Wavefront shaping for deep tissue imaging
October 28, 2024Information
- ID
 - 12273
 - To Cite
 - DCA Citation Guide
 
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.