Phase 1b study of combined selinexor and eribulin for the treatment of advanced solid tumors and triple-negative breast cancer

BACKGROUND

Selinexor (KPT-330) is a potent inhibitor of exportin 1 (XPO1), in turn inhibiting tumor growth. Selinexor enhances the antitumor efficacy of eribulin in triple-negative breast cancer (TNBC) in vitro and in vivo. Given the unmet medical need in TNBC and sarcoma, the authors explored the safety and efficacy of this combination.

METHODS

The authors conducted a phase 1b trial of combined selinexor and eribulin using a 3 + 3 dose-escalation design in patients who had advanced solid tumors and in those who had TNBC in a dose-expansion cohort.

RESULTS

Patients with TNBC (N = 19), sarcoma (N = 9), and other cancers (N = 3) were enrolled in the dose-escalation cohort (N = 10) and in the dose-expansion cohort (N = 21). The median number lines of prior therapy received was four (range, from one to seven prior lines). The most common treatment-related adverse events for selinexor were nausea (77%), leukopenia (77%), anemia (68%), neutropenia (68%), and fatigue (48%). One dose-limiting toxicity occurred at the first dose level with prolonged grade 3 neutropenia. The recommended phase 2 dose was 80 mg of selinexor orally once per week and 1 mg/m² eribulin on days 1 and 8 intravenously every 3 weeks. The objective response rate (ORR) was 10% in three patients. In the dose-escalation cohort, the ORR was 10%, whereas six patients with had stable disease. In the TNBC dose-expansion cohort (n = 18), ORR was 11%, and there were two confirmed partial responses with durations of 10.8 and 19.1 months (ongoing).

CONCLUSIONS

Selinexor and eribulin had an acceptable toxicity profile and modest overall efficacy with durable responses in select patients.

PLAIN LANGUAGE SUMMARY

Effective therapies for advanced, triple-negative breast cancer and sarcoma represent an unmet need. Exportin 1 is associated with the transport of cancer-related proteins. Preclinical studies have demonstrated tumor growth inhibition and enhanced tumor sensitivity in patients who receive selinexor combined with eribulin. In this phase 1b study, the authors evaluated the safety profile and clinical activity of the combination of selinexor, a potent oral inhibitor of exportin 1, and eribulin in patients with advanced cancers enriched for triple-negative breast cancer or sarcoma. The combination was well tolerated; most adverse events were mild or moderate, reversible, and managed with dose modifications or growth factor support. The combination of selinexor and eribulin produced an antitumor response, particularly in some patients with triple-negative breast cancer. This work lays the foundation for prospective investigations of the role of selinexor and eribulin in the treatment of triple-negative breast cancer.

Phase Ib study of selinexor and eribulin combination in advanced solid tumors and triple-negative breast cancer

3108

Background: Selinexor (KPT-330) is potent inhibitor of Exportin-1. In vitro, Selinexor was found to be synergistic with eribulin in triple negative breast cancer (TNBC) cell lines and enhanced antitumor activity of eribulin in TNBC patient-derived xenografts (PMID 28810913). Methods: We conducted a phase Ib trial in combination of selinexor and eribulin using 3 + 3 design in dose escalation for patients with advanced solid tumors and in TNBC in dose expansion cohort. Eribulin could be discontinued after combination for 6 cycles at physician discretion. Primary objectives: Safety, Recommended Phase 2 Dose (RP2D). Secondary Objectives: Objective Response Rate (ORR), Duration of Response (DOR), Disease Control Rate (DCR), Overall Survival (OS) and Progression Free Survival (PFS). Results: 31 patients, TNBC (n = 19), sarcoma (n = 8), others (n = 4) enrolled in dose escalation (n = 10) and dose expansion phases (n = 21). Median prior therapies:4 (1–6). Study initiated selinexor at 60mg twice weekly and eribulin 1.4mg/m2 on Day1, Day8 every 3 weeks which led to 1 Dose Limiting Toxicity (DLT) and hence, selinexor 80mg once weekly and eribulin 1mg/m2 was elected as RP2D due to efficacy and tolerability. As of 01/15/2022, of 29 patients (94%) who have discontinued treatment, 24 (77%) were due to progressive disease, 3 (10%) withdrew consent and 2 (6%) due to toxicities (G1 pneumonitis; G3 neutropenia) while 2 (6%) remain on trial. All 31 patients had at least one treatment emergent adverse event (TEAE) while most prevalent TEAEs (all grades) were leukopenia (77%), nausea (71%), anemia and neutropenia (68%) and fatigue (48%). The most common G3/4 TEAE were leukopenia (26%) and neutropenia (29%). 2 DLTs occurred; 1 in first dose level (DL); 1 in second DL dosed at selinexor 80 mg once weekly due to G3 neutropenia. ORR for all was 10% while DCR (SD+PR+CR) > 6 months seen in 3 (15%) TNBC and 2 (20%) sarcoma patients. The median OS and PFS for all were 12.3 (7.3, 27.3) months and 2.3 (1.6, 4.1) months. In dose escalation cohort, ORR was 10% where one patient (3%) with vaginal SCC had confirmed PR (-44%) for 2.1 months. Five patients (62.5%) with sarcoma had stable disease (SD). One patient with high grade sarcoma has SD for 68 months and remains on selinexor after 4 months of eribulin and selinexor. In TNBC dose expansion (n = 19), ORR was 10.5% with 2 confirmed PRs and median duration of response (DOR) of 10.8 months. One patient who has remained on treatment for 18 months, and after receiving 8 months of eribulin and selinexor, remains on selinexor with 100% target regression and an indeterminate brain lesion. Conclusions: Selinexor with eribulin is safe with manageable toxicity profile and modest overall clinical efficacy. Durable responses and disease control were observed with metastatic TNBC. Further study is needed to examine the determinants of response to this combination. Clinical trial information: NCT02419495.

