Low-frequency CD8+ T cells induced by SIGN-R1+ macrophage-targeted vaccine confer SARS-CoV-2 clearance in mice

Vaccine-induced T cells and neutralizing antibodies are essential for protection against SARS-CoV-2. Previously, we demonstrated that an antigen delivery system, pullulan nanogel (PNG), delivers vaccine antigen to lymph node medullary macrophages and thereby enhances the induction of specific CD8+ T cells. In this study, we revealed that medullary macrophage-selective delivery by PNG depends on its binding to a C-type lectin SIGN-R1. In a K18-hACE2 mouse model of SARS-CoV-2 infection, vaccination with a PNG-encapsulated receptor-binding domain of spike protein decreased the viral load and prolonged the survival in the CD8+ T cell- and B cell-dependent manners. T cell receptor repertoire analysis revealed that although the vaccine induced T cells at various frequencies, low-frequency specific T cells mainly promoted virus clearance. Thus, the induction of specific CD8+ T cells that respond quickly to viral infection, even at low frequencies, is important for vaccine efficacy and can be achieved by SIGN-R1+ medullary macrophage-targeted antigen delivery.

Utilization of condoliase therapy versus surgery for lumbar disc herniation and comparison of post-treatment motor improvement

STUDY DESIGN

Double-center retrospective study.

PURPOSE

Utilization trends in interventional treatment for lumbar disc herniation (LDH) have not yet been examined. Furthermore, limited information is currently available on motor recovery with condoliase therapy. Therefore, the present study investigated utilization trends in treatment for LDH and the effects of condoliase therapy on muscle weakness.

METHODS

This retrospective, double-center study involved patients with leg pain caused by LDH who received interventional treatment between September 2017 and August 2022. LDH patients were divided into two groups: an operative treatment group and condoliase therapy group. The period between September 2017 and August 2022 was divided into 5 equal parts and changes in the percentage of intervention treatment were examined. Motor recovery was also assessed in the two groups. Patients receiving condoliase therapy were divided into two groups: an effective group and non-effective group. Sex, age, the body mass index, duration of symptoms, herniation level, neurological and radiographic findings, a visual analog scale for leg pain, and the Oswestry disability index were examined in the two groups.

RESULTS

Subjects included 226 males and 115 females with a mean age of 49.2 years, mean BMI of 22.8, and mean duration of symptoms of 5.0 months. The utilization of condoliase therapy for LDH surpassed surgery in the third year after its introduction. In the fourth year, condoliase therapy became the main treatment for LDH. Lower limb muscle strength improved in 76 % of cases receiving condoliase therapy.

CONCLUSIONS

Condoliase therapy has become an intermediate treatment before surgery in our institutions. Motor recovery in patients receiving condoliase therapy was not inferior to that after surgery; however, in cases with severe muscle weakness with manual muscle test ≤3, the improvement rate was approximately 60 %. These results will be useful for clinicians when providing informed consent and selecting condoliase therapy.

Teleocidin B-4, a PKC Activator, Upregulates Hypoxia-Inducible Factor 1 (HIF-1) Activity by Promoting the Accumulation of HIF-1α Protein via the PKCα/mTORC Signaling Pathway

Hypoxia-inducible factor 1 (HIF-1) signaling is upregulated in an oxygen-dependent manner under hypoxic conditions. Activation of HIF-1 signaling increases the expression of HIF-1 target genes involved in cell survival, proliferation, and angiogenesis. Therefore, compounds that activate HIF-1 signaling have therapeutic potential in ischemic diseases. Screening for compounds that activate HIF-1 activity identified a microbial metabolite, teleocidin B-4, a PKC activator. Other PKC activators, such as TPA and 10-Me-Aplog-1, also activated HIF-1 activity. PKC activators induced HIF-1α protein accumulation through PKCα/mTORC activation. These results suggest that PKC activators without tumor-promoting activity have potential as therapeutic agents via HIF-1 target gene activation.

