Left to Their Own Devices: Breakdowns in United States Medical Device Premarket Review

Using examples from recent FDA regulatory proceedings, Jonas Hines and colleagues critique the medical device premarket review and identify eight weaknesses in the process that should be remedied

Expression, maturation and turnover of DrrS, an unusually stable, DosR regulated small RNA in Mycobacterium tuberculosis

Mycobacterium tuberculosis depends on the ability to adjust to stresses encountered in a range of host environments, adjustments that require significant changes in gene expression. Small RNAs (sRNAs) play an important role as post-transcriptional regulators of prokaryotic gene expression, where they are associated with stress responses and, in the case of pathogens, adaptation to the host environment. In spite of this, the understanding of M. tuberculosis RNA biology remains limited. Here we have used a DosR-associated sRNA as an example to investigate multiple aspects of mycobacterial RNA biology that are likely to apply to other M. tuberculosis sRNAs and mRNAs. We have found that accumulation of this particular sRNA is slow but robust as cells enter stationary phase. Using reporter gene assays, we find that the sRNA core promoter is activated by DosR, and we have renamed the sRNA DrrS for DosR Regulated sRNA. Moreover, we show that DrrS is transcribed as a longer precursor, DrrS+, which is rapidly processed to the mature and highly stable DrrS. We characterise, for the first time in mycobacteria, an RNA structural determinant involved in this extraordinary stability and we show how the addition of a few nucleotides can lead to acute destabilisation. Finally, we show how this RNA element can enhance expression of a heterologous gene. Thus, the element, as well as its destabilising derivatives may be employed to post-transcriptionally regulate gene expression in mycobacteria in combination with different promoter variants. Moreover, our findings will facilitate further investigations into the severely understudied topic of mycobacterial RNA biology and into the role that regulatory RNA plays in M. tuberculosis pathogenesis

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

MAGIC and Fermi-LAT gamma-ray results on unassociated HAWC sources

The HAWC Collaboration released the 2HWC catalogue of TeV sources, in which 19 show no association with any known high-energy (HE; E greater than or similar to 10 GeV) or very-high-energy (VHE; E greater than or similar to 300 GeV) sources. This catalogue motivated follow-up studies by both the Major Atmospheric Gamma-ray Imaging Cherenkov (MAGIC) and Fermi-LAT (Large Area Telescope) observatories with the aim of investigating gamma-ray emission over a broad energy band. In this paper, we report the results from the first joint work between High Altitude Water Cherenkov (HAWC), MAGIC, and Fermi-LAT on three unassociated HAWC sources: 2HWC J2006+341, 2HWC J1907+084*, and 2HWC J1852+013*. Although no significant detection was found in the HE and VHE regimes, this investigation shows that a minimum 1 degrees extension (at 95 per cent confidence level) and harder spectrum in the GeV than the one extrapolated from HAWC results are required in the case of 2HWC J1852+013*, whilst a simply minimum extension of 0.16 degrees (at 95 per cent confidence level) can already explain the scenario proposed by HAWC for the remaining sources. Moreover, the hypothesis that these sources are pulsar wind nebulae is also investigated in detail

Clocinnamox inhibits the intravenous self-administration of opioid agonists in rhesus monkeys: comparison with effects on opioid agonist-mediated antinociception

 The effects of CCAM, an insurmountable mu opioid receptor antagonist, were studied on the intravenous self-administration and thermoantinociception of alfentanil and nalbuphine, high- and low-efficacy opioid agonists, respectively, in rhesus monkeys. A single dose of 0.1 mg/kg CCAM IV reduced alfentanil’s reinforcing potency in an FR30 TO 45s schedule 10-fold within a 24-h period. The maximum response rates remained essentially unchanged. At 1 mg/kg, CCAM caused a 300-fold shift of the alfentanil dose-response curve and also depressed the maximum response rates. CCAM also blocked insurmountably responding for nalbuphine, which was essentially abolished in two of three animals after a dose of 0.1 mg/kg CCAM and in all animals after 1 mg/kg. The acute insurmountable antagonism of alfentanil and nalbuphine self-administration by CCAM was used to determine the (relative initial) efficacy values of both agonists. Efficacy values, tau, were 391 for alfentanil and 196 for nalbuphine; the apparent in vivo dissociation constants, K A , were 0.16 mg/kg per injection (i.e., 350 nmol/kg per injection) for alfentanil and 0.14 mg/kg (370 nmol/kg per injection) for nalbuphine. In comparison, in a rhesus monkey 50°C warm-water tail withdrawal assay, the tau values were 11 for alfentanil and 0.92 for nalbuphine, and the K A values were 0.2 mg/kg (440 nmol/kg) for alfentanil and 0.15 mg/kg (400 nmol/kg) for nalbuphine. Therefore, it seems that the higher potency of alfentanil and nalbuphine in self-administration as compared to thermal antinociception in rhesus monkeys is predominantly due to a larger efficacy of the same agonist in self-administration (i.e., a larger receptor pool) rather than differences in apparent in vivo affinity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41957/1/213-129-3-233_71290233.pd