Surgery school-who, what, when, and how: results of a national survey of multidisciplinary teams delivering group preoperative education

Background

Group education is increasing in popularity as a means of preparing patients for surgery. In recent years, these ‘surgery schools’ have evolved from primarily informing patients of what to expect before and after surgery, to providing support and encouragement for patients to ‘prehabilitate’ prior to surgery, through improving physical fitness, nutrition and emotional wellbeing.

Method

A survey aimed at clinicians delivering surgery schools was employed to capture a national overview of activity to establish research and practice priorities in this area. The survey was circulated online via the Enhanced Recovery after Surgery UK Society and the Centre for Perioperative Care mailing lists as well as social media.

Results

There were 80 responses describing 28 active and 4 planned surgery schools across the UK and Ireland. Schools were designed and delivered by multidisciplinary teams, contained broadly similar content and were well attended. Most were funded by the National Health Service. The majority included aspects of prehabilitation most commonly the importance of physical fitness. Seventy five percent of teams collected patient outcome data, but less than half collected data to establish the clinical effectiveness of the school. Few describe explicit inclusion of evidence-based behavior change techniques, but collaboration and partnerships with community teams, gyms and local charities were considered important in supporting patients to make changes in health behaviors prior to surgery.

Conclusion

It is recommended that teams work with patients when designing surgery schools and use evidence-based behavior change frameworks and techniques to inform their content. There is a need for high-quality research studies to determine the clinical effectiveness of this type of education intervention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13741-021-00188-2.

Antibacterial activity of disulfiram and its metabolites

AIMS

Disulfiram (Antabuse™) and its metabolites formed in vivo were evaluated as antibacterial agents against thirty species of Gram-positive and Gram-negative bacteria. The synergistic potential of disulfiram (DSF) and metabolite diethyldithiocarbamate (DDTC) with approved antibiotics were also compared by isobologram (checkerboard) analysis.

METHODS AND RESULTS

Standard microdilution susceptibility testing showed that most DSF metabolites did not possess appreciable antibacterial activity except for DDTC in Bacillus anthracis. Checkerboard studies revealed similarities between the combination drug effects of DSF and DDTC with standard antibiotics.

CONCLUSIONS

It was concluded from the susceptibility data that the metabolites would not extend the antibacterial spectrum of DSF in vivo. The data also suggest that the DDTC by-product of DSF metabolism potentiates the antibacterial activity of DSF as both a standalone and combination agent.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study provides a greater understanding of the antibacterial effects of Antabuse and its metabolites. This research also demonstrates the potential application of DSF as an antibiotic adjuvant for the treatment of resistant staph infections.

Automated electrotransformation of Escherichia coli on a digital microfluidic platform using bioactivated magnetic beads

This paper reports on the use of a digital microfluidic platform to perform multiplex automated genetic engineering (MAGE) cycles on droplets containing Escherichia coli cells. Bioactivated magnetic beads were employed for cell binding, washing, and media exchange in the preparation of electrocompetent cells in the electrowetting-on-dieletric (EWoD) platform. On-cartridge electroporation was used to deliver oligonucleotides into the cells. In addition to the optimization of a magnetic bead-based benchtop protocol for generating and transforming electrocompetent E. coli cells, we report on the implementation of this protocol in a fully automated digital microfluidic platform. Bead-based media exchange and electroporation pulse conditions were optimized on benchtop for transformation frequency to provide initial parameters for microfluidic device trials. Benchtop experiments comparing electrotransformation of free and bead-bound cells are presented. Our results suggest that dielectric shielding intrinsic to bead-bound cells significantly reduces electroporation field exposure efficiency. However, high transformation frequency can be maintained in the presence of magnetic beads through the application of more intense electroporation pulses. As a proof of concept, MAGE cycles were successfully performed on a commercial EWoD cartridge using variations of the optimal magnetic bead-based preparation procedure and pulse conditions determined by the benchtop results. Transformation frequencies up to 22% were achieved on benchtop; this frequency was matched within 1% (21%) by MAGE cycles on the microfluidic device. However, typical frequencies on the device remain lower, averaging 9% with a standard deviation of 9%. The presented results demonstrate the potential of digital microfluidics to perform complex and automated genetic engineering protocols.

Homo- and Co-Polycarbonates and Blends Derived from Diphenolic Acid

The properties of materials derived from diphenolic acid (4-(bis(hydroxyphenyl))pentanoic acid, DPA), such as polycarbonate homo- and co-polymers (with bisphenol A, BPA), have been determined. The influence of copolymer composition on the thermal properties of these materials has been determined. Blends of polycarbonates from BPA and from DPA appear to be compatible.

SU-F-BRCD-06: Multiple Anatomy Optimization of Accumulated Dose

PURPOSE

Multiple anatomy optimization (MAO) utilizing deformable dose accumulation on entire 4DCT data sets is implemented to overcome ambiguity between optimal dose defined on a single anatomy and optimal accumulated dose resulting from dose delivery to moving and deforming anatomy.

METHODS

Six lung cancer patients are planned using two methods of radiotherapy optimization: the internal target volume (ITV) envelope method and MAO, which simultaneously optimizes a single fluence for delivery to all 10 breathing phases such that the accumulated dose satisfies the plan objectives. Target dose is constrained to 70 Gy. The ITV-plan is optimized on a single breathing phase with the planning target volume defined as the ITV; the MAO target is the moving CTV. MAO is compared to single image ITV optimization based on the accumulated dose assuming equal monitor-units to each phase. Dose-volume differences between single image estimations and 10-image accumulation are examined.

