Utilization and reach of the Fight Colorectal Cancer Late Stage MSS CRC Clinical Trial Finder

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Background: Colorectal cancer (CRC) remains one of the most lethal cancer killers worldwide. Recently, research has shown great strides in the treatment of MSI-H mCRC using immunotherapy, however, these treatments have not been effective in MSS patients, who make up a majority of CRC cases. Due to numerous barriers, clinical trial enrollment numbers remain as low as 9% of the eligible populations, despite the reliance of many late stage CRC patients on clinical trials for treatment. Perhaps greatest of these barriers is the lack of meaningful patient-facing clinical trial matching, making advances in MSS mCRC IO clinical research extremely slow. Methods: In May 2017, Fight Colorectal Cancer (FightCRC) launched its web-based trial finder, The Late Stage MSS Trial Finder (TF) with the late Dr. Tom Marsilije, a stage IV CRC patient and researcher, and Flatiron Health. The TF is a publicly available immunotherapy-based repository of clinical trials. An algorithm automatically codes for a subset of trials from ClinicalTrials.gov to be uploaded into the tool, and trained FightCRC advocates follow a strategic logic flow to prioritize trials of highest potential benefit and lowest risk for patients. Results: Between 30 and 100 trials are uploaded into the TF for curation each week. A total of 378 trials have been indexed in the TF to date. In February 2019, a mobile application was introduced. From May 2017 to January 2019, the tool has seen > 15,000 users, yielding 26,000 searches in 105 countries; primarily from the United States, China, the United Kingdom, Canada, and France. On average, users navigate to 2.5 pages and spend > 2.5 minutes per use. Providers are using this as a tool to find clinical trials and to discuss these options in real time. CRC patient feedback confirmed the platform functionality. Conclusions: The Trial Finder is a unique tool for MSS mCRC patients pursuing clinical trials. The success of the tool may be attributed to patient focused selection of therapies that show promise. The FightCRC late stage MSS CRC trial finder is being widely utilized, in diverse settings. With our patient curators and Medical Advisory Board, FightCRC will improve the search features and outcome tracking with user feedback. The goal for the TF is to address key barriers to patient entry into clinical trials and promote patient-provider discussions to inform decision making.

Direct Patterning of p-Type-Doped Few-layer WSe2 Nanoelectronic Devices by Oxidation Scanning Probe Lithography

Direct, robust, and high-resolution patterning methods are needed to downscale the lateral size of two-dimensional materials to observe new properties and optimize the overall processing of these materials. In this work, we report a fabrication process where the initial microchannel of a few-layer WSe₂ field-effect transistor is treated by oxygen plasma to form a self-limited oxide layer on top of the flake. This thin oxide layer has a double role here. First, it induces the so-called p-doping effect in the device. Second, it enables the fabrication of oxide nanoribbons with controlled width and depth by oxidation scanning probe lithography (o-SPL). After the removal of the oxides by deionized H₂O etching, a nanoribbon-based field-effect transistor is produced. Oxidation SPL is a direct writing technique that minimizes the use of resists and lithographic steps. We have applied this process to fabricate a 5 nm thick WSe₂ field-effect transistor, where the channel consists in an array of 5 parallel 350 nm half-pitch nanoribbons. The electrical measurements show that the device presents an improved conduction level compared to the starting thin-layer transistor and a positive threshold voltage shift associated to the p-doping treatment. The method enables to pattern devices with sub-50 nm feature sizes. We have patterned an array of 10 oxide nanowires with 36 nm half-pitch by oxidation SPL.

Overactive bladder symptom bother and health-related quality of life in patients with systemic lupus erythematosus and primary Sjögren syndrome

OBJECTIVE

The objective of this paper is to assess overactive bladder (OAB) symptom bother (SB) and health-related quality of life (HRQL) among patients with systemic lupus erythematosus (SLE) and primary Sjögren syndrome (pSS).

