CRISPR-Cas9: A Potent Gene-editing Tool for the Treatment of Cancer

The prokaryotic adaptive immune system has clustered regularly interspaced short palindromic repeat. CRISPR-associated protein (CRISPR-Cas) genome editing systems have been harnessed. A robust programmed technique for efficient and accurate genome editing and gene targeting has been developed. Engineered cell therapy, in vivo gene therapy, animal modeling, and cancer diagnosis and treatment are all possible applications of this ground-breaking approach. Multiple genetic and epigenetic changes in cancer cells induce malignant cell growth and provide chemoresistance. The capacity to repair or ablate such mutations has enormous potential in the fight against cancer. The CRISPR-Cas9 genome editing method has recently become popular in cancer treatment research due to its excellent efficiency and accuracy. The preceding study has shown therapeutic potential in expanding our anticancer treatments by using CRISPR-Cas9 to directly target cancer cell genomic DNA in cellular and animal cancer models. In addition, CRISPR-Cas9 can combat oncogenic infections and test anticancer medicines. It may design immune cells and oncolytic viruses for cancer immunotherapeutic applications. In this review, these preclinical CRISPRCas9- based cancer therapeutic techniques are summarised, along with the hurdles and advancements in converting therapeutic CRISPR-Cas9 into clinical use. It will increase their applicability in cancer research.

Clinical Utility of Albumin Bilirubin Grade as a Prognostic Marker in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: a Systematic Review and Meta-analysis

PURPOSE

Hepatic function is a key prognostic marker in patients with hepatocellular cancer (HCC) and central to patient selection for transarterial chemoembolization (TACE). We investigated the clinical utility of the Albumin-Bilirubin (ALBI) grade, an emerging prognostic model, in this heterogenous cohort via a meta-analysis of published studies.

METHODS

Publications including full text articles and abstracts regarding ALBI grade were sourced by two independent researchers from databases including PubMed, Embase, Medline and Cochrane Library. Studies analysing patients with HCC undergoing TACE treatment were systematically screened utilising the PRISMA tool for data extraction and synthesis, after exclusion of duplicates, irrelevant studies and overlapping cohorts. The primary outcome was overall survival (OS), as determined by ALBI grade and assessed by hazard ratio (HRs) with 95% confidence intervals (CIs), with analysis of collated data using comprehensive meta-analysis, version 3.0 software.

RESULTS

Eight studies were included, with a pooled population of 6538 patients with HCC that underwent TACE treatment. Higher pre-treatment grade was associated with poor OS, with median OS of 12.0 months (P < 0.001) in ALBI grade 3, compared to 33.5 months in ALBI grade 1 (P < 0.001). Significant heterogeneity within each ALBI grade was associated with age and tumour size (P < 0.001) in ALBI grades 1 and 2. In contrast, age and alcohol-related liver disease were significant in the ALBI grade 3 group (P < 0.001).

CONCLUSIONS

High pre-treatment ALBI grade is associated with poorer prognosis in patients with HCC undergoing TACE therapy. The ALBI grade demonstrates clinical utility for clinical prognostication and patient selection for TACE.

Tacrolimus for the Management of Delayed Onset and Treatment-Refractory Immune-Related Hepatitis

Immune checkpoint inhibitors, such as pembrolizumab, are effective in the management of metastatic malignancies, such as melanoma, and are associated with a spectrum of immune-related organ toxicities, including immune-related hepatitis (ir-hepatitis). The clinical presentation of ir-hepatitis varies in onset and severity, and management involves immunosuppression with corticosteroids and mycophenolate mofetil as first and second-line agents. Several agents have been proposed as third-line options for treatment-refractory disease. We report the successful use of tacrolimus for delayed onset and treatment-refractory ir-hepatitis secondary to pembrolizumab.