RESULTS

Single image optimal dose distributions overestimate target V70 by 4.2%±3.1% (average, one standard deviation) and in five of six cases ipsilateral lung V20 is underestimated (1.4%±0.9%). For these five cases, MAO increases V70 by 2.8%±2.5% (maximum of 6% increase in V70) and reduces ipsilateral lung V20 by up to 3% (average decrease of 1.2%±1.3%). Contralateral lung V20, esophagus V25, and heart V30 are also reduced by up to 5%, 3%, and 3%. For the sixth case, lung tumor motion is on the order of the dose voxel size (3mm), and MAO did not improve upon the ITV plan.

CONCLUSIONS

Dose-volume optimization on a stationary image does not ensure accumulated dose coverage to the moving CTV. Multiple anatomy optimization can remove dose ambiguity and improve plan quality. P01CA11602 and Philips Medical Systems.

Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice

BACKGROUND

The incidence and prevalence of obesity are increasing world wide. In the UK, obesity governmental strategy has primarily focused on prevention measures, with less focus on the demands of treating obese patients in hospital. Increasing service demand by obese patients coupled with a lack of adequate provision for care of these patients may lead to an increase in patient safety incidents. By classifying patient safety incidents associated with obesity reported to the National Patient Safety Agency, this report aims to identify areas for improvement in the quality and safety of care of the obese patient.

METHODS

A search of the National Reporting and Learning System database was conducted for all incidents caused by or relating to obesity for the period 1 January 2005 to 31 August 2008. The keywords 'obesity', 'overweight', 'BMI' (body mass index), and 'bariatric' were used. The relevant free text fields of the resulting set of incidents were then searched for the terms designed to isolate incidents occurring in anaesthesia, critical care, and surgery. Reported incidents were analysed and subsequently categorised to identify incident themes. Levels of harm were also established.

RESULTS

555 patient safety incidents were identified; 388 met inclusion criteria for analysis. 148 incidents were related to assessment, diagnosis or treatment, 213 related to infrastructure and 27 related to staffing. The majority of incidents were classified as no or low harm. Three deaths were reported, all within the domain of anaesthesia.

CONCLUSIONS

This report identifies that the majority of safety incidents associated with obesity were related to infrastructure, suggesting that there is inadequate provision in place for the care of obese patients. While levels of harm were mostly low, the occurrence of incidents resulting in severe harm or death highlights the specific dangers associated with the care of the obese patient. A global approach to improving the safety of care delivery for obese patients is recommended, including obesity specific training, management structures, care pathways, and equipment provisioning.Further planning and development of operation policies is needed to ensure the safe delivery of healthcare to obese patients in the future.

Excellence in teaching for promotion and tenure in animal and dairy sciences at doctoral/research universities: a faculty perspective

In this study, animal or dairy sciences faculty from doctoral/research universities were surveyed to clarify teaching performance expectations for the purpose of promotion and tenure of assistant professors. A survey tool including 15 evaluation criteria was available online and at the registration desk of the 2005 Joint Annual Meeting of the American Dairy Science Association and the American Society of Animal Science. The analyzed data set included 47 faculty (41 tenured and 6 tenure-track) with a substantial teaching responsibility from 27 different departments in 25 states. Four criteria were perceived as currently overemphasized: student evaluation of the instructor, student evaluation of the course, authoring peer-reviewed publications, and authoring an undergraduate textbook or book chapter. Nevertheless, more than 50% of respondents reported that these criteria should be used. One criterion emerged as being currently underemphasized: documentation of personal assessment of one's own teaching by preparing a portfolio. The lack of consensus for the remaining 10 items may have reflected substantial differences in institutional practices. The significance of overemphasis or underemphasis of certain criteria varied substantially depending on the respondent's perceived institutional mission. When asked about recognition within their department, 68% of respondents indicated that efforts in teaching improvement were properly rewarded. Respondents doubted the meaningfulness and appropriateness of student ratings tools as currently used. Results also suggested that animal and dairy science faculty placed a higher value on criteria recognizing excellence in teaching based on intradepartmental recognition (e.g., interactions with close-up peers and students) rather than recognition within a broader community of scholars as evidenced by authorship or success in generating funding for teaching. Proposed improvements in the evaluation of teaching for promotion and tenure include 1) providing tenure-track faculty with written guidelines at the time of hiring; 2) ensuring that student ratings tools are reliable and valid; 3) carefully mentoring new faculty within the departmental and institutional culture; and 4) encouraging self-reflection and documentation of attempts to address pedagogical issues in one's own teaching. Educational leaders in doctoral/research universities should promote changes to enhance teaching performance of future faculty graduating from their institutions.

Chitin Degradation Proteins Produced by the Marine Bacterium Vibrio harveyi Growing on Different Forms of Chitin

Relatively little is known about the number, diversity, and function of chitinases produced by bacteria, even though chitin is one of the most abundant polymers in nature. Because of the importance of chitin, especially in marine environments, we examined chitin-degrading proteins in the marine bacterium Vibrio harveyi. This bacterium had a higher growth rate and more chitinase activity when grown on (beta)-chitin (isolated from squid pen) than on (alpha)-chitin (isolated from snow crab), probably because of the more open structure of (beta)-chitin. When exposed to different types of chitin, V. harveyi excreted several chitin-degrading proteins into the culture media. Some chitinases were present with all of the tested chitins, while others were unique to a particular chitin. We cloned and identified six separate chitinase genes from V. harveyi. These chitinases appear to be unique based on DNA restriction patterns, immunological data, and enzyme activity. This marine bacterium and probably others appear to synthesize separate chitinases for efficient utilization of different forms of chitin and chitin by-products.

