1,234 research outputs found
Outcomes by Cardiac Stage in Patients With Newly Diagnosed AL Amyloidosis: Phase 3 ANDROMEDA Trial
BACKGROUND:
Patients with amyloid light chain amyloidosis and severe cardiac dysfunction have a poor prognosis. Treatment options that induce rapid and deep hematologic and organ responses, irrespective of cardiac involvement, are needed.
OBJECTIVES:
The aim of this study was to evaluate the impact of baseline cardiac stage on efficacy and safety outcomes in the phase 3 ANDROMEDA trial.
METHODS:
Rates of overall complete hematologic response and cardiac and renal response at 6 months and median major organ deterioration–progression-free survival and major organ deterioration–event-free survival were compared across cardiac stages (I, II, or IIIA) and treatments (daratumumab, bortezomib, cyclophosphamide, and dexamethasone [D-VCd] or bortezomib, cyclophosphamide, and dexamethasone [VCd]). Rates of adverse events (AEs) were summarized for patients with and without baseline cardiac involvement and by cardiac stage.
RESULTS:
Median follow-up duration was 15.7 months. The proportions of stage I, II, and IIIA patients were 23.2%, 40.2%, and 36.6%. Across cardiac stages, hematologic and organ response rates were higher and major organ deterioration–progression-free survival and major organ deterioration–event-free survival were longer with D-VCd than VCd. AE rates were similar between treatments and by cardiac stage; serious AE rates were higher in patients with cardiac involvement and increased with increasing cardiac stage. The incidence of cardiac events was numerically greater with D-VCd vs VCd, but the rate of grade 3 or 4 events was similar. The exposure-adjusted incidence rate for cardiac events was lower with D-VCd than VCd (median exposure 13.4 and 5.3 months, respectively).
CONCLUSIONS:
These findings demonstrate the efficacy of D-VCd over VCd in patients with newly diagnosed amyloid light chain amyloidosis across cardiac stages, thus supporting its use in patients with cardiac involvement. (NCT03201965
Quantum control of proximal spins using nanoscale magnetic resonance imaging
Quantum control of individual spins in condensed matter systems is an
emerging field with wide-ranging applications in spintronics, quantum
computation, and sensitive magnetometry. Recent experiments have demonstrated
the ability to address and manipulate single electron spins through either
optical or electrical techniques. However, it is a challenge to extend
individual spin control to nanoscale multi-electron systems, as individual
spins are often irresolvable with existing methods. Here we demonstrate that
coherent individual spin control can be achieved with few-nm resolution for
proximal electron spins by performing single-spin magnetic resonance imaging
(MRI), which is realized via a scanning magnetic field gradient that is both
strong enough to achieve nanometric spatial resolution and sufficiently stable
for coherent spin manipulations. We apply this scanning field-gradient MRI
technique to electronic spins in nitrogen-vacancy (NV) centers in diamond and
achieve nanometric resolution in imaging, characterization, and manipulation of
individual spins. For NV centers, our results in individual spin control
demonstrate an improvement of nearly two orders of magnitude in spatial
resolution compared to conventional optical diffraction-limited techniques.
