • 02:56still in hospitalization
  • 02:57from t g one to
  • 02:58t g five in indicate
  • 02:59increased severity.
  • 03:01This is very convenient for
  • 03:02us to do our analysis,
  • 03:03but as you can see,
  • 03:05a patient can be characterized
  • 03:06by a lot of different
  • 03:07aspects.
  • 03:08If we you look at
  • 03:09the panel say, here is
  • 03:10a very simple example where
  • 03:11we show the prior, like
  • 03:14probabilities
  • 03:15and other, demographic information.
  • 03:17I highlight here, like, there's
  • 03:18a chronic,
  • 03:19lung disease role here. You
  • 03:21can say even, the most
  • 03:22moderate group, there is some
  • 03:24portion of,
  • 03:26chronic lung disease. And among
  • 03:28the two very severe group
  • 03:29like t g five and
  • 03:30t g four, t g
  • 03:30five is mortality, t g
  • 03:32four is very, very poor
  • 03:33recovery during acute infection. It
  • 03:35is not necessarily true that,
  • 03:36like, all the two most
  • 03:38severe group actually have less,
  • 03:40common ability compared to others.
  • 03:42Although the overall,
  • 03:43there is association between t
  • 03:45g group and the chronic
  • 03:46lung disease.
  • 03:48The same thing is true
  • 03:48for complications, which I didn't
  • 03:50show here. And also we
  • 03:52can if we want to
  • 03:53look beyond the acute infection,
  • 03:55one interesting thing, like, we
  • 03:56you know, I want the
  • 03:57previous work,
  • 03:59observed is actually there's a
  • 04:00very little,
  • 04:01almost no association between the
  • 04:03acute infection
  • 04:05severity and the, post acute
  • 04:07recovery, which is kind of,
  • 04:09very, very surprising thing we
  • 04:11we saw.
  • 04:14The same thing happens for
  • 04:15the immune response.
  • 04:17Not only the clinical characterization
  • 04:20can be quite high hygienous
  • 04:21and it cannot be not
  • 04:22be easily captured by one
  • 04:24single clinical parameter.
  • 04:26The same thing happens for
  • 04:27their immune response. Here is
  • 04:29a severity factor, which is
  • 04:30a one highlighted factor in,
  • 04:32the integrated, integrated analysis manual
  • 04:34script.
  • 04:35As you can see, both
  • 04:36at the base of one,
  • 04:37which is panel a baseline
  • 04:39visit and And over time,
  • 04:40there is it is indeed
  • 04:42true that this severity factor
  • 04:43captures acute severity
  • 04:45very well. There is a
  • 04:46very clear increase in trend
  • 04:48from t g one to
  • 04:49t g five. And over
  • 04:50time, the we also see
  • 04:52a divergence between t g
  • 04:53five and t g five.
  • 04:55But again, you can say
  • 04:57there is a lot of
  • 04:58variability
  • 04:59here. As John mentioned, maybe
  • 05:00variability is a hallmark
  • 05:02of in your response.
  • 05:04So,
  • 05:04motivated by this observation, so
  • 05:06we decided to take a
  • 05:08different approach. Can we just
  • 05:08directly understand the heterogeneity among
  • 05:09the host immune response characterized
  • 05:10by this super high dimension
  • 05:10of our comprehensive molecular isis
  • 05:12that is not self reported
  • 05:14from the,
  • 05:16lab measures?
  • 05:21And this can be very
  • 05:22useful because this if we
  • 05:24can done this correct, like,
  • 05:26if the result is, good,
  • 05:28then we can actually link
  • 05:30the web the immune response
  • 05:32heterogeneity
  • 05:33to all kinds
  • 05:34clinical measures in a very
  • 05:35unified framework.
  • 05:37And also it also offers,
  • 05:38like, not only offers more
  • 05:40comprehensive
  • 05:41understanding on the host immune,
  • 05:43heterogeneity, but also potentially offer
  • 05:45more insights into personal and
  • 05:47the treatment because different, immune
  • 05:48response may,
  • 05:50indicate a different type of
  • 05:51treatment.