Resting-state functional magnetic resonance imaging indices are related to electrophysiological dysfunction in degenerative cervical myelopathy

The age-related degenerative pathologies of the cervical spinal column that comprise degenerative cervical myelopathy (DCM) cause myelopathy due spinal cord compression. Functional neurological assessment of DCM can potentially reveal the severity and pathological mechanism of DCM. However, functional assessment by conventional MRI remains difficult. This study used resting-state functional MRI (rs-fMRI) to investigate the relationship between functional connectivity (FC) strength and neurophysiological indices and examined the feasibility of functional assessment by FC for DCM. Preoperatively, 34 patients with DCM underwent rs-fMRI scans. Preoperative central motor conduction time (CMCT) reflecting motor functional disability and intraoperative somatosensory evoked potentials (SEP) reflecting sensory functional disability were recorded as electrophysiological indices of severity of the cervical spinal cord impairment. We performed seed-to-voxel FC analysis and correlation analyses between FC strength and the two electrophysiological indices. We found that FC strength between the primary motor cortex and the precuneus correlated significantly positively with CMCT, and that between the lateral part of the sensorimotor cortex and the lateral occipital cortex also showed a significantly positive correlation with SEP amplitudes. These results suggest that we can evaluate neurological and electrophysiological severity in patients with DCM by analyzing FC strengths between certain brain regions.

Transcranial Magnetic Stimulation in the Diagnosis of Compressive Myelopathy at the Thoracolumbar Junction

PURPOSE

The disc level in the thoracolumbar junction at which measurement of the central motor conduction time in the lower limbs (CMCT-LL) is useful for a diagnosis remains unclear. Therefore, this study investigated the spinal vertebral level at which compressive myelopathy due to ossification of the ligamentum flavum in the thoracolumbar junction is detectable using CMCT-LL.

METHODS

We preoperatively measured CMCT-LL in 57 patients (42 men, 15 women; aged 35-85 years) with a single ossification of the ligamentum flavum from the T10-11 to T12-L1 disc levels and in 53 healthy controls. Motor evoked potentials after transcranial magnetic stimulation, compound muscle action potentials, and F waves were recorded from the abductor hallucis. Central motor conduction time in the lower limbs was calculated as follows: Motor evoked potential latency - (compound muscle action potential latency + F latency - 1)/2 (ms). Central motor conduction time in the lower limbs was compared between patients and controls.

RESULTS

Compressive lesions were located at the T10 to 11 level in 27 patients, the T11 to 12 level in 28, and the T12-L1 level in 2. Central motor conduction time values in the lower limbs at the T10 to 11 level (19.9 ± 4.7 ms) and T11 to 12 level (18.1 ± 3.4 ms) were significantly longer than control values (11.8 ± 1.1 ms; P < 0.01). Central motor conduction time in the lower limbs was not calculated at the T12-L1 level because motor evoked potentials were not recorded in any patient.

CONCLUSIONS

We confirmed that CMCT-LL was significantly longer in patients with ossification of the ligamentum flavum at the T10 to 11 and T11 to 12 levels because the S2 segment of the spinal cord is caudal at the T12 vertebral body level. Therefore, CMCT-LL is useful for diagnosing thoracolumbar junction disorders proximal to the T12 vertebral body level.

Assessment of maxillary sinus fluid volume for postmortem diagnosis of drowning

INTRODUCTION

Drowning is a comprehensive and exclusive diagnosis at autopsy. Autopsy findings such as pleural effusion and waterlogged lungs contribute to the diagnosis. Herein, we aim to reveal the practical usefulness and postmortem changes of the maxillary sinus fluid volume to diagnose drowning.

METHODS

We evaluated 52 drowning and 59 nondrowning cases. The maxillary sinus fluid volume was measured using a computed tomography (CT) scan, and pleural effusion volume and lung weight were manually measured at autopsy. The utility of these three indices for diagnosing drowning and its postmortem changes was evaluated.

