Management of Bladder Cancer following Solid Organ Transplantation

Objective. Present our experience managing bladder cancer following liver and renal transplantation. Methods. Single institution retrospective review of patients diagnosed with bladder urothelial carcinoma (BUC) following solid organ transplantation between January 1992 and December 2007. Results. Of the 2,925 renal and 2,761 liver transplant recipients reviewed, we identified eleven patients (0.2%) following transplant diagnosed with BUC. Two patients with low grade T1 TCC were managed by TURBT. Three patients with CIS and one patient with T1 low grade BUC were treated by TURBT and adjuvant BCG. All four are alive and free of recurrence at a mean follow-up of 51 ± 22 months. One patient with T1 high grade BUC underwent radical cystectomy and remains disease free with a follow-up of 98 months. Muscle invasive TCC was diagnosed in four patients at a median of 3.6 years following transplantation. Two patients are recurrence free at 24 and 36 months following radical cystectomy. Urinary diversion and palliative XRT were performed in one patient with un-resectable disease. Conclusions. Bladder cancer is uncommon following renal and liver transplantation, but it can be managed successfully with local and/or extirpative therapy. The use of intravesical BCG is possible in select immunosuppressed patients

NGTS clusters survey -- II. White-light flares from the youngest stars in Orion

We present the detection of high energy white-light flares from pre-main sequence stars associated with the Orion complex, observed as part of the Next Generation Transit Survey (NGTS). With energies up to $5.2\times10^{35}$ erg these flares are some of the most energetic white-light flare events seen to date. We have used the NGTS observations of flaring and non-flaring stars to measure the average flare occurrence rate for 4 Myr M0-M3 stars. We have also combined our results with those from previous studies to predict average rates for flares above $1\times10^{35}$ ergs for early M stars in nearby young associations.STFC ST/M001962/1; ST/P000495/

Scintillation-limited photometry with the 20-cm NGTS telescopes at Paranal Observatory

Ground-based photometry of bright stars is expected to be limited by atmospheric scintillation, although in practice observations are often limited by other sources of systematic noise. We analyse 122 nights of bright star (Gmag ≲ 11.5) photometry using the 20-cm telescopes of the Next-Generation Transit Survey (NGTS) at the Paranal Observatory in Chile. We compare the noise properties to theoretical noise models and we demonstrate that NGTS photometry of bright stars is indeed limited by atmospheric scintillation. We determine a median scintillation coefficient at the Paranal Observatory of CY=1.54⁠, which is in good agreement with previous results derived from turbulence profiling measurements at the observatory. We find that separate NGTS telescopes make consistent measurements of scintillation when simultaneously monitoring the same field. Using contemporaneous meteorological data, we find that higher wind speeds at the tropopause correlate with a decrease in long-exposure (t = 10 s) scintillation. Hence, the winter months between June and August provide the best conditions for high-precision photometry of bright stars at the Paranal Observatory. This work demonstrates that NGTS photometric data, collected for searching for exoplanets, contains within it a record of the scintillation conditions at Paranal

NGTS-28Ab:a short period transiting brown dwarf

We report the discovery of a brown dwarf orbiting a M1 host star. We first identified the brown dwarf within the Next Generation Transit Survey data, with supporting observations found in TESS sectors 11 and 38. We confirmed the discovery with follow-up photometry from the South African Astronomical Observatory, SPECULOOS-S, and TRAPPIST-S, and radial velocity measurements from HARPS, which allowed us to characterize the system. We find an orbital period of ∼1.25 d, a mass of 69.0+5.3-4.8 MJ, close to the hydrogen burning limit, and a radius of 0.95 ± 0.05 RJ. We determine the age to be &gt;0.5 Gyr, using model isochrones, which is found to be in agreement with spectral energy distribution fitting within errors. NGTS-28Ab is one of the shortest period systems found within the brown dwarf desert, as well as one of the highest mass brown dwarfs that transits an M dwarf. This makes NGTS-28Ab another important discovery within this scarcely populated region.</div

Loss of Cytoplasmic CDK1 Predicts Poor Survival in Human Lung Cancer and Confers Chemotherapeutic Resistance

The dismal lethality of lung cancer is due to late stage at diagnosis and inherent therapeutic resistance. The incorporation of targeted therapies has modestly improved clinical outcomes, but the identification of new targets could further improve clinical outcomes by guiding stratification of poor-risk early stage patients and individualizing therapeutic choices. We hypothesized that a sequential, combined microarray approach would be valuable to identify and validate new targets in lung cancer. We profiled gene expression signatures during lung epithelial cell immortalization and transformation, and showed that genes involved in mitosis were progressively enhanced in carcinogenesis. 28 genes were validated by immunoblotting and 4 genes were further evaluated in non-small cell lung cancer tissue microarrays. Although CDK1 was highly expressed in tumor tissues, its loss from the cytoplasm unexpectedly predicted poor survival and conferred resistance to chemotherapy in multiple cell lines, especially microtubule-directed agents. An analysis of expression of CDK1 and CDK1-associated genes in the NCI60 cell line database confirmed the broad association of these genes with chemotherapeutic responsiveness. These results have implications for personalizing lung cancer therapy and highlight the potential of combined approaches for biomarker discovery

Time-Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above-Normal Blood Pressure

