Disturbances of mesenteric lymph flow and in vivo intestinal lymphocyte trafficking during early gut injury induced by ischemia-reperfusion in rats

We sought to define the role of mesenteric lymph in the generation of remote organ damage at the early stage of gut ischemia-reperfusion (I/R) injury. The measurement of mesenteric lymph flow was carried out by cannulation of mesenteric lymphatics. The distribution of in vivo intestinal lymphocyte trafficking was performed by 51Cr labeled lymphocyte and measurement of 51Cr-lymphocytes distribution by gamma-counter. Endotoxin concentration was assayed using the limulus test kit and TNF-alpha level was detected by ELISA. After gut I/R injury, the volumes of lymph flow in mesenteric lymphatics per hour were sharply decreased by 72% and the number of intestinal lymphocytes per milliliter was decreased by 61%, which led to the intestinal lymphocyte output per hour significantly decreased by 90% (predominantly T cells), while the population of 51Cr-lymphocytes in Peyer's patches, small intestine (except Peyer's patches), mesenteric nodes, large intestine, and stomach increased by 87%, 191%, 87%, 266%, 262%, respectively. Meanwhile, endotoxin and TNF-alpha levels in mesenteric lymph were significantly increased. These findings demonstrate the marked disorders of mesenteric lymph flow and in vivo intestinal lymphocytes migration and the accompanying increase of endotoxin and TNF-alpha levels in mesenteric lymph in the early stage of gut I/R injury.

J/ψ suppression at forward rapidity in Pb-Pb collisions at √s(NN) = 2.76 TeV

The ALICE experiment has measured the inclusive J/ψ production in Pb-Pb collisions at √s(NN) = 2.76 TeV down to zero transverse momentum in the rapidity range 2.5 < y < 4. A suppression of the inclusive J/ψ yield in Pb-Pb is observed with respect to the one measured in pp collisions scaled by the number of binary nucleon-nucleon collisions. The nuclear modification factor, integrated over the 0%-80% most central collisions, is 0.545 ± 0.032(stat) ± 0.083(syst) and does not exhibit a significant dependence on the collision centrality. These features appear significantly different from measurements at lower collision energies. Models including J/ψ production from charm quarks in a deconfined partonic phase can describe our data.

DJ-1 protects dopaminergic neurons against rotenone-induced apoptosis by enhancing ERK-dependent mitophagy

Loss-of-function mutations in the gene encoding the multifunctional protein, DJ-1, have been implicated in the pathogenesis of early-onset familial Parkinson's disease (PD), suggesting that DJ-1 may act as a neuroprotectant for dopaminergic (DA) neurons. Enhanced autophagy may benefit PD by clearing damaged organelles and protein aggregates; thus, we determined if DJ-1 protects DA neurons against mitochondrial dysfunction and oxidative stress through an autophagic pathway. Cultured DA cells (MN9D) overexpressing DJ-1 were treated with the mitochondrial complex I inhibitor, rotenone. In addition, rotenone was injected into the left substantia nigra of rats 4weeks after injection with a DJ-1 expression vector. Overexpression of DJ-1 protected MN9D cells against apoptosis, significantly enhanced the survival of nigral DA neurons after rotenone treatment in vivo, and rescued rat behavioral abnormalities. Overexpression of DJ-1 enhanced rotenone-evoked expression of the autophagic markers, beclin-1 and LC3II, while transmission electron microscopy and confocal imaging revealed that the ultrastructural signs of autophagy were increased by DJ-1. The neuroprotective effects of DJ-1 were blocked by phosphoinositol 3-kinase and the autophagy inhibitor, 3-methyladenine, and by the ERK pathway inhibitor, U0126. Confocal imaging revealed that the size of p62-positive puncta decreased significantly in DJ-1 overexpression of MN9D cells 12h after rotenone treatment, suggesting that DJ-1 reveals the ability to clear aggregated p62 associated with PD. Factors that control autophagy, including DJ-1, may inhibit rotenone-induced apoptosis and present novel targets for therapeutic intervention in PD.

Effect of stenting on patients with chronic internal carotid artery occlusion

AIM

Effects of carotid artery stenting (CAS) on patients with chronic internal carotid artery occlusion are unknown.

METHODS

This study included 21 patients who underwent successful CAS treatment and 41 patients who received optimal medical therapy. Modified Rankin Scale (mRS) and cardiocerebral vascular events were compared between CAS and medical therapy group.

RESULTS

The mRS in CAS group was lower than in control group during a 2-year follow up (P<0.05 or 0.01). The combined cerebrovascular events and mortality in study group was lower than in the control group (33.4% vs. 56.1%, P=0.045), but there was no statistically significant difference in the cerebrovascular event (28.6% vs. 46.3%, P=0.088) or mortality rate (4.8% vs. 9.8%, P=0.247) between the two groups. Cox regression analysis revealed that smoking (RR=3.189, 95% CI 1.020-9.968, P=0.046), diabetes (RR=2.717, 95% CI 1.113-6.631, P=0.028), and baseline National Institute of Health stroke scale (RR=2.984, 95% CI 1.049-8.485, P=0.040) were independent risk factors for major cerebrovascular events following CAS.

CONCLUSION

CAS was superior to drug therapy in achieving better functional outcomes in patients with chronic internal carotid artery occlusion. However, CAS was not associated with a statistically significant reduction in cerebrovascular events or mortality. Larger and randomized clinical trials are required to ascertain the long-term benefits of CAS in patients with chronic internal carotid artery occlusion.

