Single-agent anti-PD-1 or combined with ipilimumab in patients with mucosal melanoma: an international, retrospective, cohort study.

BACKGROUND: Mucosal melanoma (MM) is a rare melanoma subtype with distinct biology and poor prognosis. Data on the efficacy of immune checkpoint inhibitors (ICIs) are limited. We determined the efficacy of ICIs in MM, analyzed by primary site and ethnicity/race. PATIENTS AND METHODS: A retrospective cohort study from 25 cancer centers in Australia, Europe, USA and Asia was carried out. Patients with histologically confirmed MM were treated with anti-programmed cell death protein 1 (PD-1) ± ipilimumab. Primary endpoints were response rate (RR), progression-free survival (PFS), overall survival (OS) by primary site (naso-oral, urogenital, anorectal, other), ethnicity/race (Caucasian, Asian, Other) and treatment. Univariate and multivariate Cox proportional hazards model analyses were conducted. RESULTS: In total, 545 patients were included: 331 (63%) Caucasian, 176 (33%) Asian and 20 (4%) Other. Primary sites included 113 (21%) anorectal, 178 (32%) urogenital, 206 (38%) naso-oral and 45 (8%) other. Three hundred and forty-eight (64%) patients received anti-PD-1 and 197 (36%) anti-PD-1/ipilimumab. RR, PFS and OS did not differ by primary site, ethnicity/race or treatment. RR for naso-oral was numerically higher for anti-PD-1/ipilimumab [40%, 95% confidence interval (CI) 29% to 54%] compared with anti-PD-1 (29%, 95% CI 21% to 37%). Thirty-five percent of patients who initially responded progressed. The median duration of response (mDoR) was 26 months (95% CI 18 months-not reached). Factors associated with short PFS were Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥3 (P < 0.01), lactate dehydrogenase (LDH) more than the upper limit of normal (ULN) (P = 0.01), lung metastases (P < 0.01) and ≥1 previous treatments (P < 0.01). Factors associated with short OS were ECOG PS ≥1 (P < 0.01), LDH >ULN (P = 0.03), lung metastases (P < 0.01) and ≥1 previous treatments (P < 0.01). CONCLUSIONS: MM has poor prognosis. Treatment efficacy of anti-PD-1 ± ipilimumab was similar and did not differ by ethnicity/race. Naso-oral primaries had numerically higher response to anti-PD-1/ipilimumab, without difference in survival. The addition of ipilimumab did not show greater benefit over anti-PD-1 for other primary sites. In responders, mDoR was short and acquired resistance was common. Other factors, including site and number of metastases, were associated with survival.

Influence of Natural Polyphenols on Isolated Yeast Dipodascus magnusii Mitochondria.

The effect of stilbene polyphenols (resveratrol and pinosilvin) and flavonoids (dihydromyricetin, epigallocatechin, and dihydroquercetin) on producing the reactive oxygen species (ROS) due to cell respiration using the isolated mitochondria of the fungus Dipodascus (Endomyces) magnusii was studied. It was shown that the inhibition of the ROS generation with stilbenes is related to both the oxygen consumption inhibition and their antioxidant properties. The degree of manifestation of polyphenol antioxidant properties depended on the number of hydroxyl groups in a polyphenol molecule. Of the flavonoids tested, dihydromyricetin was most active in reducing the ROS generation, but its inhibitory effect on oxygen consumption by mitochondria was significantly lower as compared to that of the stilbenes. The data obtained show that the mechanism of reducing the ROS generation with polyphenols is associated with both the respiratory inhibition and their antioxidant properties.

Label reading, numeracy and food & nutrition involvement.

The purpose of this study was to investigate objective performance on a nutrition label comprehension task, and the influence of numeracy and food-related involvement on this performance level. A pilot study (n = 45) was run to prepare the scales in French. For the main study (n = 101), participants provided demographic information and answered the nutrition label survey, the short numeracy scale and two different food-related involvement scales (i.e. the food involvement scale and the nutrition involvement scale). Both studies were conducted online, and consent was obtained from all participants. Participants answered correctly only two-thirds of the nutrition label task items. Numeracy and food involvement scores were positively correlated with performance on this task. Finally, food involvement interacted with numeracy. Specifically, people scoring low in numeracy performed generally more poorly on the task, but if they had high food involvement scores, their performance increased. This suggests that high food-related motivation may compensate for poor numeracy skills when dealing with nutrition labels.

Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab.

Background: Anti-PD-1 antibodies (anti-PD-1) have clinical activity in a number of malignancies. All clinical trials have excluded patients with significant preexisting autoimmune disorders (ADs) and only one has included patients with immune-related adverse events (irAEs) with ipilimumab. We sought to explore the safety and efficacy of anti-PD-1 in such patients. Patients and methods: Patients with advanced melanoma and preexisting ADs and/or major immune-related adverse events (irAEs) with ipilimumab (requiring systemic immunosuppression) that were treated with anti-PD-1 between 1 July 2012 and 30 September 2015 were retrospectively identified. Results: One hundred and nineteen patients from 13 academic tertiary referral centers were treated with anti-PD-1. In patients with preexisting AD (N = 52), the response rate was 33%. 20 (38%) patients had a flare of AD requiring immunosuppression, including 7/13 with rheumatoid arthritis, 3/3 with polymyalgia rheumatica, 2/2 with Sjogren's syndrome, 2/2 with immune thrombocytopaenic purpura and 3/8 with psoriasis. No patients with gastrointestinal (N = 6) or neurological disorders (N = 5) flared. Only 2 (4%) patients discontinued treatment due to flare, but 15 (29%) developed other irAEs and 4 (8%) discontinued treatment. In patients with prior ipilimumab irAEs requiring immunosuppression (N = 67) the response rate was 40%. Two (3%) patients had a recurrence of the same ipilimumab irAEs, but 23 (34%) developed new irAEs (14, 21% grade 3-4) and 8 (12%) discontinued treatment. There were no treatment-related deaths. Conclusions: In melanoma patients with preexisting ADs or major irAEs with ipilimumab, anti-PD-1 induced relatively frequent immune toxicities, but these were often mild, easily managed and did not necessitate discontinuation of therapy, and a significant proportion of patients achieved clinical responses. The results support that anti-PD-1 can be administered safely and can achieve clinical benefit in patients with preexisting ADs or prior major irAEs with ipilimumab.

Prenatal ß-catenin/Brn2/Tbr2 transcriptional cascade regulates adult social and stereotypic behaviors.

Social interaction is a fundamental behavior in all animal species, but the developmental timing of the social neural circuit formation and the cellular and molecular mechanisms governing its formation are poorly understood. We generated a mouse model with mutations in two Disheveled genes, Dvl1 and Dvl3, that displays adult social and repetitive behavioral abnormalities associated with transient embryonic brain enlargement during deep layer cortical neuron formation. These phenotypes were mediated by the embryonic expansion of basal neural progenitor cells (NPCs) via deregulation of a ß-catenin/Brn2/Tbr2 transcriptional cascade. Transient pharmacological activation of the canonical Wnt pathway during this period of early corticogenesis rescued the ß-catenin/Brn2/Tbr2 transcriptional cascade and the embryonic brain phenotypes. Remarkably, this embryonic treatment prevented adult behavioral deficits and partially rescued abnormal brain structure in Dvl mutant mice. Our findings define a mechanism that links fetal brain development and adult behavior, demonstrating a fetal origin for social and repetitive behavior deficits seen in disorders such as autism.

A review of craniofacial and dental findings of the RASopathies.