Evaluation of advanced, pathophysiologic new targets for imaging of CNS

The inadequate information about the in vivo pathological, physiological, and neurological impairments, as well as the absence of in vivo tools for assessing brain penetrance and the efficiency of newly designed drugs, has hampered the development of new techniques for the treatment for variety of new central nervous system (CNS) diseases. The searching sites such as Science Direct and PubMed were used to find out the numerous distinct tracers across 16 CNS targets including tau, synaptic vesicle glycoprotein, the adenosine 2A receptor, the phosphodiesterase enzyme PDE10A, and the purinoceptor, among others. Among the most encouraging are [¹⁸ F]FIMX for mGluR imaging, [¹¹ C]Martinostat for Histone deacetylase, [¹⁸ F]MNI-444 for adenosine 2A imaging, [¹¹ C]ER176 for translocator protein, and [¹⁸ F]MK-6240 for tau imaging. We also reviewed the findings for each tracer's features and potential for application in CNS pathophysiology and therapeutic evaluation investigations, including target specificity, binding efficacy, and pharmacokinetic factors. This review aims to present a current evaluation of modern positron emission tomography tracers for CNS targets, with a focus on recent advances for targets that have newly emerged for imaging in humans.

Alternating exosomes and their mimetics as an emergent strategy for targeted cancer therapy

Exosomes, a subtype of the class of extracellular vesicles and nano-sized particles, have a specific membrane structure that makes them an alternative proposition to combat with cancer through slight modification. As constituents of all most all the primary body fluids, exosomes establish the status of intercellular communication. Exosomes have specific proteins/mRNAs and miRNAs which serve as biomarkers, imparting a prognostic tool in clinical and disease pathologies. They have efficient intrinsic targeting potential and efficacy. Engineered exosomes are employed to deliver therapeutic cargos to the targeted tumor cell or the recipient. Exosomes from cancer cells bring about changes in fibroblast via TGFβ/Smad pathway, augmenting the tumor growth. These extracellular vesicles are multidimensional in terms of the functions that they perform. We herein discuss the uptake and biogenesis of exosomes, their role in various facets of cancer studies, cell-to-cell communication and modification for therapeutic and diagnostic use.

Improving the magnet alignment of undulator systems by laser interferometer

The issue of intrinsic-type misalignment errors arising from angular offsets between magnets in an undulator is addressed. A random tilt of the magnets or poles generates undesirable magnetic field components in both transverse and longitudinal directions and gives rise to errors in period lengths and amplitudes. These localized errors are carried to the entire undulator segments and are a cause of concern for precision field integral and phase error estimates. A laser interferometer has been designed to read the offsets and to fix the magnets to minimize the offsets.

Pulmonary function test: A critical domain in oral submucous fibrosis patients

INTRODUCTION

The study aims to measure and compare pulmonary function tests (PFTs) in oral submucous fibrosis (OSMF) patients (smokers/nonsmokers) and normal individuals.

MATERIALS AND METHODS

The study population included 150 participants that comprised 50 nonsmoker OSMF patients, 50 OSMF patients who smoke as well, and 50 patients with no deleterious habits. Spirometer was used to assess PFT.

RESULTS

Results showed that a significant P value was obtained for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR), and maximum voluntary ventilation (MVV) and also for the predicted values of FEV, FEV1, FEV1/FVC, PEFR, and MVV in OSMF (smokers/nonsmokers) study groups.

CONCLUSION

Thus, the decrease in pulmonary function can be an alarming sign for restrictive type of pulmonary disease.

Clinical outcomes of patients with two small hepatocellular carcinomas

BACKGROUND

Management of single small hepatocellular carcinoma (HCC) is straightforward with curative outcomes achieved by locoregional therapy or resection. Liver transplantation is often considered for multiple small or single large HCC. Management of two small HCC whether presenting synchronously or sequentially is less clear.

AIM

To define the outcomes of patients presenting with two small HCC.

METHODS

Retrospective review of HCC databases from multiple institutions of patients with either two synchronous or sequential HCC ≤ 3 cm between January 2000 and March 2018. Primary outcomes were overall survival (OS) and transplant-free survival (TFS).

