Successful osimertinib rechallenge without concomitant corticosteroids after osimertinib-induced pneumonitis.

A 60-year-old woman was diagnosed with cT4N3M1c stage IVB lung adenocarcinoma with epidermal growth factor receptor mutation of exon19 deletion. After one month of treatment with osimertinib, a cough and diffuse ground glass opacities were observed in the bilateral lung field. Based on the clinical course and the exclusion of other etiologies, osimertinib-induced pneumonitis was diagnosed. The shadows resolved after osimertinib was discontinued. However, brain metastasis and leptomeningeal metastasis developed 20 months later; therefore, osimertinib was re-administered without concomitant corticosteroids. The pulmonary lesion and leptomeningeal metastasis were successfully treated without recurrence of drug-induced pneumonitis for eight months.

High Expression of Fas-Associated Factor 1 Indicates a Poor Prognosis in Non-Small-Cell Lung Cancer.

Fas-associated factor 1 (FAF1) is a death-promoting protein identified as an interaction partner of the death receptor Fas. The downregulation and mutation of FAF1 have been reported in a variety of human tumors, but there have been few studies on lung cancer. Here, we investigated the prognostic significance of FAF1 expression in non-small-cell lung cancer (NSCLC), and whether aberrant FAF1 expression may be involved in the pathogenesis and prognosis of NSCLC. FAF1 expression was examined in NSCLC specimens as well as human lung cancer cell lines. In addition, changes in cell viability and apoptosis upon regulating FAF1 expression were investigated in lung cancer cell lines. As a result, high FAF1 expression was significantly associated with a poor prognosis in NSCLC. In lung cancer cell lines, FAF1 downregulation hindered cell viability and tended to promote early apoptosis. In conclusion, this is the first study of the clinical significance of FAF1 in NSCLC, showing that FAF1 overexpression is associated with a poor prognosis in NSCLC and that FAF1 acts as a dangerous factor rather than an apoptosis promoter in NSCLC.

Maneuverable and Efficient Locomotion of a Myriapod Robot with Variable Body-Axis Flexibility via Instability and Bifurcation.

Legged robots have remarkable terrestrial mobility, but are susceptible to falling and leg malfunction during locomotion. The use of a large number of legs, as in centipedes, can overcome these problems, but it makes the body long and leads to many legs being constrained to contact with the ground to support the long body, which impedes maneuverability. A mechanism for maneuverable locomotion using a large number legs is thus desirable. However, controlling a long body with a large number of legs requires huge computational and energy costs. Inspired by agile locomotion in biological systems, this study proposes a control strategy for maneuverable and efficient locomotion of a myriapod robot based on dynamic instability. Specifically, our previous study made the body axis of a 12-legged robot flexible and showed that changing the body-axis flexibility produces pitchfork bifurcation. The bifurcation not only induces the dynamic instability of a straight walk but also a transition to a curved walk, whose curvature is controllable by the body-axis flexibility. This study incorporated a variable stiffness mechanism into the body axis and developed a simple control strategy based on the bifurcation characteristics. With this strategy, maneuverable and autonomous locomotion was achieved, as demonstrated by multiple robot experiments. Our approach does not directly control the movement of the body axis; instead, it controls body-axis flexibility, which significantly reduces computational and energy costs. This study provides a new design principle for maneuverable and efficient locomotion of myriapod robots.

Primary Cilia Are Frequently Present in Small Cell Lung Carcinomas but Not in Non-Small Cell Lung Carcinomas or Lung Carcinoids.