EOS 2D/3D X-ray imaging system: a systematic review and economic evaluation

BACKGROUND

EOS is a biplane X-ray imaging system manufactured by EOS Imaging (formerly Biospace Med, Paris, France). It uses slot-scanning technology to produce a high-quality image with less irradiation than standard imaging techniques.

OBJECTIVE

To determine the clinical effectiveness and cost-effectiveness of EOS two-dimensional (2D)/three-dimensional (3D) X-ray imaging system for the evaluation and monitoring of scoliosis and other relevant orthopaedic conditions.

DATA SOURCES

For the systematic review of EOS, electronic databases (MEDLINE, Allied and Complementary Medicine Database, BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, Health Management Information Consortium, Inspec, ISI Science Citation Index and PASCAL), clinical trials registries and the manufacturer's website were searched from 1993 to November 2010.

REVIEW METHODS

A systematic review of studies comparing EOS with standard X-ray [film, computed radiography (CR) or digital radiography] in any orthopaedic condition was performed. A narrative synthesis was undertaken. A decision-analytic model was developed to assess the cost-effectiveness of EOS in the relevant indications compared with standard X-ray and incorporated the clinical effectiveness of EOS and the adverse effects of radiation. The model incorporated a lifetime horizon to estimate outcomes in terms of quality-adjusted life-years (QALYs) and costs from the perspective of the NHS.

RESULTS

Three studies met the inclusion criteria for the review. Two studies compared EOS with film X-ray and one study compared EOS with CR. The three included studies were small and of limited quality. One study used an earlier version of the technology, the Charpak system. Both studies comparing EOS with film X-ray found image quality to be comparable or better with EOS overall. Radiation dose was considerably lower with EOS: ratio of means for posteroanterior spine was 5.2 (13.1 for the study using the Charpak system); ratio of means for the lateral spine was 6.2 (15.1 for the study using the Charpak system). The study comparing EOS with CR found image quality to be comparable or better with EOS. Radiation dose was considerably lower with EOS than CR; ratio of means for the centre of the back was 5.9 and for the proximal lateral point 8.8. The lowest ratio of means was at the nape of the neck, which was 2.9. No other outcomes were assessed in the included studies, such as implications for patient management from the nature and quality of the image. Patient throughput is the major determinant of the cost-effectiveness of EOS. The average cost per procedure of EOS decreases with utilisation. Using estimates of patient throughput at national level from Hospital Episode Statistics data suggests that EOS is not cost-effective for the indications considered. Throughput in the region of 15,100 to 26,500 (corresponding to a workload of 60 to 106 patient appointments per working day) for EOS compared with a throughput of only 7530 for CR (30 patient appointments per working day) is needed to achieve an incremental cost-effectiveness ratio of £30,000 per QALY. EOS can be shown to be cost-effective only when compared with CR if the utilisation for EOS is about double the utilisation of CR.

LIMITATIONS

The main limitation of the systematic review of the clinical effectiveness of EOS was the limited number and quality of the data available. In particular, there were no studies assessing the potential health benefits arising from the quality and nature of the image, over and above those associated with reduced radiation exposure. Uncertainty in the model inputs was not fully explored owing to a lack of reporting of standard deviations or confidence intervals in the published literature for most of the parameters. As a result, uncertainty in the cost-effectiveness results was not presented.

CONCLUSIONS

Radiation dose is considerably lower with EOS than standard X-ray, whereas image quality remains comparable or better with EOS. However, the long-term health benefits from reduced radiation exposure with EOS are very small and there was a lack of data on other potential patient health benefits. The implications of any changes in the quality and nature of the EOS image compared with standard X-ray, for patient health outcomes, needs to be assessed. Given the higher cost of an EOS machine, utilisation is the major determinant of cost-effectiveness. Estimates of patient throughput at national level suggest that EOS is not cost-effective.

FUNDING

The National Institute for Health Research Health Technology Assessment programme.

