Recommendations for validation testing of home pregnancy tests (HPTs) in Europe

Homepregnancy tests (HPTs) available in Europe include accuracy and other performance claims listed on their packaging. Due to the lack of guidance on the standardisation of such products, it is often difficult to replicate these claims when tested on a clinical sample, whether in a laboratory setting or by lay users. The In Vitro Diagnostic Regulation is a set of requirements that mandate comprehensive validation data on human pregnancy tests and other in vitro devices. It is due to replace the current European Directive (98/79/EC) and fully implemented in Europe by 2022. In June 2019, a panel of seven experts convened to discuss the validation studies required to provide the information needed to meet the new regulation for HPTs in Europe and proposed 15 recommendations for best practice. Defining best practice at all stages of validation of these important tests may ensure that tests marketed inEurope are fit for purpose, enabling lay users to be confident of the high quality of the HPT results they obtain. The panelists believe that the recommendations proposed here for the validation of HPTs may constructively contribute to improved standardisation of validation procedures in Europe.Peer reviewe

Chiral Extrapolations and the Covariant Small Scale Expansion

We calculate the nucleon and the delta mass to fourth order in a covariant formulation of the small scale expansion. We analyze lattice data from the MILC collaboration and demonstrate that the available lattice data combined with our knowledge of the physical values for the nucleon and delta masses lead to consistent chiral extrapolation functions for both observables up to fairly large pion masses. This holds in particular for very recent data on the delta mass from the QCDSF collaboration. The resulting pion-nucleon sigma term is sigma_{piN} = 48.9 MeV. This first quantitative analysis of the quark-mass dependence of the structure of the Delta(1232) in full QCD within chiral effective field theory suggests that (the real part of) the nucleon-delta mass-splitting in the chiral limit, Delta_0 = 0.33 GeV, is slightly larger than at the physical point. Further analysis of simultaneous fits to nucleon and delta lattice data are needed for a precision determination of the properties of the first excited state of the nucleon.Comment: 11 pp, 2 figs, version accepted for publication in Phys. Lett.

Effects of radiation therapy on tissue and serum concentrations of tumour associated trypsin inhibitor and their prognostic significance in rectal cancer patients

<p>Abstract</p> <p>Background</p> <p>We have previously demonstrated that elevated concentrations of tumour-associated trypsin inhibitor (TATI) in both tumour tissue (t-TATI) and in serum (s-TATI) are associated with a poor prognosis in colorectal cancer patients. It was also found that s-TATI concentrations were lower in patients with rectal cancer compared to patients with colon cancer. In this study, we investigated the effects of neoadjuvant radiotherapy (RT) on concentrations of t-TATI and s-TATI in patients with rectal cancer.</p> <p>Methods</p> <p>TATI was analysed in serum, normal mucosa and tumour tissue collected at various time points in 53 rectal cancer patients enrolled in a case-control study where 12 patients received surgery alone, 20 patients 5 × 5 Gy (short-term) preoperative RT and 21 patients 25 × 2 Gy (long-term) preoperative RT. T-TATI was analysed by immunohistochemistry and s-TATI was determined by an immunofluorometric assay. Mann-Whitney U test and Wilcoxon Z (Z) test were used to assess t-TATI and s-TATI concentrations in relation to RT. Spearman's correlation (R) test was used to explore the associations between t-TATI, s-TATI and clinicopathological parameters. Overall survival (OS) according to high and low t-TATI and s-TATI concentrations was estimated by classification and regression tree analysis, Kaplan-Meier analysis and the log rank test.</p> <p>Results</p> <p>RT did not affect concentrations of t-TATI or s-TATI. In patients receiving short-term but not long-term RT, s-TATI concentrations were significantly higher 4 weeks post surgery than in serum drawn prior to surgery (Z = -3.366, P < 0.001). T-TATI expression correlated with male gender (R = 0.406, P = 0.008). High t-TATI expression in surgical specimens was associated with a significantly shorter OS (P = 0.045). S-TATI concentrations in serum drawn at all time points were associated with an impaired OS (P = 0.035 before RT, P = 0.001 prior to surgery, P = 0.043 post surgery). At all time points, s-TATI correlated with higher age (P < 0.001-0.021) and with increased s-creatinine concentrations assessed prior to surgery (P = 0.041).</p> <p>Conclusions</p> <p>The results presented here further validate the utility of t-TATI and s-TATI as prognostic biomarkers in patients with rectal cancer, independent of neoadjuvant RT.</p

A dithiacyclam-coordinated silver(i) polymer with anti-cancer stem cell activity

A cancer stem cell (CSC) active, solution stable, silver(i) polymeric complex bearing a dithiacyclam ligand is reported. The complex displays similar potency towards CSCs to salinomycin in monolayer and three-dimensional cultures. Mechanistic studies suggest CSC death results from cytosol entry, an increase in intracellular reactive oxygen species, and caspase-dependent apoptosis

