Megalencephaly secondary to a novel germline missense variant p.Asp322Tyr in AKT3 associated with growth hormone deficiency and central hypothyroidism: A case report

Germline gain of function variations in the AKT3 gene cause brain overgrowth syndrome with megalencephaly and diffuse bilateral cortical malformations. Here we report a child with megalencephaly, who is a carrier of a novel heterozygous missense variant in the AKT3 gene NM_005465.7:c.964G>T,p.Asp322Tyr. The phenotype of this patient is associated with pituitary deficiencies diagnosed at 2 years of age: growth hormone (GH) deficiency responsible for growth delay and central hypothyroidism. After 6 months of GH treatment, intracranial hypertension was noted, confirmed by the observation of papilledema and increased intracranial pressure, requiring the initiation of acetazolamide treatment and the discontinuation of GH treatment. This is the second reported patient described with megalencephaly and AKT3 gene variant associated with GH deficiency . Other endocrine disorders have also been reported in few cases with hypothyroidism and hypoglycemia. Pituitary deficiency may be a part of the of megalencephaly phenotype secondary to germline variant in the AKT3 gene. Special attention should be paid to growth in these patients and search for endocrine deficiency is necessary in case of growth retardation or hypoglycemia.

Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care

OBJECTIVE

The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis.

METHODS

We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded.

RESULTS

We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers.

CONCLUSION

In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.

Recommendations for robust and reproducible preclinical research in personalised medicine

BACKGROUND

Personalised medicine is a medical model that aims to provide tailor-made prevention and treatment strategies for defined groups of individuals. The concept brings new challenges to the translational step, both in clinical relevance and validity of models. We have developed a set of recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine.

METHODS

These recommendations have been developed following four main steps: (1) a scoping review of the literature with a gap analysis, (2) working sessions with a wide range of experts in the field, (3) a consensus workshop, and (4) preparation of the final set of recommendations.

RESULTS

Despite the progress in developing innovative and complex preclinical model systems, to date there are fundamental deficits in translational methods that prevent the further development of personalised medicine. The literature review highlighted five main gaps, relating to the relevance of experimental models, quality assessment practices, reporting, regulation, and a gap between preclinical and clinical research. We identified five points of focus for the recommendations, based on the consensus reached during the consultation meetings: (1) clinically relevant translational research, (2) robust model development, (3) transparency and education, (4) revised regulation, and (5) interaction with clinical research and patient engagement. Here, we present a set of 15 recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine.

CONCLUSIONS

Appropriate preclinical models should be an integral contributor to interventional clinical trial success rates, and predictive translational models are a fundamental requirement to realise the dream of personalised medicine. The implementation of these guidelines is ambitious, and it is only through the active involvement of all relevant stakeholders in this field that we will be able to make an impact and effectuate a change which will facilitate improved translation of personalised medicine in the future.

Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry

BACKGROUND

Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months.

METHODS

We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed.

RESULTS

We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05).

CONCLUSION

While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.

Open-source deep learning-based air-voids detection algorithm for concrete microscopic images

Analyzing concrete microscopic images is difficult because of its highly heterogeneous composition and the different scales involved. This article presents an open-source deep learning-based algorithm dedicated to air-void detection in concrete microscopic images. The model, whose strategy is presented alongside concrete compositions information, is built using the Mask R-CNN model. Model performances are then discussed and compared to the manual air-void enhancement technique. Finally, the selected open-source strategy is exposed. Overall, the model shows a good precision (mAP = 0.6452), and the predicted air void percentage agrees with experimental measurements highlighting the model's potential to assess concrete durability in the future. This article is protected by copyright. All rights reserved.

Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis

BACKGROUND

Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.

METHODS

In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.

RESULTS

One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.

CONCLUSION

High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

Suplementação de butirato de sódio e os efeitos nos níveis de glicose e no metabolismo lipídico de vacas leiteiras

O objetivo desse estudo foi avaliar os efeitos da suplementação com butirato de sódio nos níveis de glicose plasmática e no metabolismo lipídico de vacas no meio da lactação. Para isso, foram utilizadas 10 vacas (4 da raça Holandês e 6 da raça Jersey), multíparas, com 150 dias em lactação (DEL) e aleatoriamente divididas em 2 grupos: Grupo Controle (GC, n = %), que recebeu uma dieta padrão; Grupo Tratamento (GT, n = 5), que recebeu a dieta padrão mais 1,0g/kg de peso vivo por dia de butirato de sódio por um periodo de 8 dias. Amostras individuais de sangue foram coletadas diariamente durante o periodo experimental para análise de β-hidroxibutirato (BHB), ácidos graxos não esterificados (AGNE), triglicerídeos, colesterol e glicose. Pode ser observado que no GT os níveis de BHB plasmático foi maior (0,64 ± 0,03 mmol/l e 0,91 ± 0,03 mmol/l, para GC e GT, respectivamente, P = 0.001) e os níveis de glicose foram mais baixos que o GC (55,5 ± 0,84 mg/dL e 51,1 ± 0,75 mg/dL, para GT e GC, respectivamente, P < 0.0001). Esses resultados mostram que a suplementação de vacas com butirato de sódio pode regular a taxa de lipólise e as concentrações de AGNE, melhorando o estado de saúde do animal.

Parkinsonian gait in elderly people: Significance of the threshold value of two and more falls per year

OBJECTIVES

Parkinsonism in the elderly presents a major risk factor for recurrent falls (2 and more falls per year), which is associated with increased morbidity. The main objective was to investigate explanatory variables relating to the risk of being recurrent fallers (RF) in persons with parkinsonian gait.