H-gene-mediated resistance to Hessian fly exhibits features of penetration resistance to fungi

Features shared by host-specific phytophagous insects and biotrophic plant pathogens include gene-for-gene interactions and the ability to induce susceptibility in plants. The Hessian fly shows both. To protect against Hessian fly, grasses have H genes. Avirulent larvae die on H-gene-containing resistant plants but the cause of death is not known. Imaging techniques were used to examine epidermal cells at larval attack sites, comparing four resistant wheat genotypes (H6, H9, H13, and H26) to a susceptible genotype. Present in both resistant and susceptible plants attacked by larvae were small holes in the tangential cell wall, with the size of the holes (0.1 microm in diameter) matching that of the larval mandible. Absent from attacked resistant plants were signs of induced susceptibility, including nutritive tissue and ruptured cell walls. Present in attacked resistant plants were signs of induced resistance, including cell death and fortification of the cell wall. Both presumably limit larval access to food, because the larva feeds on the leaf surface by sucking up liquids released from ruptured cells. Resistance was associated with several subcellular responses, including elaboration of the endoplasmic reticulum-Golgi complex and associated vesicles. Similar responses are observed in plant resistance to fungi, suggesting that "vesicle-associated penetration resistance" also functions against insects.

Synthesis and characterization of fluorescent displacers for online monitoring of displacement chromatography

One of the major impediments to the implementation of displacement chromatography for the purification of biomolecules is the need to collect fractions from the column effluent for time-consuming offline analysis. The ability to employ direct online monitoring of displacement chromatography would have significant implications for applications ranging from analytical to preparative bioseparations. To this end, a set of novel fluorescent displacers were rationally designed using known chemically selective displacers as a template. Fluorescent cores were functionalized with different charge moieties, creating a homologous library of displacers. These compounds were then tested on two protein pairs, alpha-chymotrypsinogen A/ribonuclease A and cytochrome c/lysozyme, using batch and column displacement experiments. Of the synthesized displacers, two were found to be highly selective while one was determined to be a high-affinity displacer. Column displacements using one of the selective displacers yielded complete separation of both protein pairs while facilitating direct online detection using UV and fluorescence detection. Saturation transfer difference NMR was also carried out to investigate the binding of the fluorescent displacers to proteins. The results indicated a selective binding between the selective displacers and alpha-chymotrypsinogen A, while no binding was observed for ribonuclease A, confirming that protein-displacer binding is responsible for the selectivity in these systems. This work demonstrates the utility of fluorescent displacers to enable online monitoring of displacer breakthroughs while also acting as efficient displacers for protein purification.

A simple radon chamber for educational use

Radon chambers are typically able to maintain a constant, known concentration of radon by pumping a constant activity concentration of radon gas into the chamber. A radon chamber has been designed by placing a radon source inside the chamber volume and allowing radon to build up inside the chamber. Because the radon concentration is not constant, calculations have been made to determine the integrated equivalent constant radon concentration in MBqhm for up to 4 d. The chamber, made by placing a radium dial inside an incubator, has interior dimensions of 87.6 cm x 55.9 cm x 51.4 cm for a total volume of 0.25 m. The chamber can produce an integrated equivalent constant radon activity concentration level of 0.013 MBq h m over the initial 24 h, 0.043 MBq h m over the initial 48 h, 0.078 MBq h m over the initial 72 h, and 0.118 MBq h m over the initial 96 h. The chamber can also demonstrate, for educational purposes, the kinetics of the build-up of a radioactive gas in an enclosed environment as well as the kinetics of washout and leakage.

Soybean hulls as an alternative feed for horses

Soybean hulls have been successfully fed to ruminant animals as an economical substitute for hay. This feedstuff is a source of highly digestible fiber that does not contain starch. The purpose of this trial was to evaluate soybean hulls as a replacement fiber in horse diets. Four cecally cannulated Quarter Horse geldings, aged 6 to 10 yr and averaging 502 kg, were used in a 4 x 4 Latin square design with 21-d periods. Diets consisted of alfalfa/bromegrass hay (14.4% CP, 58.1% NDF, 39.1% ADF; DM basis) with the replacement of either 0, 25, 50, or 75% (as-fed basis) unpelleted soybean hulls (13.1% CP, 60.6% NDF, 43.7% ADF; DM basis). Diets were offered at 1.8% of BW (DM) daily and body weights were measured weekly. Cecal samples (90 min after feeding) and total fecal collections (3 d) were taken at the end of each treatment period. Fecal collection bags were emptied every 6 h and 10% of the total amount was frozen for later analysis. Total cecal VFA production increased linearly (P = 0.02) from 70 mM to 109 mM as proportions of soybean hulls in diets increased. Proportions of propionate increased linearly (P < 0.01) with means of 15.7, 18.0, 16.6, and 21.9 mol/100 mol total VFA for the 0, 25, 50, and 75% soybean hulls diets respectively. Proportions of butyrate decreased linearly (P < 0.01) from 5.3 to 3.9 mol/100 mol total VFA. The acetate:propionate ratio decreased linearly (P = 0.02) and cubically (P = 0.03) with means of 4.9, 4.2, 4.9, and 3.3. Apparent digestibility of DM (P = 0.95), OM (P = 0.70), NDF (P = 0.34), ADF (P = 0.31), cellulose (P = 0.93), and hemicellulose (P = 0.25) did not differ among treatments. Apparent digestibility of N decreased linearly (P < 0.01) as concentrations of soybean hulls increased in the diet, and this response was associated with increased cecal fermentation and microbial biomass production. Cecal pH decreased linearly (P = 0.01) from 7.00 to 6.45 as the level of soybean hulls increased, but there was no change (P = 0.68 for the linear effect) for cecal ammonia (mean concentration of 3.85 mM). Soybean hulls stimulate cecal fermentation and are a suitable replacement for hay in equine diets.

