Cost-Effectiveness Analysis of Cyclin-Dependent Kinase 4/6 Inhibitor Palbociclib for Inoperable or Recurrent Breast Cancer.

BACKGROUND: Palbociclib and endocrine therapy has been approved to treat hormone receptor-positive/human epidermal growth factor receptor 2-negative inoperable or recurrent breast cancer in Japan. However, this cotherapy imposes an economic burden on both patients and society because of its high cost. In this study, we assessed the cost-effectiveness of cotherapy with palbociclib and fulvestrant compared to fulvestrant monotherapy for inoperable or recurrent breast cancer. METHODS: The three-state Markov model was built by taking into count health stats in inoperable or recurrent breast cancer. The clinical outcomes of the therapies were drawn from published randomized controlled trials. Total regimen cost was calculated from medical receipts of patients at the Yamagata University Hospital. The cost-effectiveness was evaluated by the incremental cost-effectiveness ratio(ICER), in case that it was below 400,000 Yen per month. Markov chain Monte Carlo simulation was performed to assess probability. RESULTS: Acquisition cost of palbociclib and fulvestrant and fulvestrant monotherapy was 6,209,554 JPY and 780,870 JPY, and 25.7 and 22.8 months were achieved, respectively. ICER for the cotherapy was 1,847,721 JPY/quality adjusted life month(QALM)gained. CONCLUSIONS: The palbociclib and fulvestrant therapy provided better health outcomes than conventional fulvestrant monotherapy, but were costly and suggested to be less cost-effective.

Amplification of over 100 kbp DNA from Single Template Molecules in Femtoliter Droplets.

Reconstitution of the DNA amplification system in microcompartments is the primary step toward artificial cell construction through a bottom-up approach. However, amplification of >100 kbp DNA in micrometer-sized reactors has not yet been achieved. Here, implementing a fully reconstituted replisome of Escherichia coli in micrometer-sized water-in-oil droplets, we developed the in-droplet replication cycle reaction (RCR) system. For a 16 kbp template DNA, the in-droplet RCR system yielded positive RCR signals with a high success rate (82%) for the amplification from single molecule template DNA. The success rate for a 208 kbp template DNA was evidently lower (23%). This study establishes a platform for genome-sized DNA amplification from a single copy of template DNA with the potential to build more complex artificial cell systems comprising a large number of genes.

Outcome evaluations in group decision-making using authority rule: An electrophysiological study.

The present study aimed to investigate whether coincidence of opinion affects the evaluative processing of outcomes in group decision-making under authority rule. For this purpose, we examined the effects of the opinion coincidence on feedback-related negativity (FRN), an event-related brain potential (ERP) reflecting the evaluative processing of outcomes. Six three-person groups performed a group decision-making task in which one member acting as a leader (leader blocks) made a group decision to choose one of two cards after he/she observed opinions of the other members acting as followers (follower blocks), and monetary gain or loss was contingent on the group decision. To examine the effect of the opinion coincidence, each trial of each individual was classified into one of three trial types: unanimous, majority, or minority trials. As a result, the amplitude of FRN was smaller for unanimous trials than for majority trials in the leader blocks. In addition, the amplitude of FRN was larger for majority trials compared to minority trials in the follower blocks. These results suggest that the coincidence of opinion in group decision-making affects the evaluative processing of outcomes, and this occurs even when roles and responsibilities over outcomes is explicitly clarified under the authority rule.

Synthesis of a Bis-Urea Dimer and Its Effects on the Physical Properties of an Amphiphilic Tris-Urea Supramolecular Hydrogel.

The successful development of stiff supramolecular gels is an important goal toward their practical application. One approach to stiffen supramolecular gels is to introduce covalent cross-links. The bis-urea dimer 2, having a structure similar to that of the low-molecular-weight gelator 1, was synthesized. Supramolecular hydrogels were formed from mixtures of 1 and 2 in appropriate ratios, with 2 acting as a covalent cross-linker to connect the fibrous aggregates formed by the self-assembly of 1. The introduction of these covalent cross-links greatly influenced the dynamic viscoelasticity of the supramolecular hydrogels. In the supramolecular hydrogel of 1 mixed with 5 % 2, the storage modulus was 1.35 times higher than that of the supramolecular hydrogel of 1 alone, and the crossover strain was extended from 5 % to over 20 %. The supramolecular hydrogel of 1 and 2 was free-standing and supported 13 times its own weight.

Validation of MIMGO: a method to identify differentially expressed GO terms in a microarray dataset.

BACKGROUND: We previously proposed an algorithm for the identification of GO terms that commonly annotate genes whose expression is upregulated or downregulated in some microarray data compared with in other microarray data. We call these "differentially expressed GO terms" and have named the algorithm "matrix-assisted identification method of differentially expressed GO terms" (MIMGO). MIMGO can also identify microarray data in which genes annotated with a differentially expressed GO term are upregulated or downregulated. However, MIMGO has not yet been validated on a real microarray dataset using all available GO terms. FINDINGS: We combined Gene Set Enrichment Analysis (GSEA) with MIMGO to identify differentially expressed GO terms in a yeast cell cycle microarray dataset. GSEA followed by MIMGO (GSEA + MIMGO) correctly identified (p < 0.05) microarray data in which genes annotated to differentially expressed GO terms are upregulated. We found that GSEA + MIMGO was slightly less effective than, or comparable to, GSEA (Pearson), a method that uses Pearson's correlation as a metric, at detecting true differentially expressed GO terms. However, unlike other methods including GSEA (Pearson), GSEA + MIMGO can comprehensively identify the microarray data in which genes annotated with a differentially expressed GO term are upregulated or downregulated. CONCLUSIONS: MIMGO is a reliable method to identify differentially expressed GO terms comprehensively.