RESULTS

104 patients were identified (male n = 89). Median age was 63 years (interquartile range 58-67.75) and the most common aetiology of liver disease was hepatitis C (40.4%). 59 (56.7%) had synchronous HCC and 45 (43.3%) had sequential. 36 patients died (34.6%) and 25 were transplanted (24.0%). 1, 3 and 5-year OS was 93.0%, 66.1% and 62.3% and 5-year post-transplant survival was 95.8%. 1, 3 and 5-year TFS was 82.1%, 45.85% and 37.8%. When synchronous and sequential groups were compared, OS (1,3 and 5 year synchronous 91.3%, 63.8%, 61.1%, sequential 95.3%, 69.5%, 64.6%, P = 0.41) was similar but TFS was higher in the sequential group (1,3 and 5 year synchronous 68.5%, 37.3% and 29.7%, sequential 93.2%, 56.6%, 48.5%, P = 0.02) though this difference did not remain during multivariate analysis.

CONCLUSION

TFS in patients presenting with two HCC ≤ 3 cm is poor regardless of the timing of the second tumor. All patients presenting with two small HCC should be considered for transplantation.

Trajectories of socio-economic position over four time points and mortality: The role of gender

Background

Studies investigating the effect of social mobility on mortality in Sweden have used socioeconomic position (SEP) at only two time points and traditional methodological approaches. Our recent study has used SEP at four time points, but not employed latent class analyses when investigating the relationship between SEP trajectories and mortality in later life.

Methods

A cohort of 14,192 live births at Uppsala University Hospital between 1915-1929, of whom 97% were traced through parish records until routine registers became available in the 1960s. 5729 men and 5607 women were alive and living in Sweden in 1980. SEP was measured as social class of the head of household: at birth, in childhood (age 10, +/- five years), in adulthood (age 30-45, in the 1960 Census), and in later life (age 50-65, in the 1980 Census). Latent class analysis was employed to identify social class trajectories and Cox proportional hazard models used to estimate all-cause and cause-specific mortality (data from Causes of Death Register).

Results

Compared to men and women with stable high SEP trajectories, we found a higher risk of death from circulatory disease among men with stable low (HR 1.56, 95%CI 1.29-1.87), stable middle (HR 1.28, 95%CI 1.06-1.55) and upwardly mobile from low (HR 1.35, 95%CI 1.10-1.66) SEP trajectories, as well as in women with stable low or mobile from low to middle SEP trajectory (HR 1.27, 95%CI 1.02-1.59). SEP trajectories and total mortality showed similar, albeit, weaker associations in both genders. SEP trajectories were gender-specific and associations of SEP trajectories with circulatory disease mortality tended to be weaker in women.

Conclusions

Men's and women's socioeconomic position during childhood and over the life course affect their risk of late life all-cause mortality, and death from circulatory disease in particular. Improvements in social conditions at early stages of the life course are likely to contribute to reducing mortality at old age.

Key messages

Men’s and women’s socio-economic position during childhood and over the life course affect their risk of late life all-cause mortality and mortality from circulatory disease in particular. Trajectories of socioeconomic position across life course appear to be related to cause specific and total mortality in a gender specific pattern.

Prognostic role of alpha-fetoprotein in patients with hepatocellular carcinoma treated with repeat transarterial chemoembolisation

BACKGROUND

Repeat transarterial chemoembolisation (rTACE) is often required for hepatocellular carcinoma (HCC) to achieve disease control, however, current practice guidelines regarding treatment allocation vary significantly. This study aims to identify key factors associated with patient survival following rTACE to facilitate treatment allocation and prognostic discussion.

METHOD

Patients with HCC undergoing rTACE at six Australian tertiary centers from 2009 to 2014 were included. Variables encompassing clinical, tumour, treatment type and response factors were analysed against the primary outcome of overall survival. Univariate analysis and multivariate Cox regression modelling were used to identify factors pre- and post-TACE therapy significantly associated with survival.