  • 05:56When we go so the
  • 05:57first step we're going to
  • 05:58do is the major analysis
  • 06:00step is we want to
  • 06:01identify,
  • 06:02immunophenone that,
  • 06:04these are subtypes based on
  • 06:05this longitudinal molecular high dimensional
  • 06:08profiles.
  • 06:08There are two challenges here.
  • 06:10First,
  • 06:11there is a lot of
  • 06:13we have,
  • 06:14several high dimensional assays from
  • 06:16a transtomics, proteomics,
  • 06:18and each of them has
  • 06:19many, many features. So it
  • 06:21is very important for us
  • 06:22to be able to, identify
  • 06:25the most you most meaningful
  • 06:26and coherent
  • 06:28information from the high dimensional
  • 06:29assays.
  • 06:30The second challenge is this
  • 06:31longitudinal data. Of course, like
  • 06:33we can do a subtyping
  • 06:35for with one sample. Of
  • 06:37course, we can do that,
  • 06:38but that will be a
  • 06:39miss a lost information when
  • 06:40we're trying to characterize each
  • 06:42participant and their similarity.
  • 06:44We want to use all
  • 06:45the visits when determining the
  • 06:47similarity between two,
  • 06:49two participants here.
  • 06:51And, to do this, like,
  • 06:52with with some dimension reduction
  • 06:54technique to identify the multi
  • 06:56omics factors capturing the co
  • 06:58varying patterns across multiple omics.
  • 07:01So this help us to
  • 07:02reduce the dimension and then
  • 07:03focus on the most important,
  • 07:05multi omics factors.
  • 07:07The second issue is the
  • 07:09time series aspect.
  • 07:11And this is not only
  • 07:12a time series data. This
  • 07:13is a time series data
  • 07:14with very strong messiness, very
  • 07:16high messiness. As you can
  • 07:18see here, wide vessel one
  • 07:20among a multiple, like,
  • 07:23one thousand one hundred forty
  • 07:25eight participants out of the
  • 07:26in total, one hundred
  • 07:27one thousand one hundred fifty
  • 07:29two participants have vessel one
  • 07:30samples. As a way to
  • 07:32increase, like, the number of
  • 07:33samples available just sharply.
  • 07:36And, what's more troublesome here
  • 07:38is this
  • 07:40this missusness is not just
  • 07:41random.
  • 07:42This is actually severely,
  • 07:44confounded by their, actually, patient
  • 07:48status. If you,
  • 07:50will recur if the patient
  • 07:51recovered very quickly and then
  • 07:53discharged, then you may not
  • 07:54have sample measure. If the
  • 07:56patient, actually were have very
  • 07:58poor recovery in diet. Right?
  • 07:59So we won't have any
  • 08:00measurements.
  • 08:02Due to this kind of
  • 08:03bias and missingness and it
  • 08:04is a high proportion missingness,
  • 08:07we
  • 08:08we don't really want to
  • 08:09do, say, like, very,
  • 08:11intensive data imputation
  • 08:13because who knows what the
  • 08:14impute quality will be like.
  • 08:16So to do this, we
  • 08:17conduct we we actually did
  • 08:19some, imputation free, longitudinal,
  • 08:22subtyping.
  • 08:23We are we actually,
  • 08:26get some kind of pairwise
  • 08:27distance between two patients based
  • 08:29on their available samples only
  • 08:31across the Bay and then
  • 08:33conducted some,
  • 08:34class run based on the
  • 08:35pairwise distance.
  • 08:38And this enabled us to
  • 08:40identify,
  • 08:41six subtypes
  • 08:42based on using some automated
  • 08:45decision criteria.
  • 08:46And the subtype one to
  • 08:48subtype f.
  • 08:50And, panel a shows,
  • 08:52like, how does each point
  • 08:54means a participant
  • 08:55and how the participant looks
  • 08:57like when we project it,
  • 08:58each each participant into this
  • 09:00two dimensional space using,
  • 09:02multidimensional,
  • 09:03scaling.
  • 09:05And,
  • 09:06and so we can say,
  • 09:08although there's some overlapping, but
  • 09:10it is very clear that
  • 09:11the different subtypes,
  • 09:13they they occupy very different
  • 09:14space, in this two dimensional,
  • 09:17space here.
