Superlattice-Induced Insulating States and Valley-Protected Orbits in Twisted Bilayer Graphene

Twisted bilayer graphene (TBLG) is one of the simplest van der Waals heterostructures, yet it yields a complex electronic system with intricate interplay between moiré physics and interlayer hybridization effects. We report on electronic transport measurements of high mobility small angle TBLG devices showing clear evidence for insulating states at the superlattice band edges, with thermal activation gaps several times larger than theoretically predicted. Moreover, Shubnikov-de Haas oscillations and tight binding calculations reveal that the band structure consists of two intersecting Fermi contours whose crossing points are effectively unhybridized. We attribute this to exponentially suppressed interlayer hopping amplitudes for momentum transfers larger than the moiré wave vector.

Assay for Ubiquitin Ligase Activity: High-Throughput Screen for Inhibitors of HDM2

An assay for the autoubiquitination activity of the E3 ligaseHDM2 (Mdm2) was developed and adapted to a high-throughput format to identify inhibitors of this activity. The assay can also be used tomeasure the activity of other E3s andmay be useful in finding both inhibitors and activators of a wide range of different ubiquitin ligases.

Extracellular DNA traps released by acute promyelocytic leukemia cells through autophagy

Acute promyelocytic leukemia (APL) cells exhibit disrupted regulation of cell death and differentiation, and therefore the fate of these leukemic cells is unclear. Here, we provide the first evidence that a small percentage of APL cells undergo a novel cell death pathway by releasing extracellular DNA traps (ETs) in untreated patients. Both APL and NB4 cells stimulated with APL serum had nuclear budding of vesicles filled with chromatin that leaked to the extracellular space when nuclear and cell membranes ruptured. Using immunofluorescence, we found that NB4 cells undergoing ETosis extruded lattice-like structures with a DNA-histone backbone. During all-trans retinoic acid (ATRA)-induced cell differentiation, a subset of NB4 cells underwent ETosis at days 1 and 3 of treatment. The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were significantly elevated at 3 days, and combined treatment with TNF-α and IL-6 stimulated NB4 cells to release ETs. Furthermore, inhibition of autophagy by pharmacological inhibitors or by small interfering RNA against Atg7 attenuated LC3 autophagy formation and significantly decreased ET generation. Our results identify a previously unrecognized mechanism for death in promyelocytes and suggest that ATRA may accelerate ET release through increased cytokines and autophagosome formation. Targeting this cellular death pathway in addition to conventional chemotherapy may provide new therapeutic modalities for APL.

Lanthanum chloride enhances cisplatin-induced apoptosis in ovarian cancer cells

Ovarian cancer begins in an ovary. It is the leading cause of mortality from gynecologic cancer. Cisplatin is an anti-ovarian tumor drug. However, repeated use of cisplatin causes serious resistance. Recently, Lanthanum chloride (LaCl3) was found to inhibit the proliferation and promote the apoptosis in some cancer cells. In this study, we investigated the influence of LaCl3 on cisplatin-induced apoptosis in the ovarian cell line (COC1). Cell-based assays and analysis of cellular ultra structure were used. Result showed that LaCl3 enhanced cisplatin-induced apoptosis in COC1. Furthermore, the application of Cisplatin also altered the expression level of tumor related proteins, such as ERCC1, Ki67, and CDK6. Overall, we determined the inhibitory effect of LaCl3 on the COC1 growth when treated with Cisplatin, which may serve as a basis for the clinical application of LaCl3 in the treatment of ovarian cancer.

Measurement and comparison of individual external doses of high-school students living in Japan, France, Poland and Belarus-the 'D-shuttle' project

Twelve high schools in Japan (of which six are in Fukushima Prefecture), four in France, eight in Poland and two in Belarus cooperated in the measurement and comparison of individual external doses in 2014. In total 216 high-school students and teachers participated in the study. Each participant wore an electronic personal dosimeter 'D-shuttle' for two weeks, and kept a journal of his/her whereabouts and activities. The distributions of annual external doses estimated for each region overlap with each other, demonstrating that the personal external individual doses in locations where residence is currently allowed in Fukushima Prefecture and in Belarus are well within the range of estimated annual doses due to the terrestrial background radiation level of other regions/countries.