RESULTS

Total of 292 consecutive patients underwent rTACE with mainly Child Pugh A cirrhosis (61%) and BCLC stage A (57%) disease. Median overall survival (OS) was 30 months (IQR 15.2-50.2) from initial TACE. On multivariate analysis greater tumour number (p = 0.02), higher serum bilirubin (p = 0.007) post initial TACE, and hepatic decompensation (p = 0.001) post second TACE were associated with reduced survival. Patients with serum AFP ≥ 200 ng/ml following initial TACE had lower survival (p = 0.001), compared to patients with serum AFP level that remained < 200 ng/ml post-initial TACE, with an overall survival of 19.4 months versus 34.7 months (p = 0.0001) respectively.

CONCLUSION

Serum AFP level following initial treatment in patients undergoing repeat TACE for HCC is a simple and useful clinical prognostic marker. Moreover, it has the potential to facilitate appropriate patient selection for rTACE particularly when used in conjunction with baseline tumour burden and severity of hepatic dysfunction post-initial TACE.

Computational prediction of interaction and pharmacokinetics profile study for polyamino-polycarboxylic ligands on binding with human serum albumin

Human serum albumin (HSA) is one of the most abundant plasma proteins available in blood and responsible for transport of fatty acids, drugs and metabolites at its binding sites which are very important for the assessment of pharmacokinetics profile of the polyamino-polycarboxylic ligands.

Variation in menopausal vasomotor symptoms outcomes in clinical trials: a systematic review

BACKGROUND

There is substantial variation in how menopausal vasomotor symptoms are reported and measured among intervention studies. This has prevented meaningful comparisons between treatments and limited data synthesis.

OBJECTIVES

To review systematically the outcome reporting and measures used to assess menopausal vasomotor symptoms from randomised controlled trials of treatments.

SEARCH STRATEGY

We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to May 2018.

SELECTION CRITERIA

Randomised controlled trials with a primary outcome of menopausal vasomotor symptoms in women and a sample size of at least 20 women per study arm.

DATA COLLECTION AND ANALYSIS

Data about study characteristics, primary vasomotor-related outcomes and methods of measuring them.

MAIN RESULTS

The search identified 5591 studies, 214 of which were included. Forty-nine different primary reported outcomes were identified for vasomotor symptoms and 16 different tools had been used to measure these outcomes. The most commonly reported outcomes were frequency (97/214), severity (116/214), and intensity (28/114) of vasomotor symptoms or a composite of these outcomes (68/214). There was little consistency in how the frequency and severity/intensity of vasomotor symptoms were defined.

CONCLUSIONS

There is substantial variation in how menopausal vasomotor symptoms have been reported and measured in treatment trials. Future studies should include standardised outcome measures which reflect the priorities of patients, clinicians, and researchers. This is most effectively achieved through the development of a Core Outcome Set. This systematic review is the first step towards development of a Core Outcome Set for menopausal vasomotor symptoms.

TWEETABLE SUMMARY

Menopausal hot flushes and night sweats have been reported in 49 different ways in clinical research. A core outcome set is urgently required.

Treatment choice for early-stage hepatocellular carcinoma in real-world practice: impact of treatment stage migration to transarterial chemoembolization and treatment response on survival

OBJECTIVE

The objectives of our study were firstly to characterize the treatment stage migration phenomenon in early (Barcelona Clinic Liver Cancer [BCLC]-0/A) stage hepatocellular carcinoma (HCC) by comparing the efficacy of curative therapies with trans-arterial chemoembolization [TACE] and secondly, determining baseline and on-treatment predictors of survival.

METHODS

All patients within BCLC-0/A stage from six tertiary hospitals who received curative therapy with either resection, transplantation, or ablation or TACE as first-line treatment were included in the analyses. The primary endpoint was overall survival; secondary end-points were transplant-free survival and recurrence-free survival.