RESULTS

The maxillary sinus fluid volume was significantly higher in drowning cases than in other external causes and cardiovascular death cases. Receiver operating characteristic curve analysis revealed that a total maxillary sinus fluid volume >1.04 mL more usefully indicated drowning (odds ratio, 8.19) than a total pleural effusion volume >175 mL (odds ratio, 7.23) and a total lung weight >829 g (odds ratio, 2.29). The combination of maxillary sinus fluid volume and pleural effusion volume more effectively predicted drowning than one index alone. Moreover, the maxillary sinus fluid volume was less influenced by the postmortem interval than the other two indices up to a week after death.

CONCLUSION

Maxillary sinus fluid volume can be more useful than pleural effusion volume and lung weight with higher sensitivity and odds ratio for diagnosing drowning.

IMPLICATIONS FOR PRACTICE

Fluid accumulation in both the maxillary sinuses strongly predicts drowning in the postmortem imaging.

Amoxetamide A, a new anoikis inducer, produced by combined-culture of Amycolatopsis sp. and Tsukamurella pulmonis

Cancer cells including colorectal cancer cells are resistant to anoikis, an anchorage-independent programmed death, which enables metastasis and subsequent survival in a new tumor microenvironment. In this study, we identified a new anoikis inducer, amoxetamide A (1) with a β-lactone moiety, that was produced by combined-culture of Amycolatopsis sp. 26-4 and mycolic acid-containing bacteria (MACB) Tsukamurella pulmonis TP-B0596. The structure of 1 including the stereochemistry of C8 was determined by MS and NMR spectroscopy and modified Mosher's method, and the absolute configurations of C11 and C12 were suggested as 11R and 12S, respectively, by GIAO NMR calculations. Amoxetamide A (1) exhibited anoikis-inducing activity in human colorectal cancer HT-29 cells in anchorage-independent culture conditions.

Bisabosqual A: A novel asparagine synthetase inhibitor suppressing the proliferation and migration of human non-small cell lung cancer A549 cells

Asparagine synthetase (ASNS) is a crucial enzyme for the de novo biosynthesis of endogenous asparagine (Asn), and ASNS shows the positive relationship with the growth of several solid tumors. Most of ASNS inhibitors are analogs of transition-state in ASNS reaction, but their low cell permeability hinders their anticancer activity. Therefore, novel ASNS inhibitors with a new pharmacophore urgently need to be developed. In this study, we established and applied a system for in vitro screening of ASNS inhibitors, and found a promising unique bisabolane-type meroterpenoid molecule, bisabosqual A (Bis A), able to covalently modify K556 site of ASNS protein. Bis A targeted ASNS to suppress cell proliferation of human non-small cell lung cancer A549 cells and exhibited a synergistic effect with L-asparaginase (L-ASNase). Mechanistically, Bis A promoted oxidative stress and apoptosis, while inhibiting autophagy, cell migration and epithelial-mesenchymal transition (EMT), impeding cancer cell development. Moreover, Bis A induced negative feedback pathways containing the GCN2-eIF2α-ATF4, PI3K-AKT-mTORC1 and RAF-MEK-ERK axes, but combination treatment of Bis A and rapamycin/torin-1 overcame the potential drug resistance triggered by mTOR pathways. Our study demonstrates that ASNS inhibition is promising for cancer chemotherapy, and Bis A is a potential lead ASNS inhibitor for anticancer development.

Solvent-assisted synthesis of Ag2Se and Ag2S nanoparticles on carbon fabric for enhanced thermoelectric performance