METHODS

Seventy-nine among 172 eligible persons were enrolled in this prospective study, the findings of which were analyzed at 12 months. Motor and non-motor features, as well as follow-up interviews to identify falls, loss of ability to walk, fluctuating cognition, traumatic falls, all-cause hospitalizations and deaths were collated and results compared between non RF (zero and one fall per year) and RF. Bayesian model averaging was used to predict the probability of patients being RF from their medical history as well as from cognitive assessment, gait velocity, vision and posture.

RESULTS

N=79, 0.58 men, 50% had Parkinson's disease, 14% other neurodegenerative parkinsonian syndrome, 23% vascular parkinsonism and 13% Lewy body disease, 58% were RF. Median age 81.2 years and median MMSE 25/30. A history of falls and of hallucinations, median odds ratio respectively 9.06 (CI 2.34-38.22), 4.21 (CI 1.04-18.67) were associated with the highest odds ratios along with fluctuating cognition and abnormal posture. Two or more falls a year was a relevant threshold to distinguish a population with a high risk of comorbidity.

CONCLUSION

The whole history of falls, hallucinations and fluctuating cognition can be considered predictive of recurrent falls in elderly people with parkinsonian gait and provide a tracking tool for patient management.

Influência da restrição alimentar e do estresse térmico sobre parâmetros fisiológicos em ovinos

RESUMO Objetivou-se avaliar as alterações fisiológicas de ovinos submetidos à restrição alimentar, expostos à radiação solar e à sombra. Dez borregas mestiças foram divididas igualmente em dois grupos: grupo radiação solar - GRS, animais expostos ao sol durante o dia; e grupo sombra - GS, animais alocados dentro de um galpão à sombra. Nos seis dias iniciais de experimento, os animais foram submetidos à restrição alimentar, com acesso apenas à água, já expostos ao sol ou à sombra. Nos seis dias subsequentes, foi ofertada dieta composta por ração e feno de alfafa (3%PV). Os parâmetros avaliados foram frequência respiratória (FR), temperatura retal (TR), β-hidroxibutirato (BHB), pH urinário, ingestão de matéria seca (IMS) e dados bioclimáticos (temperatura, umidade relativa do ar e índice de temperatura e umidade - ITU). A FR foi o parâmetro em que houve maior diferença significativa entre os grupos (p<0,05). O balanço energético negativo foi constatado em todos os animais (BHB>0,8mmol/L; pH<7,0). Ovelhas que sofrem restrição alimentar durante períodos de alta temperatura e umidade têm menor frequência respiratória e temperatura interna, independentemente de estar na sombra ou pleno sol. Porém, quando normalizado a oferta de alimento as ovelhas em pleno sol têm menor ingestão de matéria seca.

The occurrence of diseases and their relationship with passive immune transfer in Holstein dairy calves submitted to individual management in southern Brazil

ABSTRACT Calves are extremely dependent on colostrum intake for the acquisition of passive immunity. This study aimed to determine the occurrence of diarrhea and respiratory diseases and the impact of Failure of Passive Immune Transfer (FPIT) on the health and zootechnical performance of Holstein dairy calves in individual management. This study has been carried out in five commercial farms in Rio Grande do Sul State, Brazil, from March 2017 to January 2018. In this study, 131 calves were followed from birth to 60 days of age. Total Plasmatic Protein (TPP) has been performed to determine passive immune transfer quality in 53 calves (53/131). A daily clinical follow-up has been accomplished aiming at diagnosing diseases and their incidences, and zootechnical measures such as withers height, width of the croup and weight have been evaluated. FPIT rate was 32.07%, diarrhea occurrence and respiratory diseases were 77.9% and 49.6%, respectively. FPIT increased the chances of calves presenting diarrhea and developing respiratory diseases, but no differences on zootechnical performance were found. The frequency of FPIT is still high and is a factor that corroborated the increased risk for diarrhea and respiratory disease but did not influence the performance of calves in the preweaning phase.

Effects of timing of artificial insemination and treatment of semen with a Slo3 potassium channel blocker on fertility of dairy heifers subjected to the 5-day CIDR-Synch protocol

Two experiments were conducted to evaluate the effects of the timing of artificial insemination (AI) and incorporation of the Slo3 K⁺ channel blocker 4-(4-chlorophenyl)butyl-diethyl-heptylammonium to semen extender (CSE) on pregnancy per AI (P/AI) and pregnancy loss in dairy heifers. In experiment 1, Holstein heifers were subjected to the 5-d CIDR-Synch protocol: d -8 GnRH and controlled internal drug-release device (CIDR); d -3 PGF_2α and CIDR removal; d -2 PGF_2α; d 0 GnRH) and assigned randomly to receive timed AI with control semen on d 0 (72-CON; n = 104), control semen on d -1 (48-CON; n = 100), or CSE-treated semen on d -1 (48-CSE; n = 98). Heifers were fitted with collar-mounted automated estrus detection devices to monitor physical activity and rumination. In experiment 2, Holstein heifers were subjected to the 5-d CIDR-Synch protocol and received a mount detection patch at the first PGF_2α injection. Heifers detected in estrus before d 0 were inseminated on the same day, whereas those not detected in estrus received the second GnRH injection and timed AI on d 0. Heifers were assigned randomly to receive AI with control (AI-CON; n = 148) or CSE-treated semen (AI-CSE; n = 110). Four bulls with proven fertility were used in both experiments, and ejaculates from each sire were divided and processed as CON or CSE. Pregnancy was diagnosed by transrectal ultrasonography at 29 and 54 d after AI. Data were analyzed by logistic regression, and statistical models included the fixed effects of treatment and enrollment week. In experiment 1, orthogonal contrasts were built to assess the effects of day of AI (72-CON vs. 48-CON + 48-CSE) and treatment of semen with CSE (48-CON vs. 48-CSE). Pregnancy per AI on d 29 (72-CON = 60.8, 48-CON = 35.2, 48-CSE = 39.8%) and d 54 (72-CON = 58.2, 48-CON = 31.6, 48-CSE = 36.2%) was greater for heifers inseminated on d 0 compared with d -1. However, no effect of semen extender on P/AI was observed in heifers inseminated on d -1. In experiment 2, P/AI tended to be greater for AI-CSE than for AI-CON on d 29 (58.6 vs. 47.3%) and d 54 after AI (55.6 vs. 43.7%). Advancing AI by 24 h decreased the likelihood of pregnancy, and use of CSE was unable to overcome the expected asynchrony between insemination and ovulation. Nevertheless, incorporation of CSE in semen processing tended to improve P/AI when heifers received AI upon detected estrus or timed AI concurrently with the final GnRH of the 5-d CIDR-Synch protocol.

