Unlocking biomarker discovery: Large scale application of aptamer proteomic technology for early detection of lung cancer

Lung cancer is the leading cause of cancer deaths, because ~84% of cases are diagnosed at an advanced stage. Worldwide in 2008, ~1.5 million people were diagnosed and ~1.3 million died – a survival rate unchanged since 1960. However, patients diagnosed at an early stage and have surgery experience an 86% overall 5-year survival. New diagnostics are therefore needed to identify lung cancer at this stage. Here we present the first large scale clinical use of aptamers to discover blood protein biomarkers in disease with our breakthrough proteomic technology. This multi-center case-control study was conducted in archived samples from 1,326 subjects from four independent studies of non-small cell lung cancer (NSCLC) in long-term tobacco-exposed populations. We measured >800 proteins in 15uL of serum, identified 44 candidate biomarkers, and developed a 12-protein panel that distinguished NSCLC from controls with 91% sensitivity and 84% specificity in a training set and 89% sensitivity and 83% specificity in a blinded, independent verification set. Performance was similar for early and late stage NSCLC. This is a significant advance in proteomics in an area of high clinical need

High-Speed Infrared Measurement of Injector Tip Temperature during Diesel Engine Operation

[EN] Pre-catalyst engine emissions and detrimental injector deposits have been widely associated with the near-nozzle fluid dynamics during and after the injection events. Although the heating and evaporation of fuel films on the nozzle surface directly affects some of these processes, there are no experimental data for the transient evolution of nozzle surface temperature during typical engine conditions. In order to address this gap in knowledge, we present a non-intrusive approach for the full-cycle time resolved measurement of the surface temperature of production nozzles in an optical engine. A mid-wave infrared high-speed camera was calibrated against controlled conditions, both out of engine and in-engine to account for non-ideal in surface emissivity and optical transmissivity. A custom-modified injector with a thermocouple embedded below the nozzle surface was used to validate the approach under running engine conditions. Calibrated infrared thermography was then applied to characterise the nozzle temperature at 1200 frames per second, during motored and fired engine operation, thus revealing for the first time the effect of transient operating conditions on the temperature of the injector nozzle's surface.This work was supported by the UK's Engineering and Physical Science Research Council (EPSRC grant EP/S513751/1) and BP International Ltd. Raul Payri was hosted at the University of Brighton under the Salvador de Madariaga programme (reference PRX18/00243) from Ministerio de Ciencia, Innovacion y universidades from the Spanish Government.Gander, A.; Sykes, D.; Payri, R.; De Sercey, G.; Kennaird, D.; Gold, M.; Pearson, RJ.... (2021). High-Speed Infrared Measurement of Injector Tip Temperature during Diesel Engine Operation. Energies. 14(15):1-19. https://doi.org/10.3390/en14154584119141

Extended thromboprophylaxis with betrixaban in acutely ill medical patients

BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. RESULTS: A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). CONCLUSIONS: Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218.)

Effects of SNF472, a Novel Inhibitor of Hydroxyapatite Crystallization in Patients Receiving Hemodialysis - Subgroup Analyses of the CALIPSO Trial

Coronary artery calcium (CAC) is highly prevalent and linked with poor outcomes in patients receiving maintenance hemodialysis, and its reduction may improve patient prognosis. SNF472, a selective inhibitor of hydroxyapatite crystallization, slows CAC progression in patients receiving maintenance hemodialysis. In this analysis, we assessed the efficacy of SNF472 in prespecified patient subgroups. In a randomized clinical trial SNF472 300 mg, SNF472 600 mg, or placebo were infused thrice weekly in 91, 92, and 91 patients receiving maintenance hemodialysis and with CAC at baseline, respectively. In prespecified subanalyses, the percent change in CAC volume score (CACvs) from baseline to week 52 in modified intention-to-treat (mITT) and per-protocol (PP) populations was calculated in the following subgroups: age, sex, diabetes mellitus, dialysis vintage, prior atherosclerotic cardiovascular disease, baseline use of non-calcium and calcium-based phosphate binders, calcimimetics, activated vitamin D, warfarin, and statins. In the main trial, SNF472 significantly reduced CACvs progression compared with placebo (11% versus 20% mITT analyses; P = 0.016; 8% vs. 24% PP analyses; P < 0.001). Treatment differences for CACvs progression were similar across all subgroups, and all interaction P values were non-significant in mITT and PP analyses. SNF472 treatment for 52 weeks reduced CACvs progression compared with placebo in a broad range of patients receiving maintenance hemodialysis. Future studies will determine the impact of SNF472 on cardiovascular events in this population