BCR/ABL oncogene-induced PI3K signaling pathway leads to chronic myeloid leukemia pathogenesis by impairing immuno-modulatory function of hemangioblasts

An increasing number of studies indicate that during development, endothelial and hematopoietic cells derive from common progenitors named hemangioblasts that have important roles in the pathogenesis. This is particularly true in chronic myeloid leukemia (CML). Here, we isolated fetal liver kinase-1-positive (Flk1(+)) cells from CML patients and found they expressed BCR/ABL-specific CML oncogene. We examined their biological characteristics as well as immunological functions and further detected the possible molecular mechanism involved in the leukemia genesis. We showed that CML patient-derived Flk1(+)CD31(-)CD34(-) mesenchymal stem cells (MSCs) had normal morphology, phenotype and karyotype but appeared impaired immuno-modulatory function. The capacity of Flk1(+)CD31(-)CD34(-) MSCs from CML patients to inhibit T lymphocyte activation and proliferation was impaired in vitro. CML patient-derived MSCs have dampening immuno-modulatory functions, suggesting that the dysregulation of hematopoiesis and immune response might originate from MSCs rather than hematopoietic stem cells (HSCs). These Ph(+) putative CML hemangioblast upregulated TGF-β1 and resultantly activated matrix metalloproteinase-9 (MMP-9) to enhance s-KitL and s-ICAM-1 secretion, which activated c-kit(+) HSCs from the quiescent state to the proliferative state. Further studies showed that phosphatidylinositol-3 kinase (PI3K)/Akt/nuclear factor (NF)-κB signaling pathway was involved in CML pathogenesis. Flk1(+)CD31(-)CD34(-) MSCs that express BCR/ABL leukemia oncogene are hemangioblasts and they have a critical role in the progression of CML through PI3K/Akt/NF-κB signaling pathway.

Endovascular treatment of anterior communicating artery aneurysms: a systematic review and meta-analysis

BACKGROUND AND PURPOSE

Endovascular therapy has become an acceptable alternative to traditional clipping for the management of intracranial aneurysms. However, a limited number of studies have examined outcomes and complications specific to embolization of anterior communicating artery aneurysms.

MATERIALS AND METHODS

A systematic review of the literature was conducted with the use of multiple data bases to identify reports on endovascular treatment of anterior communicating artery aneurysms between 1994 and 2012. Angiographic results, clinical outcomes, and complication rates were pooled across studies by using random-effects meta-analysis with subgroup analysis of outcomes by rupture status and time trend stratification.

RESULTS

Fourteen studies, consisting of 1552 treated anterior communicating artery aneurysms, were included in this meta-analysis. The rate of immediate and long-term complete and near-complete angiographic occlusion was 88% (95% CI = 81-93%) and 85% (95% CI = 78-90%), respectively. Intraprocedural rupture rate was 4% (95% CI = 3-6%). The re-bleeding rate was 2% (95% CI = 1-4%) and the retreatment rate was 7% (95% CI = 5-12%). Morbidity or mortality caused by perioperative stroke occurred at a 3% (95% CI = 2-6%) rate. Overall procedure-related morbidity and mortality were 6% (95% CI = 4-8%) and 3% (95% CI = 2-4%), respectively. Outcomes did not differ between ruptured and unruptured aneurysms, nor did outcomes change over time, though these latter subanalyses were relatively underpowered.

CONCLUSIONS

Endovascular therapy for anterior communicating artery aneurysms is associated with a high rate of complete angiographic occlusion. However, the procedure-related permanent morbidity and mortality are not negligible for aneurysms in this location.

Abstract P3-11-01: Prospective study of cognitive function in women with early stage breast cancer: Predictors of cognitive decline and relationship to cognitive complaints

Background: Cognitive complaints are common among women receiving adjuvant therapy (Rx) for early stage breast cancer (ESBC). Longitudinal prospective data is needed to understand cognitive complaints and decline. We conducted a prospective trial to evaluate the effects of chemotherapy (CTX) and hormone therapy (HRx) on brain and cognitive function in patients with ESBC using objective & subjective tests as well as MRI/PET imaging.

Methods: Eligibility included female patients planning to receive adjuvant Rx for ESBC. Patients were enrolled in 3 treatment groups: CTX, CTX and HRx, and HRx, with a 4th no disease age and education matched control group. Patients underwent a battery of objective and subjective cognitive tests before start of Rx, 1 month after CTX or 5 months after start of HRx (FU1), then 9 months (FU2) and 18 months (FU3) after Rx. Brain MRI, PET & serum estradiol (E) were performed at baseline, FU1 & FU3.

Results: 81 patients were enrolled as follows: 14 CTX, 33 CTX & HRx, 22 HRx, and 12 control. 90% completed FU1, 72% FU2, & 62% FU3, with 29 patients waiting to complete testing. Demographics were similar between groups: median age 54, 78% Caucasian. At each FU, approximately 25% of patients showed cognitive decline using a reliable change index; 51% showed decline at ≥ 1 time point, primarily in tests of executive function & verbal memory. 62 - 77% of patients who declined later stabilized or improved. Compared to controls, receipt of HRx (OR 4.94, p = .004) but not serum E, menopausal status, CTX, demographic factors, depression, or fatigue, were significant predictors of decline at any time point. Rx group did not predict cognitive complaints (FACT-Cog). At FUP1, depression, fatigue, and decline in letter fluency predicted overall cognitive complaints, but HRx did not. Cognitive complaints were predicted by domain-specific cognitive decline: memory decline predicted memory complaints, and verbal fluency decline predicted verbal fluency complaints, even after controlling for depression and fatigue. Additional analyses will be presented as more patients complete follow-up testing.