Denis RD, Stahlman J, Stamen R, Stanecka E, Stanek RW, Stanescu C, Stanescu-Bellu M, Stapnes S, Starchenko EA, Stark J, Staroba P, Starovoitov P, Staszewski R, Staude A, Stavina P, Steele G, Steinbach P, Steinberg P, Stekl I, Stelzer B, Stelzer HJ, Stelzer-Chilton O, Stenzel H, Stern S, Stewart GA, Stillings JA, Stockton MC, Stoerig K, Stoicea G, Stonjek S, Strachota P, Stradling AR, Straessner A, Strandberg J, Strandberg S, Strandlie A, Strang M, Strauss E, Strauss M, Strizenec P, Ströhmer R, Strom DM, Strong JA, Stroynowski R, Strube J, Stugu B, Stumer I, Stupak J, Sturm P, Styles NA, Soh DA, Su D, Subramania HS, Succurro A, Sugaya Y, Suhr C, Suk M, Sulin VV, Sultansoy S, Sumida T, Sun X, Sundermann JE, Suruliz K, Susinno G, Sutton MR, Suzuki Y, Suzuki Y, Svatos M, Swedish S, Sykora I, Sykora T, Sánchez J, Ta D, Tackmann K, Taffard A, Tafirout R, Taiblum N, Takahashi Y, Takai H, Takashima R, Takeda H, Takeshita T, Takubo Y, Talby M, Talyshev A, Tamsett MC, Tanaka J, Tanaka R, Tanaka S, Tanaka S, Tanasijczuk AJ, Tani K, Tannoury N, Tapprogge S, Tardif D, Tarem S, Tarrade F, Tartarelli GF, Tas P, Tasevsky M, Tassi E, Tatarkhanov M, Tayalati Y, Taylor C, Taylor FE, Taylor GN, Taylor W, Teinturier M, Teixeira Dias Castanheira M, Teixeira-Dias P, Temming KK, Ten Kate H, Teng PK, Terada S, Terashi K, Terron J, Testa M, Teuscher RJ, Therhaag J, Theveneaux-Pelzer T, Thoma S, Thomas JP, Thompson EN, Thompson PD, Thompson PD, Thompson AS, Thomsen LA, Thomson E, Thomson M, Thun RP, Tian F, Tibbetts MJ, Tic T, Tikhomirov VO, Tikhonov YA, Timoshenko S, Tipton P, Tique Aires Viegas FJ, Tisserant S, Todorov T, Todorova-Nova S, Toggerson B, Tojo J, Tokár S, Tokushuku K, Tollefson K, Tomoto M, Tompkins L, Toms K, Tonoyan A, Topfel C, Topilin ND, Torchiani I, Torrence E, Torres H, Torró Pastor E, Toth J, Touchard F, Tovey DR, Trefzger T, Tremblet L, Tricoli A, Trigger IM, Trincaz-Duvoid S, Tripiana MF, Trischuk W, Trocmé B, Troncon C, Trottier-McDonald M, Trzebinski M, Trzupek A, Tsarouchas C, Tseng JCL, Tsiakiris M, Tsiareshka PV, Tsionou D, Tsipolitis G, Tsiskaridze V, Tskhadadze EG, Tsukerman II, Tsulaia V, Tsung JW, Tsuno S, Tsybychev D, Tua A, Tudorache A, Tudorache V, Tuggle JM, Turala M, Turecek D, Turk Cakir I, Turlay E, Turra R, Tuts PM, Tykhonov A, Tylmad M, Tyndel M, Tzanakos G, Uchida K, Ueda I, Ueno R, Ugland M, Uhlenbrock M, Uhrmacher M, Ukegawa F, Unal G, Undrus A, Unel G, Unno Y, Urbaniec D, Usai G, Uslenghi M, Vacavant L, Vacek V, Vachon B, Vahsen S, Valenta J, Valente P, Valentinetti S, Valero A, Valkar S, Valladolid Gallego E, Vallecorsa S, Valls Ferrer JA, van der Graaf H, van der Kraaij E, Van Der Leeuw R, van der Poel E, van der Ster D, van Eldik N, van Gemmeren P, van Vulpen I, Vanadia M, Vandelli W, Vaniachine A, Vankov P, Vannucci F, Vari R, Varol T, Varouchas D, Vartapetian A, Varvell KE, Vassilakopoulos VI, Vazeille F, Vazquez Schroeder T, Vegni G, Veillet JJ, Veloso F, Veness R, Veneziano S, Ventura A, Ventura D, Venturi M, Venturi N, Vercesi V, Verducci M, Verkerke W, Vermeulen JC, Vest A, Vetterli MC, Vichou I, Vickey T, Vickey Boeriu OE, Viehhauser GHA, Viel S, Villa M, Villaplana Perez M, Vilucchi E, Vincter MG, Vinek E, Vinogradov VB, Virchaux M, Virzi J, Vitells O, Viti M, Vivarelli I, Vives Vaque F, Vlachos S, Vladoiu D, Vlasak M, Vogel A, Vokac P, Volpi G, Volpi M, Volpini G, von der Schmitt H, von Loeben J, von Radziewski H, von Toerne E, Vorobel V, Vorwerk V, Vos M, Voss R, Voss TT, Vossebeld JH, Vranjes N, Vranjes Milosavljevic M, Vrba V, Vreeswijk M, Vu Anh T, Vuillermet R, Vukotic I, Wagner W, Wagner P, Wahlen H, Wahrmund S, Wakabayashi J, Walch S, Walder J, Walker R, Walkowiak W, Wall R, Waller P, Wang C, Wang H, Wang H, Wang J, Wang J, Wang R, Wang SM, Wang T, Warburton A, Ward CP, Warsinsky M, Washbrook A, Wasicki C, Watkins PM, Watson AT, Watson IJ, Watson MF, Watts G, Watts S, Waugh AT, Waugh BM, Weber M, Weber MS, Weber P, Weidberg AR, Weigell P, Weingarten J, Weiser C, Wellenstein H, Wells PS, Wenaus T, Wendland D, Weng Z, Wengler T, Wenig S, Wermes N, Werner M, Werner P, Werth M, Wessels M, Wetter J, Weydert C, Whalen K, Wheeler-Ellis SJ, White A, White MJ, White S, Whitehead SR, Whiteson D, Whittington D, Wicek F, Wicke D, Wickens FJ, Wiedenmann W, Wielers M, Wienemann P, Wiglesworth C, Wiik-Fuchs LAM, Wijeratne PA, Wildauer A, Wildt MA, Wilhelm I, Wilkens HG, Will JZ, Williams E, Williams HH, Willis W, Willocq S, Wilson JA, Wilson MG, Wilson A, Wingerter-Seez I, Winkelmann S, Winklmeier F, Wittgen M, Wollstadt SJ, Wolter MW, Wolters H, Wong WC, Wooden G, Wosiek BK, Wotschack J, Woudstra MJ, Wozniak KW, Wraight K, Wright C, Wright M, Wrona B, Wu SL, Wu X, Wu Y, Wulf E, Wynne BM, Xella S, Xiao M, Xie S, Xu C, Xu D, Yabsley B, Yacoob S, Yamada M, Yamaguchi H, Yamamoto A, Yamamoto K, Yamamoto S, Yamamura T, Yamanaka T, Yamaoka J, Yamazaki T, Yamazaki Y, Yan Z, Yang H, Yang UK, Yang Y, Yang Z, Yanush S, Yao L, Yao Y, Yasu Y, Ybeles Smit GV, Ye J, Ye S, Yilmaz M, Yoosoofmiya R, Yorita K, Yoshida R, Young C, Young CJ, Youssef S, Yu D, Yu J, Yu J, Yuan L, Yurkewicz A, Zabinski B, Zaidan R, Zaitsev AM, Zajacova Z, Zanello L, Zaytsev A, Zeitnitz C, Zeman M, Zemla A, Zendler C, Zenin O, Ženiš T, Zinonos Z, Zenz S, Zerwas D, Zevi della Porta G, Zhan Z, Zhang D, Zhang H, Zhang J, Zhang X, Zhang Z, Zhao L, Zhao T, Zhao Z, Zhemchugov A, Zhong J, Zhou B, Zhou N, Zhou Y, Zhu CG, Zhu H, Zhu J, Zhu Y, Zhuang X, Zhuravlov V, Zieminska D, Zimin NI, Zimmermann R, Zimmermann S, Zimmermann S, Ziolkowski M, Zitoun R, Živković L, Zmouchko VV, Zobernig G, Zoccoli A, zur Nedden M, Zutshi V, Zwalinski L. A search for [Formula: see text] resonances with the ATLAS detector in 2.05 fb-1 of proton-proton collisions at [Formula: see text]