Most human malignant neoplasms show loss of primary cilia (PC). However, PC are known to be retained and involved in tumorigenesis in some types of neoplasms. The PC status in lung carcinomas remains largely uninvestigated. In this study, we comprehensively assessed the PC status in lung carcinomas. A total of 492 lung carcinomas, consisting of adenocarcinomas (ACs) (n = 319), squamous cell carcinomas (SCCs) (n = 152), and small cell lung carcinomas (SCLCs) (n = 21), were examined by immunohistochemical analysis using an antibody against ARL13B, a marker of PC. The PC-positive rate was markedly higher in SCLCs (81.0%) than in ACs (1.6%) and SCCs (7.9%). We subsequently performed analyses to characterize the PC-positive lung carcinomas further. PC-positive lung carcinomas were more numerous and had longer PC than normal cells. The presence of PC in these cells was not associated with the phase of the cell cycle. We also found that the PC were retained even in metastases from PC-positive lung carcinomas. Furthermore, the hedgehog signaling pathway was activated in PC-positive lung carcinomas. Because ARL13B immunohistochemistry of lung carcinoids (n = 10) also showed a statistically significantly lower rate (10.0%) of PC positivity than SCLCs, we searched for a gene(s) that might be upregulated in PC-positive SCLCs compared with lung carcinoids, but not in PC-negative carcinomas. This search, and further cell culture experiments, identified HYLS1 as a gene possessing the ability to regulate ciliogenesis in PC-positive lung carcinomas. In conclusion, our findings indicate that PC are frequently present in SCLCs but not in non-SCLCs (ACs and SCCs) or lung carcinoids, and their PC exhibit various specific pathobiological characteristics. This suggests an important link between lung carcinogenesis and PC.

Contribution of Phase Resetting to Statistical Persistence in Stride Intervals: A Modeling Study.

Stride intervals in human walking fluctuate from one stride to the next, exhibiting statistical persistence. This statistical property is changed by aging, neural disorders, and experimental interventions. It has been hypothesized that the central nervous system is responsible for the statistical persistence. Human walking is a complex phenomenon generated through the dynamic interactions between the central nervous system and the biomechanical system. It has also been hypothesized that the statistical persistence emerges through the dynamic interactions during walking. In particular, a previous study integrated a biomechanical model composed of seven rigid links with a central pattern generator (CPG) model, which incorporated a phase resetting mechanism as sensory feedback as well as feedforward, trajectory tracking, and intermittent feedback controllers, and suggested that phase resetting contributes to the statistical persistence in stride intervals. However, the essential mechanisms remain largely unclear due to the complexity of the neuromechanical model. In this study, we reproduced the statistical persistence in stride intervals using a simplified neuromechanical model composed of a simple compass-type biomechanical model and a simple CPG model that incorporates only phase resetting and a feedforward controller. A lack of phase resetting induced a loss of statistical persistence, as observed for aging, neural disorders, and experimental interventions. These mechanisms were clarified based on the phase response characteristics of our model. These findings provide useful insight into the mechanisms responsible for the statistical persistence of stride intervals in human walking.

Fore-Aft Asymmetry Improves the Stability of Trotting in the Transverse Plane: A Modeling Study.

Quadrupedal mammals have fore-aft asymmetry in their body structure, which affects their walking and running dynamics. However, the effects of asymmetry, particularly in the transverse plane, remain largely unclear. In this study, we examined the effects of fore-aft asymmetry on quadrupedal trotting in the transverse plane from a dynamic viewpoint using a simple model, which consists of two rigid bodies connected by a torsional joint with a torsional spring and four spring legs. Specifically, we introduced fore-aft asymmetry into the model by changing the physical parameters between the fore and hind parts of the model based on dogs, which have a short neck, and horses, which have a long neck. We numerically searched the periodic solutions for trotting and investigated the obtained solutions and their stability. We found that three types of periodic solutions with different foot patterns appeared that depended on the asymmetry. Additionally, the asymmetry improved gait stability. Our findings improve our understanding of gait dynamics in quadrupeds with fore-aft asymmetry.

Three Characteristics of Cheetah Galloping Improve Running Performance Through Spinal Movement: A Modeling Study.

Cheetahs are the fastest land animal. Their galloping shows three characteristics: small vertical movement of their center of mass, small whole-body pitching movement, and large spine bending movement. We hypothesize that these characteristics lead to enhanced gait performance in cheetahs, including higher gait speed. In this study, we used a simple model with a spine joint and torsional spring, which emulate the body flexibility, to verify our hypothesis from a dynamic perspective. Specifically, we numerically searched periodic solutions and evaluated what extent each solution shows the three characteristics. We then evaluated the gait performance and found that the solutions with the characteristics achieve high performances. This result supports our hypothesis. Furthermore, we revealed the mechanism for the high performances through the dynamics of the spine movement. These findings extend the current understanding of the dynamic mechanisms underlying high-speed locomotion in cheetahs.

