Organ preservation and survival by clinical response grade in patients with rectal cancer treated with total neoadjuvant therapy: A secondary analysis of the OPRA randomized clinical trial

IMPORTANCE: Assessing clinical tumor response following completion of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer is paramount to select patients for watch-and-wait treatment. OBJECTIVE: To assess organ preservation (OP) and oncologic outcomes according to clinical tumor response grade. DESIGN, SETTING, AND PARTICIPANTS: This was secondary analysis of the Organ Preservation in Patients with Rectal Adenocarcinoma trial, a phase 2, nonblinded, multicenter, randomized clinical trial. Randomization occurred between April 2014 and March 2020. Eligible participants included patients with stage II or III rectal adenocarcinoma. Data analysis occurred from March 2022 to July 2023. INTERVENTION: Patients were randomized to induction chemotherapy followed by chemoradiation or chemoradiation followed by consolidation chemotherapy. Tumor response was assessed 8 (±4) weeks after TNT by digital rectal examination and endoscopy and categorized by clinical tumor response grade. A 3-tier grading schema that stratifies clinical tumor response into clinical complete response (CCR), near complete response (NCR), and incomplete clinical response (ICR) was devised to maximize patient eligibility for OP. MAIN OUTCOMES AND MEASURES: OP and survival rates by clinical tumor response grade were analyzed using the Kaplan-Meier method and log-rank test. RESULTS: There were 304 eligible patients, including 125 patients with a CCR (median [IQR] age, 60.6 [50.4-68.0] years; 76 male [60.8%]), 114 with an NCR (median [IQR] age, 57.6 [49.1-67.9] years; 80 male [70.2%]), and 65 with an ICR (median [IQR] age, 55.5 [47.7-64.2] years; 41 male [63.1%]) based on endoscopic imaging. Age, sex, tumor distance from the anal verge, pathological tumor classification, and clinical nodal classification were similar among the clinical tumor response grades. Median (IQR) follow-up for patients with OP was 4.09 (2.99-4.93) years. The 3-year probability of OP was 77% (95% CI, 70%-85%) for patients with a CCR and 40% (95% CI, 32%-51%) for patients with an NCR (P \u3c .001). Clinical tumor response grade was associated with disease-free survival, local recurrence-free survival, distant metastasis-free survival, and overall survival. CONCLUSIONS AND RELEVANCE: In this secondary analysis of a randomized clinical trial, most patients with a CCR after TNT achieved OP, with few developing tumor regrowth. Although the probability of tumor regrowth was higher for patients with an NCR compared with patients with a CCR, a significant proportion of patients achieved OP. These findings suggest the 3-tier grading schema can be used to estimate recurrence and survival outcomes in patients with locally advanced rectal cancer who receive TNT. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02008656

Morphological and Genetic Analysis of Four Color Morphs of Bean Leaf Beetle

Bean leaf beetle (BLB), Cerotoma trifurcata (Forster; Coleoptera: Chrysomelidae), exhibits considerable color variation but little is known about the underlying genetic structure and gene flow among color phenotypes. Genetic and morphological variation among four color phenotypes—green with spots (G+S), green without spots (G-S), red with spots (R+S) and red without spots (R-S)—were analyzed using amplified fragment length polymorphisms (AFLP) and morphometrics, respectively. AFLP generated 175 markers that showed ≥80% polymorphism. Analysis of molecular variance (AMOVA) indicated that genetic variation was greatest within phenotypes (82.6–84.0%); gene flow among the four phenotypes was relatively high (Nm = 3.82). The dendrogram and STRUCTURE analysis indicated some population divergence of G-S from the other phenotypes. Morphological parameters were similar among phenotypes except that R+S showed significant differences in weight and body-length. Canonical variables 1 and 2, based on average morphometric characters, accounted for 98% of the total variation; some divergence was indicated between G+S and R+S from each other and from the G-S/R-S BLB color morphs. The pattern of genetic variation indicated potential divergence of G-S and G+S from each other and from R-S and R+S. Although these results indicate that the four different color morphs are not genetically or reproductively isolated, there is some genetic differentiation/structure and morphological dissimilarity suggesting weak/incomplete isolation

Global net carbon exchange and intra-annual atmospheric CO2 concentrations predicted by an Ecosystem Process Model and Three-Dimensional Atmospheric Transport Model

A generalized terrestrial ecosystem process model, BIOME-BGC (for BIOME BioGeoChemical Cycles), was used to simulate the global fluxes of CO2 resulting from photosynthesis, autotrophic respiration, and heterotrophic respiration. Daily meteorological data for the year 1987, gridded to 1° by 1°, were used to drive the model simulations. From the maximum value of the normalized difference vegetation index (NDVI) for 1987, the leaf area index for each grid cell was computed. Global NPP was estimated to be 52 Pg C, and global Rh was estimated to be 66 Pg C. Model predictions of the stable carbon isotopic ratio 13C/12C for C3 and C4 vegetation were in accord with values published in the literature, suggesting that our computations of total net photosynthesis, and thus NPP, are more reliable than Rh. For each grid cell, daily Rh was adjusted so that the annual total was equal to annual NPP, and the resulting net carbon fluxes were used as inputs to a three-dimensional atmospheric transport model (TM2) using wind data from 1987. We compared the spatial and seasonal patterns of NPP with a diagnostic NDVI model, where NPP was derived from biweekly NDVI data and Rh was tuned to fit atmospheric CO2 observations from three northern stations. To an encouraging degree, predictions from the BIOME-BGC model agreed in phase and amplitude with observed atmospheric CO2 concentrations for 20° to 55°N, the zone in which the most complete data on ecosystem processes and meteorological input data are available. However, in the tropics and high northern latitudes, disagreements between simulated and measured CO2 concentrations indicated areas where the model could be improved. We present here a methodology by which terrestrial ecosystem models can be tested globally, not by comparisons to homogeneous-plot data, but by seasonal and spatial consistency with a diagnostic NDVI model and atmospheric CO2 observations