A search for top quark pair resonances in final states containing at least one electron or muon has been performed with the ATLAS experiment at the CERN Large Hadron Collider. The search uses a data sample corresponding to an integrated luminosity of 2.05 fb-1, which was recorded in 2011 at a proton-proton centre-of-mass energy of 7 TeV. No evidence for a resonance is found and limits are set on the production cross-section times branching ratio to [Formula: see text] for narrow and wide resonances. For narrow Z' bosons, the observed 95 % Bayesian credibility level limits range from 9.3 pb to 0.95 pb for masses in the range of mZ'=500 GeV to mZ'=1300 GeV. The corresponding excluded mass region for a leptophobic topcolour Z' boson (Kaluza-Klein gluon excitation in the Randall-Sundrum model) is mZ'<880 GeV ([Formula: see text]).

Suppression of Jab1/CSN5 induces radio- and chemo-sensitivity in nasopharyngeal carcinoma through changes to the DNA damage and repair pathways

Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus-associated malignancy most common in East Asia and Africa. Radiotherapy and cisplatin-based chemotherapy are the main treatment options. Unfortunately, disease response to concurrent chemoradiotherapy varies among patients with NPC, and many cases are resistant to cisplatin. Increased DNA damage repair is one of the mechanisms contributing to this resistance. Jab1/CSN5 is a multifunctional protein that participates in controlling cell proliferation and the stability of multiple proteins. Jab1 overexpression has been found to correlate with poor prognosis in several tumor types. However, the biological significance of Jab1 activity in response to cancer treatment is unclear. In this study, we used three NPC cell lines (CNE1, CNE2, and HONE1) to investigate the hypothesis that Jab1 positively regulates the DNA repair protein Rad51 and, in turn, cellular response to treatment with DNA-damaging agents such as cisplatin, ionizing radiation (IR) and ultraviolet (UV). We found that Jab1 was overexpressed in two relatively cisplatin-, IR- and UV-resistant NPC cell lines, and knocking down its expression conferred sensitivity to cisplatin, IR and UV. By contrast, exogenous Jab1 expression enhanced the resistance of NPC cells to cisplatin, IR and UV Moreover, we provide a mechanism by which Jab1 positively regulated Rad51 through p53-dependent pathway, and increased ectopic expression of Rad51 conferred cellular resistance to cisplatin, IR and UV in Jab1-deficient cells. Taken together, our findings suggest that Jab1 plays an important role in the cellular response to cisplatin and irradiation by regulating DNA damage and repair pathways. Therefore, Jab1 is a novel biomarker for predicting the outcome of patients with NPC who are treated with DNA-damaging agents.

Bevacizumab in combination with a taxane for the first-line treatment of HER2-negative metastatic breast cancer