Conclusion: Decline in cognitive function is common in patients receiving adjuvant Rx for ESBC. Ongoing HRx was a risk factor for worse cognitive function, but not for perceived cognitive problems. Other Rx and patient related factors did not predict decline. Perceived cognitive problems were predicted by depression, fatigue, and letter fluency decline, with specific cognitive complaints predicted by domain-specific declines. Patients should be aware that HRx may be a risk factor for cognitive decline, while depression, fatigue, and cognitive decline predicted cognitive complaints. Intervention studies, including assessment for depression and fatigue, should be offered to patients who complain of cognitive changes and particularly to patients treated with HRx.

Funding: NIH R01 1AG025303-01A2.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-11-01.

[Leukotriene D4 activates BV2 microglia in vitro]

OBJECTIVE

To investigate the effects of CysLT receptor agonist leukotriene D4(LTD4) and antagonists on activation of microglia BV2 cells.

METHODS

The expression of CysLT1 and CysLT2 protein was determined by Western blotting and immunostaining in microglia BV2 cells. BV2 cells were pretreated with or without CysLT1 receptor selective antagonist montelukast, CysLT2 receptor selective antagonist HAMI 3379, or CysLT1/CysLT2 receptor dual antagonist BAY u9773 for 30 min, then the cells were treated with LTD4 for 24 h. Cell viability was detected by MTT reduction assay. Phagocytosis and mRNA expression of IL-6 were determined by fluorescent bead tracking and RT-PCR, respectively.

RESULTS

In BV2 cells, LTD4 did not affect proliferation but significantly enhanced phagocytosis and increased IL-6 mRNA expression in a concentration-dependent manner. LTD4 at 100 nmol/L induced a 1.4-fold increase of phagocytic index and a 2-fold up-regulation of IL-6 mRNA expression (P<0.01). HAMI 3379 and BAY u9773 (100 nmol/L) further increased LTD4-induced phagocytosis; BAY u9773 and montelukast decreased LTD4-induced IL-6 mRNA expression, while HAMI 3379 had no effect on that.

CONCLUSION

LTD4 activates BV2 cells in vitro and enhances IL-6 mRNA expression mediated by CysLT1 receptor, LTD4 induces phagocytosis which might be negatively regulated by CysLT2 receptor in BV2 cells.

[Expression and distribution of cysteinyl leukotriene receptors CysLT1R and CysLT2R, and GPR17 in brain of Parkinson disease model mice]

OBJECTIVE

To examine the spatiotemporal profiles and localization of CysLT1R, CysLT2R and GPR17 in mice with 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP)-induced Parkinson disease (PD).

METHODS

PD model was induced by subcutaneous injection of MPTP (25 mg/kg) for 5 d in adult male C57BL/6 mice. At d10 after MPTP injection, the expression and cellular localization of CysLT1R, CysLT2R and GPR17 in the substantia nigra were detected by immunohistochemistry and immunofluorescence.

RESULTS

CysLT1R, CysLT22 and GPR17 were normally localized in TH-positive dopaminergic neurons and microglia, while CysLT2R was also expressed in astrocytes. In dopaminergic neurons, approximately 91% co-expressed GPR17, 77% co-expressed CysLT1R and 52% co-expressed CysLT2R. Compared with the control group, TH-positive cells in the substantia nigra were significantly reduced in PD mice. CysLT1R, CysLT2R and GPR17-positive cells were significantly reduced; and CysLT1R, CysLT2R, GPR17-positive dopaminergic neurons were also significantly reduced in the PD group. In the striatum, both CysLT1R and GPR17 were normally expressed in neurons; whereas CysLT2R was expressed in astrocytes. In PD striatum, CysLT1R and GPR17-positive cells were decreased, but CysLT2R expression was significantly increased which mainly expressed in the proliferating astrocytes.

CONCLUSION

CysLT1R, CysLT2R and GPR17 may be involved in the MPTP-induced PD damage in mice.

Endometrial carcinoma tumorigenesis and pharmacotherapy research

Endometrial carcinoma is the common malignant tumor of the female genital tract, and its incidence is increasing. Two different clinicopathological subtypes are recognized based on epidemiology, genetic carcinogenesis and clinical behavior. Understanding and identifying molecular biology and genetics is essential to the development of novel therapies. This article reviews the current understanding of its risk factors, recent conceptions on its tumorigenesis and advances on its drug therapies.