The challenge of developing low-cost, highly flexible, and high-performance thermoelectric (TE) materials persists due to the low thermoelectric efficiency of conducting polymers and the inflexibility of inorganic materials. In this study, we successfully integrated Ag2Se and Ag2S with highly conductive carbon fabric (CF) to produce a flexible thermoelectric material. A facile one-step solvothermal method was employed to synthesize the Ag2Se-CF and Ag2S-CF, which were then subjected to X-ray analysis to confine the phase formation of Ag2Se and Ag2S on the carbon fabric. The analysis revealed that Ag2Se and Ag2S nanoparticles were tightly packed on the surface of carbon fabric, and compositional analysis confirmed the interaction between the material and carbon fabric. The thermoelectric properties of Ag2Se-CF and Ag2S-CF were significantly altered due to carrier concentration and mobility variations, resulting in a low power factor of 6.7 μW/mK2 for Ag2Se-CF and a high-power factor of 24 μW/mK2 at 373 K for Ag2S-CF. The growth of Ag2Se-CF and Ag2S-CF on carbon fabric led to an enhancement in their thermoelectric properties. Further, TE legs were fabricated using the Ag2Se-CF (p-type) and Ag2S-CF (n-type), and the fabricated legs exhibited an output voltage of ∼20 mV to ∼86.65 mV at a temperature gradient (ΔT) of 3-8 K. This work represents a cutting-edge approach to the fabrication of high-performance, wearable thermoelectric devices.

T cell receptor gene-modified allogeneic T cells with siRNA for endogenous T cell receptor induce efficient tumor regression without graft-versus-host disease

Adoptive immunotherapy using genetically engineered patient-derived lymphocytes to express tumor-reactive receptors is a promising treatment for malignancy. However, utilization of autologous T cells in this therapy limits the quality of gene-engineered T cells, thereby inhibiting the timely infusion of the cells into patients. In this study, we evaluated the anti-tumor efficacy and the potential to induce graft-versus-host disease (GVHD) in T cell receptor (TCR) gene-engineered allogeneic T cells that downregulate the endogenous TCR and HLA class I molecules with the aim of developing an "off-the-shelf" cell product with expanded application of genetically engineered T cells. We transduced human lymphocytes with a high-affinity TCR specific to the cancer/testis antigen NY-ESO-1 using a novel retrovirus vector with siRNAs specific to the endogenous TCR (siTCR vector). These T cells showed reduced expression of endogenous TCR and minimized reactivity to allogeneic cells in vitro. In non-obese diabetic/SCID/γcnull mice, TCR gene-transduced T cells induced tumor regression without development of GVHD. A lentivirus-based CRISPR/Cas9 system targeting β-2 microglobulin in TCR gene-modified T cells silenced the HLA class I expression and prevented allogeneic CD8+ T cell stimulation without disrupting their anti-tumor capacity. This report is the first demonstration that siTCR technology is effective in preventing GVHD. Adoptive cell therapy with allogeneic T cells engineered with siTCR vector may be useful in developing an "off-the-shelf" therapy for patients with malignancy.

Pediatric Spinal Giant Cell-rich Osteosarcoma: Case Report and Brief Literature Review

BACKGROUND

Osteosarcoma, the most common primary malignant bone tumor in childhood, very rarely occurs in the spine. Criteria of complete tumor resection/stable reconstruction of osteosarcoma and the latest protocol of neoadjuvant chemotherapy of the spine have not been reported because of its rarity, technical difficulties, and its continued severe surgical risk.

CASE REPORT

A 11-year-old female complained of back pain for several months and walking disability. The workup discovered a large destructive bone lesion in the thoracic 12th (Th12) with vertebral body collapse and subluxation, large amount of associated anteroposterior soft tissue components, and narrowing of the spinal canal. Histology at the 1st decompression and emergent instrumentation surgery revealed giant cell-rich osteosarcoma. Following the 1st surgery, we performed three cycles of neoadjuvant chemotherapy based on the osteosarcoma 95J (NECO95J) protocol and evaluated efficacy of chemotherapy on the Th12 tumor. The tumor was isolated only to Th12 spine following chemotherapy. Therefore, following vascular embolization of the Th12 tumor, we performed surgical resection by single posterior approach that included total en bloc spondylectomy (TES). She recovered well postoperatively, without motor or sensory deficit and no back pain. Six cycles of postoperative neoadjuvant chemotherapy were administered after the 2nd surgery and TES. The patient was disease-free at the 8-months clinical and radiological follow-up and showed no neurological involvement at 8-months.