This paper presents a summary of the evidence review group (ERG) report into the use of bevacizumab (Avastin®, Roche) in combination with a taxane for the treatment of untreated metastatic breast cancer (mBC). The main clinical effectiveness data were derived from a single, open-label randomised controlled trial (RCT) (E2100) that evaluated the addition of bevacizumab to weekly (q.w.) paclitaxel in patients with human epidermal growth factor receptor 2-negative mBC who had not previously received chemotherapy for advanced disease. This trial reported statistically significant increases in median progression-free survival (PFS) for the addition of bevacizumab (5.8-11.3 months). Median overall survival was not significantly different between the two groups; whether this is a true null finding or due to crossover between treatment arms cannot be established, as relevant data were not collected. The manufacturer reported that the addition of bevacizumab to paclitaxel q.w. therapy was associated with a significant improvement in quality of life, as measured by FACT-B (functional assessment of cancer therapy for breast cancer) scores. However, the ERG noted that these results were based on extreme imputed values, the removal of which led to non-significant differences in quality of life. The manufacturer conducted an indirect comparison. However, owing to methodological limitations and concerns about the validity and exchangeability of the included trials, the ERG did not consider the findings to be reliable. One additional relevant RCT [AVADO (Avastin and Docetaxel); BO17708] evaluating the addition of bevacizumab to docetaxel was excluded from the manufacturer's submission. This was summarised by the ERG. In terms of response rate and PFS, AVADO reported a markedly smaller benefit of adding bevacizumab to docetaxel than that reported for adding bevacizumab to q.w. paclitaxel in E2100. AVADO also reported no statistically significant effect of combination therapy versus docetaxel in terms of overall survival. The manufacturer developed a de novo economic model that considered patients with the same baseline characteristics as women in the E2100 trial. The model assessed BEV + PAC - bevacizumab 10 mg/kg every 2 weeks in combination with paclitaxel 90 mg/m2 weekly for 3 weeks followed by 1 week of rest; PAC q.w. - paclitaxel (monotherapy) 90 mg/m2 weekly for 3 weeks followed by 1 week of rest; DOC - docetaxel (monotherapy) 75 mg/m2 on day 1 every 21 days (considered current UK NHS clinical practice in the submission); and GEM + PAC - gemcitabine 1250 mg/m2 on days 1 and 8 plus paclitaxel 175 mg/m2 on day 1 every 21 days. Pairwise comparisons were made between BEV + PAC and PAC (using the E2100 trial), BEV + PAC and DOC, and BEV + PAC and GEM + PAC. Based on NHS list prices, the manufacturer's model estimated incremental cost-effectiveness ratios (ICERs) for BEV + PAC of £ 117,803, £ 115,059 and £ 105,777 per QALY gained, relative to PAC, DOC and GEM + PAC regimens, respectively. If the NHS Purchasing and Supply Agency prices for PAC with a 10-g cap on the cost per patient of BEV were used instead, the ICERs for BEV + PAC were estimated at £ 77,314, £ 57,753 and £ 60,101 per QALY, respectively. The submission suggested that the regimen of BEV + DOC is not cost-effective because it is considered less effective and more costly than BEV + PAC. Analysis by the ERG suggested that alternative assumptions can increase the ICERs further and, based on current prices, no plausible changes to the model assumptions will bring the ICERs for BEV + PAC lower.

Golimumab for the treatment of psoriatic arthritis

This paper presents a summary of the evidence review group (ERG) report into the use of golimumab for the treatment of psoriatic arthritis (PsA). The main clinical effectiveness data were derived from a single phase III randomised controlled trial (RCT: GO-REVEAL) that compared golimumab with placebo for treating patients with active and progressive PsA who were symptomatic despite the use of previous disease-modifying antirheumatic drugs or non-steroidal anti-inflammatory drugs. The 14-week data showed that, compared with placebo, golimumab 50 mg significantly improved joint disease response as measured by American College of Rheumatology (ACR) 20 [relative risk (RR) 5.73, 95% confidence interval (CI) 3.24 to 10.56] and Psoriatic Arthritis Response Criteria (PsARC) (RR 3.45, 95% CI 2.49 to 4.87), and skin disease response as measured by the Psoriasis Area and Severity Index (PASI) 75 (RR 15.95, 95% CI 4.62 to 59.11). The 24-week absolute data showed that these treatment benefits were maintained. There was a significant improvement in patients' functional status as measured by the Health Assessment Questionnaire (HAQ) change from baseline at 24 weeks (-0.33, p < 0.001). The open-label extension data showed that these beneficial effects were also maintained at 52 and 104 weeks. However, PASI 50 and PASI 90 at 14 weeks, and all of the PASI outcomes at 24 weeks, were not performed on the basis of intention-to-treat analysis. Furthermore, analyses of the 24-week data were less robust, failing to adjust for treatment contamination due to patient crossover at week 16. The manufacturer conducted a mixed treatment comparison (MTC) analysis. The ERG considered the assumption of exchangeability between the trials for the purpose of the MTC analysis to be acceptable, and the statistical approach in the MTC analysis to be reliable. Regarding the safety evaluation of golimumab, the manufacturer failed to provide longer-term data or to consider adverse event data of golimumab from controlled studies in other conditions, such as rheumatoid arthritis and ankylosing spondylitis. Although the adverse effect profile of golimumab appears similar to other anti-tumour necrosis factor (TNF) agents, the longer-term safety profile of golimumab remains uncertain. The manufacturer's submission presented a decision model to compare etanercept, infliximab, golimumab and adalimumab versus palliative care for patients with PsA. In the base-case model, 73% of the cohort of patients were assumed to have significant psoriasis (> 3% of body surface area). Estimates of the effectiveness of anti-TNF agents in terms of PsARC, HAQ change and PASI change were obtained from an MTC analysis of RCT data. The manufacturer failed to calculate incremental cost-effectiveness ratios (ICERs) correctly by comparing golimumab with palliative care instead of the most cost-effective alternative (etanercept). Despite the manufacturer's claim that golimumab is a cost-effective treatment option, the manufacturer's own model showed that golimumab is not cost-effective compared with other biologics when the ICERs are correctly calculated. None of the sensitivity analyses carried out by the manufacturer or the ERG regarding uncertainty in the estimates of clinical effectiveness, the acquisition and administration cost of drugs, the cost of treating psoriasis and the utility functions estimated to generate health outcomes changed this conclusion. However, a key area in determining the cost-effectiveness of anti-TNF agents is whether they should be treated as a class. If all anti-TNF agents are considered equally effective then etanercept, adalimumab and golimumab have very nearly equal costs and equal quality-adjusted life-years (QALYs), and all have an ICER of about £ 15,000 per QALY versus palliative care, whereas infliximab with a higher acquisition cost is dominated by the other biologics.

