Home Use of an Artificial Beta Cell in Type 1 Diabetes

BACKGROUND

The feasibility, safety, and efficacy of prolonged use of an artificial beta cell (closed-loop insulin-delivery system) in the home setting have not been established.

METHODS

In two multicenter, crossover, randomized, controlled studies conducted under free-living home conditions, we compared closed-loop insulin delivery with sensor-augmented pump therapy in 58 patients with type 1 diabetes. The closed-loop system was used day and night by 33 adults and overnight by 25 children and adolescents. Participants used the closed-loop system for a 12-week period and sensor-augmented pump therapy (control) for a similar period. The primary end point was the proportion of time that the glucose level was between 70 mg and 180 mg per deciliter for adults and between 70 mg and 145 mg per deciliter for children and adolescents.

RESULTS

Among adults, the proportion of time that the glucose level was in the target range was 11.0 percentage points (95% confidence interval [CI], 8.1 to 13.8) greater with the use of the closed-loop system day and night than with control therapy (P<0.001). The mean glucose level was lower during the closed-loop phase than during the control phase (difference, -11 mg per deciliter; 95% CI, -17 to -6; P<0.001), as were the area under the curve for the period when the glucose level was less than 63 mg per deciliter (39% lower; 95% CI, 24 to 51; P<0.001) and the mean glycated hemoglobin level (difference, -0.3%; 95% CI, -0.5 to -0.1; P=0.002). Among children and adolescents, the proportion of time with the nighttime glucose level in the target range was higher during the closed-loop phase than during the control phase (by 24.7 percentage points; 95% CI, 20.6 to 28.7; P<0.001), and the mean nighttime glucose level was lower (difference, -29 mg per deciliter; 95% CI, -39 to -20; P<0.001). The area under the curve for the period in which the day-and-night glucose levels were less than 63 mg per deciliter was lower by 42% (95% CI, 4 to 65; P=0.03). Three severe hypoglycemic episodes occurred during the closed-loop phase when the closed-loop system was not in use.

CONCLUSIONS

Among patients with type 1 diabetes, 12-week use of a closed-loop system, as compared with sensor-augmented pump therapy, improved glucose control, reduced hypoglycemia, and, in adults, resulted in a lower glycated hemoglobin level. (Funded by the JDRF and others; AP@home04 and APCam08 ClinicalTrials.gov numbers, NCT01961622 and NCT01778348.).

Transcriptional repression of IFNβ1 by ATF2 confers melanoma resistance to therapy

The resistance of melanoma to current treatment modalities represents a major obstacle for durable therapeutic response, and thus, the elucidation of mechanisms of resistance is urgently needed. The crucial functions of Activating Transcription Factor-2 (ATF2) in the development and therapeutic resistance of melanoma have been previously reported, although the precise underlying mechanisms remain unclear. Here, we report a protein kinase C epsilon (PKCε)- and Activating Transcription Factor-2 (ATF2)-mediated mechanism that facilitates resistance by transcriptionally repressing the expression of IFNβ1 and downstream type-I IFN signaling, which is otherwise induced upon exposure to chemotherapy. Treatment of early stage melanomas expressing low levels of PKCε with chemotherapies relieves its transcriptional repression of IFNB1, resulting in impaired S-phase progression, a senescence-like phenotype, and increased cell death. This response is lost in late stage metastatic melanomas expressing high levels of PKCε. Notably, nuclear ATF2 and low expression of IFNβ1 in melanoma tumor samples correlates with poor patient responsiveness to biochemotherapy or neoadjuvant IFN-α2a. Conversely, cytosolic ATF2 and induction of IFNβ1 coincides with therapeutic responsiveness. Collectively, we identify an IFNβ1-dependent, cell autonomous mechanism that contributes to the therapeutic resistance of melanoma via the PKCε-ATF2 regulatory axis.