CONCLUSION

We reported a case of pediatric spinal osteosarcoma, the surgical technique of complete tumor resection, and stable reconstruction of spinal osteosarcoma. We also discussed the recent neoadjuvant chemotherapy protocol for osteosarcoma.

Artificial placenta technology: History, potential and perception

As presently conceptualised, the artificial placenta (AP) is an experimental life support platform for extremely preterm infants (i.e. 400-600 g; 21-23+6 weeks of gestation) born at the border of viability. It is based around the oxygenation of the periviable fetus using gas-exchangers connected to the fetal vasculature. In this system, the lung remains fluid-filled and the fetus remains in a quiescent state. The AP has been in development for some sixty years. Over this time, animal experimental models have evolved iteratively from employing external pump-driven systems used to support comparatively mature fetuses (generally goats or sheep) to platforms driven by the fetal heart and used successfully to maintain extremely premature fetuses weighing around 600 g. Simultaneously, sizable advances in neonatal and obstetric care mean that the nature of a potential candidate patient for this therapy, and thus the threshold success level for justifying its adoption, have both changed markedly since this approach was first conceived. Five landmark breakthroughs have occurred over the developmental history of the AP: i) the first human studies reported in the 1950's; ii) foundation animal studies reported in the 1960's; iii) the first extended use of AP technology combined with fetal pulmonary resuscitation reported in the 1990s; iv) the development of AP systems powered by the fetal heart reported in the 2000's; and v) the adaption of this technology to maintain extremely preterm fetuses (i.e. 500-600 g body weight) reported in the 2010's. Using this framework, the present paper will provide a review of the developmental history of this long-running experimental system and up-to-date assessment of the published field today. With the apparent acceleration of AP technology towards clinical application, there has been an increase in the attention paid to the field, along with some inaccurate commentary regarding its potential application and merits. Additionally, this paper will address several misrepresentations regarding the potential application of AP technology that serve to distract from the significant potential of this approach to greatly improve outcomes for extremely preterm infants born at or close to the present border of viability.

Reference intervals and sources of variation of pressure pain threshold for quantitative sensory testing in a Japanese population

Quantitative sensory testing (QST) is useful when analysing musculoskeletal pain disorders. A handheld algometer is most commonly used for pressure pain threshold (PPT) tests. However, reference intervals for PPTs are not elucidated. We assessed reference intervals of PPTs for QST in 158 healthy adult Japanese with no history of musculoskeletal or neurological problems. A handheld algometer was used to record PPT at five different assessment sites on the body: lumbar paravertebral muscle, musculus gluteus maximus, quadriceps, tibialis anterior muscle, and anterior talofibular ligament. Multiple regression analysis was performed to explore sources of variation of PPT according to sex, age, body mass index, UCLA Activity Level Rating, and Tegner Activity Score. Reference intervals were determined parametrically by Gaussian transformation of PPT values using the two-parameter Box-Cox formula. Results of multiple regression analysis revealed that age was significantly associated with PPT of lumbar paravertebral muscle and musculus gluteus maximus. In females, body mass index showed significant positive correlation with PPT of anterior talofibular ligament, and UCLA Activity Level Rating also showed significant positive association with tibialis anterior muscle and anterior talofibular ligament. Site-specific reference intervals of PPTs for Japanese are of practical relevance in fields of pain research using a handheld algometer.

Posterior fixation for different thoracic-sacrum alignments containing a thoracolumbar vertebral fracture: a finite element analysis

OBJECTIVE

Thoracolumbar vertebral fractures are one of the most common fractures, however, there is a lack of mechanical analyses for what the posterior fixation is for different spine alignments.