  • 09:18And then the next thing
  • 09:19we want to check is,
  • 09:22sure. So this participant, they
  • 09:23have a very different, host
  • 09:25response.
  • 09:26But
  • 09:27this host response difference actually
  • 09:29meaningful and being reflected in
  • 09:31various clinical measures.
  • 09:33So the first thing we
  • 09:34check is our primary clinical
  • 09:36endpoints,
  • 09:37used in previous study, which
  • 09:39is a clinical trial group,
  • 09:41defined,
  • 09:42from the mixed mixed modeling
  • 09:45longitudinal mixed modeling using the
  • 09:46respiratory status over time during
  • 09:48hospitalization.
  • 09:49And as I mentioned, from
  • 09:50t g one to t
  • 09:51g five, it's a increase
  • 09:53in severity. With the t
  • 09:54g one two three, they
  • 09:55tend to have, like, better,
  • 09:57like, quick fast recovery. T
  • 09:58g five, like, people all
  • 10:00die here. And then t
  • 10:01g four is a group
  • 10:03where,
  • 10:04they didn't die in the
  • 10:05acute infection, but maybe that
  • 10:07later.
  • 10:08And and the recoveries are
  • 10:09quite poor. Like, they usually
  • 10:11tend to have prolonged hospital
  • 10:13stay.
  • 10:14And, panel in panel b,
  • 10:16you can say when we
  • 10:17plot the distribution
  • 10:19of different TG group here,
  • 10:21we can say it's very
  • 10:22clear that there is,
  • 10:24different subtypes that are enriched,
  • 10:27have differential enrichment in the,
  • 10:29t g group.
  • 10:31And you can say that
  • 10:32the ABC subtype ABC, they
  • 10:33tend to be more enriched.
  • 10:35They have, like, very few
  • 10:37mortality
  • 10:38and then primarily consists of,
  • 10:40t g one, two, three.
  • 10:41And t g one and
  • 10:42five, they are very, very,
  • 10:44very severe. They have a
  • 10:45lot of mortality and primarily
  • 10:47consider t g four and
  • 10:48t g five.
  • 10:49And t, and then some
  • 10:51type d.
  • 10:52It it's kind of more
  • 10:53on the one hand, in
  • 10:54the modeling towards the, less
  • 10:56severe side. On the other
  • 10:57hand, it also has a
  • 10:58decent amount of mortality. So
  • 11:00we consider this one be
  • 11:01a mixed group.
  • 11:03And later,
  • 11:04so so the same message
  • 11:06can be confirmed if we
  • 11:07look at their,
  • 11:08survival curve, beyond the acute
  • 11:11acute infection,
  • 11:13we can say that,
  • 11:14subtype f is very enriched
  • 11:16in the mortality, like the
  • 11:18head ratio is, very high
  • 11:20and then followed by subtype
  • 11:22e. Subtype d, although it
  • 11:23has a lot of,
  • 11:25less severe, participants,
  • 11:27it also has,
  • 11:30appear to have some kind
  • 11:31of enrichment in the mortality,
  • 11:32and ABC is also
  • 11:34they also have less mortality
  • 11:35here.
  • 11:37And, although subtype d can
  • 11:39be very interesting to to
  • 11:40to be investigated, it's a
  • 11:42mix and it's kind of
  • 11:43interesting. But we decided to
  • 11:44focus on ABC and EF
  • 11:46because they have more participants.
  • 11:48And it's easier for us
  • 11:49to do a later analysis
  • 11:51of when we have going
  • 11:52to have more recent data
  • 11:53later.
  • 11:56So, just to summary, we
  • 11:57decided to we we identified
  • 12:00four
  • 12:01five major,
  • 12:03molecular subtypes
  • 12:05with three being severe, sub
  • 12:06a, sub b, sub c,
  • 12:08and two being very critical,
  • 12:10sub e
  • 12:12and
  • 12:13sub
  • 12:14f.
  • 12:15And,
  • 12:16these subtypes not only,
  • 12:18have strong associations with the
  • 12:19primary clinical points as we
  • 12:21mentioned. They also showed a
  • 12:22very strong association patterns between,
  • 12:26with, other clinical characterizations including
  • 12:29demographics, comorbidities,
  • 12:30and the complications.