Botulinum toxin injection inhibits myogenic tone and sympathetic nerve function in the porcine internal anal sphincter

OBJECTIVE

Botulinum toxin is an effective treatment for anal fissure, though there is a lack of agreement over the optimal site for its injection. This reflects our current ignorance of its mechanism, and whether it has any action on the nerves of the internal anal sphincter (IAS). This study set out to resolve this issue through use of a pig model.

MATERIALS AND METHODS

Eight pigs were studied in pairs: one of each pair received a botulinum toxin injection into the anal sphincter, whilst the other acted as its control. Manometry was performed every two weeks under anaesthesia. Pigs were slaughtered at between four and six weeks after injection and the properties of the IAS compared in vitro.

RESULTS

Whilst maximum anal resting pressure (MARP) increased slowly in control pigs during the experimental period, reflecting weight gain, a fall was observed in treated pigs. In vitro, IAS strips from control pigs generated 400 mg of spontaneous tone per gram of tissue (+/- 45; standard error), compared to 250 (+/- 25) mg/g tissue from treated pigs (P < 0.01). Electric Field Stimulation at 50 Hz produced 150 (+/- 22) mg contraction/gram tissue in IAS strips from control pigs compared to 53 (+/- 13) mg/g tissue in treated pigs (P < 0.0005). This contractile response was blocked by guanethidine.

CONCLUSION

Botulinum toxin has a significant action on the IAS. It reduces myogenic tone and contractile responses of this tissue to sympathetic nerve stimulation. Further studies are required to clarify its mechanism of action more precisely.

By-product feeds for meat goats: effects on digestibility, ruminal environment, and carcass characteristics

Crossbred wether goats (n = 24; 50% Boer, 6 per diet) initially averaging 27.4+/-0.4 kg were fed either wheat middlings (wheat midds), soybean hulls (soyhulls), or corn gluten feed at 1% BW (as-fed) along with orchardgrass hay (10.7% CP) offered to ad-libitum consumption for 72 d followed by 5 d total fecal collection. The Control (hay) diet was supplemented with 5.7% soybean meal to bring total dietary protein to 12.5%, by-products were brought to a higher Ca:P ratio with limestone or dicalcium phosphate to make total dietary Ca:P 1.5:1, and soybean meal was added to soyhulls to bring them up to 17% CP (wheat midds = 17% and corn gluten feed = 21% CP). Total DMI (916 g/d+/-57 or 3.2%+/-0.2 BW) did not differ (P > 0.92) among treatments. Initial BW (P = 0.25), final BW (P = 0.48), and ADG (P = 0.56) did not differ for the four treatments. Carcass weight was greater (P = 0.05) for goats fed soyhulls (16.0 kg) or wheat midds (15.6 kg) as compared with goats fed the hay diet (14.5 kg), with carcass weight from goats fed corn gluten feed being intermediate (15.3 kg, SEM = 0.3 kg). Carcass grade did not differ (P = 0.80) and averaged 5.42+/-0.4. Dressing percentage tended (P = 0.12) to be lower for goats fed the hay diet (46.4%) compared with soyhull (48.3%), corn gluten feed (48.3%), or wheat midd (48.8%) diets (SEM = 0.7). Ruminal pH was highest (P < 0.01) for goats fed the hay diet (6.52) and lowest for goats fed wheat midds (6.23) with soyhull (6.41) and corn gluten feed diets (6.35) being intermediate (SEM = 0.05). Digestibility of DM (70.1+/-2.5%), OM (70.3+/-2.6%,), CP (75.5+/-2.0%), GE (68.5+/-2.7%), NDF (68.1+/-3.0%), ADF (65.4+/-3.4%), cellulose (70.1+/-2.9%), and lignin (31.1+/-8.2%) did not differ (P > 0.15). Total ruminal VFA did not differ (86.0+/-6.1 mM, P = 0.59), but acetate:propionate ratio was higher (P < 0.01) for hay (3.1) and soyhull diets (3.3) than for corn gluten feed (2.4) and wheat midd diets (2.4, SEM = 0.11). Ruminal ammonia (mg/100 mL) was lower (P < 0.01) for goats fed hay (15.4) and soyhull diets (11.6) than those fed corn gluten feed (25.2) and wheat midd diets (23.0, SEM = 1.35). Ruminal pH was lower for goats fed the byproducts, but remained above 6. Serum urea nitrogen (mg/100 mL) averaged 21.0+/-1.0 (P = 0.11) with soyhulls tending to be lowest (19.3) and corn gluten feed tending to be highest (22.8). Soyhulls, corn gluten feed, and wheat midds appear to be viable feed ingredients for meat goat diets.

Stationary phase effects on the dynamic affinity of low-molecular-mass displacers