First Report of a Leaf Spot on Pepper Caused by Cladosporium oxysporum in China

Pepper (Capsicum annuum L.) is an important vegetable crop grown in Liaoning Province of China. In June 2009, leaf spotting was observed on hot pepper cv. 37-74 in Wafangdian County of Liaoning Province. By August 2011, the disease had spread to Pulandian and Donggang Counties. Symptoms initially appeared on both sides of leaves as pinpoint chlorotic spots that enlarged and developed into irregular, brown lesions, 1 to 8 mm in diameter. To identify the pathogen, leaf pieces (3 to 5 mm) taken at the edge of lesions with both infected and healthy portions were surface disinfected by placing them in 75% ethanol for 5 s, then transferred to a 0.1% aqueous mercuric chloride solution for 30 s and rinsed with sterilized water three times. The sections were placed on potato dextrose agar (PDA) at 25°C in the dark. Ten pure fungal cultures were obtained from single spores. For growth rate determination and morphological description of colonies, single conidial isolates were inoculated on PDA, malt extract agar (MEA), and oatmeal agar (OA), and incubated at 25°C for 14 days in darkness. For studies of microscopic morphology, isolates were grown on synthetic nutrient agar (SNA) in slide cultures. Colonies grew up to 77 to 80 mm in diameter on PDA, 62 to 66 mm on MEA, and 58 to 60 mm on OA after 14 days. Conidiophores were straight to slightly flexuous. Conidia ranged in shape from subglobose or ovoid to subcylindrical. Macronematous conidiophores measured 40 to 670 × 3 to 5.5 μm with swellings, micronematous conidiophores 15 to 137 × 1.5 to 3.5 μm, terminal conidia 2 to 4 × 2 to 3 μm, and intercalary conidia 4 to 10 × 2.5 to 4 μm. Ramoconidia were rarely observed. Secondary ramoconidia were zero- to one-septate and measured 5.2 to 14.8 × 2.4 to 4 μm. On the basis of these characteristics, the isolates were identified as Cladosporium oxysporum (1). The internal transcribed spacer (ITS) region from isolate W10-02 was amplified using primers ITS1 and ITS4 and sequenced (GenBank Accession No. JQ775499). The 525-bp amplicons had 99% identity to C. oxysporum (GenBank Accession No. EF029816). On the basis of morphological characteristics and nucleotide homology, the isolate was identified as C. oxysporum. Koch's postulates were fulfilled in the laboratory on pepper leaves inoculated with C. oxysporum conidial suspensions (10⁷ conidia ml^-1). Eight inoculated 4-week-old seedlings were incubated under moist conditions for 8 to 10 days at 25°C. All leaf spots that developed on inoculated leaves were similar in appearance to those observed on diseased pepper in the field. C. oxysporum was reisolated from lesions and its identity was confirmed by morphological characteristics. C. oxysporum was first reported as a pathogen of pepper in the Sultanate of Oman (2). To our knowledge, this is the first report of C. oxysporum causing leaf spot on pepper in China. The outbreak and spread of this disease may decrease the yield of pepper in the northern regions of China. More studies are needed on the management strategy including the resistance of pepper cultivars against C. oxysporum. References: (1) K. Bensch et al. 2010. Stud. Mycol. 67:1, 2010. (2) A. M. Hammouda. Plant Dis. 76:536, 1992.

Search for supersymmetry in events with three leptons and missing transverse momentum in √[s]=7 TeV pp collisions with the ATLAS detector

A search for the weak production of charginos and neutralinos decaying to a final state with three leptons (electrons or muons) and missing transverse momentum is presented. The analysis uses 2.06 fb(-1) of √[s]=7 TeV proton-proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with standard model expectations in two signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric and simplified models. For the simplified models, degenerate lightest chargino and next-to-lightest neutralino masses up to 300 GeV are excluded for mass differences from the lightest neutralino up to 300 GeV.