Stress response of Chlorella pyrenoidosa to nitro-aromatic compounds

Handling of two nitro-aromatic compounds, 4-nitroaniline (4NA) and 4-nitrophenol (4NP), simultaneously by Chlorella pyrenoidosa was investigated. Algae would secrete or degrade nitro-aromatic compounds depending on different environmental conditions, in which the mode of handling was determined by the relative formation and degradation rate of the compound. Repeated intermittent trigger with externally added 4NA would induce the continuous secretion of 4NA by algae. Simultaneous exposure of both 4NA and 4NP to algae at normal condition would induce the algae to secrete both compounds. An increase in 4NA exposure concentration would elevate both 4NA and 4NP secretion, and that would be inhibited by the stress conditions of starving or lack of oxygen. Increased 4NA degradation per production rate induced by starving or lack of oxygen might explain the subsequent decrease in 4NA secretion in the presence of 4NP in algae. For 4NP in the presence of 4NA, secretion at normal condition was completely stopped and turned to degradation mode in stress conditions. The decreased formation and increased degradation of 4NP during starving for replenishing energy would explain the net degradation of 4NP in starving condition. The condition of lack of oxygen would inhibit the 4NP formation from 4NA via oxidative deamination, while the degradation of 4NP might not be significantly affected because alternative pathway of degradation via nitro-reduction was available. It may lead to the degradation rate exceeding the formation and explain the net degradation of 4NP in the condition of lack of oxygen.

Virulence and Molecular Analyses Support Asexual Reproduction of Puccinia striiformis f. sp. tritici in the U.S. Pacific Northwest

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici, occurs every year and causes significant yield losses in the U.S. Pacific Northwest (PNW). A large number of P. striiformis f. tritici races are identified every year and predominant races have changed rapidly. Barberry and mahonia plants, which have been identified under controlled conditions as alternate hosts for the fungus, are found in the region. However, whether sexual reproduction occurs in the P. striiformis f. sp. tritici population under natural conditions is not clear. To determine the reproduction mode of the P. striiformis f. sp. tritici population using virulence and molecular markers, a systematic collection of leaf samples with a single stripe of uredia was made in 26 fields in the PNW in 2010. In total, 270 isolates obtained from the PNW collection, together with 66 isolates from 20 other states collected in the same year, were characterized by virulence tests and simple sequence repeat (SSR) markers. In total, 21 races and 66 multilocus genotypes (MLGs) were detected, of which 15 races and 32 MLGs were found in the PNW. Cluster analysis with the SSR marker data revealed two genetic groups, which were significantly correlated to the two virulence groups. The analyses of genotype/individual ratio, multilocus linkage disequilibrium, and heterozygosity strongly supported asexual reproduction for the pathogen population in the PNW, as well as other regions of the United States.

Molecular mapping of genes Yr64 and Yr65 for stripe rust resistance in hexaploid derivatives of durum wheat accessions PI 331260 and PI 480016

This manuscript reports two new genes ( Yr64 and Yr65 ) for effective resistance to stripe rust and usefulness of their flanking SSR markers for marker-assisted selection. Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most important diseases of wheat worldwide and resistance is the best control strategy. Durum wheat accessions PI 331260 and PI 480016 were resistant to all tested Pst races. To transfer the resistance genes to common wheat and map them to wheat chromosomes, both accessions were crossed with the stripe rust-susceptible spring wheat 'Avocet S'. Resistant F3 plants with 42 chromosomes were selected cytologically and by rust phenotype. A single dominant gene for resistance was identified in segregating F4 lines from each cross. F6 populations for each cross were developed from single F5 plants and used for genetic mapping. Different genes from PI 331260 and PI 480016 were mapped to different loci in chromosome 1BS using simple sequence repeat markers. The gene from PI 331260 was flanked by Xgwm413 and Xgdm33 in bin 1BS9-0.84-1.06 at genetic distances of 3.5 and 2.0 cM; and the gene from PI 480016 was flanked by Xgwm18 and Xgwm11 in chromosome bin C-1BS10-0.50 at 1.2 and 2.1 cM, respectively. Chromosomal locations and race and allelism tests indicated that the two genes are different from previously reported stripe rust resistance genes, and therefore are named as Yr64 from PI 331260 and Yr65 from PI 480016. These genes and their flanking markers, and selected common wheat lines with the genes should be valuable for diversifying resistance genes used in breeding wheat cultivars with stripe rust resistance.