Altered rumen fermentation patterns in lactating dairy cows supplemented with phytochemicals improve milk production and efficiency

Tannins and other phytochemicals are known to improve RUP in the diet by binding protein and then limiting ruminal degradation, which may improve milk yield and milk protein synthesis. The objective of this study was to evaluate the effects of dietary phytochemicals (tannins and Capsicum species) as rumen modifiers on production parameters and milk efficiency in dairy cows. Twenty-four multiparous Holstein cows (96 ± 16 d in milk; mean ± standard deviation) were used in a replicated 3 × 3 Latin square design balanced to measure carryover effects. Cows were blocked according to days in milk, milk production, and body weight and randomly assigned to 1 of 3 groups (n = 8/group). Each group was assigned to a unique treatment sequence across the 3 periods in the Latin square. The experiment consisted of a 14-d covariate period and three 30-d treatment periods. Cows received a basal diet supplemented with soybean meal pellets (SB) as the control diet, phytochemicals (RUM; Rumiviv, CCPA, Janzé, France) pelleted with soybean meal, or expeller soybean meal (ESBM; SoyPlus, West Central Soy, Ralston, IA). Milk production and dry matter intake during the last 4 d of each period were used for statistical analysis. Blood and rumen fluid samples were collected on d 27 of each period. Rumen fluid was analyzed for ammonia N and volatile fatty acids as well as ruminal bacteria via quantitative PCR amplification of 16S ribosomal DNA genes. Greater milk yield (37.9 vs. 36 kg/d), energy-corrected milk (39.7 vs 37.1 kg/d), and protein yield (1.15 vs. 1.08 kg/d) were observed in RUM compared with SB, but these parameters were similar between RUM and ESBM. Concentrations of total volatile fatty acids (118.1 vs. 101.5 mM) were greater in RUM in comparison to SB and ESBM diets. Cows fed RUM had greater β-hydroxybutyrate (0.49 vs. 0.42 mmol/L) than SB and ESBM. Selenomonas ruminantium, Succinimonas amylolytica, and Streptococcus bovis in rumen fluid were lower in RUM fed cows in comparison to SB and ESBM. Increased total volatile fatty acids and lower ruminal abundance of bacteria associated with low feed efficiency in RUM cows can partially explain the improvements observed in milk yield and milk efficiency. Overall, these data suggest that feeding a combination of tannin mixture and Capsicum can significantly affect rumen fermentation characteristics via partial manipulation of rumen microbiota, and these effects were reflected in improved milk production and efficiency.

Immune checkpoint inhibitors (ICI): An analysis of FDA’s and EMA’s decision patterns and times for initial approvals and extensions of indication

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Background: In certain clinical settings ICI have demonstrated unprecedented patterns of efficacy, resulting since 2011 in regulatory approvals worldwide in a variety of cancer indications. As immuno-oncology (IO) drugs constitute today an intense area of oncology drug development, we sought to analyze and compare the regulatory approval decisions for ICI, issued until end of 2018 by the US FDA and the European Medicines Agency (EMA). Methods: We reviewed the biological license applications (BLA) of the 7 (EU: 6) ICI, for which marketing approval decisions for were granted so far. Together with parallel and extension of indication applications, 43 (FDA) respectively 23 (EMA) approval procedures were finalized between March 2011 and December 2018. We analyzed agency decision outcomes and timeline patterns; approval decisions issued for novel non-IO cancer drugs served as benchmarks. The primary variable for analysis was median approval time (MAT). Results: MAT for initial BLA applications for ICI in the USA were with 189 days [Interquartile range (IQR) 154-209] shorter than MAT for BLA and NDA approvals for non-IO drugs: for the 51 novel oncology drugs approved 2011-2018 by the FDA, MAT was 227 days [IQR 159-303]. With 181 days [IQR 155-184], FDA’s MAT for ICI line extensions did not differ from MAT for initial ICI approvals. For the EU, MAT for initial ICI marketing applications were with 373 days (IQR 326-413) also shorter than MAT for the 51 non-IO drugs approved 2011-18 (422 days [IQR 368-450]); for ICI line extensions, MAT was 254 days [IQR 187-293). Conclusions: For ICI as for novel non-IO cancer drugs, initial regulatory approvals are usually issued in the USA first. Regulatory approval times for initial approvals are shorter in the USA, compared to Europe, the same applies for ICI extensions of indication. FDA’s extensive granting of breakthrough therapy designations (BTD) helped to bring US MAT for initial ICI BLA down to 6 months – i.e. to the same time, FDA requires for its priority review of extensions of indication. For some ICI extensions of indication, the granting of BTD supported approval decisions within 3 months, supporting patients’ rapid access to novel therapies.