Hrd1 facilitates tau degradation and promotes neuron survival

Intraneuronal accumulation of abnormal phosphorylated tau (p-tau) is a molecular pathology in many neurodegenerative tauopathies, including Alzheimer's disease (AD) and frontotemporal dementia with parkinsonism-linked to chromosome 17 (FTDP-17). However, the underlying mechanism remains unclear. Here, we showed an inverse relationship between endoplasmic reticulum membrane ubiquitin ligase (E3) Hrd1 expression and p-tau accumulation in the hippocampal neurons of AD, and proposed that Hrd1 may be a negative regulator of p-tau. This notion was further supported by in vitro study demonstrating that Hrd1 interacted with tau and promoted the degradation of total tau and p-tau as well. The degradation of tau depended on its Hrd1 E3 activity. Knockdown of endogenous Hrd1 with siRNA stabilized tau levels. In addition, inhibition of proteasome maintained tau level and increased Hrd1-mediated tau ubiquitination, suggesting the proteasome was involved in tau/p-tau degradation. Over-expression of Hrd1 significantly alleviated tau cytotoxicity and promoted cell survival. These results indicated that Hrd1 functions as an E3 targeting tau or abnormal p-tau for proteasome degradation. The study provides an important insight into the molecular mechanisms of human tauopathies.

Risk factors and incidence of thromboembolic events (TEEs) in older men and women with breast cancer

BACKGROUND

The purpose of this study is to evaluate the risk factors and the prevalence of thromboembolic events (TEEs) in breast cancer patients.

PATIENTS AND METHODS

This is a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare database. Breast cancer patients diagnosed from 1992 to 2005 ≥66 years old were identified. International Classification of Diseases, Ninth Revision, and Healthcare Common Procedure Coding System codes were used to identify TEEs within 1 year of the breast cancer diagnosis. Analyses were conducted using descriptive statistics and logistic regression.

RESULTS

A total of 89 841 patients were included, of them 2658 (2.96%) developed a TEE. In the multivariable analysis, males had higher risk of a TEE than women [odd ratio (OR) = 1.57; confidence interval (CI) 1.10-2.25] and blacks had higher risk than whites (OR = 1.20; CI 1.04-1.40). Compared with stage I patients, patients with stage II, III and IV had 22%, 39% and 98% increase, respectively, in risk. Placement of central catheters (OR = 2.71; CI 2.43-3.02), chemotherapy treatment (OR = 1.66; CI 1.48-1.86) or treatment with erythropoiesis-stimulating agents (ESAs) (OR = 1.33; CI 1.33-1.52) increase the risk. Other significant predictors included comorbidities, age, receptor status, marital status and year of diagnosis. Similar estimates were seen for pulmonary embolism, deep vein thromboembolism and other TEEs.

CONCLUSIONS

In total, 2.96% of patients in this cohort developed a TEE within 1 year from breast cancer diagnosis. Stage, gender, race, use of chemotherapy and ESAs, comorbidities, receptor status and catheter placement were associated with the development of TEEs.

Association of the C47T polymorphism in SOD2 with diabetes mellitus and diabetic microvascular complications: a meta-analysis

AIMS/HYPOTHESIS

A meta-analysis was performed to assess the association of C47T (rs4880) (also called Val16Ala) polymorphism in SOD2 gene with reduced risk of diabetes mellitus, including type 1 and type 2 diabetes, and diabetic microvascular complications (DMI) including diabetic nephropathy, diabetic retinopathy and diabetic polyneuropathy.

METHODS

A comprehensive search was conducted to identify all case-control or cohort design studies of the above-mentioned associations. The fixed or random effect pooled measure was selected on the basis of homogeneity test among studies. Heterogeneity among studies was evaluated using the I (2). Meta-regression and the 'leave one out' sensitive analysis of Patsopoulos et al. were used to explore potential sources of between-study heterogeneity. Publication bias was estimated using modified Egger's linear regression test as proposed by Harbord et al.

RESULTS

Seventeen articles were included. After excluding articles that deviated from Hardy-Weinberg equilibrium in cases and/or in controls, and were also the key contributors to between-study heterogeneity, the meta-analysis showed a significant association of the C allele with reduced risk of DMI in dominant (OR 0.788, 95% CI 0.680-0.914), recessive (OR 0.808, 95% CI 0.685-0.953) and codominant (OR 0.828, 95% CI 0.751-0.913) models. It also showed a significant association with reduced risk of diabetic nephropathy in the dominant model (OR 0.801, 95% CI 0.664-0.967), and reduced risk of diabetic retinopathy in the dominant (OR 0.601, 95% CI 0.423-0.855), recessive (OR 0.548, 95% CI 0.369-0.814) and codominant (OR 0.651, 95% CI 0.517-0.820) models.