Pericytes contribute to airway remodeling in a mouse model of chronic allergic asthma

Myofibroblast accumulation, subepithelial fibrosis, and vascular remodeling are complicating features of chronic asthma, but the mechanisms are not clear. Platelet-derived growth factors (PDGFs) regulate the fate and function of various mesenchymal cells and have been implicated as mediators of lung fibrosis. However, it is not known whether PDGF-BB signaling via PDGFRβ, which is critical for the recruitment of pericytes to blood vessels, plays a role in airway remodeling in chronic asthma. In the present study, we used a selective PDGFRβ inhibitor (CP-673451) to investigate the role of PDGFRβ signaling in the development of airway remodeling and lung dysfunction in an established mouse model of house dust mite-induced chronic allergic asthma. Unexpectedly, we found that pharmacological inhibition of PDGFRβ signaling in the context of chronic aeroallergen exposure led to exacerbated lung dysfunction and airway smooth muscle thickening. Further studies revealed that the inflammatory response to aeroallergen challenge in mice was associated with decreased PDGF-BB expression and the loss of pericytes from the airway microvasculature. In parallel, cells positive for pericyte markers accumulated in the subepithelial region of chronically inflamed airways. This process was exacerbated in animals treated with CP-673451. The results indicate that perturbed PDGF-BB/PDGFRβ signaling and pericyte accumulation in the airway wall may contribute to airway remodeling in chronic allergic asthma

Extending the climatological concept of'Detection and Attribution' to global change ecology in the Anthropocene

Research into global change ecology is motivated by the need to understand the role of humans in changing biotic systems. Mechanistic understanding of ecological responses requires the separation of different climatic parameters and processes that often operate on diverse spatiotemporal scales. Yet most environmental studies do not distinguish the effects of internal climate variability from those caused by external, natural (e.g. volcanic, solar, orbital) or anthropogenic (e.g. greenhouse gases, ozone, aerosols, land-use) forcing factors. We suggest extending the climatological concept of ‘Detection and Attribution’ (DA) to unravel abiotic drivers of ecological dynamics in the Anthropocene. We therefore apply DA to quantify the relative roles of natural versus industrial temperature change on elevational shifts in the outbreak epicentres of the larch budmoth (LBM; Zeiraphera diniana or griseana Gn.); the classic example of a cyclic forest defoliating insect. Our case study shows that anthropogenic warming shifts the epicentre of travelling LBM waves upward, which disrupts the intensity of population outbreaks that occurred regularly over the past millennium in the European Alps. Our findings demonstrate the ability of DA to detect ecological responses beyond internal system variability, to attribute them to specific external climate forcing factors and to identify climate-induced ecological tipping points. In order to implement the climatological concept of ‘Detection and Attribution’ successfully into modern global change ecology, future studies should combine high-resolution paleoenvironmental reconstructions and state-of-the-art climate model simulations to inform inference-based ecosystem models

Effective Hadron Dynamics: From Meson Masses to the Proton Spin Puzzle

We construct a three flavor chiral Lagrangian of pseudoscalars and vectors with special emphasis on the symmetry breaking terms. Comparing tree level two and three point functions with experiment allows us to first, fix the parameters of the model (including the light quark mass ratios) and second, to predict $m(K^{*+})-m(K^{*\circ}),\, \Gamma(K^*\rightarrow K\pi)$ and $\Gamma(\phi\rightarrow K {\overline K})$. The last mentioned quantities come out reasonably well, in contrast to an ``ordinary" $SU(3)$ treatment. For this purpose we need ``second order" symmetry breakers involving the vector fields analogous to those needed for the chiral perturbation theory program with only pseudoscalars. An improved description of the $\eta-\eta^\prime$ system is also given. We then use the soliton sector of this improved chiral Lagrangian to investigate some aspects of baryon physics which are especially sensitive to symmetry breaking. For this purpose a fairly elaborate ``cranking" techinque is employed in connection with the collective Hamiltonian. In addition to the ``strong" baryon mass spectrum a careful investigation is made of the non-electromagnetic part of the neutron-proton mass difference. This work is needed to improve our previous estimates concerning the two component approach to the ``proton spin" puzzle. We find that both the ``matter" and ``glue" contributions are small but they do tend to cancel each other.Comment: 33 pages, LaTe

Establishment of reference values for plasma neurofilament light based on healthy individuals aged 5-90 years