METHODS

This study employed a three-dimensional finite element model of a T1-sacrum. Three alignment models were created: intact, degenerative lumbar scoliosis (DLS), and adolescent idiopathic scoliosis (AIS). The burst fracture was assumed to be at the L1 vertebral level. Posterior fixation models with pedicle screws (PS) were constructed for each model: 1 vertebra above to 1 below (A1B1) PS (4PS) and A1B1 PS with additional short pedicle screws at the L1 (6PS); intact-Burst-4PS, intact-Burst-6PS, DLS- Burst -4PS, DLS- Burst -6PS, AIS-Burst-4PS, and AIS-Burst-6PS models. T1 was loaded with a moment of 4Nm assuming flexion and extension.

RESULTS

The vertebrae stress varied with spinal alignment. The stress of L1 in IB, DLS-B and AIS-B increased by more than 190% compared to the each nonfractured models. L1 stress in IB, DLS, and AIS-4PS increased to more than 47% compared to each nonfractured model. L1 stress in IB, DLS, and AIS-6PS increased to more than 25% compared to the each nonfractured model. In flexion and extension, stress on the screws and rods of IB-6PS, DLS-6PS, and AIS-6PS was lower than in the IB-4PS, DLS-4PS, and AIS-4PS models.

CONCLUSIONS

It may be more beneficial to use 6PS compared to 4PS to reduce stresses on the fractured vertebrae and instrumentation, regardless of the spinal alignment.

Spin-Derived Electric Polarization and Chirality Density Inherent in Localized Electron Orbitals

In solid state physics, any phase transition is commonly observed as a change in the microscopic distribution of charge, spin, or current. However, there is an exotic order parameter inherent in the localized electron orbitals that cannot be primarily captured by these three fundamental quantities. This order parameter is described as the electric toroidal multipoles connecting different total angular momenta under the spin-orbit coupling. The corresponding microscopic physical quantity is the spin current tensor on an atomic scale, which induces spin-derived electric polarization aligned circularly and the chirality density of the Dirac equation. Here, elucidating the nature of this exotic order parameter, we obtain the following general consequences that are not restricted to localized electron systems; chirality density is indispensable to unambiguously describe electronic states and it is a species of electric toroidal multipoles, just as the charge density is a species of electric multipoles. Furthermore, we derive the equation of continuity for chirality and discuss its relation to chiral anomaly and optical chirality. These findings link microscopic spin currents and chirality in the Dirac theory to the concept of multipoles and provide a new perspective for quantum states of matter.

Monte Carlo study of cuprate superconductors in a four-bandd-pmodel: role of orbital degrees of freedom

Understanding the various competing phases in cuprate superconductors is a long-standing challenging problem. Recent studies have shown that orbital degrees of freedom, both Cue_gorbitals and Oporbitals, are a key ingredient for a unified understanding of cuprate superconductors, including the material dependence. Here we investigate a four-bandd-pmodel derived from the first-principles calculations with the variational Monte Carlo method, which allows us to elucidate competing phases on an equal footing. The obtained results can consistently explain the doping dependence of superconductivity, antiferromagnetic and stripe phases, phase separation in the underdoped region, and also novel magnetism in the heavily-overdoped region. The presence ofporbitals is critical to the charge-stripe features, which induce two types of stripe phases withs)-wave andd-wave bond stripe. On the other hand, the presence ofdz2orbital is indispensable to material dependence of the superconducting transition temperature (Tc), and enhances local magnetic moment as a source of novel magnetism in the heavily-overdoped region as well. These findings beyond one-band description could provide a major step toward a full explanation of unconventional normal state and highTcin cuprate supercondutors.

Enhancement of thermoelectric power factor via electron energy filtering in Cu doped MoS2 on carbon fabric for wearable thermoelectric generator applications