Denis RD, Stahl T, Stahlman J, Stamen R, Stanecka E, Stanek RW, Stanescu C, Stapnes S, Starchenko EA, Stark J, Staroba P, Starovoitov P, Staude A, Stavina P, Stavropoulos G, Steele G, Steinbach P, Steinberg P, Stekl I, Stelzer B, Stelzer HJ, Stelzer-Chilton O, Stenzel H, Stevenson K, Stewart GA, Stillings JA, Stockmanns T, Stockton MC, Stoerig K, Stoicea G, Stonjek S, Strachota P, Stradling AR, Straessner A, Strandberg J, Strandberg S, Strandlie A, Strang M, Strauss E, Strauss M, Strizenec P, Ströhmer R, Strom DM, Strong JA, Stroynowski R, Strube J, Stugu B, Stumer I, Stupak J, Sturm P, Soh DA, Su D, Subramania HS, Sugaya Y, Sugimoto T, Suhr C, Suita K, Suk M, Sulin VV, Sultansoy S, Sumida T, Sun X, Sundermann JE, Suruliz K, Susinno G, Sutton MR, Suzuki Y, Swedish S, Sykora I, Sykora T, Sánchez J, Ta D, Tackmann K, Taffard A, Tafirout R, Taga A, Taiblum N, Takahashi Y, Takai H, Takashima R, Takeda H, Takeshita T, Talby M, Talyshev A, Tamsett MC, Tanaka J, Tanaka R, Tanaka S, Tanaka S, Tani K, Tannoury N, Tapprogge S, Tardif D, Tarem S, Tarrade F, Tartarelli GF, Tas P, Tasevsky M, Tassi E, Tatarkhanov M, Tayalati Y, Taylor C, Taylor FE, Taylor GN, Taylor W, Teixeira Dias Castanheira M, Teixeira-Dias P, Temming KK, Ten Kate H, Teng PK, Terada S, Terashi K, Terron J, Terwort M, Testa M, Teuscher RJ, Tevlin CM, Therhaag J, Theveneaux-Pelzer T, Thioye M, Thoma S, Thomas JP, Thompson EN, Thompson PD, Thompson PD, Thompson RJ, Thompson AS, Thomson E, Thomson M, Thun RP, Tic T, Tikhomirov VO, Tikhonov YA, Timmermans CJWP, Tipton P, Tique Aires Viegas FJ, Tisserant S, Todorov T, Todorova-Nova S, Toggerson B, Tojo J, Tokár S, Tokunaga K, Tokushuku K, Tollefson K, Tomoto M, Tompkins L, Toms K, Tonazzo A, Tonoyan A, Topfel C, Topilin ND, Torchiani I, Torrence E, Torró Pastor E, Toth J, Touchard F, Tovey DR, Traynor D, Trefzger T, Treis J, Tremblet L, Tricoli A, Trigger IM, Trincaz-Duvoid S, Trinh TN, Tripiana MF, Trischuk W, Trivedi A, Trocmé B, Troncon C, Trottier-McDonald M, Trzupek A, Tsarouchas C, Tseng JCL, Tsiakiris M, Tsiareshka PV, Tsionou D, Tsipolitis G, Tsiskaridze V, Tskhadadze EG, Tsukerman II, Tsulaia V, Tsung JW, Tsuno S, Tsybychev D, Tua A, Tuggle JM, Turala M, Turecek D, Turk Cakir I, Turlay E, Turra R, Tuts PM, Twomey MS, Tykhonov A, Tylmad M, Tyndel M, Typaldos D, Tyrvainen H, Tzanakos G, Uchida K, Ueda I, Ueno R, Ugland M, Uhlenbrock M, Uhrmacher M, Ukegawa F, Unal G, Undrus A, Unel G, Unno Y, Urbaniec D, Urkovsky E, Urrejola P, Usai G, Uslenghi M, Vacavant L, Vacek V, Vachon B, Vahsen S, Valderanis C, Valenta J, Valente P, Valentinetti S, Valkar S, Valladolid Gallego E, Vallecorsa S, Valls Ferrer JA, van der Graaf H, van der Kraaij E, Van Der Leeuw R, van der Poel E, van der Ster D, Van Eijk B, van Eldik N, van Gemmeren P, van Vulpen I, Vandelli W, Vaniachine A, Vankov P, Vannucci F, Vari R, Varnes EW, Varouchas D, Vartapetian A, Varvell KE, Vassilakopoulos VI, Vazeille F, Vegni G, Veillet JJ, Veloso F, Veness R, Veneziano S, Ventura A, Ventura D, Venturi M, Venturi N, Vercesi V, Verducci M, Verkerke W, Vermeulen JC, Vest A, Vetterli MC, Vichou I, Vickey T, Viehhauser GHA, Viel S, Villa M, Villani EG, Villaplana Perez M, Vilucchi E, Vincter MG, Vinek E, Vinogradov VB, Virchaux M, Viret S, Virzi J, Vitale A, Vitells O, Viti M, Vivarelli I, Vives Vaque F, Vlachos S, Vlasak M, Vlasov N, Vogel A, Vokac P, Volpi G, Volpi M, Volpini G, von der Schmitt H, von Loeben J, von Radziewski H, von Toerne E, Vorobel V, Vorwerk V, Vos M, Voss R, Voss TT, Vossebeld JH, Vovenko AS, Vranjes N, Vranjes Milosavljevic M, Vrba V, Vreeswijk M, Vu Anh T, Vuillermet R, Vukotic I, Wagner W, Wagner P, Wahlen H, Wakabayashi J, Walbersloh J, Walch S, Walder J, Walker R, Walkowiak W, Wall R, Waller P, Wang C, Wang H, Wang J, Wang J, Wang R, Wang SM, Warburton A, Ward CP, Warsinsky M, Wastie R, Watkins PM, Watson AT, Watson MF, Watts G, Watts S, Waugh AT, Waugh BM, Weber J, Weber M, Weber MS, Weber P, Weidberg AR, Weigell P, Weingarten J, Weiser C, Wellenstein H, Wells PS, Wen M, Wenaus T, Wendler S, Weng Z, Wengler T, Wenig S, Wermes N, Werner M, Werner P, Werth M, Werthenbach U, Wessels M, Whalen K, Wheeler-Ellis SJ, White A, White MJ, White S, Whitehead SR, Whiteson D, Whittington D, Wicek F, Wicke D, Wickens FJ, Wiedenmann W, Wielers M, Wienemann P, Wiik-Fuchs LAM, Wijeratne PA, Wildauer A, Wildt MA, Wilhelm I, Wilkens HG, Will JZ, Williams E, Williams HH, Willis W, Willocq S, Wilson JA, Wilson MG, Wilson A, Wingerter-Seez I, Winkelmann S, Winklmeier F, Wittgen M, Wolter MW, Wolters H, Wooden G, Wosiek BK, Wotschack J, Woudstra MJ, Wraight K, Wright C, Wright D, Wrona B, Wu SL, Wu X, Wu Y, Wulf E, Wynne BM, Xaplanteris L, Xella S, Xie S, Xu C, Xu D, Yabsley B, Yamada M, Yamamoto A, Yamamoto K, Yamamoto S, Yamamura T, Yamaoka J, Yamazaki T, Yamazaki Y, Yan Z, Yang H, Yang UK, Yang Y, Yang Z, Yanush S, Yao WM, Yao Y, Yasu Y, Ybeles Smit GV, Ye J, Ye S, Yilmaz M, Yoosoofmiya R, Yorita K, Yoshida R, Young C, Youssef S, Yu D, Yu J, Yu J, Yuan L, Yurkewicz A, Zaidan R, Zaitsev AM, Zajacova Z, Zalite YK, Zanello L, Zarzhitsky P, Zaytsev A, Zeitnitz C, Zeller M, Zema PF, Zemla A, Zendler C, Zenin AV, Zenin O, Ženiš T, Zinonos Z, Zenz S, Zerwas D, Zevi della Porta G, Zhan Z, Zhang D, Zhang H, Zhang J, Zhang Q, Zhang X, Zhang Z, Zhao L, Zhao T, Zhao Z, Zhemchugov A, Zhong J, Zhou B, Zhou N, Zhou Y, Zhu CG, Zhu H, Zhu Y, Zhuang X, Zhuravlov V, Zieminska D, Zilka B, Zimmermann R, Zimmermann S, Zimmermann S, Ziolkowski M, Zitoun R, Živković L, Zmouchko VV, Zobernig G, Zoccoli A, Zolnierowski Y, Zsenei A, zur Nedden M, Zutshi V, Zwalinski L. Search for lepton flavour violation in the eμ continuum with the ATLAS detector in [Formula: see text]pp collisions at the LHC

