Janus kinase inhibitors: a new tool for the treatment of axial spondyloarthritis

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease involving the spine, peripheral joints, and entheses. This condition causes stiffness, pain, and significant limitation of movement. In recent years, several effective therapies have become available based on the use of biologics that selectively block cytokines involved in the pathogenesis of the disease, such as tumor necrosis factor-α (TNFα), interleukin (IL)-17, and IL-23. However, a significant number of patients show an inadequate response to treatment. Over 10 years ago, small synthetic molecules capable of blocking the activity of Janus kinases (JAK) were introduced in the therapy of rheumatoid arthritis. Subsequently, their indication extended to the treatment of other inflammatory rheumatic diseases. The purpose of this review is to discuss the efficacy and safety of these molecules in axSpA therapy

Advances in the pathogenesis and treatment of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a genetically predisposed, female-predominant disease, characterized by multiple organ damage, that in its most severe forms can be life-threatening. The pathogenesis of SLE is complex and involves cells of both innate and adaptive immunity. The distinguishing feature of SLE is the production of autoantibodies, with the formation of immune complexes that precipitate at the vascular level, causing organ damage. Although progress in understanding the pathogenesis of SLE has been slower than in other rheumatic diseases, new knowledge has recently led to the development of effective targeted therapies, that hold out hope for personalized therapy. However, the new drugs available to date are still an adjunct to conventional therapy, which is known to be toxic in the short and long term. The purpose of this review is to summarize recent advances in understanding the pathogenesis of the disease and discuss the results obtained from the use of new targeted drugs, with a look at future therapies that may be used in the absence of the current standard of care or may even cure this serious systemic autoimmune disease

Flux creep in Bi2Sr2CaCu2O8(sub +x) single crystals

The results of a magnetic study on a Bi2Sr2CaCu2O(8+x) single crystal are reported. Low field susceptibility (dc and ac), magnetization cycles and time dependent measurements were performed. With increasing the temperature the irreversible regime of the magnetization cycles is rapidly restricted to low fields, showing that the critical current J(sub c) becomes strongly field dependent well below T(sub c). At 2.4 K the critical current in zero field, determined from the remanent magnetization by using the Bean formula for the critical state, is J(sub c) = 2 10(exp 5) A/sq cm. The temperature dependence of J(sub c) is satisfactorily described by the phenomenological law J(sub c) = J(sub c) (0) (1 - T/T(sub c) (sup n), with n = 8. The time decay of the zero field cooled magnetization and of the remanent magnetization was studied at different temperatures for different magnetic fields. The time decay was found to be logarithmic in both cases, at least at low temperatures. At T = 4.2 K for a field of 10 kOe applied parallel to the c axis, the average pinning energy, determined by using the flux creep model, is U(sub o) = 0.010 eV

Solving classification tasks by a receptron based on nonlinear optical speckle fields

Among several approaches to tackle the problem of energy consumption in modern computing systems, two solutions are currently investigated: one consists of artificial neural networks (ANNs) based on photonic technologies, the other is a different paradigm compared to ANNs and it is based on random networks of nonlinear nanoscale junctions resulting from the assembling of nanoparticles or nanowires as substrates for neuromorphic computing. These networks show the presence of emergent complexity and collective phenomena in analogy with biological neural networks characterized by self-organization, redundancy, non-linearity. Starting from this background, we propose and formalize a generalization of the perceptron model to describe a classification device based on a network of interacting units where the input weights are nonlinearly dependent. We show that this model, called "receptron", provides substantial advantages compared to the perceptron as, for example, the solution of non-linearly separable Boolean functions with a single device. The receptron model is used as a starting point for the implementation of an all-optical device that exploits the non-linearity of optical speckle fields produced by a solid scatterer. By encoding these speckle fields we generated a large variety of target Boolean functions without the need for time-consuming machine learning algorithms. We demonstrate that by properly setting the model parameters, different classes of functions with different multiplicity can be solved efficiently. The optical implementation of the receptron scheme opens the way for the fabrication of a completely new class of optical devices for neuromorphic data processing based on a very simple hardware

Discovery of chemotherapy-associated ovarian cancer antigens by interrogating memory T cells

According to the immunogenic cell death hypothesis, clinical chemotherapy treatments may result in CD8(+) and CD4(+) T-cell responses against tumor cells. To discover chemotherapy-associated antigens (CAAs), T cells derived from ovarian cancer (OC) patients (who had been treated with appropriate chemotherapy protocols) were interrogated with proteins isolated from primary OC cells. We screened for immunogenicity using two-dimensional electrophoresis gel-eluted OC proteins. Only the selected immunogenic antigens were molecularly characterized by mass-spectrometry-based analysis. Memory T cells that recognized antigens associated with apoptotic (but not live) OC cells were correlated with prolonged survival in response to chemotherapy, supporting the model of chemotherapy-induced apoptosis as an adjuvant of anti-tumor immunity. The strength of both memory CD4(+) and CD8(+) T cells producing either IFN- or IL-17 in response to apoptotic OC antigens was also significantly greater in Responders to chemotherapy than in nonresponders. Immunogenicity of some of these antigens was confirmed using recombinant proteins in an independent set of patients. The T-cell interrogation system represents a strategy of reverse tumor immunology that proposes to identify CAAs, which may then be validated as possible prognostic tumor biomarkers or cancer vaccines