  • 12:32For example, you can say,
  • 12:36sub e is actually the
  • 12:37group has the oldest age
  • 12:38even though sub f is
  • 12:40more severe seems to be.
  • 12:42And then sub a and
  • 12:43b, they they are tend
  • 12:44to be younger.
  • 12:45They also show some difference
  • 12:47in the ethnic ethnicity distribution.
  • 12:50And regarding the sex, so
  • 12:51we can say sub c
  • 12:52has a very high enrichment
  • 12:54in female and then sub
  • 12:56a and sub c has
  • 12:57less females.
  • 12:58There are many comorbidities and
  • 12:59any complications. Just overall, I
  • 13:01do not dig into one
  • 13:03by one. But you can
  • 13:04say, although sub c is,
  • 13:06on a more a more,
  • 13:07like, severe side, not critical
  • 13:09side, sub c and sub
  • 13:10e and f, they both
  • 13:11have more prior comorbidities,
  • 13:14because it's in their, population.
  • 13:16And when we look at,
  • 13:17sub a and sub b,
  • 13:18they are, they tend to
  • 13:19be more healthy regarding the
  • 13:21prior conditions. When we look
  • 13:23at the complications,
  • 13:24like, beyond risk for status,
  • 13:26status, we can say sub
  • 13:27e and sub f especially
  • 13:28sub f has strong enrichment
  • 13:30in different complications.
  • 13:32And, we,
  • 13:34we decide to from now
  • 13:36on, let's focus more
  • 13:38on the comparison between among
  • 13:40APC and among EF because,
  • 13:42there's a tons of work
  • 13:43separating, like, severe versus the
  • 13:45critical. But the characterization
  • 13:47between within, participants,
  • 13:50expecting similar severity levels is
  • 13:52actually less, available out there.
  • 13:55So when we look at
  • 13:56the for example, when we
  • 13:57look at the complications
  • 13:58and let's say comparing the
  • 14:00comparison between EF and the
  • 14:01comparison between among ABC.
  • 14:04We we can say that
  • 14:05it is indeed like there's
  • 14:06a lot of statistical significance,
  • 14:08regarding the elevated complication in
  • 14:11subtype f compared to subtype
  • 14:12e. And even among ABC,
  • 14:15all of the pattern is
  • 14:16less,
  • 14:18less obvious because they tend
  • 14:19to have less complication overall.
  • 14:21We still see something very
  • 14:22interesting. For example, we say,
  • 14:24overall, like, subtype c seem
  • 14:26to, have
  • 14:28a slightly higher cardiac con
  • 14:30complications, especially the CHF.
  • 14:32And it also has, higher
  • 14:34renal complications.
  • 14:36Although subtype c is also
  • 14:38the one that has the
  • 14:39least amount of, pulmonary, the
  • 14:41lung related complications. So there
  • 14:42is some difference between other
  • 14:44organs and the lung here,
  • 14:46for the subtype c.
  • 14:52What's more interesting is we
  • 14:53mentioned when we compare the
  • 14:55acute infection severity and the
  • 14:57PAS, our previous work actually
  • 14:59identified almost none association at
  • 15:02all, not even, like, significant.
  • 15:05Weak in effect size.
  • 15:07What's interesting is when we,
  • 15:09check the task,
  • 15:11self reported task and the
  • 15:13subtype we define, there is
  • 15:14actually
  • 15:15quite a strong enrichment in
  • 15:17certain sense. As you can
  • 15:18see for, when we're comparing,
  • 15:20like, each subtype against others,
  • 15:22we overall,
  • 15:24there is a strong, there's
  • 15:25this this is statistical significance,
  • 15:29regarding, like, subtype f, subtype
  • 15:31c, and subtype a,
  • 15:32which have, like, very different
  • 15:34distribution compared to the,
  • 15:36global distribution of the past.
  • 15:39So the,
  • 15:41let's
  • 15:42what are the past category
  • 15:43here? So minimum past here
  • 15:45can be viewed as,
  • 15:47the recovered convalescent.
  • 15:49And then the, physical cognitive
  • 15:51multiple, just three kinds of
  • 15:52different past characterization by clinical
  • 15:54team. And the multiple means
  • 15:56that it has all kinds
  • 15:57of deficits.