This paper presents a search for the t-channel exchange of an R-parity violating scalar top quark ([Formula: see text]) in the e±μ∓ continuum using 2.1 fb-1 of data collected by the ATLAS detector in [Formula: see text]pp collisions at the Large Hadron Collider. Data are found to be consistent with the expectation from the Standard Model backgrounds. Limits on R-parity-violating couplings at 95 % C.L. are calculated as a function of the scalar top mass ([Formula: see text]). The upper limits on the production cross section for pp→eμX, through the t-channel exchange of a scalar top quark, ranges from 170 fb for [Formula: see text] to 30 fb for [Formula: see text].

Abstract LB-308: Combination of CTx-0294945 a highly selective inhibitor of focal adhesion kinase with bevacizumab in pre-clinical models of breast cancer

Background: Focal adhesion kinase (FAK) is a non-receptor tyrosine kinase that provides a critical hub for signalling from at least four different classes of cellular sensing mechanisms including growth factor receptors, GPCRs, integrins and mechanical stress forces. By temporal and spatial integration of signals from these sources, FAK plays a central role in cell migration, invasion and proliferation; processes vital for tumorigenesis. The significance of FAK to the function of signal transduction pathways provides a strong rationale for the combination of FAK inhibitors with other targeted agents to achieve improved efficacy against a range of cancers. Others have demonstrated the importance of FAK in angiogenesis and therefore combining a FAKi with anti-VEGF agents is attractive as it employs two complementary mechanisms of suppressing the formation of tumor vasculature. Here we present results from the co-administration of CTx-0294945, a highly selective FAKi, and bevacizumab (bev) in an orthotopic model of human breast cancer. Methods and Results: CTx-0294945 is an orally bioavailable small molecule ATP competitive inhibitor of focal adhesion kinase (FAK KD=0.21 nM). It exhibits high selectivity against a diverse panel of 125 kinases including the closely related Pyk2. CTx-0294945 inhibits autophosphorylation of 397Y-FAK in MDA-MB-231 cells with an IC50 = 7 nM and exhibits low general cellular toxicity (IC50 = 2.7 µM, MDA-MB-231 cells). CTx-0294945 is suitable for oral administration (%F=58 and t1/2=5.1 h at 20 mg/Kg in rat) and does not inhibit (IC50 &gt;20 µM) any of the cytochrome p450 isoforms tested to date. To assess the co-administration of CTx-0294945 with bev, mice were injected orthotopically with MDA-MB-231 cells (106). After 14 days, when tumors were palpable, mice were randomized into 4 groups and dosing commenced. The groups were treated with CTx-0294945 (80 mg/kg QD, PO), bev (12.5 mg/Kg IP, x2/week), CTx-0294945 (80 mg/Kg QD, PO) and bev (12.5 mg/Kg IP, x2/week) or vehicle. Tumor growth was monitored and on day 28 animals in the vehicle and CTx-0294945 arms were culled when the size of the tumors reached ethical end point (1000 mm3). Tumor growth in the bev only and the CTx-0294945 + bev arms was significantly inhibited (75% and 88% TGI respectively). At this time the treatment regimes for both cohorts were stopped and tumor growth allowed to progress. After an additional 14 days the experiment was terminated when the bev treatment group reached ethical end point; however the average size of the tumors in the CTx-0294945 + bev cohort was still was only 562 mm3. Conclusions: Our data suggest the potential utility of combining a selective FAK inhibitor with bevacizumab to prevent tumour progression and enhance the durability of response.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-308. doi:1538-7445.AM2012-LB-308