This scanning-field-gradient microscope enables a wide range of applications
including materials characterization, spin entanglement, and nanoscale
magnetometry.Comment: 7 pages, 4 figure
Quantum control of hybrid nuclear-electronic qubits
Pulsed magnetic resonance is a wide-reaching technology allowing the quantum
state of electronic and nuclear spins to be controlled on the timescale of
nanoseconds and microseconds respectively. The time required to flip either
dilute electronic or nuclear spins is orders of magnitude shorter than their
decoherence times, leading to several schemes for quantum information
processing with spin qubits. We investigate instead the novel regime where the
eigenstates approximate 50:50 superpositions of the electronic and nuclear spin
states forming "hybrid nuclear-electronic" qubits. Here we demonstrate quantum
control of these states for the first time, using bismuth-doped silicon, in
just 32 ns: this is orders of magnitude faster than previous experiments where
pure nuclear states were used. The coherence times of our states are five
orders of magnitude longer, reaching 4 ms, and are limited by the
naturally-occurring 29Si nuclear spin impurities. There is quantitative
agreement between our experiments and no-free-parameter analytical theory for
the resonance positions, as well as their relative intensities and relative
Rabi oscillation frequencies. In experiments where the slow manipulation of
some of the qubits is the rate limiting step, quantum computations would
benefit from faster operation in the hybrid regime.Comment: 20 pages, 8 figures, new data and simulation
Probing host pathogen cross-talk by transcriptional profiling of both Mycobacterium tuberculosis and infected human dendritic cells and macrophages
This study provides the proof of principle that probing the host and the microbe transcriptomes simultaneously is a valuable means to accessing unique information on host pathogen interactions. Our results also underline the extraordinary plasticity of host cell and pathogen responses to infection, and provide a solid framework to further understand the complex mechanisms involved in immunity to M. tuberculosis and in mycobacterial adaptation to different intracellular environments
ATTR amyloidosis during the COVID-19 pandemic: insights from a global medical roundtable
BACKGROUND: The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causing the ongoing coronavirus disease 2019 (COVID-19) pandemic has raised serious concern for patients with chronic disease. A correlation has been identified between the severity of COVID-19 and a patient's preexisting comorbidities. Although COVID-19 primarily involves the respiratory system, dysfunction in multiple organ systems is common, particularly in the cardiovascular, gastrointestinal, immune, renal, and nervous systems. Patients with amyloid transthyretin (ATTR) amyloidosis represent a population particularly vulnerable to COVID-19 morbidity due to the multisystem nature of ATTR amyloidosis. MAIN BODY: ATTR amyloidosis is a clinically heterogeneous progressive disease, resulting from the accumulation of amyloid fibrils in various organs and tissues. Amyloid deposition causes multisystem clinical manifestations, including cardiomyopathy and polyneuropathy, along with gastrointestinal symptoms and renal dysfunction. Given the potential for exacerbation of organ dysfunction, physicians note possible unique challenges in the management of patients with ATTR amyloidosis who develop multiorgan complications from COVID-19. While the interplay between COVID-19 and ATTR amyloidosis is still being evaluated, physicians should consider that the heightened susceptibility of patients with ATTR amyloidosis to multiorgan complications might increase their risk for poor outcomes with COVID-19. CONCLUSION: Patients with ATTR amyloidosis are suspected to have a higher risk of morbidity and mortality due to age and underlying ATTR amyloidosis-related organ dysfunction. While further research is needed to characterize this risk and management implications, ATTR amyloidosis patients might require specialized management if they develop COVID-19. The risks of delaying diagnosis or interrupting treatment for patients with ATTR amyloidosis should be balanced with the risk of exposure in the health care setting. Both physicians and patients must adapt to a new construct for care during and possibly after the pandemic to ensure optimal health for patients with ATTR amyloidosis, minimizing treatment interruptions
A Dual-Color Fluorescence-Based Platform to Identify Selective Inhibitors of Akt Signaling
Background: Inhibition of Akt signaling is considered one of the most promising therapeutic strategies for many cancers. However, rational target-orientated approaches to cell based drug screens for anti-cancer agents have historically been compromised by the notorious absence of suitable control cells. Methodology/Principal Findings: In order to address this fundamental problem, we have developed BaFiso, a live-cell screening platform to identify specific inhibitors of this pathway. BaFiso relies on the co-culture of isogenic cell lines that have been engineered to sustain interleukin-3 independent survival of the parental Ba/F3 cells, and that are individually tagged with different fluorescent proteins. Whilst in the first of these two lines cell survival in the absence of IL-3 is dependent on the expression of activated Akt, the cells expressing constitutively-activated Stat5 signaling display IL-3 independent growth and survival in an Akt-independent manner. Small molecules can then be screened in these lines to identify inhibitors that rescue IL-3 dependence. Conclusions/Significance: BaFiso measures differential cell survival using multiparametric live cell imaging and permits selective inhibitors of Akt signaling to be identified. BaFiso is a platform technology suitable for the identification of smal
Global Patterns of City Size Distributions and Their Fundamental Drivers
Urban areas and their voracious appetites are increasingly dominating the flows of energy and materials around the globe. Understanding the size distribution and dynamics of urban areas is vital if we are to manage their growth and mitigate their negative impacts on global ecosystems. For over 50 years, city size distributions have been assumed to universally follow a power function, and many theories have been put forth to explain what has become known as Zipf's law (the instance where the exponent of the power function equals unity). Most previous studies, however, only include the largest cities that comprise the tail of the distribution. Here we show that national, regional and continental city size distributions, whether based on census data or inferred from cluster areas of remotely-sensed nighttime lights, are in fact lognormally distributed through the majority of cities and only approach power functions for the largest cities in the distribution tails. To explore generating processes, we use a simple model incorporating only two basic human dynamics, migration and reproduction, that nonetheless generates distributions very similar to those found empirically. Our results suggest that macroscopic patterns of human settlements may be far more constrained by fundamental ecological principles than more fine-scale socioeconomic factors
Roles of AP-2 in clathrin-mediated endocytosis.