MODELING DNA DAMAGE BY PHOTONS AND LIGHT IONS OVER ENERGY RANGES USED IN MEDICAL APPLICATIONS

Comprehensive track structure-based simulations of DNA damage induced in human cells by photons (5 keV-1.3 MeV) and light ions (0.25-512 MeV/u) were performed with PARTRAC. DNA strand breaks, double-strand breaks and their clustering were scored. Effective LET values were established for photons that provide LET-dependent damage yields in agreement with the data for ions. The resulting database captures the variations of biological effectiveness with radiation quality. In particular, it can help compare the effectiveness of conventional radiotherapy using photon beams with techniques relying on proton or ion beams.

MODELING STUDIES ON DICENTRICS INDUCTION AFTER SUB-MICROMETER FOCUSED ION BEAM GRID IRRADIATION

The biophysical simulation tool PARTRAC contains modules for DNA damage response representing non-homologous end joining of DNA double-strand breaks (DSB) and the formation of chromosomal aberrations. Individual DNA ends from the induced DSB are followed regarding both their enzymatic processing and spatial mobility, as is needed for chromosome aberrations to arise via ligating broken ends from different chromosomes. In particular, by tracking the genomic locations of the ligated fragments and the positions of centromeres, the induction of dicentrics can be modeled. In recent experiments, the impact of spatial clustering of DNA damage on dicentric yields has been assessed in AL human-hamster hybrid cells: Defined numbers of 20 MeV protons (linear energy transfer, LET 2.6 keV/μm), 45 MeV Li ions (60 keV/μm) and 55 MeV C ions (310 keV/μm) focused to sub-μm spot sizes were applied with the ion microbeam SNAKE in diverse grid modes, keeping the absorbed dose constant. The impact of the μm-scaled spatial distribution of DSB (focusing effect) has thus been separated from nm-scaled DSB complexity (LET effect). The data provide a unique benchmark for the model calculations. Model and parameter refinements are described that enabled the simulations to largely reproduce both the LET-dependence and the focusing effect as well as the usual biphasic rejoining kinetics. The predictive power of the refined model has been benchmarked against dicentric yields for photon irradiation.

Hematological and biochemical parameters of dairy calves submitted to pegbovigrastim administration

This study was designed to evaluate the response of hematological and biochemical parameters submitted to pegbovigrastim administration and postchallenge with lipopolysaccharide (LPS). In experiment 1, 20 newborn Holstein calves were divided into 2 groups: the Imrestor (Elanco Saúde Animal, São Paulo, Brazil) group (IMR, n = 10), which received a 25 μg/kg of body weight (BW) subcutaneous administration of pegbovigrastim, and the control group (CTR, n = 10), which received a subcutaneous administration of 0.9% saline solution. Blood samples were collected on d 0, 10, 12, and 14 relative to birth to analyze the biochemical and hematological parameters. Moreover, growth measurements were taken on d 0, 7, 14, 21, and 60 relative to birth. The number of total leukocytes in the IMR group increased on d 12 and 14 in comparison to the CTR group, as well as the counts of segmented neutrophils, band cells, and monocytes. No differences were observed in the other hematological, biochemical, and growth parameters. In experiment 2, 20 Holstein calves from 30 to 60 d old were divided into 4 groups: group 1 (LPS, n = 5) received a 0.25 μg/kg of BW single intravenous dose of Escherichia coli LPS at d 0; group 2 (IMR, n = 5) received a 25 μg/kg of BW subcutaneous dose of pegbovigrastim at d 1; group 3 (IMR + LPS, n = 5) received a 0.25 μg/kg of BW intravenous LPS dose at d 0 and a 25 μg/kg of BW subcutaneous dose of pegbovigrastim at d 1; and group 4 (CTR, n = 5) received an intravenous dose of 0.9% sodium chloride at d 0 and a subcutaneous dose of 0.9% sodium chloride at d 1. For the analysis of biochemical and hematological parameters, blood samples were collected on d -1, 0, 1, 2, 3, 4, 8, 14, and 21 relative to LPS administration. An increase in the number of total leukocytes was observed in the IMR, IMR + LPS, and LPS groups, and the IMR group remained as the highest from d 2 to 21. The levels of paraoxonase 1 were higher in the IMR group compared with all the others. The administration of pegbovigrastim in the dairy calves increased the number of circulating leukocytes, especially neutrophils, with an increase in paraoxonase 1, without altering the metabolites for the hepatic function.

Clinical Development and Initial Approval of Novel Immune Checkpoint Inhibitors in Oncology: Insights From a Global Regulatory Perspective

Immune checkpoint inhibitors (ICI) have demonstrated meaningful patterns of clinical efficacy across various cancers. During their development, novel regulatory strategies and clinical design approaches were explored. This metrics-based narrative review examines submission strategies and clinical evidence expectations of the US, European, and Japanese drug agencies, as well as their impact on approval and overall development times. Also discussed is the role of emerging clinical science and biomarker evaluation to get the first six ICI initially approved.

AT THE PHYSICS-BIOLOGY INTERFACE: THE NEUTRON AFFAIR

We present predictions of neutron relative biological effectiveness (RBE) for cell irradiations with neutron beams at PTB-Braunschweig. A neutron RBE model is adopted to evaluate initial DNA damage induction given the neutron-induced charged particle field. RBE values are predicted for cell exposures to quasi-monoenergetic beams (0.56 MeV, 1.2 MeV) and to a broad energy distribution neutron field with dose-averaged energy of 5.75 MeV. Results are compared to what obtained with our RBE predictions for neutrons at similar energies, when a 30-cm sphere is irradiated in an isotropic neutron field. RBE values for experimental conditions are higher for the lowest neutron energies, because, as expected, target geometry determines the weight of the low-effectiveness photon component of the neutron dose. These results highlight the importance of characterizing neutron fields in terms of physical interactions, to fully understand neutron-induced biological effects, contributing to risk estimation and to the improvement of radiation protection standards.