Discovery and confirmation of the shortest gamma-ray burst from a collapsar

Gamma-ray bursts (GRBs) are among the brightest and most energetic events in the Universe. The duration and hardness distribution of GRBs has two clusters1, now understood to reflect (at least) two different progenitors2. Short-hard GRBs (SGRBs; T90 2 s) have been attributed to the collapse of peculiar massive stars (collapsars)3. The discovery of SN 1998bw/GRB 980425 (ref. 4) marked the first association of an LGRB with a collapsar, and AT 2017gfo (ref. 5)/GRB 170817A/GW170817 (ref. 6) marked the first association of an SGRB with a binary neutron star merger, which also produced a gravitational wave. Here, we present the discovery of ZTF20abwysqy (AT2020scz), a fast-fading optical transient in the Fermi satellite and the Interplanetary Network localization regions of GRB 200826A; X-ray and radio emission further confirm that this is the afterglow. Follow-up imaging (at rest-frame 16.5 days) reveals excess emission above the afterglow that cannot be explained as an underlying kilonova, but which is consistent with being the supernova. Although the GRB duration is short (rest-frame T90 of 0.65 s), our panchromatic follow-up data confirm a collapsar origin. GRB 200826A is the shortest LGRB found with an associated collapsar; it appears to sit on the brink between a successful and a failed collapsar. Our discovery is consistent with the hypothesis that most collapsars fail to produce ultra-relativistic jets

Fires in the deep: The luminosity distribution of early-time gamma-ray-burst afterglows in light of the Gamow Explorer sensitivity requirements

Context. Gamma-ray bursts (GRBs) are ideal probes of the Universe at high redshift (), pinpointing the locations of the earliest star-forming galaxies and providing bright backlights with simple featureless power-law spectra that can be used to spectrally fingerprint the intergalactic medium and host galaxy during the period of reionization. Future missions such as Gamow Explorer (hereafter Gamow) are being proposed to unlock this potential by increasing the rate of identification of high- ( > 5) GRBs in order to rapidly trigger observations from 6 to 10 m ground telescopes, the James Webb Space Telescope (JWST), and the upcoming Extremely Large Telescopes (ELTs). Aims. Gamow was proposed to the NASA 2021 Medium-Class Explorer (MIDEX) program as a fast-slewing satellite featuring a wide-field lobster-eye X-ray telescope (LEXT) to detect and localize GRBs with arcminute accuracy, and a narrow-field multi-channel photo- infrared telescope (PIRT) to measure their photometric redshifts for > 80% of the LEXT detections using the Lyman-α dropout technique. We use a large sample of observed GRB afterglows to derive the PIRT sensitivity requirement. Methods. We compiled a complete sample of GRB optical-near-infrared (optical-NIR) afterglows from 2008 to 2021, adding a total of 66 new afterglows to our earlier sample, including all known high- GRB afterglows. This sample is expanded with over 2837 unpublished data points for 40 of these GRBs. We performed full light-curve and spectral-energy-distribution analyses of these after-glows to derive their true luminosity at very early times. We compared the high- sample to the comparison sample at lower redshifts. For all the light curves, where possible, we determined the brightness at the time of the initial finding chart of Gamow, at different high redshifts and in different NIR bands. This was validated using a theoretical approach to predicting the afterglow brightness. We then followed the evolution of the luminosity to predict requirements for ground-and space-based follow-up. Finally, we discuss the potential biases between known GRB afterglow samples and those to be detected by Gamow. Results. We find that the luminosity distribution of high- GRB afterglows is comparable to those at lower redshift, and we therefore are able to use the afterglows of lower- GRBs as proxies for those at high . We find that a PIRT sensitivity of 15 μJy (21 mag AB) in a 500 s exposure simultaneously in five NIR bands within 1000 s of the GRB trigger will meet the Gamow mission requirements. Depending on the E and NIR band, we find that between 75% and 85% of all afterglows at > 5 will be recovered by Gamow at 5 detection significance, allowing the determination of a robust photo-. As a check for possible observational biases and selection effects, we compared the results with those obtained through population-synthesis models, and find them to be consistent. Conclusions. Gamow and other high- GRB missions will be capable of using a relatively modest 0.3 m onboard NIR photo- telescope to rapidly identify and report high- GRBs for further follow-up by larger facilities, opening a new window onto the era of reionization and the high-redshift Universe