OBJECTIVES: The RASopathies are a group of syndromes that have in common germline mutations in genes that encode components of the Ras/mitogen-activated protein kinase (MAPK) pathway and have been a focus of study to understand the role of this pathway in development and disease. These syndromes include Noonan syndrome (NS), Noonan syndrome with multiple lentigines (NSML or LEOPARD syndrome), neurofibromatosis type 1 (NF1), Costello syndrome (CS), cardio-facio-cutaneous (CFC) syndrome, neurofibromatosis type 1-like syndrome (NFLS or Legius syndrome) and capillary malformation-arteriovenous malformation syndrome (CM-AVM). These disorders affect multiple systems, including the craniofacial complex. Although the craniofacial features have been well described and can aid in clinical diagnosis, the dental phenotypes have not been analysed in detail for each of the RASopathies. In this review, we summarize the clinical features of the RASopathies, highlighting the reported craniofacial and dental findings. METHODS: Review of the literature. RESULTS: Each of the RASopathies reviewed, caused by mutations in genes that encode different proteins in the Ras pathway, have unique and overlapping craniofacial and dental characteristics. CONCLUSIONS: Careful description of craniofacial and dental features of the RASopathies can provide information for dental clinicians treating these individuals and can also give insight into the role of Ras signalling in craniofacial development.

What Do You Believe In? French Translation of the FAD-Plus to Assess Beliefs in Free Will and Determinism and Their Relationship with Religious Practices and Personality Traits.

The influence of (dis)belief in free will on prosocial behaviors and sense of control has attracted considerable interest over the last few years. The provision of relevant research tools to assess beliefs in free will and determinism for the community thus becomes a central endeavour. However, no relevant validated questionnaires are currently available to the French language community. Therefore, the present study was aimed at providing a valid French translation of the FAD-plus (Paulhus & Carey, 2011), a questionnaire built to assess people's beliefs in Free will and Determinism. Exploratory factor analysis of the data obtained in Sample 1 revealed a four factor model. Confirmatory factor analyses on the basis of Sample 2 data were conducted to compare the theoretical model advanced by Paulhus and Carey's versus the model obtained in Sample 1. With only but a few modifications as compared to the original questionnaire, the questionnaire that we here propose appears to constitute a reliable tool for the French language community. We also examined the relationship between beliefs in free will, determinism and religious practices. We found that the more people are engaged in religious practices, the more they believe in determinism and in the inevitability of their future.

Efficacy and toxicity of treatment with the anti-CTLA-4 antibody ipilimumab in patients with metastatic melanoma after prior anti-PD-1 therapy.

BACKGROUND: Recent phase III clinical trials have established the superiority of the anti-PD-1 antibodies pembrolizumab and nivolumab over the anti-CTLA-4 antibody ipilimumab in the first-line treatment of patients with advanced melanoma. Ipilimumab will be considered for second-line treatment after the failure of anti-PD-1 therapy. METHODS: We retrospectively identified a cohort of 40 patients with metastatic melanoma who received single-agent anti-PD-1 therapy with pembrolizumab or nivolumab and were treated on progression with ipilimumab at a dose of 3 mg kg(-1) for a maximum of four doses. RESULTS: Ten percent of patients achieved an objective response to ipilimumab, and an additional 8% experienced prolonged (>6 months) stable disease. Thirty-five percent of patients developed grade 3-5 immune-related toxicity associated with ipilimumab therapy. The most common high-grade immune-related toxicity was diarrhoea. Three patients (7%) developed grade 3-5 pneumonitis leading to death in one patient. CONCLUSIONS: Ipilimumab therapy can induce responses in patients who fail the anti-PD-1 therapy with response rates comparable to previous reports. There appears to be an increased frequency of high-grade immune-related adverse events including pneumonitis that warrants close surveillance.

[Oil degradation by basidiomycetes in soil and peat at low temperatures].

A total of 17 basidiomycete strains causing white rot and growing on oil-contaminated substrates have been screened. Three strains with high (Steccherinum murashkinskyi), average (Trametes maxima), and low (Pleurotus ostreatus) capacities for the colonization of oil-contaminated substrates have been selected. The potential for degrading crude oil hydrocarbons has been assessed with the use of fungi grown on nonsterile soil and peat at low temperatures. Candida sp. and Rhodococcus sp. commercial strains have been used as reference organisms with oil-degrading ability. All microorganisms introduced in oil-contaminated soil have proved to be ineffective, whereas the inoculation of peat with basidiomycetes and oil-degrading microorganisms accelerated the destruction of oil hydrocarbons. The greatest degradation potential of oil-aliphatic hydrocarbons has been found in S. murashlinskyi. T. maxima turned out to be the most successful in degrading aromatic hydrocarbons. It has been suggested that aboriginal microflora contributes importantly to the effectiveness of oil-destructing microorganisms. T. maxima and S. murashkinskyi strains are promising for further study as oil-oxidizing agents during bioremediation of oil-contaminated peat soil under conditions of low temperatures.