The notion that AP-2 clathrin adaptor is an essential component of an endocytic clathrin coat appears to conflict with recent observations that substantial AP-2 depletion, using RNA interference with synthesis of AP-2 subunits, fails to block uptake of certain ligands known to internalize through a clathrin-based pathway
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SVEP1 as a Genetic Modifier of TEK-Related Primary Congenital Glaucoma.
Purpose: Affecting children by age 3, primary congenital glaucoma (PCG) can cause debilitating vision loss by the developmental impairment of aqueous drainage resulting in high intraocular pressure (IOP), globe enlargement, and optic neuropathy. TEK haploinsufficiency accounts for 5% of PCG in diverse populations, with low penetrance explained by variable dysgenesis of Schlemm's canal (SC) in mice. We report eight families with TEK-related PCG, and provide evidence for SVEP1 as a disease modifier in family 8 with a higher penetrance and severity. Methods: Exome sequencing identified coding/splice site variants with an allele frequency less than 0.0001 (gnomAD). TEK variant effects were assayed in construct-transfected HEK293 cells via detection of autophosphorylated (active) TEK protein. An enucleated eye from an affected member of family 8 was examined via histology. SVEP1 expression in developing outflow tissues was detected by immunofluorescent staining of 7-day mouse anterior segments. SVEP1 stimulation of TEK expression in human umbilical vascular endothelial cells (HUVECs) was measured by TaqMan quantitative PCR. Results: Heterozygous TEK loss-of-function alleles were identified in eight PCG families, with parent-child disease transmission observed in two pedigrees. Family 8 exhibited greater disease penetrance and severity, histology revealed absence of SC in one eye, and SVEP1:p.R997C was identified in four of the five affected individuals. During SC development, SVEP1 is secreted by surrounding tissues. SVEP1:p.R997C abrogates stimulation of TEK expression by HUVECs. Conclusions: We provide further evidence for PCG caused by TEK haploinsufficiency, affirm autosomal dominant inheritance in two pedigrees, and propose SVEP1 as a modifier of TEK expression during SC development, affecting disease penetrance and severity
Improving the practicality of using non-aversive handling methods to reduce background stress and anxiety in laboratory mice
Handling can stimulate stress and anxiety in laboratory animals that negatively impacts welfare
and introduces a confounding factor in many areas of research. Picking up mice by the tail is a major
source of handling stress that results in strong aversion to the handler, while mice familiarised with
being picked up in a tunnel or cupped on the open hand show low stress and anxiety, and actively seek
interaction with their handlers. Here we investigate the duration and frequency of handling required for
effective familiarisation with these non-aversive handling methods, and test whether this is sufficient
to prevent aversion and anxiety when animals then experience immobilisation and a mild procedure
(subcutaneous injection). Very brief handling (2 s) was sufficient to familiarise mice with tunnel
handling, even when experienced only during cage cleaning. Brief but more frequent handling was
needed for familiarisation with cup handling, while pick up by tail induced strong aversion even when
handling was brief and infrequent. Experience of repeated immobilisation and subcutaneous injection
did not reverse the positive effects of tunnel handling. Our findings demonstrate that replacing tail with
tunnel handling during routine cage cleaning and procedures provides a major refinement with little if
any cost for familiarisation
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