RESULTS

Between January 2000 and December 2013, we identified 253 BCLC-0/A HCC patients of whom 148 (58.5%) received curative therapy and 105 (41.5%) migrated to TACE. Patients undergoing TACE had lower median survival (2.7 vs. 6.7 years; p < .0001), transplant-free survival (2.6 vs. 4.8 years; p < .0001) and recurrence-free survival (1.3 vs. 2.7 years; p < .001). On multivariate analysis treatment allocation to TACE was an independent prognostic predictor for both lower overall survival (HR 1.70, p = .04) and for HCC recurrence (HR 2.25, p < .001). The main prognostic determinant for each target outcome was Child-Pugh score.

CONCLUSIONS

Our study confirms that curative treatments should always be preferred when applicable in early-stage HCC, but that in cases where this is not possible, TACE is a reasonable albeit inferior treatment option. In addition, it provides unique prognostic information on a significant proportion of patients with early-stage disease in whom curative therapy is not applicable.

Influence of food availability on mate-guarding behaviour of ladybirds

A recent study on ladybird, Menochilus sexmaculatus (Fabricius) demonstrates that males perform post-copulatory mate guarding in the form of prolonged mating durations. We investigated whether food resource fluctuation affects pre- and post-copulatory behaviour of M. sexmaculatus. It has not been studied before in ladybirds. For this, adults were subjected to prey resource fluctuations sequentially at three levels: post-emergence (Poe; 10 days), pre-mating (Prm; 24 h) and post-mating (Pom; 5 days; only female). The food resource conditions at each level could be any one of scarce, optimal or abundant. Pre-copulatory and post-copulatory behaviour, and reproductive output were assessed. Post-emergence and pre-mating nutrient conditions significantly influenced the pre-copulatory behaviour. Males reared on scarce post-emergence conditions were found to require significantly higher number of mating attempts to establish mating unlike males in the other two food conditions. Under scarce post-emergence and pre-mating conditions, time to commencement of mating and latent period were high but opposite result was obtained for mate-guarding duration. Fecundity and per cent egg viability were more influenced by post-mating conditions, with scarce conditions stopping oviposition regardless of pre-mating and post-emergence conditions. Present results indicate that pre- and post-copulatory behaviour of ladybird is plastic in nature in response to food resource fluctuations.

Hysterectomy and incidence of depressive symptoms in midlife women: the Australian Longitudinal Study on Women's Health

AIMS

There is limited longitudinal research that has looked at the longer term incidence of depressive symptoms, comparing women with a hysterectomy to women without a hysterectomy. We aimed to investigate the association between hysterectomy status and the 12-year incidence of depressive symptoms in a mid-aged cohort of Australian women, and whether these relationships were modified by use of exogenous hormones.

METHODS

We used generalised estimating equation models for binary outcome data to assess the associations of the incidence of depressive symptoms (measured by the 10-item Centre for Epidemiologic Studies Depression Scale) across five surveys over a 12-year period, in women with a hysterectomy with ovarian conservation, or a hysterectomy with bilateral oophorectomy compared with women without a hysterectomy. We further stratified women with hysterectomy by their current use of menopausal hormone therapy (MHT). Women who reported prior treatment for depression were excluded from the analysis.

RESULTS

Compared with women without a hysterectomy (n = 4002), both women with a hysterectomy with ovarian conservation (n = 884) and women with a hysterectomy and bilateral oophorectomy (n = 450) had a higher risk of depressive symptoms (relative risk (RR) 1.20; 95% confidence interval (CI) 1.06-1.36 and RR 1.44; 95% CI 1.22-1.68, respectively). There were differences in the strength of the risk for women with a hysterectomy with ovarian conservation, compared with those without, when we stratified by current MHT use. Compared with women without a hysterectomy who did not use MHT, women with a hysterectomy with ovarian conservation who were also MHT users had a higher risk of depressive symptoms (RR 1.57; 95% CI 1.31-1.88) than women with a hysterectomy with ovarian conservation but did not use MHT (RR 1.17; 95% CI 1.02-1.35). For women with a hysterectomy and bilateral oophorectomy, MHT use did not attenuate the risk. We could not rule out, however, that the higher risk seen among MHT users may be due to confounding by indication, i.e. MHT was prescribed to treat depressive symptoms, but their depressive symptoms persisted.

