Prognostic value of gross tumor volume delineated by FDG-PET-CT based radiotherapy treatment planning in patients with locally advanced pancreatic cancer treated with chemoradiotherapy

<p>Abstract</p> <p>Background</p> <p>We aimed to assess whether gross tumor volume (GTV) determined by fusion of contrast-enhanced computerized tomography (CT) and 18F-fluoro-deoxy-D-glucose positron emission tomography-CT (FDG-PET-CT) based radiotherapy planning could predict outcomes, namely overall survival (OS), local-regional progression-free survival (LRPFS), and progression-free survival (PFS) in cases with locally advanced pancreas cancer (LAPC) treated with definitive concurrent chemoradiotherapy.</p> <p>Methods</p> <p>A total of 30 patients with histological proof of LAPC underwent 50.4 Gy (1.8 Gy/28 fractions) of radiotherapy concurrent with continuously infused 5-FU followed by 4 to 6 courses of maintenance gemcitabine. Target volume delineations were performed on FDG-PET-CT-based RTP. Patients were stratified into 2 groups: GTV lesser (GTV_L) versus greater (GTV_G) than cut off value determined by receiver operating characteristic (ROC) analysis, and compared in terms of OS, LRPFS and PFS.</p> <p>Results</p> <p>Median GTV delineated according to the FDG-PET-CT data was 100.0 cm³. Cut off GTV value determined from ROC curves was 91.1 cm³. At a median follow up of 11.2 months, median OS, LRPFS and PFS for the entire population were 10.3, 7.8 and 5.7 months, respectively. Median OS, LRPFS and PFS for GTV_Land GTV_Gcohorts were 16.3 vs. 9.5 (<it>p </it>= 0.005), 11.0 vs. 6.0 (<it>p </it>= 0.013), and 9.0 vs. 4.8 months (<it>p </it>= 0.008), respectively.</p> <p>Conclusions</p> <p>The superior OS, LRPFS and PFS observed in GTV_Lpatients over GTV_Gones suggests a potential for FDG-PET-CT-defined GTV size in predicting outcomes of LAPC patients treated with definitive C-CRT, which needs to be validated by further studies with larger cohorts.</p

Procalcitonin Predicts Response to Beta-Lactam Treatment in Hospitalized Children with Community-Acquired Pneumonia

BACKGROUND: Antibiotic treatment of community-acquired pneumonia (CAP) in children remains mostly empirical because clinical and paraclinical findings poorly discriminate the principal causes of CAP. Fast response to beta-lactam treatment can be considered a proxy of pneumococcal aetiology. We aimed to identify the best biological predictor of response to beta-lactam therapy in children hospitalized for CAP. METHODS: A retrospective, single-centre cohort study included all consecutive patients 1 month to 16 years old hospitalized in a teaching hospital in Paris, France, because of CAP empirically treated with a beta-lactam alone from 2003 to 2010. Uni- and multivariate analyses were used to study the ability of routine biological parameters available in the Emergency Department to predict a favourable response to beta-lactam (defined as apyrexia within 48 hours of treatment onset). RESULTS: Among the 125 included patients, 85% (106) showed a favourable response to beta-lactam. In multivariate logistic regression, we found procalcitonin (PCT) the only independent predictor of apyrexia (p = 0.008). The adjusted odds ratio for the decadic logarithm of PCT was 4.3 (95% CI 1.5-12.7). At ≥ 3 ng/mL, PCT had 55.7% sensitivity (45.7-65.3), 78.9% specificity (54.4-93.9), 93.7% positive predictive value (84.5-98.2), 24.2% negative predictive value (14.2-36.7), 2.64 positive likelihood ratio (1.09-6.42) and 0.56 negative likelihood ratio (0.41-0.77). In the 4 children with a PCT level ≥ 3 ng/mL and who showed no response to beta-lactam treatment, secondary pleural effusion had developed in 3, and viral co-infection was documented in 1. CONCLUSIONS: PCT is the best independent biologic predictor of favourable response to beta-lactam therapy in children hospitalized for CAP. Thus, a high PCT level is highly suggestive of pneumococcal aetiology. However, a 3-ng/mL cut-off does not seem compatible with daily medical practice, and additional research is needed to further define the role of PCT in managing CAP in children

Epidemiology and clinical features of vivax malaria imported to Europe: Sentinel surveillance data from TropNetEurop