The novel BH-3 mimetic apogossypolone induces Beclin-1- and ROS-mediated autophagy in human hepatocellular carcinoma [corrected] cells

Apogossypolone (ApoG2), a novel derivative of gossypol, exhibits superior antitumor activity in Bcl-2 transgenic mice, and induces autophagy in several cancer cells. However, the detailed mechanisms are not well known. In the present study, we showed that ApoG2 induced autophagy through Beclin-1- and reactive oxygen species (ROS)-dependent manners in human hepatocellular carcinoma (HCC) cells. Incubating the HCC cell with ApoG2 abrogated the interaction of Beclin-1 and Bcl-2/xL, stimulated ROS generation, increased phosphorylation of ERK and JNK, and HMGB1 translocation from the nucleus to cytoplasm while suppressing mTOR. Moreover, inhibition of the ROS-mediated autophagy by antioxidant N-acetyl-cysteine (NAC) potentiates ApoG2-induced apoptosis and cell killing. Our results show that ApoG2 induced protective autophagy in HCC cells, partly due to ROS generation, suggesting that antioxidant may serve as a potential chemosensitizer to enhance cancer cell death through blocking ApoG2-stimulated autophagy. Our novel insights may facilitate the rational design of clinical trials for Bcl-2-targeted cancer therapy.

Molecular mapping of Yr53, a new gene for stripe rust resistance in durum wheat accession PI 480148 and its transfer to common wheat

Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most damaging diseases of wheat worldwide. It is essential to identify new genes for effective resistance against the disease. Durum wheat PI 480148, originally from Ethiopia, was resistant in all seedling tests with several predominant Pst races in the US under controlled greenhouse conditions and at multiple locations subject to natural infection for several years. To map the resistance gene(s) and to transfer it to common wheat, a cross was made between PI 480148 and susceptible common wheat genotype Avocet S (AvS). Resistant F(3) plants with 42 chromosomes were selected cytologically and by testing with Pst race PST-100. A total of 157 F(4) plants from a single F(3) plant with 2n = 42 tested with PST-100 segregated in a 3 resistant: 1 susceptible ratio, indicating that a single dominant gene from PI 480148 conferred resistance. Using the F(3:4) population and the resistance gene-analog polymorphism (RGAP) and simple sequence repeat (SSR) markers, the gene was mapped to the long arm of chromosome 2B. SSR marker Xwmc441 and RGAP marker XLRRrev/NLRRrev ( 350 ) flanked the resistance gene by 5.6 and 2.7 cM, respectively. The effective resistance of the gene to an Australian Pst isolate virulent to Yr5, which is also located on 2BL and confers resistance to all US Pst races, together with an allelism test of the two genes, indicated that the gene from PI 480148 is different from Yr5 and should be a new and useful gene for resistance to stripe rust. Resistant common wheat lines with plant types similar to AvS were selected for use in breeding programs.

All vertebral body metastases of breast cancer: a case report and literature review

OBJECTIVE

Investigating the clinical and imaging features of bone metastasis in breast cancer, in order to raise early diagnosis level and to avoid misdiagnosis.

MATERIALS AND METHODS

An analysis of imaging of breast cancer bone metastasis by consulting relevant literatures. The authors also performed bone biopsy in the patient presented.

RESULTS

Biopsy results show that ductal carcinoma can be seen in bone marrow and in immune markers CK (+) and CD68 (-).

CONCLUSION

Multiple systemic metastases are common for breast cancer, but it is rare that one patient has metastasis in all vertebrae. The positive rate of ordinary X-ray is lower than magnetic resonance imaging (MRI) or positron emission tomography/computed tomography (PET/CT) for detecting bone metastasis, but if an accurate diagnosis is to be made, all the imaging and clinical data should be combined.