CONCLUSIONS/INTERPRETATION

The meta-analysis suggested that C allele of C47T polymorphism in SOD2 gene has protective effects on risk of DMI, diabetic nephropathy and diabetic retinopathy. This risk needs to be confirmed by further studies.

Modeling pathogenesis of Huntington's disease with inducible neuroprogenitor cells

Huntington's disease (HD) is caused by an abnormal expansion of CAG trinucleotide repeats encoding polyglutamine (polyQ) in the first exon of the huntingtin (htt) gene. Despite considerable efforts, the pathogenesis of HD remains largely unclear due to a paucity of models that can reliably reproduce the pathological characteristics of HD. Here, we report a neuronal cell model of HD using the previously established tetracycline regulated rat neuroprogenitor cell line, HC2S2. Stable expression of enhanced green fluorescence protein tagged htt exon 1 (referred to as 28Q and 74Q, respectively) in the HC2S2 cells did not affect rapid neuronal differentiation. However, compared to the cells expressing wild type htt, the cell line expressing mutant htt showed an increase in time-dependent cell death and neuritic degeneration, and displayed increased vulnerability to oxidative stress. Increased protein aggregation during the process of neuronal aging or when the cells were exposed to oxidative stress reagents was detected in the cell line expressing 74Q but not in its counterpart. These results suggest that the neuroprogenitor cell lines mimic the major neuropathological characteristics of HD and may provide a useful tool for studying the neuropathogenesis of HD and for high throughput screening of therapeutic compounds.

Involvement of cysteinyl leukotriene receptors in angiogenesis in rat thoracic aortic rings

Cysteinyl leukotrienes (CysLTs) are potent inflammatory mediators that induce inflammation through the activation of CysLT1 and CysLT2 receptors. It has been reported that inflammatory mediators, such as prostaglandins, play an important role in angiogenesis. However, whether CysLTs and the receptor subtypes are involved in angiogenesis is not clarified. Here, we determined the effects of CysLT receptor agonist leukotriene D4 (LTD4) and antagonists on angiogenesis by rat thoracic aortic ring assay. We found that the microvessel growth in 25% serum-containing cultures was significantly inhibited by the CysLT1 receptor antagonist montelukast (0.1-1 microM), but not by the CysLT2 receptor antagonist BAY cyslt2 (0.1-1 microM). The microvessel growth in serum-free culture was affected neither by montelukast (0.01-1 microM) nor by BAY cyslt2 (0.1-1 microM). Furthermore, LTD4 at 100 nM significantly enhanced the microvessel growth in serum-free culture and LTD4 at 10-100 nM significantly enhanced the microvessel growth in 25% serum-containing cultures. The enhancement was abrogated by both montelukast and BAY cyslt2. Thus, CysLT1 receptors may mediate endogenously regulated microvessel growth in normal culture; whereas the exogenous agonist LTD4 induces angiogenesis through the activation of both CysLT1 and CysLT2 receptors. The CysLT receptor antagonists can be developed as angiogenesis inhibitors.

Complications associated with erythropoietin stimulating agents (ESAs) in patients with metastatic breast cancer: A surveillance, epidemiology, and end results (SEER)–Medicare study

1034

Background: Results of recent clinical trials suggest that the use of ESAs is associated with adverse outcomes. ESAs increase the risk for thrombotic events and have the potential of decreasing survival. Guidelines recommend the use of ESAs in patients with chemotherapy-induced anemia being treated with non curative intent. In this population-based study, we sought to evaluate the thromboembolic effects associated with the use of ESAs in patients receiving chemotherapy for metastatic breast cancer. Methods: Retrospective cohort study using the SEER-Medicare linked database. Patients with stage IV breast cancer diagnosed from 1995–2002, who were 66 and older, were treated with chemotherapy, and had full coverage of Medicare A and B were identified. Patients with end stage renal disease were excluded. ICD-9 and HCPCS codes were used to identify the use of ESAs, chemotherapy, comorbidities, and complications of therapy. Analyses were conduced using descriptive statistics, logistic regression, and Cox proportional hazard models. Results: 1411 women were included, 519 (36.8%) received ESAs and 892 (63.2%) did not; median age was 73 and 74 years old respectively. Median time from diagnosis to first ESA dose was 6 months, median number of ESAs doses was 8.5. In univariate analysis, patients receiving ESAs had higher rates of MI/CAD (38% vs 32.9% p = 0.051), thrombosis (32.4% vs 23.2% p = 0.0002), phlebitis (21.4% vs 12.6% p < 0.0001), and transfusion (37.76% vs 19.4% p < 0.0001), with no difference in the rate of stroke or pulmonary embolism. Multivariate analysis showed HR for MI/CAD 1.29 (1.01–1.66); thrombosis 1.5 (1.116–1.93), phlebitis 1.79 (1.32–2.43), and transfusion 2.65 (2.05–3.43). Significant dose effect was evident for the thrombosis and phlebitis outcomes for patients receiving more than 5 ESAs doses. Conclusions: The use of ESAs in patients with metastatic breast cancer increases the risk of thrombosis and phlebitis, with evidence of a dose-dependent effect. Patients receiving ESAs were more likely to have blood transfusions. These data support current practice of using ESAs for minimum necessary time to reduce risk of complications.