CONCLUSIONS

Women with a hysterectomy (with and without bilateral oophorectomy) have a higher risk of new incidence of depressive symptoms in the longer term that was not explained by lifestyle or socio-economic factors.

Efficacy and Safety of Mycophenolate Mofetil in Patients With Autoimmune Hepatitis and Suboptimal Outcomes After Standard Therapy

BACKGROUND & AIMS

Little is known about outcomes of patients with autoimmune hepatitis (AIH) who have a suboptimal outcome to standard therapy and are then given mycophenolate mofetil as rescue therapy. We evaluated the efficacy and safety of mycophenolate mofetil in patients failed by or intolerant to corticosteroids, with or without azathioprine.

METHODS

We performed a retrospective study of 105 patients with AIH who received mycophenolate mofetil therapy after an inadequate response or intolerance to standard therapy (98% received combination therapy with corticosteroids plus thiopurines). Patients were recruited from 17 liver clinics via the Australian Liver Association Clinical Research Network. We reviewed records for baseline demographic features and characteristics of liver disease, initial therapy, mycophenolate mofetil indications, treatment outcome, and side effects. The primary outcome was biochemical remission, defined as levels of alanine and aspartate transferase and IgG level within the normal reference range, with or without normal liver histology within the first 2 years of treatment.

RESULTS

The indication for mycophenolate mofetil therapy was non-response to treatment for 40% of cases and intolerance to therapy for 60%. Overall, 63 patients (60%) achieved biochemical remission following a median 12 weeks treatment with mycophenolate mofetil. The proportion of patients who achieved biochemical remission was similar between patients receiving mycophenolate mofetil for non-response to standard therapy (57%) and patients with intolerance to standard therapy (62%). However, a lower proportion of patients with cirrhosis achieved biochemical remission (47%) than patients without cirrhosis (6%) (P = .07). Serious adverse events occurred in 3 patients (2.7%) including 1 death, and 10 patients (9.2%) discontinued mycophenolate mofetil because of adverse events.

CONCLUSION

In this retrospective study of patients with AIH who received mycophenolate mofetil as a rescue therapy, we found the drug to be well tolerated and moderately effective, inducing biochemical remission in 60% of subjects. Rates of response are lower and rates of infection are higher in patients with AIH and cirrhosis. Prospective studies of mycophenolate mofetil are warranted for this population.

Magnetic design and modelling of a 14 mm-period prototype superconducting undulator

The magnetic design of a ten-period (each period 14 mm) prototype superconducting undulator is reported using RADIA. The results of modelling the magnetic flux density are presented in an analytical formula. The dependence of the field integrals and phase error on the current density and undulator gap has been calculated, and temperature curves are determined for the models and are compared with earlier reported Moser-Rossmanith fits.

Slow and fast development in two aphidophagous ladybirds on scarce and abundant prey supply

Developmental rates are highly variable, both within and between genotypes and populations. But the rationale for two differential (slow and fast) developmental rates within same cohort under varying prey supply has yet not been explored. For this purpose, we investigated the effect of scarce and abundant prey supply on slow and fast development at 27°C in two aphidophagous ladybirds, Menochilus sexmaculatus (Fabricius) and Propylea dissecta (Mulsant) and its effect on their body mass and reproductive attributes. The ladybirds were provided with scarce and abundant supply of Aphis craccivora Koch under standardized abiotic conditions in the laboratory. A clear bimodal (two peaks, where the first peak represented the fast developing individuals and the second peak slow developing individuals) pattern of distribution for both prey supplies was obtained, which got skewed with change in prey supply. On abundant prey supply, more fast developing individuals (139 M. sexmaculatus and 123 P. dissecta) were found and less (46 M. sexmaculatus and 36 P. dissecta) on scarce prey supply. Slow developing individuals had female biased sex ratio, higher longevity and lower body mass. Fast developing females laid higher number of eggs with higher egg viability. Results of the study are indicative of occurrence and constancy of the slow and fast developing individuals in the egg batch.