In this paper, the selectivity of a variety of cation-exchange stationary phases was investigated using a homologous series of displacer molecules based on pentaerythritol. These displacers were derived from pentaerythritol and contained either four trimethyl ammonium groups [pentaerythrityl-(trimethylammonium chloride)4, PE(TMA)4], benzene rings [pentaerythrityl-(benzyl dimethylammonium chloride)4, PE(DMABzCl)4], heptyl groups [pentaerythrityl-(heptyl dimethylammonium iodide)4, PE(DMAHepI)4] or cyclohexyl groups [pentaerythrityl-(cyclohexyl dimethylammonium iodide)4, PE(DMACyI)4]. This series enabled us to probe the secondary interactions that can play a role in the affinity of low-molecular-mass displacers for different stationary phases. The relative affinities of these displacers were examined using a displacer ranking plot based on the steric mass action (SMA) isotherm model. While hydrophobicity and aromaticity played important roles in generating the affinity to the hydrophilized polystyrene-divinylbenzene (Source 15S) and polymethacrylate-based (Toyopearl 650M) resins, these secondary interactions had a minimal impact on the selectivity in agarose resins coated with dextran (SP Sepharose XL), "gel in a shell" (S Ceramic HyperD F), and monolithic (Bio-Rad Uno S6) cation-exchange materials. Further, the results with a tentacular stationary phase (Fractogel EMD) suggest that the alkyl chains on PE(DMAHepI)4 play an important role in increasing the affinity, possibly because of strong interactions between the alkyl moiety and the polymer matrix as well as between the charged groups and the polyelectrolyte tentacles. The results of this study provide insight into the design of high affinity, low-molecular-mass displacers for different cation-exchange stationary phase materials.

Net absorption and utilization of nitrogenous compounds across ruminal, intestinal, and hepatic tissues of growing beef steers fed dry-rolled or steam-flaked sorghum grain

Our objectives were to determine effects of grain processing on splanchnic (gut tissues and liver) N metabolism and whole-body N balance by growing steers and to ascertain the relative contributions of ruminal and intestinal tissues to net absorption and utilization of N-containing nutrients. Seven beef steers (348 kg initial BW), surgically implanted with appropriate catheters, were fed diets containing 77% steam-flaked (SF) or dry-rolled (DR) sorghum grain. Blood flows and net output or uptake of ammonia N, urea N, and alpha-amino N (estimate of amino acids) were measured across portal-drained viscera (PDV or gut tissues) and intestinal, ruminal, hepatic, and splanchnic tissues (PDV + hepatic). The experimental design was a crossover between DR and SF diets, with six samplings of blood at 2-h intervals on 2 d for each steer. Nitrogen intake (139 +/- 3 g/d), output in urine (43 +/- 2 g/d), and retention (40 +/- 3 g/d) were similar for both processing treatments. When steers were fed SF sorghum compared to DR sorghum, N retention as a percentage of N intake was numerically greater (P < 0.12), output of fecal N was numerically lower (P < 0.13), and urinary urea N was lower (P < 0.04). For SF vs DR, net uptake of alpha-amino N by liver was higher (P < 0.04; 20 vs 9 g/d) and was numerically lower (P < 0.16) for ruminal tissues (15 vs 33 g/d). Feeding steers SF compared to DR tended to increase net transfer (cycling) of blood urea N to PDV (57 vs 41 g/d; P < 0.07), increased cycling to intestinal tissues (15 vs 6 g/d; P < 0.05), and numerically increased transfer to ruminal tissues (42 vs 32 g/d; P < 0.12) but did not alter other net output or uptake of N across splanchnic tissues. Total urea N transfer (blood + saliva) was similar for both treatments. Net uptake of alpha-amino N by ruminal tissues was about 30% of the net amount of alpha-amino N absorbed across the intestinal tissues. In summary, most of the blood urea N cycled from the liver to gut tissues was transferred to ruminal tissues for potential microbial protein synthesis, and the net ruminal utilization of alpha-amino N was about 30% of that absorbed from intestinal tissues. Feeding growing steers SF compared to DR sorghum diets numerically increased whole-body N retention (percentage of N intake) by about 15% and tended to increase transfer of blood urea N to the gut by about 40%, which could increase the supply of high-quality microbial protein for absorption.

Regional estimation of current and future forest biomass

The 90,674 wildland fires that burned 2.9 million ha at an estimated suppression cost of $1.6 billion in the United States during the 2000 fire season demonstrated that forest fuel loading has become a hazard to life, property, and ecosystem health as a result of past fire exclusion policies and practices. The fire regime at any given location in these regions is a result of complex interactions between forest biomass, topography, ignitions, and weather. Forest structure and biomass are important aspects in determining current and future fire regimes. Efforts to quantify live and dead forest biomass at the local to regional scale has been hindered by the uncertainty surrounding the measurement and modeling of forest ecosystem processes and fluxes. The interaction of elevated CO2 with climate, soil nutrients, and other forest management factors that affect forest growth and fuel loading will play a major role in determining future forest stand growth and the distribution of species across the southern United States. The use of satellite image analysis has been tested for timely and accurate measurement of spatially explicit land use change and is well suited for use in inventory and monitoring of forest carbon. The incorporation of Landsat Thematic Mapper data coupled with a physiologically based productivity model (PnET), soil water holding capacity, and historic and projected climatic data provides an opportunity to enhance field plot based forest inventory and monitoring methodologies. We use periodic forest inventory data from the USDA Forest Service's Forest Inventory and Analysis (FIA) project to obtain estimates of forest area and type to generate estimates of carbon storage for evergreen, deciduous, and mixed forest classes for use in an assessment of remotely sensed forest cover at the regional scale for the southern United States. The displays of net primary productivity (NPP) generated from the PnET model show areas of high and low forest carbon storage potential and their spatial relationship to other landscape features for the southern United States. At the regional scale, predicted annual NPP in 1992 ranged from 836 to 2181 g/m2/year for evergreen forests and 769-2634 g/m2/year for deciduous forests with a regional mean for all forest land of 1448 g/m2/year. Prediction of annual NPP in 2050 ranged from 913 to 2076 g/m2/year for evergreen forest types to 1214-2376 g/m2/year for deciduous forest types with a regional mean for all forest land of 1659 g/m2/year. The changes in forest productivity from 1992 to 2050 are shown to display potential areas of increased or decreased forest biomass. This methodology addresses the need for spatially quantifying forest carbon in the terrestrial biosphere to assess forest productivity and wildland fire fuels.