The recent development of assays that accurately quantify neurofilament light, a neuronal cytoskeleton protein, in plasma has generated a vast literature supporting that it is a sensitive, dynamic, and robust biomarker of neuroaxonal damage. As a result, efforts are now made to introduce plasma neurofilament light into clinical routine practice, making it an easily accessible complement to its cerebrospinal fluid counterpart. An increasing literature supports the use of plasma neurofilament light in differentiating neurodegenerative diseases from their non-neurodegenerative mimics and suggests it is a valuable biomarker for the evaluation of the effect of putative disease-modifying treatments (e.g. in multiple sclerosis). More contexts of use will likely emerge over the coming years. However, to assist clinical interpretation of laboratory test values, it is crucial to establish normal reference intervals. In this study, we sought to derive reliable cut-offs by pooling quantified plasma neurofilament light in neurologically healthy participants (5-90 years) from eight cohorts. A strong relationship between age and plasma neurofilament light prompted us to define the following age-partitioned reference limits (upper 95th percentile in each age category): 5-17 years = 7 pg/mL; 18-50 years = 10 pg/mL; 51-60 years = 15 pg/mL; 61-70 years = 20 pg/mL; 70 + years = 35 pg/mL. The established reference limits across the lifespan will aid the introduction of plasma neurofilament light into clinical routine, and thereby contribute to diagnostics and disease-monitoring in neurological practice

A bioinspired redox-modulating copper(II)– macrocyclic complex bearing non-steroidal anti-inflammatory drugs with anti-cancer stem cell activity

Copper(II) coordination compounds have been investigated for their anticancer properties for decades, however, none have reached advanced human clinical trials. The poor translation of copper(II) complexes from in vitro studies to (pre)clinical studies can be attributed to their limited efficacy in animal models, which is largely associated with copper leaching and speciation (in biological fluids). Here we report a biologically stable copper(II) complex based on the active site of Type I Cu electron transport proteins. The copper(II) complex 1 comprises of dithiacyclam (with soft and hard donor atoms) and two diclofenac units, a nonsteriodial anti-inflammatory drug (NSAID). Extensive biophysical and electrochemical studies show that the solid state structure of 1 is preserved in solution and that it can access both copper(I) and copper(II) oxidation states without leaching copper or undergoing speciation (in the presence of a cellular reductant). Cell studies show that 1 kills bulk breast cancer cells and highly resistant breast cancer stem cells (CSCs) at micromolar concentrations, and is significantly less toxic towards a panel of non-cancerous cells. Clinically relevant spheroid studies show that 1 is able to inhibit breast CSC-enriched mammosphere formation to a similar extent as salinomycin, a gold standard anti-CSC agent. Mechanistic studies show that 1 evokes breast CSC death by elevating intracellular reactive oxygen species (ROS) and inhibiting cyclooxygenase-2 (COX-2) activity. The former leads to the activation of stress pathways (JNK and p38), which culminates in caspase-dependent apoptosis. This study reinforces the therapeutic potential of copper(II)–NSAID complexes and provides a bioinspired route to develop stable, ROS-generating copper-based anti-CSC drug candidates

Study protocol for locoregional precision treatment of hepatocellular carcinoma with transarterial chemoembolisation (TACTida), a clinical study:idarubicin dose selection, tissue response and survival

INTRODUCTION: Hepatocellular carcinoma (HCC) is a common cause of cancer-related death, often detected in the intermediate stage. The standard of care for intermediate-stage HCC is transarterial chemoembolisation (TACE), where idarubicin (IDA) is a promising drug. Despite the fact that TACE has been used for several decades, treatment success is unpredictable. This clinical trial has been designed believing that further improvement might be achieved by increasing the understanding of interactions between local pharmacology, tumour targeting, HCC pathophysiology, metabolomics and molecular mechanisms of drug resistance. METHODS AND ANALYSIS: The study population of this single-centre clinical trial consists of adults with intermediate-stage HCC. Each tumour site will receive TACE with two different IDA doses, 10 and 15 mg, on separate occasions. Before and after each patient's first TACE blood samples, tissue and liquid biopsies, and positron emission tomography (PET)/MRI will be performed. Blood samples will be used for pharmacokinetics (PK) and liver function evaluation. Tissue biopsies will be used for histopathology analyses, and culturing of primary organoids of tumour and non-tumour tissue to measure cell viability, drug response, multiomics and gene expression. Multiomics analyses will also be performed on liquid biopsies. PET/MRI will be used to evaluate tumour viability and liver metabolism. The two doses of IDA will be compared regarding PK, antitumour effects and safety. Imaging, molecular biology and multiomics data will be used to identify HCC phenotypes and their relation to drug uptake and metabolism, treatment response and survival. ETHICS AND DISSEMINATION: Participants give informed consent. Personal data are deidentified. A patient will be withdrawn from the study if considered medically necessary, or if it is the wish of the patient. The study has been approved by the Swedish Ethical Review Authority (Dnr. 2021-01928) and by the Medical Product Agency, Uppsala, Sweden. TRIAL REGISTRATION NUMBER: EudraCT number: 2021-001257-31