On a Scheme of Sampling of Two Units With Inclusion With Inclusion

This paper introduces an unequal probability sampling without replacement scheme with inclusion probability proportional to size. This new scheme possesses some desirable properties with regard to ?i and ?ij , and provides a non-negative variance estimator of the Horvitz and Thompson estimator, when the values of the auxiliary variable fulfill some restrictions. On comparing the suggested scheme with some of the existing sampling schemes in respect of efficiency and stability of the variance estimator empirically, it has been observed that the performance of the scheme is satisfactory.

Influence of temperature on reproductive biology and phenotype of a ladybird, Menochilus sexmaculatus (Fabricius) (Coleoptera: Coccinellidae)

Body melanisation in insects is polygenic, resulting from genetic polymorphism or phenotypic plasticity, with diverse implications ranging from thermal budgeting to reproductive success. In this study, we assessed the, mate choice, reproductive success, and offspring colouration of typical (T) and melanic (M) morphs of the ladybird Menochilus sexmaculatus paired at three temperatures 15°C, 25°C and 35°C. Mating success of the two morphs and the consequences for offspring fitness and offspring phenotype under these temperature regimes were evaluated. Melanic adults of both sexes achieved significantly higher mating success at 15°C and 25°C, but at 35°C no influence of adult morph on mate selection was observed. Melanic females were more fecund than typical females at all temperatures. Offspring of melanic parents developed faster than those of typicals at 15°C and 25°C, but not at 35°C. Evidence was also found of phenotypic plasticity in colour form at 15°C and 35°C. At 25°C the parents of pure (T) and (M) morphs produced offspring of the same morph. However, low temperature induced partial melanisation among the offspring of typical parents (T). Whereas at 35°C the offspring of (T) parents became paler in colour with very fine zigzag lines on elytra, i.e. they decrease the degree of melanisation. Pure melanics (M) compensated for elevated temperature stress by producing offspring that were either pure melanic but small or large with reduced melanisation. Our results on offspring phenotype variation indicate that the degree of melanism in morphs is a result of environmentally regulated expression of the parental genotype.

Trends in Indigenous and non-Indigenous caesarean section births in the Northern Territory of Australia, 1986-2012: a total population-based study

OBJECTIVE

To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers.

DESIGN

Total population-based study.

SETTING

Northern Territory of Australia, 1986-2012.

POPULATION

Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37-42 weeks' gestation (n = 78 561).

METHODS

Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors.

MAIN OUTCOME MEASURES

Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery.

RESULTS

The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34-1.60)].

CONCLUSIONS

Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers.

TWEETABLE ABSTRACT

Caesarean section rates increased between 1986 and 2012 in the Northern Territory of Australia.

Resource partitioning in a ladybird, Menochilus sexmaculatus: function of body size and prey density

In the present study, resource partitioning by natural conspecific size variants (small and large) of ladybird, Menochilus sexmaculatus (Fabricius) females, in response to varying prey densities was assessed using functional and numerical responses as measures of prey density. The prey provided was small (second) and large (fourth) instars of Aphis craccivora Koch. Results revealed that under choice condition, small and large females of M. sexmaculatus consumed higher number of small and large instars, respectively. Small females exhibited a modified Type II functional response on small aphid instars and a Type II functional response on fourth aphid instars. Large females exhibited a Type II functional response when provided either second or fourth aphid instars. Numerical response in terms of numbers of eggs laid by both the females increased with increase in the density of either of the aphid instars. However, in small females, oviposition had a positive correlation with the numbers of small and large aphid instars consumed; being strong for the small aphid instars. While in large females, oviposition was positively correlated with the numbers of large aphid instars consumed and not small aphid instars. It therefore seems that intraspecific resource partitioning in M. sexmaculatus occurs prominently in large females than the small females.