A genome-wide study of blood pressure in African Americans accounting for gene-smoking interaction

Cigarette smoking has been shown to be a health hazard. In addition to being considered a negative lifestyle behavior, studies have shown that cigarette smoking has been linked to genetic underpinnings of hypertension. Because African Americans have the highest incidence and prevalence of hypertension, we examined the joint effect of genetics and cigarette smoking on health among this understudied population. The sample included African Americans from the genome wide association studies of HyperGEN (N = 1083, discovery sample) and GENOA (N = 1427, replication sample), both part of the FBPP. Results suggested that 2 SNPs located on chromosomes 14 (NEDD8; rs11158609; raw p = 9.80 × 10(−9), genomic control-adjusted p = 2.09 × 10(−7)) and 17 (TTYH2; rs8078051; raw p = 6.28 × 10(−8), genomic control-adjusted p = 9.65 × 10(−7)) were associated with SBP including the genetic interaction with cigarette smoking. These two SNPs were not associated with SBP in a main genetic effect only model. This study advances knowledge in the area of main and joint effects of genetics and cigarette smoking on hypertension among African Americans and offers a model to the reader for assessing these risks. More research is required to determine how these genes play a role in expression of hypertension

Localization of IFN-γ-Activated Stat1 and IFN Regulatory Factors 1 and 2 in Breast Cancer Cells

The aim of the present work was to evaluate the induction and localization of Stat1, interferon (IFN) regulatory factor-1 (IRF-1), and IRF-2 after IFN-γ exposure of human breast cancer cell lines, SKBR3, MDA468, MCF7, and BT20. Results from growth assays, Western staining, electrophoretic mobility shift assay (EMSA), and immunohistochemical staining were collated to test our hypothesis that immunohistochemical analysis of Stat1, IRF-1, and IRF-2 would provide additional information about the functionality of the IFN-γ signaling pathway in human tumor lines. EMSA results showed that in each of four cell lines, Stat1 expression was increased and demonstrated functional activity after IFN-γ stimulation. Western and EMSA analysis showed upregulation of IRF-1 but not IRF-2 in each cell line. Confocal microscopy of cells stained for Stat1, IRF-1, and IRF-2 confirmed the results and also provided novel information about the intracellular localization of proteins and intercellular variations in responses. The proportion of cells with IRF-1 stimulation and translocation was positively correlated with the IFN-γ growth suppression in vitro. In conclusion, using four independent assays, we have demonstrated that heterogeneity in IFN-γ-mediated upregulation of signal transduction proteins can be detected in vitro and that these differences can explain distinct cellular growth effects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63148/1/107999003322558755.pd

An Ileal Crohn's Disease Gene Signature Based on Whole Human Genome Expression Profiles of Disease Unaffected Ileal Mucosal Biopsies

Previous genome-wide expression studies have highlighted distinct gene expression patterns in inflammatory bowel disease (IBD) compared to control samples, but the interpretation of these studies has been limited by sample heterogeneity with respect to disease phenotype, disease activity, and anatomic sites. To further improve molecular classification of inflammatory bowel disease phenotypes we focused on a single anatomic site, the disease unaffected proximal ileal margin of resected ileum, and three phenotypes that were unlikely to overlap: ileal Crohn's disease (ileal CD), ulcerative colitis (UC), and control patients without IBD. Whole human genome (Agilent) expression profiling was conducted on two independent sets of disease-unaffected ileal samples collected from the proximal margin of resected ileum. Set 1 (47 ileal CD, 27 UC, and 25 Control non-IBD patients) was used as the training set and Set 2 was subsequently collected as an independent test set (10 ileal CD, 10 UC, and 10 control non-IBD patients). We compared the 17 gene signatures selected by four different feature-selection methods to distinguish ileal CD phenotype with non-CD phenotype. The four methods yielded different but overlapping solutions that were highly discriminating. All four of these methods selected FOLH1 as a common feature. This gene is an established biomarker for prostate cancer, but has not previously been associated with Crohn's disease. Immunohistochemical staining confirmed increased expression of FOLH1 in the ileal epithelium. These results provide evidence for convergent molecular abnormalities in the macroscopically disease unaffected proximal margin of resected ileum from ileal CD subjects

Genetic Variability of the European Corn Borer, Ostrinia nubilalis, Suggests Gene Flow Between Populations in the Midwestern United States

The European corn borer, Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae), is a widely distributed and serious economic pest to corn production in the U.S. Genetic variability of O. nubilalis was studied in 18 sub-populations in the upper Midwestern United States using amplified fragment length polymorphism. The relatively low GST values indicate that more variation exists within populations than between populations. High gene flow (Nm) values were indicated across the entire O. nubilalis population; the lowest degree of gene flow was in the northern samples (Nm = 1.96) and the highest degree of gene flow was in the southern samples (Nm = 2.77). The differences observed in the respective regions (north vs. south) may be explained by the voltinism patterns (univoltine vs. multivoltine, respectively) of O. nubilalis: southern multivoltine populations have opportunities for multiple matings for the duration of the year, further mix alleles. AMOVA results also indicated that most of the genetic variation was within sub-populations (≈ 81% of total variation); less variation (≈ 13%) was detected among populations within each of the three regions as designated for this study. However, the most striking and unexpected result was the low percentage of variation between all groups (≈ 6%), further supporting implications of a high degree of gene flow. These results provide support for current requirements of refugia corn planting in Bt-corn management. These results also indicate that if resistance to Bt were to evolve in O. nubilalis, quick action would be necessary to deter the rapid spread of the gene for resistance