Syngeneic animal models of tobacco-associated oral cancer reveal the activity of in situ anti-CTLA-4.

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. Tobacco use is the main risk factor for HNSCC, and tobacco-associated HNSCCs have poor prognosis and response to available treatments. Recently approved anti-PD-1 immune checkpoint inhibitors showed limited activity (≤20%) in HNSCC, highlighting the need to identify new therapeutic options. For this, mouse models that accurately mimic the complexity of the HNSCC mutational landscape and tumor immune environment are urgently needed. Here, we report a mouse HNSCC model system that recapitulates the human tobacco-related HNSCC mutanome, in which tumors grow when implanted in the tongue of immunocompetent mice. These HNSCC lesions have similar immune infiltration and response rates to anti-PD-1 (≤20%) immunotherapy as human HNSCCs. Remarkably, we find that >70% of HNSCC lesions respond to intratumoral anti-CTLA-4. This syngeneic HNSCC mouse model provides a platform to accelerate the development of immunotherapeutic options for HNSCC

Predicting the risk to develop preeclampsia in the first trimester combining promoter variant -98A/C of LGALS13 (placental protein 13), Black ethnicity, previous preeclampsia, obesity, and maternal age

BACKGROUND: We studied LGALS13 [Placental Protein 13 (PP13)] promoter DNA polymorphisms in preeclampsia (PE) prediction, given PP13’s effects on hypotension, angiogenesis and immunotolerance. METHODS: We retrieved 67 PE (49 term, 18 preterm) cases and 196 matched controls from first trimester plasma samples prospectively collected at King's College Hospital, London. Cell-free DNA was extracted and the four LGALS13 exons were sequenced after PCR amplification. Expression of LGALS13 promoter reporter constructs were determined in BeWo trophoblast-like cells with luciferase assays. RESULTS: A/C genotype in –98 position was the lowest in term PE compared to controls (p<0.032), similar to a South African cohort. Control but not all PE allele frequencies were in Hardy-Weinberg equilibrium (p=0.036). The Odds ratio for term PE calculated from prior risk, the A/A genotype and black ethnicity was 14 (p<0.001). In luciferase assays, the LGALS13 promoter “-98A" variant had 13% (p=0.04) and 26% (p<0.001) lower expression than the "-98C" variant in non-differentiated and differentiated BeWo cells, respectively. After 48-hour differentiation, there was 4.55- fold increase in expression of "-98C" variant versus 3.85-fold of "-98A" variant (p<0.001). CONCLUSION: Lower LGALS13 (PP13) expression by the "-98A/A" genotype appears to impose higher risk to develop PE and could aid in PE prediction

A Man with Labile Blood Pressure

Ronald Ma and colleagues discuss the differential diagnosis and management of a patient who presented with recurrent episodes of chest discomfort, palpitations, and labile blood pressure

Dynamic model of supercritical Organic Rankine Cycle waste heat recovery system for internal combustion engine

The supercritical Organic Rankine Cycle (ORC) for the Waste Heat Recovery (WHR) from Internal Combustion (IC) engines has been a growing research area in recent years, driven by the aim to enhance the thermal efficiency of the ORC and engine. Simulation of a supercritical ORC-WHR system before a real-time application is important as high pressure in the system may lead to concerns about safety and availability of components. In the ORC-WHR system, the evaporator is the main contributor to thermal inertia of the system and is considered to be the critical component since the heat transfer of this device influences the efficiency of the system. Since the thermo-physical properties of the fluid at supercritical pressures are dependent on temperature, it is necessary to consider the variations in properties of the working fluid. The wellknown Finite Volume (FV) discretization method is generally used to take those property changes into account. However, a FV model of the evaporator in steady state condition cannot be used to predict the thermal inertia of the cycle when it is subjected to transient heat sources. In this paper, a dynamic FV model of the evaporator has been developed and integrated with other components in the ORC-WHR system. The stability and transient responses along with the performance of the ORC-WHR system for the transient heat source are investigated and are also included in this paper

Renal Denervation Update From the International Sympathetic Nervous System Summit:JACC State-of-the-Art Review

Three recent renal denervation studies in both drug-naïve and drug-treated hypertensive patients demonstrated a significant reduction of ambulatory blood pressure compared with respective sham control groups. Improved trial design, selection of relevant patient cohorts, and optimized interventional procedures have likely contributed to these positive findings. However, substantial variability in the blood pressure response to renal denervation can still be observed and remains a challenging and important problem. The International Sympathetic Nervous System Summit was convened to bring together experts in both experimental and clinical medicine to discuss the current evidence base, novel developments in our understanding of neural interplay, procedural aspects, monitoring of technical success, and others. Identification of relevant trends in the field and initiation of tailored and combined experimental and clinical research efforts will help to address remaining questions and provide much-needed evidence to guide clinical use of renal denervation for hypertension treatment and other potential indications

Some psychosocial and cultural factors in the Arab-Israeli conflict: a review of the literature

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66497/2/10.1177_002200277201600210.pd

The Patriarchal Bargain in a Context of Rapid Changes to Normative Gender Roles: Young Arab Women’s Role Conflict in Qatar

Social norms in patriarchal countries in the Middle East are changing at differing rates. In Qatar, expectations about education have shifted, and women’s participation in higher education is normative. However, women’s participation in the workforce remains relatively low, and women still are expected to perform all household and child-rearing activities. Interviews with 27 18–25 year-old Qatari women enrolled in college in Qatar are used to illustrate the conflict between norms about education, workforce, and family. Many young women resolve this normative conflict by giving preference to family over work and education. Other women hold conflicting norms and goals for their future without acknowledging the normative conflict. Overall, young women in this sample feared divorce, were uncertain about customary family safety nets, and thus desired financial independence so they would be able to support themselves if they were left alone later in life due to divorce, or the death of their husband. The Qatari government should revisit the appropriateness of continuing to emphasize the patriarchal family structure and socially conservative family norms, if they desire to advance women in their society

Loneliness and Social Internet Use: Pathways to Reconnection in a Digital World?

With the rise of online social networking, social relationships are increasingly developed and maintained in a digital domain. Drawing conclusions about the impact of the digital world on loneliness is difficult because there are contradictory findings, and cross-sectional studies dominate the literature, making causation difficult to establish. In this review, we present our theoretical model and propose that there is a bidirectional and dynamic relationship between loneliness and social Internet use. When the Internet is used as a way station on the route to enhancing existing relationships and forging new social connections, it is a useful tool for reducing loneliness. But when social technologies are used to escape the social world and withdraw from the “social pain” of interaction, feelings of loneliness are increased. We propose that loneliness is also a determinant of how people interact with the digital world. Lonely people express a preference for using the Internet for social interaction and are more likely to use the Internet in a way that displaces time spent in offline social activities. This suggests that lonely people may need support with their social Internet use so that they employ it in a way that enhances existing friendships and/or to forge new ones