Larval and female footprints as feeding deterrent cues for immature stages of two congeneric ladybird predators (Coleoptera: Coccinellidae)

In the present study predation parameters, i.e. consumption rate, conversion efficiency and growth rate, and total developmental duration of immature stages of two congeneric ladybirds, Coccinella septempunctata (L.) and Coccinella transversalis F., have been evaluated in presence of conspecific and heterospecific fourth instar larval and adult female tracks. We hypothesized that the semiochemicals within larval/adult female tracks might act as foraging/feeding deterrent pheromones (FDPs) and would reduce the predation parameters; and would prolong total developmental duration of ladybird predators. Results of the study positively affirmed our hypothesis. The deterrence in prey consumption and reduction in conversion efficiency and growth rate was density dependent with species-specific variations. Consumption rate, conversion efficiency, and growth rate of larval instars decreased and the total developmental duration of immature stages increased when exposed to an increasing density of zero, two, three, and four conspecific/heterospecific larval/adult female tracks. Between ladybird species, C. septempunctata had higher consumption rate, growth rate, and total developmental durations, whereas conversion efficiency was higher in C. transversalis. Despite the presence of semiochemical tracks as foraging barriers, early instars showed higher conversion efficiencies and growth rates, whereas fourth instars had highest consumption rate in all experimental treatments. The present study, therefore, suggests that semiochemical tracks significantly reduce the predation potential and prolong developmental duration of conspecifics and heterospecifics. They, thus behave as FDP.

The role of lifestyle behaviors on 20-year cognitive decline

This study examined the association between smoking, physical activity and dietary choice at 36 and 43 years, and change in these lifestyle behaviors between these ages, and decline in verbal memory and visual search speed between 43 and 60-64 years in 1018 participants from MRC National Survey of Health and Development (NSHD, the British 1946 birth cohort). ANCOVA models were adjusted for sex, social class of origin, childhood cognition, educational attainment, adult social class, and depression; then the lifestyle behaviors were additionally mutually adjusted. Results showed that healthy dietary choice and physical activity were associated, respectively, with slower memory and visual search speed decline over 20 years, with evidence that increasing physical activity was important. Adopting positive health behaviors from early midlife may be beneficial in reducing the rate of cognitive decline and ultimately reducing the risk of dementia.

Tumor targeting using anti-epidermal growth factor receptor (ior egf/r3) immunoconjugate with a tetraaza macrocyclic agent (DO3A-EA)

Epidermal growth factor receptor (EGFR) signaling inhibition represents a highly promising arena for the application of molecularly targeted cancer therapies. EGFR conjugated metal chelates have been proposed as potential imaging agents for cancers that overexpress EGFR receptors. Through improved understanding of EGFR biology in human cancers, there is anticipation that more tumor-selective therapy approaches with diminished collateral normal tissue toxicity can be advanced. We report here on the results with a thermodynamically stable chelate, 1,4,7-tris(carboxymethyl)-10-(2-aminoethyl)-1,4,7,10-tetraazacyclododecane (DO3A-EA) and anti-EGFr (ior egf/r3) conjugate to develop immunospecific imaging agent. Conjugation and labelling with anti-EGFr was performed using standard procedure and subjected to purification on size exclusion chromatography. The conjugated antibodies were labeled with a specific activity 20-30 mCi/mg of protein. Labeling efficiencies were measured by ascending paper chromatography on ITLC-SG strips. Radiolabeling of the immunoconjugate was found to be 98.5 ± 0.30%. (99m)Tc-DO3A-EA-EGFr conjugate was studied in athymic mice bearing U-87MG, MDA-MB-468 tumors following intravenous injection. Pharmacokinetic and biodistribution studies confirmed long circulation times (t(1/2)(fast)  =  45 min and t1/2(slow)  = 4 hours 40 min) and efficient accumulation in tumors. Biodistribution studies in athymic mice grafted with U-87MG human glioblastoma multiforme and Hela human cervical carcinoma tumors revealed significant localization of (99m)Tc-labeled antibodies conjugate in tumors and reduced accumulation in normal organs. This new chelating agent is promising for immunoscintigraphy since good tumour-to-normal organ contrast could be demonstrated. These properties can be exploited for immunospecifc contrast agents in nuclear medicine and SPECT imaging.