METHODS

We recruited adult SLE and pSS patients and two groups of age- and sex-matched controls. We applied the OAB questionnaire-short form (OABq-SF) to all participants to assess SB and HRQL and collected clinical information relevant for OAB. We compared the OABq-SF scores for SB and HRQL between patients and controls using univariate and multivariate linear regression analysis.

RESULTS

We recruited 95 rheumatic patients (68 SLE, 27 pSS) and 231 controls. Compared to controls SLE patients showed higher OABq-SF SB scores (22.6 ± 20.4 vs 14.7 ± 17.0, p = 0.004) and lower HRQL scores (89.8 ± 15.8 vs 93.8 ± 11.4, p = 0.044). On multivariate analysis SLE was significantly associated with a higher SB score (ß-coefficient 7.13, p = 0.008) and tended to be associated with worse HRQL values (ß-coefficient -3.53, p = 0.055). Patients with pSS had numerically higher mean SB scores (22.8 ± 22.5 vs 16.2 ± 18.0, respectively, p = 0.107) and lower HRQL scores (91.0 ± 10.7 vs 93.2 ± 11.6, respectively, p = 0.369), although these differences were not statistically significant. Diagnosis of pSS was not significantly associated with SB or HRQL scores on univariate or multivariate analysis.

CONCLUSIONS

Patients with SLE have significantly worse OAB-SB and poorer HRQL compared to controls. A similar trend was seen for pSS patients, especially for SB. These findings suggest that clinically subtle OAB symptoms may be present in rheumatic patients for whom, later on, bladder pain syndrome may occur.

Mapping stress in polycrystals with sub-10 nm spatial resolution

From aircraft to electronic devices, and even in Formula One cars, stress is the main cause of degraded material performance and mechanical failure in applications incorporating thin films and coatings. Over the last two decades, the scientific community has searched for the mechanisms responsible for stress generation in films, with no consensus in sight. The main difficulty is that most current models of stress generation, while atomistic in nature, are based on macroscopic measurements. Here, we demonstrate a novel method for mapping the stress at the surface of polycrystals with sub-10 nm spatial resolution. This method consists of transforming elastic modulus maps measured by atomic force microscopy techniques into stress maps via the local stress-stiffening effect. The validity of this approach is supported by finite element modeling simulations. Our study reveals a strongly heterogeneous distribution of intrinsic stress in polycrystalline Au films, with gradients as high as 100 MPa nm^-1 near the grain boundaries. Consequently, our study discloses the limited capacity of macroscopic stress assessments and standard tests to discriminate among models, and the great potential of nanometer-scale stress mapping.

Re-emergence of rabies virus maintained by canid populations in Paraguay

Paraguay has registered no human cases of rabies since 2004, and the last case in dogs, reported in 2009, was due to a variant maintained in the common vampire bat "Desmodus rotundus". In 2014, a dog was diagnosed as positive for rabies with aggression towards a boy and all required measures of control were successfully adopted. Epidemiological investigation revealed that the dog was not vaccinated and had been attacked by a crab-eating fox, "zorro" (Cerdocyon thous). The sample was diagnosed by the Official Veterinary Service of the Country and sent to the Center on Rabies Research from the University of São Paulo, Brazil, for antigenic and genetic characterization. A second sample from a dog positive for rabies in the same region in 2015 and 11 samples from a rabies outbreak from Asuncion in 1996 were also characterized. The antigenic profile of the samples, AgV2, was compatible with one of the variants maintained by dogs in Latin America. In genetic characterization, the samples segregated in the canine (domestic and wild species)-related group in an independent subgroup that also included samples from Argentina. These results and the epidemiology of the case indicate that even with the control of rabies in domestic animals, the virus can still circulate in wildlife and may be transmitted to domestic animals and humans, demonstrating the importance of continuous and improved surveillance and control of rabies, including in wild species, to prevent outbreaks in controlled areas.