  • 15:59When we look at the
  • 16:00distribution, we can say that
  • 16:01the the subtype a is
  • 16:02actually a subtype that has,
  • 16:05much more minimal deficits and
  • 16:07the less other,
  • 16:08task groups.
  • 16:09And then, subtype c is
  • 16:11the one that is more
  • 16:13enriched in,
  • 16:14like, long COVID and the
  • 16:16less has less, like, comes
  • 16:17convalescent,
  • 16:19but
  • 16:20and driven mostly by the
  • 16:21physical and a little bit
  • 16:22by the multiple deficit.
  • 16:25Subtype f is also a
  • 16:26a subtype that is, has
  • 16:28more past compared to others
  • 16:30and particularly compared to subtype
  • 16:31e. You can we can
  • 16:33say it has, like, much
  • 16:34fewer, minimal deficit, mainly driven
  • 16:36by the enrichment of cognitive
  • 16:38deficit.
  • 16:41And when we,
  • 16:43so we also check whether
  • 16:45utilizing the molecular profile
  • 16:48can improve over a pure,
  • 16:50clinical model that utilize
  • 16:52age, sex, which, can be
  • 16:53potentially be related to past,
  • 16:55prediction,
  • 16:56and comability probabilities
  • 16:59as well as a viral
  • 17:00load and antibody because in
  • 17:02the previous,
  • 17:03study, like, we we identified
  • 17:05this as an early correlative
  • 17:06PASC. So you can say
  • 17:08we're a little bit, not
  • 17:09one hundred percent fair to
  • 17:11other models. The clinical model
  • 17:13has been selecting the most
  • 17:15important predictors from from our
  • 17:16previous study. But, anyway, so,
  • 17:19that that's okay because if
  • 17:21we can improve this model,
  • 17:22it's the improvement is real.
  • 17:24So, we we we consider
  • 17:27two models. One is a
  • 17:28clinical model
  • 17:29plus only one additional feature,
  • 17:31just our subtype.
  • 17:33The other is a clinical
  • 17:34model plus subtype and plus
  • 17:35the multi omics features
  • 17:37because our subtype is unsupervised
  • 17:39and
  • 17:40okay,
  • 17:41and then we want to
  • 17:42say whether we miss anything.
  • 17:43So the result is very,
  • 17:45that that is a very
  • 17:46challenging task. So but we
  • 17:47can see that there's improvement
  • 17:49comparing clinical plus subtype versus
  • 17:52clinical, clinical plus subtype, and
  • 17:54the plus means additional,
  • 17:55other factors. They both improve
  • 17:57clinical and the, the statistical
  • 17:59significance of the real. So
  • 18:01this is the evaluative test
  • 18:02data that haven't been touched
  • 18:04on the training.
  • 18:05And,
  • 18:07so the model we use
  • 18:08is,
  • 18:09is the kernel SVM, and
  • 18:11then we can also use
  • 18:12in the recently, like, popular
  • 18:14measure, like, the shape value
  • 18:15to identify what are the
  • 18:17important features for our model
  • 18:18prediction. We can say there
  • 18:20are some clinical measures, but,
  • 18:21like, it's the subtype is
  • 18:22one of the top features
  • 18:23here that is,
  • 18:26very important for our model
  • 18:27prediction in the last model
  • 18:29including everything. And when we
  • 18:31plot the percent of,
  • 18:34shift value on the test
  • 18:35sample only, and we can
  • 18:37say that indeed,
  • 18:39their improvement their contribution from
  • 18:41this the subtype and some
  • 18:42other top top features,
  • 18:44they actually,
  • 18:46strongly associated with the task,
  • 18:49on all the sample evaluation.
  • 18:52Okay.
  • 18:53So
  • 18:54to summarize, like, we identify
  • 18:56the molecular subtypes that are
  • 18:57not only separate severe and
  • 18:59critical, but also
  • 19:00associated with a bunch of
  • 19:02different, clinical calculations
  • 19:04as well as long as
  • 19:05long COVID.
  • 19:08I want I don't have
  • 19:09time to tell you the
  • 19:10details about what the immune
  • 19:11implication is, but there are
  • 19:13actually many interesting things we
  • 19:14found. And we and, again,
  • 19:16I you said the last
  • 19:18two minutes. I won't talk
  • 19:19about difference between APs and
  • 19:20EF because it's very clear.