Quenching of biotinylated aequorin bioluminescence by dye-labeled avidin conjugates: application to homogeneous bioluminescence resonance energy transfer assays

[see reaction]. Avidin conjugates containing the covalently attached dyes QSY-7 and dabcyl were prepared and shown to quench the bioluminescence of biotinylated aequorin. Quenching efficiency was shown to be dependent on both the label-to-avidin ratio and the concentration of the avidin conjugate. These properties were exploited to develop a homogeneous bioluminescence resonance energy transfer (BRET) assay for biotin.

Design of Acridinium-9-carboxamides and Anti-acridinium Antibodies for Chemiluminescent Signal Enhancement

A novel system of signal enhancement is presented in which every labeled antibody is capable of generating a signal. Three chemiluminescent acridinium-9-carboxamide haptens (1, 2, and 3) which incorporated differences in charge and location of the linker were designed and synthesized. Anti-acridinium polyclonal antibodies for each hapten were screened using surface plasmon resonance instrumentation to determine specificity for each hapten. Anti-acridinium 2 antibodies were found to be non-cross-reactive to acridinium 1. This property was exploited to design secondary antibody conjugates which would bind to primary antibodies labeled with 2 yet could still be labeled with the structurally similar acridinium 1. Consequently, both layers contributed to the overall chemiluminescent signal. This format is an advance over other signal amplification formats which employ non-signal-generating, labeled antibodies to construct multilayered systems.

Factors influencing blood flow patterns in the human right coronary artery

Evidence suggests that atherogenesis is linked to local hemodynamic factors such as wall shear stress. We investigated the velocity and wall shear stress patterns within a human right coronary artery (RCA), an important site of atherosclerotic lesion development. Emphasis was placed on evaluating the effect of flow waveform and inlet flow velocity profile on the hemodynamics in the proximal, medial, and distal arterial regions. Using the finite-element method, velocity and wall shear stress patterns in a rigid, anatomically realistic model of a human RCA were computed. Steady flow simulations (ReD=500) were performed with three different inlet velocity profiles; pulsatile flow simulations utilized two different flow waveforms (both with Womersley parameter=1.82, mean ReD=233), as well as two of the three inlet profiles. Velocity profiles showed Dean-like secondary flow features that were remarkably sensitive to the local curvature of the RCA model. Particularly noteworthy was the "rotation" of these Dean-like profiles, which produced large local variations in wall shear stress along the sidewalls of the RCA model. Changes in the inlet velocity profiles did not produce significant changes in the arterial velocity and wall shear stress patterns. Pulsatile flow simulations exhibited remarkably similar cycle-average wall shear stress distributions regardless of waveform and inlet velocity profile. The oscillatory shear index was very small and was attributed to flow reversal in the waveform, rather than separation. Cumulatively, these results illustrate that geometric effects (particularly local three-dimensional curvature) dominate RCA hemodynamics, implying that studies attempting to link hemodynamics with atherogenesis should replicate the patient-specific RCA geometry.

8 french transradial coronary interventions: clinical outcome and late effects on the radial artery and hand function

BACKGROUND

Limited information is available on the effects of 8 French (Fr) transradial procedures on radial patency. In addition, the effects of radial procedures and radial occlusion on hand function are unknown.

METHODS

Two groups were recruited: twenty-four patients who had undergone 26 transradial 8 Fr interventions and 16 patients who had undergone 16 transradial 6 Fr procedures. At 1 year, radial patency, hand strength and hand endurance were measured.

RESULTS

No major adverse cardiac events or vascular complications were noted in either group. Late radial occlusion was noted in 2/18 (11%) 8 Fr patients and 3/16 (19%) 6 Fr patients (p = ns). There were no differences in the 8 Fr group between the catheterized and uncatheterized radial arteries for diameter (3.2 +/- 1.1 mm versus 3.3 +/- 0.7 mm, respectively; p = NS) or volumetric flow (55 +/- 51 ml/minute versus 57 +/- 45 ml/minute, respectively; p = NS). No differences in hand strength or hand endurance were seen between the catheterized and uncatheterized arms in the 8 Fr group, between the 8 Fr and 6 Fr groups, or between occluded and non-occluded patients.

CONCLUSION

Transradial use of 8 Fr guiding catheters appears to be feasible and safe in highly selected patients, albeit associated with a low incidence of silent radial occlusion. Additionally, neither the use of 8 Fr sheaths nor the presence of radial artery occlusion appear to adversely affect hand strength or endurance.

Purification of oligonucleotides by high affinity, low molecular weight displacers

High affinity, low molecular weight anionic displacers were successfully employed for the purification of antisense oligonucleotides. Several important structural characteristics were identified that contribute to the affinity of low molecular weight displacers to a hydrophilized polystyrene divinyl benzene anion exchanger. Sulfonic acid groups were found to possess higher affinity than carboxylic acid and phosphate functionalities, and nonspecific interactions (particularly hydrophobic interactions) were shown to play a major role in the retention process on this stationary phase material. Using this information, two high affinity, low molecular weight displacers were identified. These molecules are relatively inexpensive organic dyes that possess multiple sulfonic acid moieties, as well as aromatic functionalities, which increase nonspecific interactions with the stationary phase. These high affinity displacers, which can be readily detected, were then employed to displace several strongly retained antisense oligonucleotides that could not be displaced by previously established low molecular weight displacers. The displacement process resulted in very high purities of the antisense oligonucleotides. The results presented in this paper are significant in that they demonstrate that low molecular weight displacers for ion-exchange chromatography can possess equal to or greater affinities than their higher molecular weight counterparts, when nonspecific interactions with the stationary phase are exploited. In addition, the results illustrate the high resolutions possible with displacement chromatography and demonstrate an attractive technology for the process scale purification of oligonucleotides.