Enhanced superconductivity by rare-earth metal doping in phenanthrene

We successfully synthesized La- and Sm-doped phenanthrene powder samples and observed superconductivity in them at T(c) around 6 K. The T(c)s are 6.1 K for La(1) phenanthrene and 6.0 K for Sm(1) phenanthrene, which are enhanced by about 1 and 0.5 K compared to those in A(3) phenanthrene (A = K and Rb) and in Ae(1.5) phenanthrene (Ae = Sr and Ba) superconductors, respectively. The superconductive shielding fractions for La(1) phenanthrene and Sm(1) phenanthrene are 46.1% and 49.8% at 2 K, respectively. The small effect of doping with the magnetic ion Sm(3+) on T(c) and the positive pressure dependence coefficient of T(c) strongly suggest unconventional superconductivity in the doped phenanthrene superconductors. The charge transfer to organic molecules from dopants of La and Sm induces a redshift of 7 cm(-1) per electron for the mode at 1441 cm(-1) in the Raman spectra, which is almost the same as those observed in A(3) phenanthrene (A = K and Rb) and Ae(1.5) phenanthrene (Ae = Sr and Ba) superconductors.

Clinical severity and quality of life in children and adolescents with Rett syndrome

OBJECTIVE

The clinical features and genetics of Rett syndrome (RTT) have been well studied, but examination of quality of life (QOL) is limited. This study describes the impact of clinical severity on QOL among female children and adolescents with classic RTT.

METHODS

Cross-sectional and longitudinal analyses were conducted on data collected from an NIH-sponsored RTT natural history study. More than 200 participants from 5 to 18 years of age with classic RTT finished their 2-year follow-up at the time of analysis. Regression models after adjustment for their MECP2 mutation type and age at enrollment were used to examine the association between clinical status and QOL.

RESULTS

Severe clinical impairment was highly associated with poor physical QOL, but worse motor function and earlier age at onset of RTT stereotypies were associated with better psychosocial QOL; conversely, better motor function was associated with poorer psychosocial QOL.

CONCLUSIONS

Standard psychosocial QOL assessment for children and adolescents with RTT differs significantly with regard to their motor function severity. As clinical trials in RTT emerge, the Child Health Questionnaire 50 may represent one of the important outcome measures.

Extinction of care-induced vocalizations by a desensitization routine on a palliative care unit

Vocalizations during care occur frequently in patients with dementia, and are not uncommon in the palliative setting. Underlying trigger factors may include pain during movement, fear of being turned, startle reflex, attempts at verbal communication, environmental factors such as cold water, and other possible etiologies. A case of a 92 year old female who screamed and called out during bathing is presented. This patient with comorbid dementia and brain lesions did not respond to pre-event pain medication, and became somnolent due to opioid administration for presumed incident pain. A non-pharmacological approach, with a patient-centered focus rather than task orientation, succeeded in extinguishing the vocalizations after a period of six weeks.

Measurements of the anisotropic in-plane resistivity of underdoped FeAs-based pnictide superconductors

We systematically investigated the in-plane resistivity anisotropy of electron-underdoped EuFe(2-x)Co(x)As(2) and BaFe(2-x)Co(x)As(2) and hole-underdoped Ba(1-x)K(x)Fe(2)As(2). Large in-plane resistivity anisotropy was found in the former samples, while tiny in-plane resistivity anisotropy was detected in the latter ones. When it is detected, the anisotropy starts above the structural transition temperature and increases smoothly through it. As the temperature is lowered further, the anisotropy takes a dramatic enhancement through the magnetic transition temperature. We found that the anisotropy is universally tied to the presence of T-linear behavior of resistivity. Our results demonstrate that the nematic state is caused by electronic degrees of freedom, and the microscopic orbital involvement in the magnetically ordered state must be fundamentally different between the hole- and electron-doped materials.

Measurement of a sign-changing two-gap superconducting phase in electron-doped Ba(Fe(1-x)Co(x))2As2 single crystals using scanning tunneling spectroscopy

Scanning tunneling spectroscopic studies of Ba(Fe(1-x)Co(x))(2)As(2) (x=0.06, 0.12) single crystals reveal direct evidence for predominantly two-gap superconductivity. These gaps decrease with increasing temperature and vanish above the superconducting transition T(c). The two-gap nature and the slightly doping- and energy-dependent quasiparticle scattering interferences near the wave vectors (±π, 0) and (0, ±π) are consistent with sign-changing s-wave superconductivity. The excess zero-bias conductance and the large gap-to-T(c) ratios suggest dominant unitary impurity scattering.