Trial design and baseline characteristics of CaLIPSO : a randomized, double-blind placebo-controlled trial of SNF472 in patients receiving haemodialysis with cardiovascular calcification

The objective of CaLIPSO, a Phase 2b, randomized, double-blind, placebo-controlled clinical trial, is to test the hypothesis that myo-inositol hexaphosphate (SNF472) attenuates the progression of cardiovascular calcification in patients receiving maintenance haemodialysis. Here we report the trial design and baseline characteristics of trial participants. Adult patients on maintenance haemodialysis (≥6 months) with an Agatston coronary artery calcium score, as measured by a multidetector computed tomography scanner, of 100-3500 U were enrolled. Patients were stratified by Agatston score (100-1000 U) and randomized in a 1:1:1 ratio to receive placebo, SNF472 300 mg or SNF472 600 mg administered intravenously three times weekly during each haemodialysis session. Overall, 274 patients were randomized. The mean age of trial participants was 63.6 (standard deviation 8.9) years and 39% were women. The coronary artery, aorta and aortic valve median (25th-75th percentile) Agatston scores at baseline were 730 U (315-1435), 1728 U (625-4978) and 103 U (31-262), respectively, and the median (25th-75th percentile) calcium volume scores at baseline were 666 (310-1234), 1418 (536-4052) and 107 (38-278), respectively. Older age and diabetes mellitus were associated with higher calcium scores at baseline. The CaLIPSO trial enrolled patients on haemodialysis with pre-existent cardiovascular calcification to test the hypothesis that SNF472 attenuates its progression in the coronary arteries, aorta and aortic valve

Context-dependent preferences in starlings: linking ecology, foraging and choice

Foraging animals typically encounter opportunities that they either pursue or skip, but occasionally meet several alternatives simultaneously. Behavioural ecologists predict preferences using absolute properties of each option, while decision theorists focus on relative evaluations at the time of choice. We use European starlings (Sturnus vulgaris) to integrate ecological reasoning with decision models, linking and testing hypotheses for value acquisition and choice mechanism. We hypothesise that options' values depend jointly on absolute attributes, learning context, and subject's state. In simultaneous choices, preference could result either from comparing subjective values using deliberation time, or from processing each alternative independently, without relative comparisons. The combination of the value acquisition hypothesis and independent processing at choice time has been called the Sequential Choice Model. We test this model with options equated in absolute properties to exclude the possibility of preference being built at the time of choice. Starlings learned to obtain food by responding to four stimuli in two contexts. In context [AB], they encountered options A5 or B10 in random alternation; in context [CD], they met C10 or D20. Delay to food is denoted, in seconds, by the suffixes. Observed latency to respond (Li) to each option alone (our measure of value) ranked thus: LA≈LC<LB<<LD, consistently with value being sensitive to both delay and learning context. We then introduced simultaneous presentations of A5 vs. C10 and B10 vs. C10, using latencies in no-choice tests to predict sign and strength of preference in pairings. Starlings preferred A5 over C10 and C10 over B10. There was no detectable evaluation time, and preference magnitude was predictable from latency differentials. This implies that value reflects learning rather than choice context, that preferences are not constructed by relative judgements at the time of choice, and that mechanisms adapted for sequential decisions are effective to predict choice behaviour.This work was supported by Biotechnology and Biological Sciences Research Council (BBSRC) Grant BB/G007144/1 to AK www.bbsrc.ac.uk; TM was supported by a Doctoral Grant from the Portuguese Foundation for Science and Technology (FCT) www.fct.pt/index.phtml.en. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript