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Neurofeedback cognitive training is a promising tool used to promote cognitive functions effectively and efficiently. In this study, we investigated a novel functional near-infrared spectroscopy (fNIRS)-based frontoparietal functional connectivity (FC) neurofeedback training paradigm related to working memory, involving healthy adults. Compared with conventional cognitive training studies, we chose the frontoparietal network, a key brain region for cognitive function modulation, as neurofeedback, yielding a strong targeting effect. In the experiment, 10 participants (test group) received three cognitive training sessions of 15 min using fNIRS-based frontoparietal FC as neurofeedback, and another 10 participants served as the control group. Frontoparietal FC was significantly increased in the test group ( $p =0.03$ ), and the cognitive functions (memory and attention) were significantly promoted compared with the control group (accuracy of 3-back test: $p =0.0005$ , reaction time of 3-back test: $p =0.0009$ ). After additional validations on long-term training effect and on different patient populations, the proposed method exhibited considerable potential to be developed as a fast, effective, and widespread training approach for cognitive function enhancement.

Skull drilling is an important and difficult process in neurosurgical craniotomy, which will inevitably produce a lot of heat. Correct understanding of the heat production law of skull drilling has important guiding significance for craniotomy robot. In this study, cortical bone and cancellous bone were layered to establish models according to the 3D reconstruction data of skull. The finite element method based on ABAQUS is used to establish the skull drilling model and realize the simulation of bone tissue surgical instrument interaction state for surgical robot. The results show that when the drill rotation speed and feed speed increase, the drilling temperature will also increase, but the drill rotation speed will have a more significant effect on bone drilling temperature, and when the drill rotation speed is low (300r/min, 600r/min), the drill bit diameter has little effect on the drilling temperature, but when the drill rotation speed is higher (900r/min, 1200r/min), the larger diameter drill bit(11mm) will produce more drilling heat.

Various neuropeptides related to the energy equilibrium affect bone growth in humans and animals. Neuropeptides W (NPW) are identical in the internal ligands of the two G‐protein receptors (GPRs) included in subtypes 7 and 8. Neuropeptides W inhibits proliferation in the cultivated rat calvarial osteoblast‐like (ROB) cells. This study examines the expression of NPW and GPR7 in murine chondrocyte and their function. An immunohistochemical analysis showed that NPW and GPR7 were expressed in the proliferative chondrocytes of the growth plates in the hind limbs of mice. The NPW mRNA quickly elevated in the early differentiation (7‐14 days) of ATDC5 cells, while NPW and GPR7 mRNA were reduced during the late stage (14‐21 days) of differentiation. Neuropeptide W‐23 (NPW‐23) promoted the proliferation of ATDC5 cells, which was attenuated by inhibiting the GPR7, protein kinase A (PKA), protein kinase C (PKC) and ERK1/2 pathways. Neuropeptide W‐23 enhanced the early cell differentiation, as evaluated by collagen type II and the aggrecan gene expression, which was unaffected by inhibiting the ERK1/2 pathway, but significantly decreased by inhibiting the PKA, PKC and p38 MAPK pathways. In contrast, NPW‐23 was not involved in the terminal differentiation of the chondrocytes, as evaluated by the mineralization of the chondrocytes and the activity of the alkaline phosphatase. Neuropeptides W stimulated the PKA, PKC, p38 MAPK and ERK1/2 activities in a dose‐ and time‐dependent manner in the ATDC5 cells. These results show that NPW promotes the proliferation and early differentiation of murine chondrocyte via GPR7 activation, as well as PKA and PKC‐dependent signalling cascades, which may be involved in endochondral bone formation.

Tributyltin (TBT) is a persistent organotin pollutant widely used as agricultural and wood biocides, exhibiting well-documented toxicity to reproductive functions in aquatic organisms. However, the effect of TBT on early pregnancy and placental development has been rarely studied in mice. Pregnant mice were fed with 0, 0.2, and 2 mg/kg/day TBT from gravid day 1 to day 8 or 13. TBT exposure led to an increase in the number of resorbed embryo and a reduction in the weight of fetus at gestational days 13. Further study showed that TBT significantly decreased placental weight and area, lowered laminin immunoreactivity and the expressions of placental development-related molecules including Fra1, Eomes, Hand1, and Ascl2. Moreover, TBT treatment markedly inhibited the placental proliferation and induced up-regulation of p53 and cleaved caspase-3 proteins, and down-regulation of Bcl-2 protein. In addition, TBT administration increased levels of malondialdehyde and H2 O2 and decreased activities of catalase and superoxide dismutase. Collectively, these results suggested TBT-induced adverse pregnancy outcomes during early pregnancy might be involved in developmental disorders of the placenta via dysregulation of key molecules, proliferation, apoptosis, and oxidative stress.

In the paper, 3968 solder bumps and underfills were prepared on ceramic substrates with flip chip method. After thermal shocks the solder joints of serial number before 24 were left wrapped and the solder joints of serial number after 39 were right wrapped. The average spreading area and diameter of solder joints were 4681 μm2 and 119 μm, respectively. The solder joints with small serial number were left offset and the maximum offset of left was 28 μm. Inversely, the solder joints with big serial number were right offset and the maximum offset of right was 31μm. The deviation of solder joints on both sides were the most evident. This might be owing to CTE mis-matching between silicon chip and ceramic substrate. Besides, the IMC layer of both sides was mainly Cu 6 Sn 5 . The IMC layer on top of Cu pillar was Ni and Ni 6 Sn 5 .

Background: Cognitive impairments in temporal lobe epilepsy (TLE) patients has been described as a chronically progressive feature of the disease. However, how severe recurrent seizures modify neuronal circuits in the human brain and subsequently degrade cognitive function, remains largely unknown. Here, we aimed to investigate longitudinal alterations by functional magnetic resonance imaging (fMRI) in TLE patients and to assess how those alterations are related to cognitive function performance. Methods: Sixteen TLE patients and 20 normal controls (NCs) were recruited for a study to observe longitudinal alterations in resting-state functional connectivity (FC) and to estimate alertness, orientation, and executive function both at baseline and at a follow-up time ~3 years later. Results: TLE patients, compared with NCs, showed impaired executive function, intrinsic alertness, and phasic alertness and exhibited lengthened reaction time (RT) in the spatial cue and center cue conditions at baseline. The orienting function of TLE patients was declined at follow-up compared to the baseline. Cross-sectional analysis demonstrated that TLE patients displayed significantly greater positive correlation than NCs between the right dorsolateral prefrontal cortex (DLPFC) and the right inferior parietal lobule (IPL) and right superior frontal gyrus (SFG). Furthermore, among TLE patients, the longitudinal study revealed a decrease in correlation between the right DLPFC and the right SFG compared to the baseline. In addition, there was a significant negative correlation between the longitudinal change in FC and the change in orienting function in TLE subjects. Conclusions: Abnormal connectivity between the DLPFC and the SFG suggests the potential of longitudinal resting-state fMRI to delineate regions relevant to cognitive dysfunction for disease progression.

Perfluorooctanoic acid (PFOA) is a widely used perfluorinated compound and known to cause developmental toxicity which includes the increase of resorbed embryo, decrease of fetal survival, and fetal growth retardation. Nevertheless, whether it is associated with alteration of placental development remains unknown. Pregnant mice were gavaged with 0, 2.5, 5, 10 mg PFOA /kg/day from pregnancy day (PD) 1 to PD 13. Results showed that PFOA exposure markedly decreased the placental weight and caused interstitial edema of placenta. Laminin staining indicated that blood sinusoids area was shrunken in placenta of PFOA-exposed mice. Furthermore, PFOA treatment significantly reduced numbers of uNK cells. Western blot analysis revealed that levels of Bax and cleaved-caspase 3 proteins were markedly up-regulated in PFOA-treated groups. In addition, TEM examination showed that PFOA treatment caused rupture of nuclear membrane and nuclear pyknosis and fragmentation. Thus, our results suggested that gestational PFOA exposure significantly inhibited development of early placenta through shrinkage of labyrinth vessels and downregulation of uNK cells and apoptosis induction, which may result in adverse gestational outcomes.

In biomedical studies, it is often of interest to estimate how the risk profile of an adverse event is related to the timing of an intervention. For example, in randomized controlled clinical trials of bivalent human papillomavirus (HPV) vaccine, investigators are interested to know how miscarriage rate relates to the timing of HPV vaccination. A risk window is defined as an interval for the covariate where the risk of adverse event is elevated. Existing methods cannot make simultaneous inference on both the risk window and the magnitude of the risk. A hierarchical Bayesian logistic regression model is developed to estimate the risk window of miscarriage on the time of conception with respect to vaccination. Hierarchical priors are proposed and used in Markov Chain Monte Carlo for statistical inference. The performance of the Bayesian model and two existing methods is evaluated in simulation settings with varying risk windows and relative risks. The proposed model provides both point and interval estimates for the risk window regarding to vaccination, and captures its effect modification on miscarriage risk in pregnancy. Analysis of the vaccine trial using the proposed model shows no significant evidence of an association between the HPV vaccine and miscarriage risk. The hierarchical Bayesian model is useful in general in analyzing a randomized trial or an epidemiological study in which the effect of an agent is potentially modified by a temporal factor.

Background To date, no functional MRI (fMRI) studies have focused on brain entropy in right temporal lobe epilepsy (rTLE) patients. Here, we characterized brain entropy (BEN) alterations in patients with rTLE using resting‐state functional MRI(rs‐fMRI) and explored the relationship between BEN and alertness. Method Thirty‐one rTLE patients and 33 controls underwent MRI scanning to investigate differences in BEN and resting‐state functional connectivity (rs‐FC) in regions of interest (ROIs) between patients and controls. Correlation analyses were performed to examine relationships between the BEN of each ROI and alertness reaction times (RTs) in rTLE patients. Results Compared with controls, the BEN of rTLE patients was significantly increased in the right middle temporal gyrus, inferior temporal gyrus, and other regions of the left hemisphere and significantly decreased in the right middle frontal gyrus and left supplementary motor area (p, Decreased in BEN was associated with the intrinsic alertness RT and phasic alertness in patients with rTLE. The abnormal FC in brain regions with altered entropy suggests reconstruction of brain functional connectivity.

Acrylamide (ACR), a neurotoxicity and carcinogenic chemical, has attracted considerable attention since it is present at high concentrations in thermally cooked carbohydrate-rich foods. ACR exposure significantly increased rate of fetal resorption, and decreased fetal body weights in mice. However, no detailed information is available about the effect of ACR on uterine decidualization, which is a vital process in the establishment of successful pregnancy. Thus, our aim of this study was to explore the effect and mechanism of ACR on uterine decidualization in vivo during mice pregnancy. Mice were gavaged with 0, 10, and 50 mg ACR /kg/day from gestational days (GD) 1 until GD 8, whereas pseudopregnant mice from pseudopregnant day (PPD) 4 until PPD 8. Results indicated ACR treatment dramatically reduced numbers of implanted embryos, and decreased the weights of implantation site and oil-induced uterus. Nevertheless, no significant difference was observed in the weights of no oil-induced uterus between control and ACR-treated group. Furthermore, ACR significantly reduced numbers of polyploidy and PCNA-positive decidual cells and expression of cyclin D3 and p21 proteins, and induced apoptosis of decidua, as presented by up-regulation of Bax and cleaved-caspase-3, and decreased Bcl-2 protein during normal pregnant and pseudopregnant process. In summary, ACR exposure significantly inhibited uterine endometrial decidualization via the apoptosis and suppression of cyclin D3/p21 in mice.

Kisspeptin and its G protein-coupled receptor KISS1R play key roles in mammalian reproduction due to their involvement in the onset of puberty and control of the hypothalamic-pituitary-gonadal axis. However, recent studies have indicated a potential role of extra-hypothalamic kisspeptin in reproductive function. Here, we summarize recent advances in our understanding of the physiological significance of kisspeptin/KISS1R in the peripheral reproductive system (including the ovary, testis, uterus, and placenta) and the potential role of kisspeptin/KISS1R in reproductive diseases. A comprehensive understanding of the expression, function, and potential molecular mechanisms of kisspeptin/KISS1R in the peripheral reproductive system will contribute to the diagnosis, treatment and prevention of reproductive diseases.

Astrocytic connexin dysfunction is closely associated with synaptic impairment and contributes to the pathological development of depressive-like behaviours. However, little is known about the expression of connexins in astrocytes from different brain regions, or how tissue specific connexin expression affects local neuronal activity. Here, we established a mouse model of chronic social defeated stress (CSDS), from which we isolated astrocytes from the medial prefrontal cortex (mPFC), hippocampus, amygdala, and ventral tegmental area (VTA). Expression profiling was then performed for connexins Cx26, Cx30, and Cx43. Expression of Cx30 and Cx43 was significantly decreased in mPFC and hippocampus of CSDS mice and was strongly associated with decreases in neuronal activity. Furthermore, overexpression of Cx30 and Cx43 in the mPFC and hippocampus increased neuronal activity and inhibited depressive-like behaviours; while suppression of Cx30 and Cx43 in normal mice was sufficient to reduce neuronal activity and induced depressive-like behaviours. Taken togetner, aberrant expression of astrocytic Cx30 and Cx43 in the mPFC and hippocampus significantly affects brian region-specific neuronal activity and drives depressive-like behaviours. These observations provide novel insights into the role of astrocyte gene expression in stress-induced depressive-like behaviours.

This study is to investigate the therapeutic effect of acupuncture treatment (ACT) on PSD through resting state functional connectivity analysis. The participants include seven PSD patients who have completed ACT trial and seven PSD patients who have completed the control trial. The resting-state functional connectivity patterns between the automated anatomical labeling brain regions were used to reveal the neuroimaging evidence for PSD with ACT. A two-factor mixed experimental design was adopted to investigate the interaction effect of acupuncture on PSD. The functional connectivity was increased in PSD patients after ACT but decreased in those without ACT after 3 weeks. The brain regions such as the right orbit middle frontal gyrus, paracentral lobule, right medial superior frontal gyrus, left angular gyrus, left anterior cingulate gyrus, and right supramarginal gyrus were related to sensorimotor and working memory. Significantly increased functional connectivity was found in PSD patients after ACT but not in those without ACT. ACT can enhance the functional connectivity in the brain. The results indicate that the sensorimotor and working memory of PSD patients is improved.

Previous studies have shown that temporal lobe epilepsy (TLE) involves abnormal structural or functional connectivity in specific brain areas. However, limited comprehensive studies have been conducted on TLE associated changes in the topological organization of structural and functional networks. Additionally, epilepsy is associated with impairment in alertness, a fundamental component of attention. In this study, structural networks were constructed using diffusion tensor imaging (DTI) tractography and functional networks were obtained from resting-state functional MRI (rsfMRI) temporal series correlations in 20 right temporal lobe epilepsy (rTLE) patients and 19 healthy controls. Global network properties were computed by graph theoretical analysis, and correlations were assessed between global network properties and alertness. The results from these analyses showed that rTLE patients exhibit abnormal small-world attributes in structural and functional networks. Structural networks shifted towards more regular attributes, but functional networks trended towards more random attributes. After controlling for the influence of the disease duration, negative correlations were found between alertness, small-worldness and the cluster coefficient. However, alertness did not correlate with either the characteristic path length or global efficiency in rTLE patients. Our findings show that disruptions of the topological construction of brain structural and functional networks as well as small world property bias are associated with deficits in alertness in rTLE patients. These data suggest that reorganization of brain networks develops as a mechanism to compensate for altered structural and functional brain function during disease progression.

Type 1 diabetes is characterized by infiltration of pancreatic islets with immune cells, leading to insulin deficiency. Although infiltrating immune cells are traditionally considered to negatively impact β-cells by promoting their death, their contribution to proliferation is not fully understood. Here we report that islets exhibiting insulitis also manifested proliferation of β-cells that positively correlated with the extent of lymphocyte infiltration. Adoptive transfer of diabetogenic CD4+ and CD8+ T cells, but not B cells, selectively promoted β-cell proliferation in vivo independent from the effects of blood glucose or circulating insulin or by modulating apoptosis. Complementary to our in vivo approach, coculture of diabetogenic CD4+ and CD8+ T cells with NOD.RAG1−/− islets in an in vitro transwell system led to a dose-dependent secretion of candidate cytokines/chemokines (interleukin-2 [IL-2], IL-6, IL-10, MIP-1α, and RANTES) that together enhanced β-cell proliferation. These data suggest that soluble factors secreted from T cells are potential therapeutic candidates to enhance β-cell proliferation in efforts to prevent and/or delay the onset of type 1 diabetes.

Despite the significant clinical consequences of red blood cell (RBC) alloimmunization, our understanding of the fundamental molecular and cellular mechanisms regulating anti-RBC antibody generation is limited. Relative to infectious stimuli,[1][1] transfused RBCs induce a less robust antibody

Immature thymocytes expressing autoreactive T-cell receptors (TCR) can adopt differing cell fates: clonal deletion by apoptosis or deviation into alternative lineages such as FoxP3 + regulatory T cells (Treg). We revisited the role of the transcription factor Nr4a1 (Nur77), an immediate-early response gene induced by TCR engagement. Nr4a1KO mice show clear quantitative defects in antigen-induced clonal deletion. The impact of the Nr4a1 deletion is not enhanced by deletion of the proapoptotic factor Bim. In addition, Nr4a1 curtails initial differentiation into the Treg lineage in TCR transgenic mice and in nontransgenic mice. Transcriptional profiling of Nr4a1KO thymocytes under selection conditions reveals that Nr4a1 activates the transcription of several targets, consistent with these diverse actions: ( i ) Nr4a1 partakes in the induction of Bim after TCR triggering; ( ii ) perhaps paradoxically, Nr4a1 positively controls several transcripts of the Treg signature, in particular Ikzf2 and Tnfrsf9 ; ( iii ) consistent with its prosurvival and metabolic role in the liver, Nr4a1 is also required for the induction by TCR of a coordinated set of enzymes of the glycolytic and Krebs cycle pathways, which we propose may antagonize Treg selection as does activation of mTOR/Akt. Thus, Nr4a1 appears to act as a balancing molecule in fate determination at a critical juncture of T-cell differentiation.

Erk1/2-dependent TCR decisions, but not negative selection, are impaired in NOD thymocytes, leading to preferential development of αβ CD4+CD8+ thymocytes over γδ thymocytes and saturation of selection niches in TCR tg mouse models., Based on analyses of multiple TCR transgenic (tg) models, the emergence of pathogenic T cells in diabetes-prone NOD mice has been ascribed to a failure to censure autoreactive clones in the thymus. In contrast, using isolated and preselected thymocytes, we show that nonobese diabetic (NOD) genetic variation impairs neither clonal deletion nor downstream transcriptional programs. However, we find that NOD genetic variation influences αβ/γδ-lineage decisions promoted by early expression of tg αβ-TCRs at the double-negative (DN) stage. In B6 and other genetic backgrounds, tg αβ-TCRs behave like γδ-TCRs and commit a large fraction of DNs toward the γδ-lineage, thereby decreasing the size of the double-positive (DP) pool, which is efficiently positively and negatively selected. In NOD DNs, αβ-TCR signalosomes instead behave like pre-TCRs, resulting in high numbers of DPs competing for limited selection niches, and poor positive and negative selection. Once niche effects are neutralized in mixed bone marrow chimeras, positive and negative selection are equally efficient on B6 and NOD backgrounds. Biochemical analysis revealed a selective defect in the activation of Erk1/2 downstream of NOD αβ-TCR signalosomes. Therefore, NOD genetic variation influences αβ/γδ-lineage decisions when the αβ-TCR heterodimer is prematurely expressed, but not the process of negative selection.

This study aimed to investigate alterations in the alertness-related network in patients with right temporal lobe epilepsy (rTLE) and explore the functional mechanisms of impaired alertness.We recruited twenty patients with rTLE and eighteen matched healthy controls. All participants took a neuropsychological attention network test (ANT) and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. We extracted the alertness-related network using multiple independent component analysis (MICA). Subsequently, we compared the intergroup differences in functional connectivity (FC) of this network. Then, the neuropsychological data were correlated to voxels that showed significant FC differences in patients and controls.The alertness-related network extracted from the patients was similar to that of the controls, covering the right dorsolateral prefrontal cortex, middle frontal gyrus, parietal lobe, part of the temporal lobe, and left posterior lobe of the cerebellum (p0.05). Compared to controls, patients with rTLE exhibited decreased FC values in the right inferior parietal lobe (IPL) and angular gyrus (p0.05). Additionally, increased FC was shown in the right inferior frontal gyrus, Rolandic operculum, middle frontal gyrus, dorsolateral superior frontal gyrus, cuneus, and superior occipital gyrus (p0.05). Behaviorally, patients with rTLE exhibited longer reaction times (RT) in the no cue (t=-2.07, p0.05) and double cue (t=-2.28, p0.05) conditions. However, the alertness effect in patients did not significantly differ from that of controls. Moreover, the alertness effect was negatively correlated with the mean Z-value in the right cuneus, which showed increased FC (r=-0.556, p=0.013) in patients with rTLE. There was no significant correlation in the control group.Our results demonstrated that alterations in the alertness-related network may contribute to the alertness impairment exhibited by patients with rTLE. Our study may provide new insights into the mechanisms of alertness impairments in rTLE.

Loss of function mutations in the autoimmune regulator (Aire) gene in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy patients and mutant mice lead to autoimmune manifestations that segregate as a monogenic trait, but with wide variation in the spectrum of organs targeted. To investigate the cause of this variability, the Aire knockout mutation was backcrossed to mice of diverse genetic backgrounds. The background loci strongly influenced the pattern of organs that were targeted (stomach, eye, pancreas, liver, ovary, thyroid, and salivary gland) and the severity of the targeting (particularly strong on the nonobese diabetic background, but very mild on the C57BL/6 background). Autoantibodies mimicked the disease pattern, with oligoclonal reactivity to a few antigens that varied between Aire-deficient strains. Congenic analysis and a whole genome scan showed that autoimmunity to each organ had a distinctive pattern of genetic control and identified several regions that controlled the pattern of targeting, including the major histocompatibility complex and regions of Chr1 and Chr3 previously identified in controlling type 1 diabetes.

In clinical trials, patients with different biomarker features may respond differently to the new treatments or drugs. In personalized medicine, it is important to study the interaction between treatment and biomarkers in order to clearly identify patients that benefit from the treatment. With the local partial-likelihood estimation (LPLE) method proposed by Fan J, Lin H, Zhou Y. Local partial-likelihood estimation for lifetime data. The Annals of Statistics 2006; 34(1):290Ű325, the treatment effect can be modeled as a flexible function of the biomarker. In this paper, we propose a bootstrap test method for survival outcome data based on the LPLE, for assessing whether the treatment effect is a constant among all patients or varies as a function of the biomarker. The test method is called local partial-likelihood bootstrap (LPLB) and is developed by bootstrapping the martingale residuals. The test statistic measures the amount of change in treatment effects across the entire range of the biomarker and is derived based on asymptotic theories for martingales. The LPLB method is nonparametric and is shown in simulations and data analysis examples to be flexible enough to identify treatment effects in a biomarker-defined subset and more powerful to detect treatment-biomarker interaction of complex forms than the Cox regression model with a simple interaction. We use data from a breast cancer and a prostate cancer clinical trial to illustrate the proposed LPLB test.

Background: High dose chemotherapy followed by autologous stem cell transplant (ASCT) is the standard curative option for patients with relapsed or refractory, chemosensitive, aggressive non-Hodgkin lymphoma (NHL). The optimal timing for ASCT following salvage chemotherapy is not known. Cancer Care Ontario (CCO)-the cancer agency for Ontario, Canada's largest province-treatment guidelines recommend that no more than 91 days should elapse from the first day of salvage chemotherapy to stem cell transplant. We evaluated the impact of time to stem cell transplant in the context of the international CCTG LY.12 phase 3 clinical trial. Methods: Patients with relapsed or refractory (R/R) aggressive NHL were randomly assigned to gemcitabine, cisplatin and dexamethasone (GDP) or dexamethasone, cytarabine, cisplatin (DHAP), with or without rituximab, followed by ASCT [Crump JCO 2014]. Time interval definitions were based on CCO guidelines: Total Wait Time (TWT) as the number of days from the first day of salvage chemotherapy to day of ASCT; Apheresis Wait Time (AWT) as the number of days from the first day of salvage to the first day of stem cell collection; Stem cell transplant Wait Time (SWT) as the number of days from the last day of stem cell collection to the day of ASCT. Patients were considered to have experienced a delay in TWT, AWT or SWT if the time intervals exceeded 91, 70 and 21 days respectively. Overall survival (OS) and event-free survival (EFS) from transplant date were compared between patients who met and exceeded TWT targets using a Cox proportional hazards model. A linear regression model was applied to analyze TWT as a continuous variable. Univariate and multivariate analyses were performed to estimate the adjusted hazard ratio (HR) for TWT for the following co-variables: age ≤60, performance status 0/1, disease stage (I/II), presence of ≤1 extranodal sites, and response after cycle 2 (complete response, CR; complete response, unconfirmed, CRu; partial response, PR). Results: Of 619 patients enrolled on LY.12, 307 (47%) had sufficient response to salvage chemotherapy and adequate stem cell collection to complete ASCT on protocol. Among these, median age was 54.6 years, 64% were male and 94% had a performance status of 0 or 1. International Prognostic Index (IPI) score at relapse was 0-1 in 45%, 2 in 31% and ≥3 in 24%. The majority of patients had poor risk disease at study entry; 58% had a best response of stable disease (SD) or progressive disease (PD) to primary therapy, or initial duration of response < 1 year. Following up to 2 cycles of salvage chemotherapy, 75/307 (24%) achieved CR/CRu, 142/307 (46%) achieved PR, 89/307 (29%) had SD. One patient had missing data. The median TWT for the total transplanted population was 91 days (range 50-217). Median AWT and SWT were 63 (range 0-151) and 26 (range 6-146) days, respectively. Fifty percent of patients exceeded TWT target of 91 days; 32% and 57% of patients exceeded AWT and SWT targets. There was no difference in median OS (HR 0.96, 95% CI 0.66-1.39, p=0.81) or EFS (HR 1.13, 95% CI 0.82-1.55, p=0.46) between patients who exceeded and met TWT targets. The 4-year OS for patients who met and exceeded TWT was 62% and 64%, respectively. The 4-year EFS for patients who met and exceeded TWT was 43% and 50%, respectively. When analyzed as a continuous variable, TWT did not affect OS (HR 0.99) or EFS (HR 0.99). Comparison of the quartiles with shortest and longest TWT demonstrated HR 0.72 (95% CI 0.42-1.26, p=0.25) for overall survival and 0.69 (95% CI 0.44-1.09, p=0.11) for EFS. Comparison of the 10th and 90th percentiles for TWT demonstrated HR 0.67 (95% CI 0.28-1.59, p=0.36) for overall survival and 0.71 (95% CI 0.35-1.44, p=0.34) for EFS. Only the presence of ≤1 extranodal sites of disease was found to be predictive of OS in the transplanted population on univariate and multivariate analysis (adjusted HR 0.51, p=0.005). The median TWT was longer for the 31 patients transplanted at Italian centers, compared to 266 transplanted at Canadian centers (median TWT 90 vs. 118 days, t < 0.0001). Conclusion: In this exploratory analysis, limited to patients who completed transplant on the LY.12 clinical trial, we did not find evidence that those meeting current CCO ASCT wait time targets had superior outcomes compared with those who did not. Table. Table. Figure 1. Figure 1. Figure 2. Figure 2. Disclosures Kuruvilla: BMS: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; Amgen: Honoraria; Abbvie: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Gilead: Consultancy, Honoraria; Merck: Honoraria; Roche Canada: Consultancy, Honoraria, Research Funding; Seattle Genetics: Consultancy, Honoraria; Lundbeck: Honoraria. Luminari:Roche: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accomodations, Expenses; Takeda: Other: Travel, Accomodations, Expenses; Teva Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria. Hay:Amgen: Research Funding; Novartis: Research Funding; Janssen: Research Funding; Kite Pharmaceuticals: Research Funding.

Interleukin-17(IL-17)-producing T helper(Th)17 cells are considered as a new subset of cells critical to the development of inflammatory bowel disease (IBD). We aimed to investigate the distribution of Th17 cells, the expressions of Th17-related cytokines (IL-17, IL-21 and IL-22) and their association with disease activity in IBD patients.We collected intestinal tissue biopsies from 40 patients with active ulcerative colitis (UC), 20 patients with active Crohn's disease (CD) and 20 healthy controls. The distribution of Th17 cells and expressions of Th17-related cytokines in colonic tissues were evaluated by a standard immunohistochemical procedure. Serum IL-17, IL-21 and IL-22 levels were determined by ELISA. Pearson's and Spearman's correlation analyses were performed to analyze the correlation between the number of Th17 cells, the expressions of Th17-related cytokines and disease activity index, endoscopic and histological grading, and CRP and PLT levels, respectively.Compared with healthy controls, the number of Th17 cells and the expressions of IL-17, IL-21 and IL-22 were significantly increased in active IBD patients (P 0.05). In addition, Pearson's and Spearman's correlation analyses showed that the number of Th17 cells and the expressions of Th17-related cytokines were correlated with disease activity index, endoscopic and histological grading, CRP and PLT levels (P 0.05).Th17 cells and Th17-related cytokines (IL-17, IL-21 and IL-22) were increased in the intestinal mucosa in active IBD patients and may play an important role in disease activity and mucosal damage.

Interleukin-17A and interleukin-17F (IL-17A and IL-17F) are candidate genes for chronic inflammatory disease. We investigated the association between IL17A/F gene polymorphisms and susceptibility to and clinical features of inflammatory bowel disease (IBD).A total of 270 ulcerative colitis (UC) patients, 82 Crohn's disease (CD) patients and 268 healthy controls were recruited in this study. Genomic DNA was extracted and analyzed for IL17A/F gene polymorphisms using ligase detection reaction allelic technology.Compared to the controls, the mutant allele C for IL17F rs763780 was significantly more common in CD patients [14.0 vs 8.4 %, P = 0.033, odds ratio (OR) 1.18, 95 % confidence interval (CI) 1.41-3.04] and was associated with the disease lesion location. This variant of IL17F rs763780 also had a weak correlation with the age of UC onset (P = 0.05, OR 0.97, 95 % CI 0.94-1.00). The IL17A (rs2275913, G-197A) variant had a weak association with the severity of disease: patients with the mutant allele A tended to suffer mild active UC. The haplotype (GGTT) of IL17A formed with four single nucleotide polymorphisms (rs2275913, rs8193037, rs8193038, and rs3804513) was associated with an increased risk of UC (P = 0.034, OR 4.58, 95 % CI 1.54-13.64).The IL17F (rs763780, 7488T/C) variant was associated with an increased risk for the development of CD, and affected some clinical features of UC and CD. The IL17A (rs2275913, G-197A) variant had a weak association with the severity of UC. There was a risk haplotype in IL17A which could increase the risk of UC.

AIM To evaluate diagnostic yields of capsule endoscopy (CE) and/or single-balloon enteroscopy (SBE) in patients with suspected small bowel diseases. METHODS We retrospectively analyzed 700 patients with suspected small bowel diseases from September 2010 to March 2016. CE, SBE, or SBE with prior CE was performed in 401, 353, and 47 patients, respectively. Data from clinical and endoscopy records were collected for analysis. Indications, procedure times, diagnostic yields, and complications were summarized and evaluated. RESULTS The overall diagnostic yield for the CE group was 57.6%. The diagnostic yield of CE in patients with obscure gastrointestinal bleeding (OGIB) was significantly greater than that in patients with no bleeding (70.5% vs 43.8%, P < 0.01). The overall diagnostic yield of SBE was 69.7%. There was no difference in the diagnostic yield of SBE between patients with OGIB and those with no bleeding (72.5% vs 68.9%, P = 0.534). Forty-seven patients underwent CE prior to SBE. Among them, the diagnostic yield of SBE with positive findings on prior CE was 93.3%. In addition, SBE detected two cases with superficial ulcer and erosive lesions in the small bowel, which were missed by CE. However, one case with lymphoma and two with Crohn’s disease were not confirmed by SBE. The rate of capsule retention was 2.0%. There were no significant complications during or after SBE examinations. CONCLUSION SBE is a safe and effective technique for diagnosing small bowel diseases. SBE with prior CE seemed to improve the diagnostic yield of small bowel diseases.

Purpose: Many anticancer therapies benefit only a subset of treated patients and may be overlooked by the traditional broad eligibility approach to design phase III clinical trials. New biotechnologies such as microarrays can be used to identify the patients that are most likely to benefit from anticancer therapies. However, due to the high-dimensional nature of the genomic data, developing a reliable classifier by the time the definitive phase III trail is designed may not be feasible. Experimental Design: Previously, Freidlin and Simon (Clinical Cancer Research, 2005) introduced the adaptive signature design that combines a prospective development of a sensitive patient classifier and a properly powered test for overall effect in a single pivotal trial. In this article, we propose a cross-validation extension of the adaptive signature design that optimizes the efficiency of both the classifier development and the validation components of the design. Results: The new design is evaluated through simulations and is applied to data from a randomized breast cancer trial. Conclusion: The cross-validation approach is shown to considerably improve the performance of the adaptive signature design. We also describe approaches to the estimation of the treatment effect for the identified sensitive subpopulation. Clin Cancer Res; 16(2); 691–8

Many molecularly targeted anticancer agents entering the definitive stage of clinical development benefit only a subset of treated patients. This may lead to missing effective agents by the traditional broad-eligibility randomized trials due to the dilution of the overall treatment effect. We propose a statistically rigorous biomarker-adaptive threshold phase III design for settings in which a putative biomarker to identify patients who are sensitive to the new agent is measured on a continuous or graded scale.The design combines a test for overall treatment effect in all randomly assigned patients with the establishment and validation of a cut point for a prespecified biomarker of the sensitive subpopulation. The performance of the biomarker-adaptive design, relative to a traditional design that ignores the biomarker, was evaluated in a simulation study. The biomarker-adaptive design was also used to analyze data from a prostate cancer trial.In the simulation study, the biomarker-adaptive design preserved the power to detect the overall effect when the new treatment is broadly effective. When the proportion of sensitive patients as identified by the biomarker is low, the proposed design provided a substantial improvement in efficiency compared with the traditional trial design. Recommendations for sample size planning and implementation of the biomarker-adaptive design are provided.A statistically valid test for a biomarker-defined subset effect can be prospectively incorporated into a randomized phase III design without compromising the ability to detect an overall effect if the intervention is beneficial in a broad population.