Contribution of Afferent Feedback to Adaptive Hindlimb Walking in Cats: A Neuromusculoskeletal Modeling Study.

Mammalian locomotion is generated by central pattern generators (CPGs) in the spinal cord, which produce alternating flexor and extensor activities controlling the locomotor movements of each limb. Afferent feedback signals from the limbs are integrated by the CPGs to provide adaptive control of locomotion. Responses of CPG-generated neural activity to afferent feedback stimulation have been previously studied during fictive locomotion in immobilized cats. Yet, locomotion in awake, behaving animals involves dynamic interactions between central neuronal circuits, afferent feedback, musculoskeletal system, and environment. To study these complex interactions, we developed a model simulating interactions between a half-center CPG and the musculoskeletal system of a cat hindlimb. Then, we analyzed the role of afferent feedback in the locomotor adaptation from a dynamic viewpoint using the methods of dynamical systems theory and nullcline analysis. Our model reproduced limb movements during regular cat walking as well as adaptive changes of these movements when the foot steps into a hole. The model generates important insights into the mechanism for adaptive locomotion resulting from dynamic interactions between the CPG-based neural circuits, the musculoskeletal system, and the environment.

m6A demethylase ALKBH5 promotes tumor cell proliferation by destabilizing IGF2BPs target genes and worsens the prognosis of patients with non-small-cell lung cancer.

The modification of N6-methyladenosine (m6A) in RNA and its eraser ALKBH5, an m6A demethylase, play an important role across various steps of human carcinogenesis. However, the involvement of ALKBH5 in non-small-cell lung cancer (NSCLC) development remains to be completely elucidated. The current study revealed that the expression of ALKBH5 was increased in NSCLC and increased expression of ALKBH5 worsened the prognosis of patients with NSCLC. In vitro study revealed that ALKBH5 knockdown suppressed cell proliferation ability of PC9 and A549 cells and promoted G1 arrest and increased the number of apoptotic cells. Furthermore, ALKBH5 overexpression increased the cell proliferation ability of the immortalized cell lines. Microarray analysis and western blotting revealed that the expression of CDKN1A (p21) or TIMP3 was increased by ALKBH5 knockdown. These alterations were offset by a double knockdown of both ALKBH5 and one of the IGF2BPs. The decline of mRNAs was, at least partly, owing to the destabilization of these mRNAs by one of the IGF2BPs. In conclusions, the ALKBH5-IGF2BPs axis promotes cell proliferation and tumorigenicity, which in turn causes the unfavorable prognosis of NSCLC.

Center of Mass Offset Enhances the Selection of Transverse Gallop in High-Speed Running by Horses: A Modeling Study.

Horses use the transverse gallop in high-speed running. However, different animals use different gaits, and the gait preference of horses remains largely unclear. Horses have fore-aft asymmetry in their body structure and their center of mass (CoM) is anteriorly located far from the center of the body. Since such a CoM offset affects the running dynamics, we hypothesize that the CoM offset of horses is important in gait selection. In order to verify our hypothesis and clarify the gait selection mechanisms by horses from a dynamic viewpoint, we developed a simple model with CoM offset and investigated its effects on running. Specifically, we numerically obtained periodic solutions and classified these solutions into six types of gaits, including the transverse gallop, based on the footfall pattern. Our results show that the transverse gallop is optimal when the CoM offset is located at the position estimated in horses. Our findings provide useful insight into the gait selection mechanisms in high-speed running of horses.

EGFR-Mutated Lung Adenocarcinoma Successfully Treated With Osimertinib After Spontaneous Transformation to SCLC and Adenocarcinoma With Neuroendocrine Differentiation: Case Report.

Lineage transformation from lung adenocarcinoma (LUAD) to SCLC is associated with resistance to EGFR tyrosine kinase inhibitors. In addition to loss of p53 and RB, transformed SCLCs are usually not dependent on EGFR signaling, which renders the tumors unresponsive to EGFR tyrosine kinase inhibitors. Here, we present a case of spontaneous transformation from EGFR-mutant LUAD with loss of p53 and RB to EGFR expression-positive SCLC and neuroendocrine-differentiated LUAD, which was successfully treated with osimertinib.

Transient leukocytopenia following combination therapy for COVID-19.

BACKGROUND: Combination therapy with dexamethasone, remdesivir, and baricitinib has become a promising treatment for moderate or severe COVID-19; however, we have observed transient leukocytopenia in COVID-19 patients who received combination therapy. METHODS: Twelve consecutive COVID-19 patients treated with combination therapy were included in this retrospective analysis. Blood cell counts collected at the following three time points were analyzed: before the start of therapy (period 1), within 24 h of starting therapy (period 2), and within 48 h of period 2 (period 3). RESULTS: The leukocyte count significantly decreased in period 2 compared to period 1 and then significantly increased in period 3 without withdrawal of baricitinib. The neutrophil count transiently decreased in period 2 and recovered in period 3. CONCLUSIONS: Clinicians should be aware of transient leukocytopenia in patients with COVID-19 during the early phase of combination therapy.

Quantitative evaluation of posture control in rats with inferior olive lesions.

Impairment of inferior olivary neurons (IONs) affects whole-body movements and results in abnormal gait and posture. Because IONs are activated by unpredicted motion rather than regular body movements, the postural dysfunction caused by ION lesions is expected to involve factors other than simple loss of feedback control. In this study, we measured the postural movements of rats with pharmacological ION lesions (IO rats) trained to stand on their hindlimbs. The coordination of body segments as well as the distribution and frequency characteristics of center of mass (COM) motion were analyzed. We determined that the lesion altered the peak properties of the power spectrum density of the COM, whereas changes in coordination and COM distribution were minor. To investigate how the observed properties reflected changes in the control system, we constructed a mathematical model of the standing rats and quantitatively identified the control system. We found an increase in linear proportional control and a decrease in differential and nonlinear control in IO rats compared with intact rats. The dystonia-like changes in body stiffness explain the nature of the linear proportional and differential control, and a disorder in the internal model is one possible cause of the decrease in nonlinear control.

Generation of Direct-, Retrograde-, and Source-Wave Gaits in Multi-Legged Locomotion in a Decentralized Manner via Embodied Sensorimotor Interaction.

Multi-legged animals show several types of ipsilateral interlimb coordination. Millipedes use a direct-wave gait, in which the swing leg movements propagate from posterior to anterior. In contrast, centipedes use a retrograde-wave gait, in which the swing leg movements propagate from anterior to posterior. Interestingly, when millipedes walk in a specific way, both direct and retrograde waves of the swing leg movements appear with the waves' source, which we call the source-wave gait. However, the gait generation mechanism is still unclear because of the complex nature of the interaction between neural control and dynamic body systems. The present study used a simple model to understand the mechanism better, primarily how local sensory feedback affects multi-legged locomotion. The model comprises a multi-legged body and its locomotion control system using biologically inspired oscillators with local sensory feedback, phase resetting. Each oscillator controls each leg independently. Our simulation produced the above three types of animal gaits. These gaits are not predesigned but emerge through the interaction between the neural control and dynamic body systems through sensory feedback (embodied sensorimotor interaction) in a decentralized manner. The analytical description of these gaits' solution and stability clarifies the embodied sensorimotor interaction's functional roles in the interlimb coordination.

Fast and Slow Adaptations of Interlimb Coordination via Reflex and Learning During Split-Belt Treadmill Walking of a Quadruped Robot.

Interlimb coordination plays an important role in adaptive locomotion of humans and animals. This has been investigated using a split-belt treadmill, which imposes different speeds on the two sides of the body. Two types of adaptation have been identified, namely fast and slow adaptations. Fast adaptation induces asymmetric interlimb coordination soon after a change of the treadmill speed condition from same speed for both belts to different speeds. In contrast, slow adaptation slowly reduces the asymmetry after fast adaptation. It has been suggested that these adaptations are primarily achieved by the spinal reflex and cerebellar learning. However, these adaptation mechanisms remain unclear due to the complicated dynamics of locomotion. In our previous work, we developed a locomotion control system for a biped robot based on the spinal reflex and cerebellar learning. We reproduced the fast and slow adaptations observed in humans during split-belt treadmill walking of the biped robot and clarified the adaptation mechanisms from a dynamic viewpoint by focusing on the changes in the relative positions between the center of mass and foot stance induced by reflex and learning. In this study, we modified the control system for application to a quadruped robot. We demonstrate that even though the basic gait pattern of our robot is different from that of general quadrupeds (due to limitations of the robot experiment), fast and slow adaptations that are similar to those of quadrupeds appear during split-belt treadmill walking of the quadruped robot. Furthermore, we clarify these adaptation mechanisms from a dynamic viewpoint, as done in our previous work. These results will increase the understanding of how fast and slow adaptations are generated in quadrupedal locomotion on a split-belt treadmill through body dynamics and sensorimotor integration via the spinal reflex and cerebellar learning and help the development of control strategies for adaptive locomotion of quadruped robots.

YTHDF1 and YTHDF2 are associated with better patient survival and an inflamed tumor-immune microenvironment in non-small-cell lung cancer.

The human YTH domain family (YTHDF) proteins are RNA-binding proteins that recognize N6-methyladenosine (m6A), facilitating various biological processes via m6A RNA modification. How these molecules associate with non-small-cell lung cancer (NSCLC) molecular mechanisms remain unclear. The protein expression levels of YTHDF1 and YTHDF2 in 603 cases of resected NSCLC were evaluated using immunohistochemistry. We analyzed the associations of these attributes with patient characteristics and survival. We also assessed four subsets of lymphocytes (PD-1+, CD8+, Foxp3+, and CD45RO+) as tumor-infiltrating lymphocytes (TILs) in the tumor nest and in the surrounding stroma separately. In addition, we investigated differentially expressed genes and the expression of PD-L1 in YTHDF1- and YTHDF2-deprived lung cancer cells. The expressions of both YTHDF1 and YTHDF2 were less in the advanced-stage tumors than in the early-stage tumors. The expressions of both YTHDF1 and YTHDF2 were also independent favorable prognostic factors for recurrence-free survival (HR, 0.745; 95% CI, 0.562-0.984 for YTHDF1; HR, 0.683; 95% CI, 0.503-0.928 for YTHDF2). The TIL densities of almost all four lymphocyte subsets in the stroma were significantly higher in the tumors with high YTHDF1 and YTHDF2 expression. In vitro, YTHDF1 and YTHDF2 knockdown in cells upregulated tumor PD-L1 expression and altered multiple immune-related genes. High expressions of both YTHDF1 and YTHDF2 are associated with a favorable prognostic outcome of NSCLC patients, a greater amount of TILs, and downregulation of PD-L1. YTHDF1 and YTHDF2 could be novel prognostic and druggable targets related to the tumor-immune microenvironment in lung cancers.

Dynamical determinants enabling two different types of flight in cheetah gallop to enhance speed through spine movement.

Cheetahs use a galloping gait in their fastest speed range. It has been reported that cheetahs achieve high-speed galloping by performing two types of flight through spine movement (gathered and extended). However, the dynamic factors that enable cheetahs to incorporate two types of flight while galloping remain unclear. To elucidate this issue from a dynamical viewpoint, we developed a simple analytical model. We derived possible periodic solutions with two different flight types (like cheetah galloping), and others with only one flight type (unlike cheetah galloping). The periodic solutions provided two criteria to determine the flight type, related to the position and magnitude of ground reaction forces entering the body. The periodic solutions and criteria were verified using measured cheetah data, and provided a dynamical mechanism by which galloping with two flight types enhances speed. These findings extend current understanding of the dynamical mechanisms underlying high-speed locomotion in cheetahs.

Identification and characterization of primary cilia-positive salivary gland tumours exhibiting basaloid/myoepithelial differentiation.

Primary cilia (PC) are non-motile, antenna-like structures on the cell surface. Many types of neoplasms exhibit PC loss, whereas in some neoplasms PC are retained and involved in tumourigenesis. To elucidate the PC status and characteristics of major salivary gland tumours (SGTs), we examined 100 major SGTs encompassing eight histopathological types by immunohistochemical analysis. PC were present in all (100%) of the pleomorphic adenomas (PAs), basal cell adenomas (BCAs), adenoid cystic carcinomas (AdCCs), and basal cell adenocarcinomas (BCAcs) examined, but absent in all (0%) of the Warthin tumours, salivary duct carcinomas, mucoepidermoid carcinomas, and acinic cell carcinomas examined. PC were also detected by electron-microscopic analysis using the NanoSuit method. It is worthy of note that the former category and latter category of tumours contained and did not contain a basaloid/myoepithelial differentiation component, respectively. The four types of PC-positive SGTs showed longer PC than normal and exhibited a characteristic distribution pattern of the PC in the ductal and basaloid/neoplastic myoepithelial components. Two PC-positive carcinomas (AdCC and BCAc) still possessed PC in their recurrent/metastatic sites. Interestingly, activation of the Hedgehog signalling pathway, shown by predominantly nuclear GLI1 expression, was significantly more frequently observed in PC-positive SGTs. Finally, we identified tau tubulin kinase 2 (TTBK2) as being possibly involved in the production of PC in SGTs. Taken together, our findings indicate that SGTs that exhibit basaloid/myoepithelial differentiation (PA, BCA, AdCC, and BCAc) are ciliated, and their PC exhibit tumour-specific characteristics, are involved in activation of the Hedgehog pathway, and are associated with TTBK2 upregulation, providing a significant and important link between SGT tumourigenesis and PC. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

CD200 and CD200R1 are differentially expressed and have differential prognostic roles in non-small cell lung cancer.

CD200, a member of the immunoglobulin superfamily, interacts with its receptor CD200R1 to modulate cancer immune microenvironments. Here, we explored the clinicopathological and prognostic implications of the CD200/CD200R1 axis in non-small-cell lung cancer (NSCLC) patients. We evaluated CD200/CD200R1 expression in the tumors and stroma of 632 NSCLC patients using immunohistochemistry. Associations between CD200/CD200R1 expression levels and clinicopathological data were analyzed. We also examined their expression in lung cancer cell lines. Changes in endogenous immune-related factors and cell proliferation were evaluated by CD200 and CD200R1 knockdown and CD200Fc fusion protein administration. CD200 expression was observed mainly in the tumor, and also in the stroma among a few cases, whereas CD200R1 expression was observed in both the tumor and stroma. High tumoral CD200 expression was significantly associated with female sex, never-smoking status, adenocarcinoma histology, EGFR mutation, and a low density of tumor-infiltrating lymphocytes. Meanwhile, high CD200R1 expression in the tumor and stroma was associated with ever smoking, non-adenocarcinoma histology, and increased tumor-infiltrating lymphocytes. High CD200R1 expression was associated with worse survival (log-rank, P <.001 for both tumor and stroma), whereas high CD200 expression was associated with better survival outcomes (log-rank, P <.001). The transient knockdown of CD200R1 in lung cancer cell lines impaired cell proliferation, and the in vitro modulation of CD200 and CD200R1 altered endogenous oncogenic and inflammation-related gene expression. CD200R1 expression was associated with poor prognosis, whereas CD200 expression was an independent favorable prognostic factor. Our results suggest the importance of CD200 and CD200R1 in lung cancer biology.

Fractal mechanism of basin of attraction in passive dynamic walking.

Passive dynamic walking is a model that walks down a shallow slope without any control or input. This model has been widely used to investigate how humans walk with low energy consumption and provides design principles for energy-efficient biped robots. However, the basin of attraction is very small and thin and has a fractal-like complicated shape, which makes producing stable walking difficult. In our previous study, we used the simplest walking model and investigated the fractal-like basin of attraction based on dynamical systems theory by focusing on the hybrid dynamics of the model composed of the continuous dynamics with saddle hyperbolicity and the discontinuous dynamics caused by the impact upon foot contact. We clarified that the fractal-like basin of attraction is generated through iterative stretching and bending deformations of the domain of the Poincaré map by sequential inverse images. However, whether the fractal-like basin of attraction is actually fractal, i.e., whether infinitely many self-similar patterns are embedded in the basin of attraction, is dependent on the slope angle, and the mechanism remains unclear. In the present study, we improved our previous analysis in order to clarify this mechanism. In particular, we newly focused on the range of the Poincaré map and specified the regions that are stretched and bent by the sequential inverse images of the Poincaré map. Through the analysis of the specified regions, we clarified the conditions and mechanism required for the basin of attraction to be fractal.