Bioacústica como método de avaliação do comportamento em pastejo de novilhas Girolando

RESUMO Objetivou-se validar o método de análise de dados bioacústicos na descrição do comportamento em pastejo de novilhas em área de integração lavoura-pecuária (iLP) e floresta (iLPF). Foram utilizadas oito novilhas Girolando (¾Holandês x ¼Gir) com média de 25±6,8 meses de idade e 268±83kg de peso vivo (PV), distribuídas em delineamento crossover 2x2 (dois sistemas x dois períodos de avaliação). A coleta de dados para análise bioacústica foi realizada utilizando-se gravadores MP3. Esses dados foram analisados pelo software Audacity® para identificação das atividades de pastejo, ruminação e ócio. Concomitantemente, o comportamento também foi avaliado pelo método de observação visual, realizado no período de 8 até 16 horas, em intervalos de 15 minutos. Não houve diferença (P>0,05) entre médias dos tempos (minutos) de pastejo, ruminação e ócio registrados pelos métodos de bioacústica e avaliação visual, sendo, respectivamente, 127 vs. 137; 122 vs. 113 e 238 vs. 216, no sistema iLP, e 134 vs. 103; 130 vs. 165 e 233 vs. 203, no sistema iLPF. Por meio desses resultados, foi possível concluir que o método da bioacústica é uma importante ferramenta para avaliar o comportamento de pastejo em diferentes sistemas de produção a pasto, com a vantagem de possibilitar o registro de atividades durante o período noturno, além de maior praticidade e precisão do que o método observacional.

Einfluß des Therapiekonzepts auf die Prognose des Schilddrüsenkarzinoms

Das von uns angewandte Therapiekonzept für die Behandlung des Schilddrüsenkarzinoms sieht eine fakultative perkutane Nachbestrahlung des Halses und eine obligate, intensive Nachbehandlung mit Radiojod vor. Letztere beinhaltet eine vollständige Elimination von Restgewebe und eine kombiniert diagnostische und therapeutische Radiojodgabe in der Nachsorge. Die therapeutische Wirkung von Operation, Hormonsubstitution, Radiojodtherapie und perkutaner Nachbestrahlung zusammen auf die Prognose des Schilddrüsenkarzinoms war offensichtlich, jene von Einzelmaßnahmen erwies sich dagegen als schwer abgrenz- und quantifizierbar. Ein günstiger Einfluß der perkutanen Strahlentherapie konnte nur beim anaplastischen, nicht dagegen beim follikulären Karzinom belegt werden. Trotz prophylaktischer Anwendung von Radiojod in hohen Dosen war die Prognose des differenzierten Schilddrüsenkarzinoms weiterhin vorrangig von biologischen Determinanten abhängig. Die Radiojodbehandlung wird bei allen Patienten mit follikulärem Karzinom und bei Patienten älter als 30 Jahre mit papillärem Karzinom empfohlen, die prophylaktische Behandlung sollte aber auf die Dauer von 5 Jahren begrenzt bleiben.

Untersuchungen zur Monozytopoese bei malignen Erkrankungen und unter B CG-Immunstimulation mit Hilfe des DNA-Markers 3H-Thymidin

Bei Patienten mit Morbus Hodgkin, Non-Hodgkin-Lymphom, Mycosis fungoides, Mammakarzinom oder malignem Melanom wurde die monozytopoetische Proliferationsaktivität im Knochenmark und Blut untersucht. Bei allen Patienten wurde die Studie vor der Behandlung durchgeführt. Bei einem Teil der Patienten erfolgte eine nochmalige Untersuchung nach der Operation und der prophylaktischen Immunstimulation mit BCG. Bei allen Patienten mit unbehandeltem Malignom lag eine mehr oder weniger ausgeprägte Stimulation der Monozytopoese vor. Bei der postoperativ durchgeführten prophylaktischen Behandlung mit BCG konnte vorübergehend eine Zunahme der Proliferationsaktivität der Monozytopoese beobachtet werden. Nach der vierten BCG-Immunstimulation fielen die Werte jedoch in den Normbereich ab. Die Ergebnisse machen deutlich, daß bei Patienten mit Malignomen ein erhöhter Monozytenbedarf vorliegt. Eine Immunstimulation mit BCG in der von uns durchgeführten Weise steigert die Proliferationsaktivität der Monozytopoese. Dieser Effekt ist jedoch vorübergehend.

Effect of porcine somatotropin on metabolism, testicular size and sperm characteristics in young boars

ABSTRACT The aim of this study was to evaluate the effect of pST injections on metabolism, testicular size, and sperm characteristics in young boars. Sixty 22-day old piglets were divided into two groups: pST (n=30) and Control (n=30). The pST group was submitted to pST injections (90µg/kg body weight) every three days up to 330 days of age. Blood collections were performed weekly. Testicular weight was measures at 22, 82, 142, 202 and 365 days of age. Libido and fresh semen characteristics were evaluated between 150 and 210 days of age. Semen characteristics were also evaluated during a 72h storage period (15ºC). Testosterone, albumin, and phosphorus blood concentrations were higher in the pST group (P<0.05). The pST group had a higher IGF-I concentration in seminal plasma (P=0.05) and higher testicular weight (P<0.001) compared to the Control group. The pST group had higher ejaculate volume (P<0.001), total sperm count (P=0.047) and number of inseminating doses/ejaculate (P=0.047). During the 72h storage period, the pST group had a lower number of morphological alterations (P<0.001) compared to the Control group. In sum, pST injection in young boars increased testosterone concentration, testicular size, and sperm quality.