Binding interactions of vancomycin tracers with a bacterial cell wall peptidoglycan analogue

Binding interactions between several vancomycin tracers and (N,N'-diacetyl)KDADA in solution were evaluated in a competition format using a surface plasmon resonance instrument. Tracers derivatized from the carboxy terminus or the N-vancosaminyl sugar moiety of vancomycin bind the peptide with an affinity similar to that of underivatized vancomycin. In contrast, N-methylleucyl derivatized vancomycin tracers bind the peptide with a reduced affinity relative to vancomycin.

Use of advanced breast biopsy instrumentation while performing stereotactic breast biopsies: review of 150 consecutive biopsies

BACKGROUND

Stereotactic breast biopsies are being performed in the United States with increasing frequency. Advanced breast biopsy instrumentation (ABBI) is a recent addition to the list of available stereotactic breast biopsy devices (eg, fine-needle aspiration, automated needle cores, and vacuum-assisted devices). Indications for the ABBI procedure in the management of patients with nonpalpable mammographic lesions have not been established.

STUDY DESIGN

Prospectively collected data on 150 patients biopsied with the ABBI procedure were reviewed.

RESULTS

From April 1996 to May 1997, 150 patients with indeterminate or suspicious nonpalpable mammographic lesions were biopsied using the ABBI technique. Complications were minor. One patient (0.6%) required a repeat biopsy because of insufficient tissue and one patient had repeat excision to confirm the diagnosis of atypical ductal hyperplasia. Cancer was diagnosed in 26%. Followup mammograms were obtained in 94% of the patients. Lesions were missed in three patients (2%), none of whom were later found to have cancer. One patient (0.6%) required a repeat ABBI biopsy for postbiopsy architectural distortion. Postprocedure mammographic scarring was otherwise minimal and was noted in only 16% of the patients. Of the 111 patients with benign diagnoses, 67 were seen for clinical followup; 98% had good cosmetic outcomes and were satisfied with the ABBI technique.

CONCLUSIONS

The ABBI technique is a safe, reliable stereotactic breast biopsy technique that is well accepted by patients. The sensitivity and specificity of ABBI biopsy for the diagnosis of carcinoma in this series were each 100% for the 142 patients returning for followup. Indications for the technique are similar to those for traditional needle localization excisional breast biopsies.

Escherichia coli dimethylallyl diphosphate:tRNA dimethylallyltransferase: pre-steady-state kinetic studies

Escherichia coli dimethylallyl diphosphate:tRNA dimethylallyltransferase (DMAPP-tRNA transferase) catalyzes the first step in the biosynthesis of the hypermodified A37 residue in tRNAs that read codons beginning with uridine. The mechanism of the enzyme-catalyzed reaction was studied by isotope trapping, pre-steady-state rapid quench, and single turnover experiments. Isotope trapping indicated that the enzyme.tRNA complex is catalytically competent, whereas the enzyme.DMAPP complex is not. The results are consistent with an ordered sequential mechanism for substrate binding where tRNA binds first. The association and dissociation rate constants for the enzyme.tRNA binary complex are 1. 15+/-0.33x10(7) M(-1) s(-1) and 0.06+/-0.01 s(-1), respectively. Addition of DMAPP gives an enzyme.tRNA.DMAPP ternary complex in rapid equilibrium with the binary complex and DMAPP. Rapid quench studies yielded a linear profile (k(cat)=0.36+/-0.01 s(-1)) with no evidence for buildup of enzyme-bound product. Product release from DMAPP-tRNA transferase is therefore not rate-limiting. The Michaelis constant for tRNA and the equilibrium dissociation constant for DMAPP calculated from the individual rate constants determined here are consistent with values obtained from a steady-state kinetic analysis.

Evaluation of chemiluminescent estradiol conjugates by using a surface plasmon resonance detector

A series of chemiluminescent 17beta-estradiol probes were synthesized. Relative equilibrium dissociation constants (K(D)) for the interaction of an anti-E(2) Fab fragment for the probes in solution were evaluated using a single E(2)-analog biosensor surface on a BIAcore surface plasmon resonance instrument. The results show the antibody fragment binds all chemiluminescent conjugates tested with high affinity showing only minor preferences for site of substitution (C6 versus C7), stereochemistry (alpha versus beta), or linker moiety.

Application of surface plasmon resonance toward studies of low-molecular-weight antigen-antibody binding interactions

Methods for studying low-molecular-weight antigen-antibody binding interactions using surface plasmon resonance detection are presented. The experimental parameters most relevant to studies of low-molecular-weight antigen-antibody binding interactions are discussed. Direct kinetic analysis of the binding interactions is most informative, providing both apparent association and dissociation rate constants from which equilibrium constants can be calculated. Equilibrium analysis, including steady-state and solution affinity studies, offers an alternative approach to direct kinetic analysis when knowledge of the individual kinetic rate constants is not required or difficult to determine. The various methods are illustrated by studies of an anti-T(4) Fab fragment binding interaction with several thyroxine analogs. The methods utilized were dependent on the affinity of the interaction. The high-affinity anti-T(4) Fab fragment/l-T(4) binding interaction was evaluated using direct kinetic analysis. An intermediate affinity anti-T(4) Fab fragment/l-T(3) binding interaction was evaluated using a combination of direct kinetic analysis, steady-state analysis, and solution affinity analysis. The relatively weak anti-T(4) Fab fragment/l-T(2) binding interaction was evaluated using steady-state and solution affinity analysis protocols. Several thyroxine tracers that could not be immobilized to a biosensor surface were also evaluated via the solution affinity format. In cases where a given binding interaction was examined using multiple methods the results were comparable.