No significant financial relationships to disclose.

Off-label drug use in women with breast cancer

1016

Background: Despite reports of widespread use of off-label agents in cancer treatment, little is known about the off-label use of agents in the treatment of breast cancer patients. Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER) - Medicare linked database to identify 2082 persons older than 65 years who were diagnosed with distant stage breast cancer between 1991 and 2002 and who were treated with chemotherapy between diagnosis and death. Off versus on-label classification was based upon FDA-approved indication in the treatment of breast cancer. We calculated the percentage of patients receiving off-label chemotherapy and used multivariate logistic regression models to estimate predictors of off-label chemotherapy use. We also evaluated the appropriateness of off-label chemotherapy drugs using DRUGDEX classifications. Results: Overall, 34.9% of patients were treated with off-label chemotherapy drugs. Of the thirty-six agents that were used to treat these patients, only 8 (22%) were FDA-approved for use in the treatment of breast cancer. Off-label use was least common in patients age 80 years and older (OR 1.93, 95% 1.35–2.76 for 80+ vs. 66–70 years) and varied by diagnosis year and geographic region. The most commonly used off-label agents were vinorelbine and gemcitabine, with 16.0% and 8.4% of patients receiving these agents, respectively. While 71% of the drugs used off-label lacked supporting evidence for their use in the treatment of breast cancer, these drugs were used in a small number of patients. Only 6.7% of patients were treated with drugs considered inappropriate for use in the treatment of breast cancer. Conclusions: Off-label chemotherapy use is widespread among patients with metastatic breast cancer. However, the majority of patients who received off-label chemotherapy received drugs with scientific data supporting such use.

No significant financial relationships to disclose.

Automated diagnosis of fetal alcohol syndrome using 3D facial image analysis

OBJECTIVES

Use three-dimensional (3D) facial laser scanned images from children with fetal alcohol syndrome (FAS) and controls to develop an automated diagnosis technique that can reliably and accurately identify individuals prenatally exposed to alcohol.

METHODS

A detailed dysmorphology evaluation, history of prenatal alcohol exposure, and 3D facial laser scans were obtained from 149 individuals (86 FAS; 63 Control) recruited from two study sites (Cape Town, South Africa and Helsinki, Finland). Computer graphics, machine learning, and pattern recognition techniques were used to automatically identify a set of facial features that best discriminated individuals with FAS from controls in each sample.

RESULTS

An automated feature detection and analysis technique was developed and applied to the two study populations. A unique set of facial regions and features were identified for each population that accurately discriminated FAS and control faces without any human intervention.

CONCLUSION

Our results demonstrate that computer algorithms can be used to automatically detect facial features that can discriminate FAS and control faces.

Inclusive K(S);(0)K(S);(0) resonance production in ep collisions at HERA

Inclusive K_{S};{0}K_{S};{0} production in ep collisions at the DESY ep collider HERA was studied with the ZEUS detector using an integrated luminosity of 0.5 fb;{-1}. Enhancements in the mass spectrum were observed and are attributed to the production of f_{2}(1270)/a_{2};{0}(1320), f_{2};{'}(1525) and f_{0}(1710). Masses and widths were obtained using a fit which takes into account theoretical predictions based on SU(3) symmetry arguments, and are consistent with the Particle Data Group values. The f_{0}(1710) state, which has a mass consistent with a glueball candidate, was observed with a statistical significance of 5 standard deviations. However, if this state is the same as that seen in gammagamma-->K_{S};{0}K_{S};{0}, it is unlikely to be a pure glueball state.

Cerebral White Matter Lesions and Cognitive Function in a Non-demented Chinese Veteran Cohort

This study examined the association between cerebral white matter lesions (WMLs) and cognitive function in a male, non-demented Chinese veteran cohort. A total of 662 participants underwent CT scan and cognitive function assessments; 51 were excluded from the analysis because they exhibited non-lacunar infarcts or suspected dementia. Subjects were allocated to one of four groups according to WML status and between-group comparisons were made for seven cognitive function tests. Logistic regression was used to assess odds ratios for impaired performance associated with WML status. In all cognitive tests, subjects with severe WMLs differed significantly from those without WMLs or with mild WMLs, and in three tests subjects with severe WMLs differed significantly from those with moderate WMLs. For each cognitive test severe WMLs were strongly associated with increased risk of impaired performance. Severe WMLs were associated with greater diminished cognitive function and there may be a WML threshold after which, in elderly Chinese subjects, an impact on cognitive function occurs.