BACKGROUND: Plasmodium vivax is the second most common species among malaria patients diagnosed in Europe, but epidemiological and clinical data on imported P. vivax malaria are limited. The TropNetEurop surveillance network has monitored the importation of vivax malaria into Europe since 1999. OBJECTIVES: To present epidemiological and clinical data on imported P. vivax malaria collected at European level. MATERIAL AND METHODS: Data of primary cases of P. vivax malaria reported between January 1999 and September 2003 were analysed, focusing on disease frequency, patient characteristics, place of infection, course of disease, treatment and differences between network-member countries. RESULTS: Within the surveillance period 4,801 cases of imported malaria were reported. 618 (12.9%) were attributed to P. vivax. European travellers and immigrants were the largest patient groups, but their proportion varied among the reporting countries. The main regions of infection in descending order were the Indian subcontinent, Indonesia, South America and Western and Eastern Africa, as a group accounting for more than 60% of the cases. Regular use of malaria chemoprophylaxis was reported by 118 patients. With 86 (inter-quartile range 41–158) versus 31 days (inter-quartile range 4–133) the median symptom onset was significantly delayed in patients with chemoprophylaxis (p < 0.0001). Common complaints were fever, headache, fatigue, and musculo-skeletal symptoms. All patients survived and severe clinical complications were rare. Hospitalization was provided for 60% and primaquine treatment administered to 83.8% of the patients, but frequencies varied strongly among reporting countries. CONCLUSIONS: TropNetEurop data can contribute to the harmonization of European treatment policies

RNA Oxidation Adducts 8-OHG and 8-OHA Change with Aβ42 Levels in Late-Stage Alzheimer's Disease

While research supports amyloid-β (Aβ) as the etiologic agent of Alzheimer's disease (AD), the mechanism of action remains unclear. Evidence indicates that adducts of RNA caused by oxidation also represent an early phenomenon in AD. It is currently unknown what type of influence these two observations have on each other, if any. We quantified five RNA adducts by gas chromatography/mass spectroscopy across five brain regions from AD cases and age-matched controls. We then used a reductive directed analysis to compare the RNA adducts to common indices of AD neuropathology and various pools of Aβ. Using data from four disease-affected brain regions (Brodmann's Area 9, hippocampus, inferior parietal lobule, and the superior and middle temporal gyri), we found that the RNA adduct 8-hydroxyguanine (8-OHG) decreased, while 8-hydroxyadenine (8-OHA) increased in AD. The cerebellum, which is generally spared in AD, did not show disease related changes, and no RNA adducts correlated with the number of plaques or tangles. Multiple regression analysis revealed that SDS-soluble Aβ42 was the best predictor of changes in 8-OHG, while formic acid-soluble Aβ42 was the best predictor of changes in 8-OHA. This study indicates that although there is a connection between AD related neuropathology and RNA oxidation, this relationship is not straightforward

Non-Agonistic Bivalent Antibodies That Promote c-MET Degradation and Inhibit Tumor Growth and Others Specific for Tumor Related c-MET

The c-MET receptor has a function in many human cancers and is a proven therapeutic target. Generating antagonistic or therapeutic monoclonal antibodies (mAbs) targeting c-MET has been difficult because bivalent, intact anti-Met antibodies frequently display agonistic activity, necessitating the use of monovalent antibody fragments for therapy. By using a novel strategy that included immunizing with cells expressing c-MET, we obtained a range of mAbs. These c-MET mAbs were tested for binding specificity and anti-tumor activity using a range of cell-based techniques and in silico modeling. The LMH 80 antibody bound an epitope, contained in the small cysteine-rich domain of c-MET (amino acids 519–561), that was preferentially exposed on the c-MET precursor. Since the c-MET precursor is only expressed on the surface of cancer cells and not normal cells, this antibody is potentially tumor specific. An interesting subset of our antibodies displayed profound activities on c-MET internalization and degradation. LMH 87, an antibody binding the loop connecting strands 3d and 4a of the 7-bladed β-propeller domain of c-MET, displayed no intrinsic agonistic activity but promoted receptor internalization and degradation. LMH 87 inhibited HGF/SF-induced migration of SK-OV-3 ovarian carcinoma cells, the proliferation of A549 lung cancer cells and the growth of human U87MG glioma cells in a mouse xenograft model. These results indicate that c-MET antibodies targeting epitopes controlling receptor internalization and degradation provide new ways of controlling c-MET expression and activity and may enable the therapeutic targeting of c-MET by intact, bivalent antibodies

Dark energy survey year 1 results: the relationship between mass and light around cosmic voids