The design and construction of state-of-the-art wearable thermoelectric materials are important for the development of self-powered wearable thermoelectric generators (WTEGs). Molybdenum disulfide (MoS₂) has been reported as a noteworthy thermoelectric (TE) material because of its large intrinsic bandgap and high carrier mobility. In this work, Cu-doped two-dimensional layered MoS₂ nanosheets were grown on carbon fabric (CF) via a hydrothermal method. The electrical conductivity, Seebeck coefficient, and power factor for the Cu-doped MoS₂ were found to increase with increasing temperature. The maximum Seebeck coefficient was obtained for a MoS₂ sample doped with 4 at% of Cu (CM4) was ∼10 μV/K at 303 K and ∼13 μV/K at 373 K. The enhancement in the Seebeck coefficient was attributed to an energy-filtering effect caused by the interfacial barrier between MoS₂ and Cu. In addition, a thermoelectric device was designed with four pairs of TE materials, where CM4 (4 at%) was used as a p-type material and Cu wire was used as an n-type material. These p- and n-type materials were connected electrically in series and thermally in parallel to generate a voltage of 190.7 μV at a temperature gradient of 8 K.

Formation and evolution of carbonaceous asteroid Ryugu: Direct evidence from returned samples

Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide-bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu's parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of <1 (by mass). Less altered fragments contain olivine, pyroxene, amorphous silicates, calcite, and phosphide. Numerical simulations, based on the mineralogical and physical properties of the samples, indicate that Ryugu's parent body formed ~2 million years after the beginning of Solar System formation.

Search for the Majorana Nature of Neutrinos in the Inverted Mass Ordering Region with KamLAND-Zen

The KamLAND-Zen experiment has provided stringent constraints on the neutrinoless double-beta (0νββ) decay half-life in ^{136}Xe using a xenon-loaded liquid scintillator. We report an improved search using an upgraded detector with almost double the amount of xenon and an ultralow radioactivity container, corresponding to an exposure of 970 kg yr of ^{136}Xe. These new data provide valuable insight into backgrounds, especially from cosmic muon spallation of xenon, and have required the use of novel background rejection techniques. We obtain a lower limit for the 0νββ decay half-life of T_{1/2}^{0ν}>2.3×10^{26}  yr at 90% C.L., corresponding to upper limits on the effective Majorana neutrino mass of 36-156 meV using commonly adopted nuclear matrix element calculations.

Current Concepts of Biomaterial Scaffolds and Regenerative Therapy for Spinal Cord Injury

Spinal cord injury (SCI) is a catastrophic condition associated with significant neurological deficit and social and financial burdens. It is currently being managed symptomatically, with no real therapeutic strategies available. In recent years, a number of innovative regenerative strategies have emerged and have been continuously investigated in preclinical research and clinical trials. In the near future, several more are expected to come down the translational pipeline. Among ongoing and completed trials are those reporting the use of biomaterial scaffolds. The advancements in biomaterial technology, combined with stem cell therapy or other regenerative therapy, can now accelerate the progress of promising novel therapeutic strategies from bench to bedside. Various types of approaches to regeneration therapy for SCI have been combined with the use of supportive biomaterial scaffolds as a drug and cell delivery system to facilitate favorable cell-material interactions and the supportive effect of neuroprotection. In this review, we summarize some of the most recent insights of preclinical and clinical studies using biomaterial scaffolds in regenerative therapy for SCI and summarized the biomaterial strategies for treatment with simplified results data. One hundred and sixty-eight articles were selected in the present review, in which we focused on biomaterial scaffolds. We conducted our search of articles using PubMed and Medline, a medical database. We used a combination of "Spinal cord injury" and ["Biomaterial", or "Scaffold"] as search terms and searched articles published up until 30 April 2022. Successful future therapies will require these biomaterial scaffolds and other synergistic approaches to address the persistent barriers to regeneration, including glial scarring, the loss of a structural framework, and biocompatibility. This database could serve as a benchmark to progress in future clinical trials for SCI using biomaterial scaffolds.