Biomass production and carbon sequestration potential in poplar plantations with different management patterns

Biomass production and carbon storage in short-rotation poplar plantations over 10 years were evaluated at the Hanyuan Forestry Farm, Baoying County, China. Experimental treatments applied in a split-plot design included four planting densities (1111, 833, 625 and 500 stems ha(-1)) and three poplar clones (NL-80351, I-69 and I-72). Based on the model of total biomass production developed, total plantation biomass production was significantly different in the plantations. The ranking of the plantation biomass production by planting density was 1111>833 more more than 625>500 stems ha(-1), and by components was stem>root>or=branch>leaf for all plantations. At 10 years, the highest total biomass in the plantation of 1111 stems ha(-1) reached about 146 t ha(-1), which was 5.3%, 11.6% and 24.2% higher than the plantations of 833, 625 and 500 stems ha(-1), respectively. The annual increment of biomass production over 10 years differed significantly among initial planting densities and stand ages (p<0.01), but no significant difference was observed from age 7 to 10. Mean carbon concentration among all biomass components ranged from 42-50%, with the highest carbon concentrations in stems and the lowest in leaves. Over the study period, the dynamic pattern of total plantation carbon storage by planting density was similar to that of total biomass production. At age 10, the highest total plantation carbon storage in the plantation of 1111 stems ha(-1) reached about 72.0 t ha(-1), which was 5.4%, 11.9% and 24.8% higher than in the plantations of 833, 625 and 500 stems ha(-1), respectively. The annual carbon storage increment over 10 years differed significantly among initial planting densities and stand ages (p<0.01), and it showed a pattern similar to the annual biomass production increment of the plantations. The results suggest that biomass production and carbon storage potential were highest for planting densities of 1111 and 833 stems ha(-1) grown over 5- and 6-year cutting cycles, respectively. If 3- or 4-year cutting cycles are used, the planting density should be higher than 1111 stems ha(-1) (e.g., 1667 or 2500 stems ha(-1)). Based on the mean annual carbon storage for the plantation of 625 stems ha(-1), as an estimation, the mean carbon storage in the biomass of poplar plantations (excluding leaves) amounts to 3.75x10(7) t ha(-1)yr(-1) in China.

Ethnic differences in socioeconomic status, diagnosis, treatment, and survival among older women with epithelial ovarian cancer

The purpose of the study was to determine the ethnic disparities in socioeconomic status (SES) and in receiving definitive surgical treatment and adjuvant chemotherapy and to examine if these differences contribute to ethnic disparities in survival. We studied a population-based cohort of 5131 women diagnosed with epithelial ovarian cancer at age >or=65 between 1992 and 1999, identified from the Surveillance, Epidemiology and End Results-Medicare linked databases with up to 11 years of follow-up. The percentage of women diagnosed with epithelial ovarian cancer at advanced stage (stage III or IV) was 71.6% in Caucasians and 69.7% in African-Americans. Of these 4264 with stage IC-IV disease who are recommended for chemotherapy, fewer African-Americans received chemotherapy compared to Caucasians (50.2% versus 64.7%, P < 0.001). The risk of all-cause mortality in African-Americans was not significantly different from Caucasians (hazard ratio [HR] = 1.00, 95% CI = 0.88-1.13) after controlling for patient demographics, tumor characteristics, and comorbidity. The HR remained not significant in African-Americans compared to Caucasians after additionally adjusting for treatments (0.93, 0.82-1.06) or SES (0.94, 0.82-1.08) or both (0.88, 0.77-1.01). Women who underwent cancer-directed surgery and received adjuvant chemotherapy were 50% less likely to die than those who did not. The survival benefits from these therapies were similar in Caucasian and African-American women with ovarian cancer. There was no significant difference in survival between African-American and Caucasian women with ovarian cancer after adjusting for tumor characteristics, treatment, and sociodemographic factors. Although adjuvant chemotherapy was effective in prolonging survival, substantial numbers of women with ovarian cancer still did not receive chemotherapy.

Combination of linear and nonlinear methods on electroencephalogram state recognition

Electroencephalogram EEG) reveals brain state, i.e. awake, sleep, rather than the content of thinking. We calculated fast/slow power spectrum ratio and approximate entropy on the EEG of three brain states, normal awake, sleep and coma. Based on the above EEG quantities, the EEG in different brain states can be clearly separated in the following way: (1) fast and complex for normal awake, (2) slow and complex for sleep and (3) slow and simple for coma.