What are the mass and galaxy profiles of cosmic voids? In this paper, we use two methods to extract voids in the Dark Energy Survey (DES) Year 1 redMaGiC galaxy sample to address this question. We use either 2D slices in projection, or the 3D distribution of galaxies based on photometric redshifts to identify voids. For the mass profile, we measure the tangential shear profiles of background galaxies to infer the excess surface mass density. The signal-to-noise ratio for our lensing measurement ranges between 10.7 and 14.0 for the two void samples. We infer their 3D density profiles by fitting models based on N-body simulations and find good agreement for void radii in the range 15–85 Mpc. Comparison with their galaxy profiles then allows us to test the relation between mass and light at the 10 per cent level, the most stringent test to date. We find very similar shapes for the two profiles, consistent with a linear relationship between mass and light both within and outside the void radius. We validate our analysis with the help of simulated mock catalogues and estimate the impact of photometric redshift uncertainties on the measurement. Our methodology can be used for cosmological applications, including tests of gravity with voids. This is especially promising when the lensing profiles are combined with spectroscopic measurements of void dynamics via redshift-space distortions

Dark Energy Survey Year 1 results: galaxy-galaxy lensing

We present galaxy-galaxy lensing measurements from 1321 sq. deg. of the Dark Energy Survey (DES) Year 1 (Y1) data. The lens sample consists of a selection of 660,000 red galaxies with high-precision photometric redshifts, known as redMaGiC, split into five tomographic bins in the redshift range 0.15<z<0.9 . We use two different source samples, obtained from the Metacalibration (26 million galaxies) and Im3shape (18 million galaxies) shear estimation codes, which are split into four photometric redshift bins in the range 0.2<z<1.3 . We perform extensive testing of potential systematic effects that can bias the galaxy-galaxy lensing signal, including those from shear estimation, photometric redshifts, and observational properties. Covariances are obtained from jackknife subsamples of the data and validated with a suite of log-normal simulations. We use the shear-ratio geometric test to obtain independent constraints on the mean of the source redshift distributions, providing validation of those obtained from other photo-z studies with the same data. We find consistency between the galaxy bias estimates obtained from our galaxy-galaxy lensing measurements and from galaxy clustering, therefore showing the galaxy-matter cross-correlation coefficient r to be consistent with one, measured over the scales used for the cosmological analysis. The results in this work present one of the three two-point correlation functions, along with galaxy clustering and cosmic shear, used in the DES cosmological analysis of Y1 data, and hence the methodology and the systematics tests presented here provide a critical input for that study as well as for future cosmological analyses in DES and other photometric galaxy surveys

Characterizing the intracluster light over the redshift range 0.2 < z < 0.8 in the DES-ACT overlap

We characterize the properties and evolution of bright central galaxies (BCGs) and the surrounding intracluster light (ICL) in galaxy clusters identified in the Dark Energy Survey and Atacama Cosmology Telescope Survey (DES-ACT) overlapping regions, covering the redshift range 0.20 14.4. We also measure the stellar mass–halo mass (SMHM) relation for the BCG+ICL system and find that the slope, β, which characterizes the dependence of M200m,SZ on the BCG+ICL stellar mass, increases with radius. The outskirts are more strongly correlated with the halo than the core, which supports that the BCG+ICL system follows a two-phase growth, where recent growth (z < 2) occurs beyond the BCG’s core. Additionally, we compare our observed SMHM relation results to the IllustrisTNG300-1 cosmological hydrodynamic simulations and find moderate qualitative agreement in the amount of diffuse light. However, the SMHM relation’s slope is steeper in TNG300-1 and the intrinsic scatter is lower, likely from the absence of projection effects in TNG300-1. Additionally, we find that the ICL exhibits a colour gradient such that the outskirts are bluer than the core. Moreover, for the lower halo mass clusters (log10(M200m,SZ/M⊙) < 14.59), we detect a modest change in the colour gradient’s slope with lookback time, which combined with the absence of stellar mass growth may suggest that lower mass clusters have been involved in growth via tidal stripping more recently than their higher mass counterparts

Galaxy-galaxy lensing in the Dark Energy Survey Science Verification data

We present galaxy-galaxy lensing results from 139 deg2 of Dark Energy Survey (DES) Science Verification (SV) data. Our lens sample consists of red galaxies, known as redMaGiC, which are specifically selected to have a low photometric redshift error and outlier rate. The lensing measurement has a total signal-to-noise ratio of 29 over scales 0.09 < R < 15 Mpc h-1, including all lenses over a wide redshift range 0.2 < z < 0.8. Dividing the lenses into three redshift bins for this constant moving number density sample, we find no evidence for evolution in the halo mass with redshift. We obtain consistent results for the lensing measurement with two independent shear pipelines, NGMIX and IM3SHAPE. We perform a number of null tests on the shear and photometric redshift catalogues and quantify resulting systematic uncertainties. Covariances from jackknife subsamples of the data are validated with a suite of 50 mock surveys. The result and systematic checks in this work provide a critical input for future cosmological and galaxy evolution studies with the DES data and redMaGiC galaxy samples. We fit a halo occupation distribution (HOD) model, and demonstrate that our data constrain the mean halo mass of the lens galaxies, despite strong degeneracies between individual HOD parameters