[Development of a One-minute Educational Video for Eye-drop Instillation and Changes in Instillation Behavior after Watching the Video]

We created a one-minute video titled "a simple method of eye-drop instillation" (video) for online instillation guidance, to compare the instillation method before and after study participants watch the video and verify the usefulness of watching the video. Moreover, we prepared a document questionnaire to investigate instillation habits and clarify instillation behavior. Study participants were randomly recruited from among students and faculty members via a poster posted at Tokushima Bunri University. The instillation behavior of the study participants was videotaped before and after they watched the video created by the authors. The images were played in a super slow motion, to confirm success or failure in instillation, drop sites, and eye-opening method. Of the 109 participants in the study, the successful instillation rate before and after watching the video was 55.0% and 69.7%, respectively. The use rate of wet wipes for finger disinfection before instillation increased from 0.0% before watching the video to 74.3% after watching the video. After watching the video, the blinking rate after instillation decreased from 95.4 to 45.0%, the rate of pressing the nasolacrimal duct increased from 2.8 to 77.1%, and the rate of wiping the drug solution spilled around the eyes increased from 89.9 to 98.2%. According to the questionnaire, 72.5% of the participants instilled one drop, 22.0% instilled two drops, and 5.5% instilled three drops or more. Watching the video significantly increased the successful instillation rate and improved instillation behavior. Thus, the video created by the authors can be used for online instillation guidance.

Chimeric antigen receptor T-cell therapy targeting a MAGE A4 peptide and HLA-A*02:01 complex for unresectable advanced or recurrent solid cancer: protocol for a multi-institutional phase 1 clinical trial

INTRODUCTION

Adoptive cell transfer of genetically engineered T cells is a promising treatment for malignancies; however, there are few ideal cancer antigens expressed on the cell surface, and the development of chimeric antigen receptor T cells (CAR-T cells) for solid tumour treatment has been slow. CAR-T cells, which recognise major histocompatibility complex and peptide complexes presented on the cell surface, can be used to target not only cell surface antigens but also intracellular antigens. We have developed a CAR-T-cell product that recognises the complex of HLA-A*02:01 and an epitope of the MAGE-A4 antigen equipped with a novel signalling domain of human GITR (investigational product code: MU-MA402C) based on preclinical studies.

METHODS AND ANALYSIS

This is a dose-escalation, multi-institutional, phase 1 study to evaluate the tolerability and safety of MU-MA402C for patients with MAGE A4-positive and HLA-A*02:01-positive unresectable advanced or recurrent solid cancer. Two dose cohorts are planned: cohort 1, MU-MA402C 2×10⁸/person; cohort 2, MU-MA402C 2×10⁹/person. Prior to CAR-T-cell infusion, cyclophosphamide (CPA) and fludarabine (FLU) will be administered as preconditioning chemotherapy. Three evaluable subjects per cohort, for a total of 6 subjects (maximum of 12 subjects), will be recruited for this clinical trial. The primary endpoints are safety and tolerability. The severity of each adverse event will be evaluated in accordance with Common Terminology Criteria for Adverse Events V.5.0. The secondary endpoint is efficacy. Antitumour response will be evaluated according to Response Evaluation Criteria in Solid Tumours V.1.1.

ETHICS AND DISSEMINATION

This clinical trial will be conducted in accordance with the current version of Good Clinical Practice. The protocol was approved by the Clinical Research Ethics Review Committee of Mie University Hospital (approval number F-2021-017). The trial results will be published in peer-reviewed journals and/or disseminated through international conferences.

TRIAL REGISTRATION NUMBER

jRCT2043210077.

Identification of the polyether ionophore lenoremycin through a new screening strategy for targeting cancer stem cells

Targeting and eradicating cancer stem cells (CSCs), also termed tumor-initiating cells, are promising strategies for preventing cancer progression and recurrence. To identify candidate compounds targeting CSCs, we established a new screening strategy with colorectal CSC spheres and non-CSC spheres in three-dimensional (3D) culture system. Through chemical screening using our system with in-house microbial metabolite library, we identified polyether cation ionophores that selectively inhibited CSC sphere formation, whereas CSC spheres were resistant to conventional anticancer agents. One of the hit compounds, the most selective and effective microbial metabolite lenoremycin, decreased CSC populations via inducing reactive oxygen species production. This study demonstrated that our newly established screening system is useful for discovering agents that selectively eliminate CSCs.