Clonal deviation is a mechanism by which immature thymocytes expressing a self-reactive T cell antigen receptor (TCR) are rescued from clonal deletion by adopting an alternative differentiation pathway resistant to apoptosis. Here, we confirm and generalize previous indications that genetic alleles in NOD mice condition ineffective clonal deviation toward the CD8αα lineage, a peculiar population of TCRαβ lymphocytes that electively colonizes the intraepithelial lymphocyte pool in the gut. Thymic selection of CD8αα cells was very age-dependent, occurring almost exclusively in the postnatal period. Fewer CD8αα cells were found in the thymus and intraepithelial lymphocytes of BDC2.5 TCR transgenic mice on the NOD than on the C57BL/6 (B6) background; this paucity extended to standard NOD mice, albeit to a lesser extent. CD8αα cells resided in the BDC2.5 pancreatic infiltrate, and they were more abundant on the B6 than the NOD background, correlating with aggressivity of the lesion. A (B6 g7 × NOD)F 2 intercross in agonist-challenged BDC2.5 fetal thymic organ cultures demonstrated the existence of a major quantitative trait locus on chromosome 3, coincident with an interval associated with resistance to clonal deletion. A replicate linkage confirmed these positions and showed that the same region also controls clonal deviation toward the CD4 + FoxP3 + regulatory T cell lineage. That clonal deviation toward the CD8αα and regulatory T cell pathways share genetic control further highlights the similarities between these two “rescue lineages,” consistent with an immunoregulatory role for CD8αα cells.

Background: To date, the role of IL-17C and its specific receptor subunit IL-17RE in inflammatory bowel disease (IBD) settings is entirely based on murine models. Therefore, the aim of this study was to analyze the role of the novel IL-17 family member IL-17C and its receptor IL-17RE in human IBD. Methods: IL-17C expression in intestinal epithelial cells (IEC) was analyzed by qPCR, immunoblotting, immunohistochemistry, EMSA, RNA interference and pharmacological or antibody-mediated inhibition. IL-17C protein and mRNA expression in IBD patient samples was assessed by ELISA, qPCR and immunohistochemistry. IL-17C serum levels were correlated to IL23R genotype status. Results: IL-17A amplifies IL-17C expression in human IEC upon TNF-α stimulation; this depends on TNFα-activated NF-κB, ERK-1/2 and p38 MAP kinases, and IL-17A-activated Akt kinase, MCPIP and C/EBP-δ pathways. IL-17C serum levels are elevated in patients with ulcerative colitis (UC) (P=0.008). IL-17C mRNA is increased in inflamed colonic sections of IBD patients (P=0.005) and correlates significantly with the mRNA expression of Th1 cytokines (e.g., IFN-γ; P

Ovarian cancer is the 5th leading cause of cancer related death in women, and has the highest associated mortality rate of any of the gynecological cancers. Approximately 75-80% of women diagnosed will succumb to the disease. The high mortality rate associated with ovarian cancer is due to poor screening and detection methods, resulting in late stage diagnosis, and also to resistance of the tumours to chemotherapeutic drugs. Primary drug resistance occurs in about 20% of patients during their treatment phase while approximately 70-80% of women that initially respond to chemotherapy will develop drug resistance over the course of treatment or at the time of relapse. Being able to accurately predict which patients will not successfully respond to drugs is the first step in developing personalized medicine and preventing useless chemotherapy treatments. In order to discover biomarkers of cisplatin resistance, a multi-platform integrative approach was taken utilizing data from aCGH as well as miRNA and mRNA microarrays. Data were collected from a drug sensitive and drug resistant ovarian cancer cell line pair (A2780 and A2780cis). Working with the paired cell lines provided a homogeneous population with which to build an integration algorithm. Data analysis using GeneSpring and Nexus software showed an enrichment of genes involved in TGFβ and EGF signaling. These signaling pathways lead us to investigate the involvement of the epithelial to mesenchymal transition (EMT) in drug resistance. Interestingly, many of the key genes involved in the regulation of the EMT process were found to be upregulated in our mRNA expression data. Observations from cell culture work support EMT involvement. We have noted a slower growth rate and a change to a fibroblastic appearance in the resistant cells relative to their drug sensitive parents. Immunohistochemistry has also been utilized to show an increase in mesenchymal markers in the resistant cell line. In order to determine if these findings were representative of drug resistance in human ovarian cancer, expression data from cisplatin sensitive and resistant ovarian cancer tumours were mined specifically for these and other EMT genes. A large number of the same EMT genes were consistently shown to be upregulated in the drug resistant tumour tissues relative to the sensitive tumours. Together, these data suggest the potential involvement of the epithelial to mesenchymal transition in the development of cisplatin resistance in ovarian cancer. Further validation of these results in vitro is currently in progress. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1719. doi:10.1158/1538-7445.AM2011-1719