Background High‐resistance inspiratory muscle strength training (IMST) is a novel, time‐efficient physical training modality. &nbsp; Methods and Results We performed a double‐blind, randomized, sham‐controlled trial to investigate whether 6&nbsp;weeks of IMST (30&nbsp;breaths/day, 6&nbsp;days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50&ndash;79&nbsp;years) with systolic blood pressure &ge;120&nbsp;mm&nbsp;Hg, while also investigating potential mechanisms and long‐lasting effects. Thirty‐six participants completed high‐resistance IMST (75% maximal inspiratory pressure, n=18) or low‐resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (&asymp;95% of training sessions completed). Casual systolic blood pressure decreased from 135&plusmn;2&nbsp;mm&nbsp;Hg to 126&plusmn;3&nbsp;mm&nbsp;Hg (P&lt;0.01) with IMST, which was &asymp;75% sustained 6&nbsp;weeks after IMST (P&lt;0.01), whereas IMST modestly decreased casual diastolic blood pressure (79&plusmn;2&nbsp;mm&nbsp;Hg to 77&plusmn;2&nbsp;mm&nbsp;Hg, P=0.03); blood pressure was unaffected by sham training (all P&gt;0.05). Twenty‐four hour systolic blood pressure was lower after IMST versus sham training (P=0.01). Brachial artery flow‐mediated dilation improved &asymp;45% with IMST (P&lt;0.01) but was unchanged with sham training (P=0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity (P&lt;0.05). IMST decreased C‐reactive protein (P=0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness (P&gt;0.05). &nbsp; Conclusions High‐resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above‐normal initial systolic blood pressure. &nbsp; Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03266510. &nbsp;</p

The education effect: higher educational qualifications are robustly associated with beneficial personal and socio-political outcomes

Level of education is a predictor of a range of important outcomes, such as political interest and cynicism, social trust, health, well-being, and intergroup attitudes. We address a gap in the literature by analyzing the strength and stability of the education effect associated with this diverse range of outcomes across three surveys covering the period 1986–2011, including novel latent growth analyses of the stability of the education effect within the same individuals over time. Our analyses of the British Social Attitudes Survey, British Household Panel Survey, and International Social Survey Programme indicated that the education effect was robust across these outcomes and relatively stable over time, with higher education levels being associated with higher trust and political interest, better health and well-being, and with less political cynicism and less negative intergroup attitudes. The education effect was strongest when associated with political outcomes and attitudes towards immigrants, whereas it was weakest when associated with health and well-being. Most of the education effect appears to be due to the beneficial consequences of having a university education. Our results demonstrate that this beneficial education effect is also manifested in within-individual changes, with the education effect tending to become stronger as individuals age

The genetic landscape of high-risk neuroblastoma

Neuroblastoma is a malignancy of the developing sympathetic nervous system that often presents with widespread metastatic disease, resulting in survival rates of less than 50%1. To determine the spectrum of somatic mutation in high-risk neuroblastoma, we studied 240 cases using a combination of whole exome, genome and transcriptome sequencing as part of the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) initiative. Here we report a low median exonic mutation frequency of 0.60 per megabase (0.48 non-silent), and remarkably few recurrently mutated genes in these tumors. Genes with significant somatic mutation frequencies included ALK (9.2% of cases), PTPN11 (2.9%), ATRX (2.5%, an additional 7.1% had focal deletions), MYCN (1.7%, a recurrent p.Pro44Leu alteration), and NRAS (0.83%). Rare, potentially pathogenic germline variants were significantly enriched in ALK, CHEK2, PINK1, and BARD1. The relative paucity of recurrent somatic mutations in neuroblastoma challenges current therapeutic strategies reliant upon frequently altered oncogenic drivers

An ultrahot Neptune in the Neptune desert

About 1 out of 200 Sun-like stars has a planet with an orbital period shorter than one day: an ultrashort-period planet. All of the previously known ultrashort-period planets are either hot Jupiters, with sizes above 10 Earth radii (R⊕), or apparently rocky planets smaller than 2 R⊕. Such lack of planets of intermediate size (the ‘hot Neptune desert’) has been interpreted as the inability of low-mass planets to retain any hydrogen/helium (H/He) envelope in the face of strong stellar irradiation. Here we report the discovery of an ultrashort-period planet with a radius of 4.6 R⊕ and a mass of 29 M⊕, firmly in the hot Neptune desert. Data from the Transiting Exoplanet Survey Satellite revealed transits of the bright Sun-like star LTT 9779 every 0.79 days. The planet’s mean density is similar to that of Neptune, and according to thermal evolution models, it has a H/He-rich envelope constituting 9.0^(+2.7)_(−2.9)% of the total mass. With an equilibrium temperature around 2,000 K, it is unclear how this ‘ultrahot Neptune’ managed to retain such an envelope. Follow-up observations of the planet’s atmosphere to better understand its origin and physical nature will be facilitated by the star’s brightness (V_(mag) = 9.8)

Modulation of Glucose Transporter 1 (GLUT1) Expression Levels Alters Mouse Mammary Tumor Cell Growth In Vitro and In Vivo

Tumor cells exhibit an altered metabolism characterized by elevated aerobic glycolysis and lactate secretion which is supported by an increase in glucose transport and consumption. We hypothesized that reducing or eliminating the expression of the most prominently expressed glucose transporter(s) would decrease the amount of glucose available to breast cancer cells thereby decreasing their metabolic capacity and proliferative potential