Combinação de butafosfan e cianocobalamina no metabolismo da glicose em vacas leiteiras após o parto

RESUMO A hipótese deste estudo é de que o uso da combinação de butafosfan e cianocobalamina pode melhorar a resistência periférica à insulina, aumentar a quantidade de glicose disponível para a glândula mamária e a produção de leite. Assim, o objetivo foi investigar os efeitos combinados de butafosfan e cianocobalamina sobre o metabolismo da glicose em vacas leiteiras no período pós-parto. Vinte e uma vacas leiteiras foram divididas em dois grupos: grupo controle (CON, n= 11), que recebeu cinco aplicações de solução salina (20mL / animal 0,9% NaCl), e grupo Catosal(r) (ABC, n= 10), que recebeu cinco aplicações de 20mL de uma solução contendo as substâncias butafosfan e cianocobalamina (B12 Catosal(r), 100mg da substância butafosfan e 50µg de cianocobalamina por mL). As aplicações foram realizadas por via intramuscular, nos dias sete, 12, 17, 22 e 27 pós-parto. As amostras de sangue foram coletadas para a avaliação das concentrações plasmáticas de fósforo, glicose, ácidos graxos não esterificados (AGNE), albumina, aspartato aminotransferase (AST) e creatina quinase (CK). Nos dias oito e 28 pós-parto, os animais foram pesados e submetidos aos testes de tolerância à glicose e à insulina. O tratamento promoveu perda de peso (ABC 40,4kg, CON 10,73kg, P<0,05) e aumento da AST (ABC 62,92 ±3,31U/L, CON 53,11±3,49 U / L, P<0,05) e dos níveis de CK (ABC 134,09± 19,08U / L, CON 79,43 ± 18,27U / L). Os grupos não diferiram quanto ao metabolismo (área sob a curva) da glicose nos dias oito e 28, porém os animais tratados tiveram um aumento na glicemia (P<0,05) no dia 28 pós-parto (97,54 ± 8,54mg / dL), após a administração de insulina, em comparação ao dia oito (83,01 ± 8,54mg / dL). Assim, pode-se concluir que a combinação de butafosfan e cianocobalamina melhora a adaptação do metabolismo da glicose em vacas leiteiras no início da lactação.

Comprehensive track-structure based evaluation of DNA damage by light ions from radiotherapy-relevant energies down to stopping

Track structures and resulting DNA damage in human cells have been simulated for hydrogen, helium, carbon, nitrogen, oxygen and neon ions with 0.25–256 MeV/u energy. The needed ion interaction cross sections have been scaled from those of hydrogen; Barkas scaling formula has been refined, extending its applicability down to about 10 keV/u, and validated against established stopping power data. Linear energy transfer (LET) has been scored from energy deposits in a cell nucleus; for very low-energy ions, it has been defined locally within thin slabs. The simulations show that protons and helium ions induce more DNA damage than heavier ions do at the same LET. With increasing LET, less DNA strand breaks are formed per unit dose, but due to their clustering the yields of double-strand breaks (DSB) increase, up to saturation around 300 keV/μm. Also individual DSB tend to cluster; DSB clusters peak around 500 keV/μm, while DSB multiplicities per cluster steadily increase with LET. Remarkably similar to patterns known from cell survival studies, LET-dependencies with pronounced maxima around 100–200 keV/μm occur on nanometre scale for sites that contain one or more DSB, and on micrometre scale for megabasepair-sized DNA fragments.

The origin of neutron biological effectiveness as a function of energy

The understanding of the impact of radiation quality in early and late responses of biological targets to ionizing radiation exposure necessarily grounds on the results of mechanistic studies starting from physical interactions. This is particularly true when, already at the physical stage, the radiation field is mixed, as it is the case for neutron exposure. Neutron Relative Biological Effectiveness (RBE) is energy dependent, maximal for energies ~1 MeV, varying significantly among different experiments. The aim of this work is to shed light on neutron biological effectiveness as a function of field characteristics, with a comprehensive modeling approach: this brings together transport calculations of neutrons through matter (with the code PHITS) and the predictive power of the biophysical track structure code PARTRAC in terms of DNA damage evaluation. Two different energy dependent neutron RBE models are proposed: the first is phenomenological and based only on the characterization of linear energy transfer on a microscopic scale; the second is purely ab-initio and based on the induction of complex DNA damage. Results for the two models are compared and found in good qualitative agreement with current standards for radiation protection factors, which are agreed upon on the basis of RBE data.

Health benefits of multicomponent training programmes in seniors: a systematic review

BACKGROUND

The ageing process is intrinsically associated with decline in physical endurance, muscle strength and gait ability and balance, which all contribute to functional disability. Regular physical training, and more particularly multicomponent training (MCT), has demonstrated many health benefits.

OBJECTIVE

To evaluate the evidence of the health benefits of MCT including endurance training, muscle strengthening, balance exercises, and/or stretching (i.e. flexibility training) and/or coordination training in adults aged 65 years or over.

METHODS

A comprehensive, systematic database search for manuscripts was performed in CINAHL Plus, Embase, Medline, PubMed Central, ScienceDirect, Scopus, Sport Discus and Web of Science using key words. For potential inclusion, two reviewers independently assessed all intervention studies published in English language from 1 January 2000 to 30 April 2015.