  • 19:22The only systematic inflate inflammation,
  • 19:25is very hallmark for separating
  • 19:27critical against severe. But there
  • 19:29are also a lot of
  • 19:30interesting things, separating ABC and
  • 19:33the second EF. Particularly,
  • 19:34in ABC, when we look
  • 19:36at the serology
  • 19:37and the set off and
  • 19:38the, like, different, cytokine chemokines,
  • 19:41we we saw, like, subtype
  • 19:43ABC, they actually have strong
  • 19:44shape to the in their
  • 19:45antiviral immune response, particularly sub
  • 19:48a has much stronger humoral
  • 19:50response compared to sub c
  • 19:51where sub c has very
  • 19:52early strong T cell response
  • 19:54as T cell cytotoxic response,
  • 19:56but it's a hormone response
  • 19:57just somehow do not work
  • 19:59very well. And it also
  • 20:00has a very slow var
  • 20:01varial clearance.
  • 20:02And the difference between between
  • 20:04sub e and sub f
  • 20:06is also is, you know,
  • 20:07is very different story. They
  • 20:08are both in a very
  • 20:09hyperinflammation
  • 20:10state, but the sub e
  • 20:11somehow tend to be adapting
  • 20:13to it better.
  • 20:14For example, where they are
  • 20:16both, in a hyperinflammation state
  • 20:17with a lot of calculation,
  • 20:20regulation,
  • 20:21calculation complement,
  • 20:23protein.
  • 20:24Sub e is actually the
  • 20:26one that also has, associating
  • 20:28alongside with, anti coagulation components.
  • 20:31But the sub eigen just
  • 20:32given up very strong coagulation
  • 20:34complement, but the anti coagulation
  • 20:36is just silent.
  • 20:37I don't know why that
  • 20:38that's what happening. And, also,
  • 20:40sub although, you know, in
  • 20:41during this hyper inflammation state,
  • 20:43sub e is, has,
  • 20:45less ox oxidative stress,
  • 20:47indicated by both its complications,
  • 20:49its metabolites,
  • 20:51and protein levels. And the
  • 20:52sub f is has, like,
  • 20:54higher oxidative stress and with
  • 20:56a higher n,
  • 20:58n six to n three,
  • 20:59like,
  • 21:01on certain fatty acid ratios,
  • 21:03anemia, and all kinds of
  • 21:05things. So,
  • 21:07this this is very essentially,
  • 21:08very we found this very
  • 21:10interesting. Just this kind of
  • 21:11different in immune responses that
  • 21:13can potentially
  • 21:14be explaining why they're so
  • 21:15different in many different aspects
  • 21:17and even in long COVID.
  • 21:19So lastly, so this is
  • 21:19the work. It's a teamwork.
  • 21:21It's part of the impact
  • 21:22project, and we also have,
  • 21:23many PIs from the EL
  • 21:25sites as I listed here
  • 21:26and other people. And also,
  • 21:27like, this, here are the
  • 21:29six lead authors, student authors,
  • 21:31and the collaborators
  • 21:32that, without whose help this
  • 21:34project won't be possible. Thank
  • 21:41you. Thank you, Liying.
  • 21:43Maybe time for one
  • 21:45any pressing question?
  • 21:49Not actually one quick one.
  • 21:51I see that the percent
  • 21:53of PACE,
  • 21:55it's
  • 21:56it's highest in CNF. Right?
  • 21:58So and then you have
  • 21:59a gradient sort of going
  • 22:00up from a, b, c
  • 22:01to e, f. And then
  • 22:03within each one of those
  • 22:04two sub subgroups, you know,
  • 22:06is it the same gradient,
  • 22:07but just more intense in
  • 22:08the e, f group?
  • 22:10I didn't check. That's a
  • 22:10good question. I didn't exactly
  • 22:12check
  • 22:12the ratio in
  • 22:14the decrease.
  • 22:17Yeah. But we can see.
  • 22:18But there is a decrease.
  • 22:19Yeah. Okay. Thank you. Thank
  • 22:21you. Okay.
  • 22:22Thanks again.