Combination of chemotherapy and PD-1 blockade induces T cell responses to tumor non-mutated neoantigens

Grimaldi and Cammarata et al. develop a proteomics-based, target discovery platform to identify immunogenic proteins specific to apoptotic tumor cells. This study highlights the importance of protein modifications in apoptotic tumor cells as a mechanism of generating immunogenic neoantigens that can be targeted for T cell-based immunotherapy.Here, we developed an unbiased, functional target-discovery platform to identify immunogenic proteins from primary non-small cell lung cancer (NSCLC) cells that had been induced to apoptosis by cisplatin (CDDP) treatment in vitro, as compared with their live counterparts. Among the multitude of proteins identified, some of them were represented as fragmented proteins in apoptotic tumor cells, and acted as non-mutated neoantigens (NM-neoAgs). Indeed, only the fragmented proteins elicited effective multi-specific CD4(+) and CD8(+) T cell responses, upon a chemotherapy protocol including CDDP. Importantly, these responses further increased upon anti-PD-1 therapy, and correlated with patients' survival and decreased PD-1 expression. Cross-presentation assays showed that NM-neoAgs were unveiled in apoptotic tumor cells as the result of caspase-dependent proteolytic activity of cellular proteins. Our study demonstrates that apoptotic tumor cells generate a repertoire of immunogenic NM-neoAgs that could be potentially used for developing effective T cell-based immunotherapy across multiple cancer patients

Guidance on noncorticosteroid systemic immunomodulatory therapy in noninfectious uveitis: fundamentals of care for uveitis (focus) initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic reviewof the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE,CINAHL,SCOPUS,BIOSIS, andWeb of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review.Atotal of 44 globally representativegroupmembersmet in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents

Monovision-based vehicle detection, distance and relative speed measurement in urban traffic

This study presents a monovision-based system for on-road vehicle detection and computation of distance and relative speed in urban traffic. Many works have dealt with monovision vehicle detection, but only a few of them provide the distance to the vehicle which is essential for the control of an intelligent transportation system. The system proposed integrates a single camera reducing the monetary cost of stereovision and RADAR-based technologies. The algorithm is divided in three major stages. For vehicle detection, the authors use a combination of two features: the shadow underneath the vehicle and horizontal edges. They propose a new method for shadow thresholding based on the grey-scale histogram assessment of a region of interest on the road. In the second and third stages, the vehicle hypothesis verification and the distance are obtained by means of its number plate whose dimensions and shape are standardised in each country. The analysis of consecutive frames is employed to calculate the relative speed of the vehicle detected. Experimental results showed excellent performance in both vehicle and number plate detections and in the distance measurement, in terms of accuracy and robustness in complex traffic scenarios and under different lighting conditions

Odontostomatologic management of patients receiving oral anticoagulant therapy: a retrospective multicentric study

Introduction: Today, we frequently find patients taking oral anticoagulant therapy (OAT), a prophylaxis against the occurrence of thromboembolic events. An oral surgeon needs to know how to better manage such patients, in order to avoid hemorrhagic and thromboembolic complications. Materials and methods: A group of 193 patients (119 men aged between 46 and 82 and 74 women aged between 54 and 76) undergoing OAT for more than 5 years were managed with a standardized management protocol and a 2-months follow-up. The aim of the present study was to apply a protocol, which could provide a safe intra- and postoperative management of patients on OAT. Results: Among the 193 patients, only 2 had postoperative complications. Conclusions: We think that the protocol used in the present study can be used for complete safety in the treatment of this type of patients. Keywords: Oral Anticoagulant Therapy (OAT), Tranexamic Acid, Oral Surger

Brixsino High-Flux Dual X-Ray and THz Radiation Source Based on Energy Recovery Linacs

We present the conceptual design of a compact light source named BriXSinO. BriXSinO was born as demonstrator of the Marix project, but it is also a dual high flux radiation source Inverse Compton Source (ICS) of X-ray and Free-Electron Laser of THz spectral range radiation conceived for medical applications and general applied research. The accelerator is a push-pull CW-SC Energy Recovery Linac (ERL) based on superconducting cavities technology and allows to sustain MW-class beam power with almost just one hundred kW active power dissipation/consumption. ICS line produces 33 keV monochromatic X-Rays via Compton scattering of the electron beam with a laser system in Fabry-Pérot cavity at a repetition rate of 100 MHz. The THz FEL oscillator is based on an undulator imbedded in optical cavity and generates THz wavelengths from 15 to 50 micron