RESULTS

Of 2525 articles initially identified, 27 studies were finally included in this systematic review. They were all divided into five categories according to their main outcome measurements (cardio-respiratory fitness, metabolic outcomes, functional and cognitive functions and quality of life, QoL). These studies reported that MCT has a significant beneficial effect on cardio-respiratory fitness and on metabolic outcomes. Substantial improvement in functional and cognitive performance was also measured and a slighter but positive effect on QoL.

CONCLUSION

Overall, this review demonstrates a positive effect of MCT with functional benefits and positive health outcomes for seniors. Based on this evidence, clinicians should encourage all adults aged 65 or over to engage in MCT programmes to favour healthy ageing and keeping older members of our society autonomous and independent.

French consensus procedure for assessing cognitive function in Parkinson's disease

INTRODUCTION

One of the objectives of the French expert centers for Parkinson's disease (NS-Park) network was to determine a consensus procedure for assessing cognitive function in patients with Parkinson's. This article presents this procedure and briefly describes the selected tests.

METHODS

A group of 13 experts used the Delphi method for consensus building to define the overall structure and components of the assessment procedure. For inclusion in the battery, tests had to be validated in the French language, require little motor participation, have normative data and be recognized by the international community. Experimental tasks and tests requiring specific devices were excluded.

RESULTS

Two possibilities were identified, depending on whether an abbreviated or comprehensive assessment of cognitive function was necessary. For an abbreviated assessment, the experts recommended the Montreal Cognitive Assessment (MoCA) as a screening test for cognitive impairment or dementia. For a comprehensive neuropsychological assessment, the experts recommended assessing global efficiency plus the five main cognitive domains (attention and working memory, executive function, episodic memory, visuospatial function and language) that may be impaired in Parkinson's disease, using two tests for each domain.

DISCUSSION AND CONCLUSION

A common procedure for assessing cognitive function is now available across the French network dedicated to Parkinson's disease, and is recommended for both research and clinical practice. It will also help to promote standardization of the neuropsychological assessment of Parkinson's disease.

Sequestration of bovine seminal plasma proteins by different assemblies of phosphatidylcholine: A new technical approach

Binder of SPerm (BSP) proteins, the main proteins from bovine seminal plasma, are known to partially intercalate into the outer leaflet of the spermatozoa membrane and bind to choline-containing lipids being present therein. This insertion generates a negative effect on semen quality after cryopreservation by inducing an early-stage capacitation of spermatozoa. The assumption of surface properties exhibited by BSP proteins was checked by tensiometry measurements: BSP proteins are highly surface active. This suggests that BSP proteins can reach the interface covered by phospholipids not only by interactions between one and each other but also due to their own surface activity. The insertion of BSP proteins into the lipid domains outer leaflet of spermatozoa was reproduced on a biomimetic system such as Langmuir monolayers. The insertion of BSP proteins can be performed in the compressible fluid domains which contain choline-bearing lipids. Monolayer films were used as well to study the complexation of BSP proteins by two phospholipid assemblies: low density lipoprotein (LDLs) from egg yolk or liposomes produced from egg phospholipids. Irrespective of the phospholipid structure (lipoprotein or liposome), BSP was hindered to alter the structure of the membrane. Only the overall ratio BSP proteins:phosphatidylcholine was important. The difference between the two sequestering agents lies on their surface properties: LDL have a strong tendency to merge with the outer layer whereas liposomes mainly remain in the bulk on the same time scale.

180 ASSESSMENT OF BULL SEMEN QUALITY LOADED IN NEW SensiTemp STRAWS USING SEMEN AND IN VITRO PRODUCTION TECHNOLOGIES

SensiTemp, a new in vitro maturation (IMV) bull straw concept, presents the advantage of colour changing while the straw is thawed. The colour of frozen straws is blue and straws start to become white when the temperature reaches 33°C, with a complete change of colour at 37°C. The objective of this study is to assess sperm quality after thawing of semen frozen in SensiTemp from 2 bulls, by analysing, in experiment 1, sperm motility and membrane integrity using computer-assisted semen analysis (CASA) and flow cytometry (FC), and, in experiment 2, the in vitro embryo production (IVP) using IVP technologies [IVM, IVF, and in vitro culture (IVC)]. The ejaculates of 2 bulls, selected during preliminary experiments on high in vitro fertility, were harvested at CIA L’Aigle, France, and split ejaculates were frozen in experimental (SensiTemp) and conventional (control) straws. In experiment 1 after thawing semen from the 2 types of straws (5 pooled straws each; 2 replicates), motility was assessed using the IVOS CASA system (Hamilton Thorne Inc., Beverly, MA, USA) and membrane integrity was evaluated through FC with Cytosoft software (Millipore-Guava Technologies Inc., Hayward, CA, USA). In experiment 2, IVF was used to evaluate the non-toxicity of SensiTemp and control straws. Cumulus-oocyte complexes (COC; n = 1178; 4 replicates) collected from slaughterhouse ovaries were matured in IVM medium (TCM-199 with bicarbonate, Sigma-Aldrich, Saint Quentin Fallavier, France; 10 µg mL–1 FSH-LH, Reprobiol, Liège, Belgium; and 10% FCS, Thermo Fisher, Illkirch, France) for 22 h. After fertilization, presumptive zygotes of each group (SensiTemp and control for each bull) were cultured in synthetic oviduct fluid medium (SOF, Minitube, Tiefenbach, Germany) with 1% estrous cow serum (ECS) and 0.6% BSA (Sigma-Aldrich, France) up to 8 days. All cultures were conducted at 38.5C in 5% CO2, and 5% O2. The cleavage and blastocysts rates were evaluated on Days 3 and 7, respectively, for each group. Embryo quality was recorded on Day 7 according to the IETS evaluation. Data from each bull were analysed separately using the chi-squared test (P < 0.05). In experiment 1, neither sperm motility from bull 1 (61.2 and 60.5%) and bull 2 (66.2 and 66.5%) nor membrane integrity from bull 1 (58.6 and 52.2%) and bull 2 (61.0 and 61.9%) were different between SensiTemp and control, respectively. Results from experiment 2 showed no difference (P > 0.05) in cleavage rate between SensiTemp and control for the 2 bulls: 92.1 and 91.7% for bull 1 and 94.2 and 94.6% for bull 2 respectively. The blastocysts rate on Day 7 did not differ (P > 0.05) among groups (47.5, 47.1 and 51.3, 50.4% for SensiTemp and control bull 1 and bull 2, respectively) nor the quality of embryos retrieved in the different groups: 25.4, 23.3, and 30.8, 29.6% in grade 1 embryo for SensiTemp and control bull 1 and bull 2, respectively. Those results demonstrate, in vitro, that the new SensiTemp straws were non-toxic and did not affect the semen quality after thawing nor did the SensiTemp straws affect the ability of sperm cells to fertilize oocytes and produce 8-day-old embryos.