Linear and nonlinear EEG indexes in relation to the severity of coma

Glascow's coma scale (GCS) is a clinical standard for assessing the severity of coma in intensive care units (ICUs). The EEG monitoring can be on-line work, soon responds to the change in the brain wave, and allows long-term continuous monitoring of brain activity. In this paper, several EEG parameters, including spectral possession distribution and nonlinear description (approximate entropy and Lempel-Ziv complexity) were used to assess the capability of EEG indexes for the severity of coma. Our results demonstrated that all EEG parameters are moderately related to the GCS, with the Spearman statistical correlation of 0.62-0.71 between the spectral possession distribution and the GCS and 0.62-0.66 between nonlinear measures and the GCS. The moderate correlation between EEG parameters and the GCS implies the possibility of the EEG-derived index to reveal the neurological status of patients in coma.

Management of preterm infants with intrauterine growth restriction

Preterm intrauterine growth restriction (IUGR) is strongly associated with increased mortality and morbidity. In the management of these infants, complications of preterm birth can be amplified by the effect of suboptimal fetal growth. It is important that pregnancies with IUGR are detected before birth, so that delivery can be arranged in a high-risk maternity unit with the appropriate neonatal staff in attendance. The provision of full support for resuscitation and stabilisation of these infants is crucial to the short-term and long-term health of these infants, who have suffered chronic hypoxia and malnutrition in utero. The long term outcome studies of these infants are retrospective and they include SGA infants. The effects of prematurity affect the outcome of IUGR infants. IUGR is associated with cerebral palsy in those delivered more than 32 weeks gestation. Infants less than 32 weeks of gestation may have poor developmental outcome if the head growth is affected, these infants may have associated cognitive and behavioural problems. Children who fail to grow by 2-4 years are at risk of long term growth problems. This paper outlines the acute and long-term management of these infants.

Forecasting seasonal population growth of Aphis glycines (Hemiptera: Aphididae) in soybean in Illinois

From 2001 to 2004, 252 fifty-plant samples were collected from commercial soybean, Glycine max L., fields in three townships (93-km2 area) in Illinois. Townships were sampled every 3 wk from late June or early July when aphids (Aphis glycines Matsumura) first invaded the townships to early August. We used linear regression of 18 mean township field densities to calibrate several simple models to predict the change in aphid population density in a township from one sampling date to the next. The best exponential model for the complete data set has an r2 = 0.54, Y2 = Ylexp (0.09659 x DAY), where Y1 and Y2 are the first and second samples of aphids separated by a 3-wk period (the number of days, DAY). Our intrinsic rate of increase for the population is much lower than rates calculated in other studies. The best single-variable linear model has an r2 = 0.88, Y2 = Y1 + 0.1084 x Y1 x DAY. The latter model indicates the value of including monitoring data in the prediction. The best two-variable model has an R2 = 0.98, Y2 = Y1 + 0.08136 x Y1 x DAY + 0.000080 x N1(2) x DAY, where N1(2) x DAY is the interaction term for initial, squared, sample density of the season multiplied by the number of days between samples. The latter two models indicate that the change in the population density is greater for more dense populations. Degree-days were generally inferior to days as the time component in the simple models.

A field guide to ubiquitylation

The capacity for exquisite regulation of ubiquitylation provides eukaryotic cells with a means to fine-tune both protein function and levels. This complex set of processes affects myriad proteins and potentially impacts all cellular processes. Ubiquitylation is brought about through multienzyme processes, with specificity conferred primarily by interactions of substrates with specific ubiquitin protein ligases (E3s) in association with ubiquitin conjugating enzymes (E2s). Regulation of ubiquitylation occurs at multiple levels, including E2-E3 interactions, substrate recognition, chain elongation, binding of ubiquitin to conserved motifs and deubiquityation. This review presents the fundamentals of the ubiquitin conjugating system.

Concentric sclerosis: imaging diagnosis and clinical analysis of 3 cases

Baló's Concentric sclerosis (BCS) is a rare demyelinating disease considered to be a variant of multiple sclerosis (MS). The typical magnetic resonance imaging (MRI) changes associated with BCS consist of concentric rings or onions' cross-section on T1-weighted (T1W) images. Because MRI reveals pathological changes consistent with autopsy in the focus of BCS, it plays an important role in the before-death diagnosis of BCS. We report three cases of BCS diagnosed antemortem on the basis of the typical concentric rings pattern on MRI and on the basis of clinical findings and cerebrospinal fluid (CSF) examination. BCS often occurs in the prime of life, acutely or subacutely. Then come cerebral multifocal symptoms and signs. We find that BCS is not always an acute and irreversible pathological process as described in the past.