Unusual cutaneous features associated with a heterozygous gain-of-function mutation in IFIH1: overlap between Aicardi-Goutières and Singleton-Merten syndromes

Cutaneous lesions described as chilblain lupus occur in the context of familial chilblain lupus or Aicardi-Goutières syndrome. To date, seven genes related to Aicardi-Goutières syndrome have been described. The most recently described encodes the cytosolic double-stranded RNA receptor IFIH1 (also known as MDA5), a key component of the antiviral type I interferon-mediated innate immune response. Enhanced type I interferon signalling secondary to gain-of-function mutations in IFIH1 can result in a range of neuroinflammatory phenotypes including classical Aicardi-Goutières syndrome. It is of note that none of the patients with a neurological phenotype so far described with mutations in this gene was reported to demonstrate cutaneous involvement. We present a family segregating a heterozygous pathogenic mutation in IFIH1 showing dermatological involvement as a prominent feature, variably associated with neurological disturbance and premature tooth loss. All three affected individuals exhibited increased expression of interferon-stimulated genes in whole blood, and the mutant protein resulted in enhanced interferon signalling in vitro, both in the basal state and following ligand stimulation. Our results further extend the phenotypic spectrum associated with mutations in IFIH1, indicating that the disease can be confined predominantly to the skin, while also highlighting phenotypic overlap with both Aicardi-Goutières syndrome and Singleton-Merten syndrome.

Health benefits of endurance training alone or combined with diet for obese patients over 60: a review

BACKGROUND

The prevalence of obesity is rapidly increasing in older patients and it is ubiquitous in many developed countries. Obesity is related to various negative health outcomes, making it a major public health target for intervention.

PURPOSE

The aim of this study was to explore and summarise the literature that addresses endurance training alone or combined with nutrition interventions to combat obesity in obese patients over age 60.

METHODS

We searched online electronic databases up to September 2014 for original observational and intervention studies published between 1995 and 2014 on the relationship between endurance training alone or combined with a diet in obese patients over 60 regarding health outcomes.

RESULTS

Twenty-six studies examined interventions aimed specifically at promoting endurance training alone or combined with diet for older obese patients over 60. These studies demonstrated a positive effect of this intervention on the primary prevention of cardiovascular disease, and a significant beneficial effect on the lipid profile. Improvement of body composition and insulin sensitivity, and a reduction in blood pressure were also well established.

CONCLUSIONS

Overall, this review demonstrates a positive effect of endurance training alone or combined with diet on health outcomes and metabolic benefits in older adults. Clinicians can now use this evidence to formulate actions to encourage the older obese to profit from the health benefits of endurance training and diet. This will not only help reduce the dramatic increase in the number of older obese but also help prevent sarcopenic obesity, which is a complex challenge for healthcare professionals.

Cross-section scaling for track structure simulations of low-energy ions in liquid water

Radiation damage by low-energy ions significantly contributes to the high biological efficiency of ion beams in distal Bragg peak regions as well as to the energy-dependent efficiency of neutron irradiation. To enable assessing biological effects of ions at energies <1 MeV u(-1) with track-structure based models, a Barkas-like scaling procedure is developed that provides ion cross sections in liquid water based on those for hydrogen ions. The resulting stopping power and range for carbon ions agree with the ICRU 73 database and other low-energy stopping power data. The method represents the basis for extending PARTRAC simulations of light ion track structures and biological effects down to the keV u(-1) range.

Modelling proton bunches focussed to submicrometre scales: low-LET radiation damage in high-LET-like spatial structure

Microbeam experiments approximating high-LET tracks by bunches of lower-LET particles focussed to submicrometre scales (Schmid et al. 2012, Phys. Med. Biol. 57, 5889) provide an unprecedented benchmark for models of biological effects of radiation. PARTRAC track structure-based Monte Carlo simulations have verified that focussed 20 MeV proton bunches resemble the radial dose distributions of single 55 MeV carbon ions as used in the experiments. However, the predicted yields of double-strand break and short (<1 kbp) DNA fragments by focussed protons correspond to homogeneous proton irradiation and are much smaller than for carbon tracks. The calculated yields of dicentrics overestimate the effect of focussing but reproduce the fourfold difference between carbon ions and homogeneously distributed protons. The extent to which focussed low-LET particles approximate high-LET radiation is limited by the achievable focussing: submicrometre focussing of proton bunches cannot reproduce local nanometre clustering, i.e. DNA damage complexity characteristic of high-LET radiation.