Insulin degludec/insulin aspart produces a dose-proportional glucose-lowering effect in subjects with type 1 diabetes mellitus.

AIMS: To evaluate the pharmacodynamic dose-response relationship of insulin degludec/insulin aspart (IDegAsp), a novel, soluble co-formulation of the ultra-long-acting basal insulin, insulin degludec (IDeg), with the rapid-acting prandial insulin (IAsp), across different doses in patients with type 1 diabetes (T1DM). METHODS: This was a randomized, single-centre, double-blind, four-period, incomplete block, crossover trial. A cohort of 33 people with T1DM received single doses (0.4, 0.6 or 0.8 U/kg) of IDegAsp or the comparator, biphasic insulin aspart 30, in a randomized sequence of four treatment periods, each separated by a washout of 13-21 days. Pharmacodynamic response was assessed using a 26-h euglycaemic glucose clamp, with blood glucose stabilized at a target of 5.5 mmol/l (100 mg/dl). RESULTS: A rapid onset of action and a distinct peak attributable to IAsp was observed in the glucose infusion rate (GIR) profile, followed by a separate, flat and stable basal glucose-lowering effect attributable to the IDeg component. The mean area under the GIR curve over 24 h (AUC(GIR,0-24 h)), and the mean maximum GIR (GIR(max)) increased with increasing dose level of IDegAsp. A dose-response relationship for IDegAsp was demonstrated for AUC(GIR,0-24 h) and GIR(max), indicating dose proportionality. A dose-concentration relationship was also observed for both the basal and bolus components of IDegAsp. CONCLUSIONS: IDegAsp has a clear dose-response relationship, indicating the clinical potential for straightforward titration according to individual patient needs.

Magnetic coupling of vortices in a two dimensional lattice.

We investigated the magnetization reversal of magnetic vortex structures in a two-dimensional lattice. The structures were formed by permalloy (Py) film deposition onto large arrays of self assembled spherical SiO(2)-particles with a diameter of 330 nm. We present the dependence of the nucleation and annihilation field of the vortex structures as a function of the Py layer thickness(aspect ratio) and temperature. By increasing the Py thickness up to 90 nm or alternatively by lowering the temperature the vortex structure becomes more stable as expected. However, the increase of the Py thickness results in the onset of strong exchange coupling between neighboring Py caps due to the emergence of Py bridges connecting them. In particular, we studied the influence of magnetic coupling locally by in-field scanning magne to-resistive microscopy and full-field magnetic soft x-ray microscopy, revealing a domain-like nucleation process of vortex states, which arises via domain wall propagation due to exchange coupling of the closely packed structures. By analyzing the rotation sense of the reversed areas, large connected domains are present with the same circulation sense. Furthermore, the lateral core displacements when an in-plane field is applied were investigated, revealing spatially enlarged vortex cores and a broader distribution with increasing Py layer thickness. In addition, the presence of some mixed states, vortices and c-states, is indicated for the array with the thickest Py layer.

Longitudinal, quantitative monitoring of therapeutic response in 3D in vitro tumor models with OCT for high-content therapeutic screening.

In vitro three-dimensional models of cancer have the ability to recapitulate many features of tumors found in vivo, including cell-cell and cell-matrix interactions, microenvironments that become hypoxic and acidic, and other barriers to effective therapy. These model tumors can be large, highly complex, heterogeneous, and undergo time-dependent growth and treatment response processes that are difficult to track and quantify using standard imaging tools. Optical coherence tomography is an optical ranging technique that is ideally suited for visualizing, monitoring, and quantifying the growth and treatment response dynamics occurring in these informative model systems. By optimizing both optical coherence tomography and 3D culture systems, it is possible to continuously and non-perturbatively monitor advanced in vitro models without the use of labels over the course of hours and days. In this chapter, we describe approaches and methods for creating and carrying out quantitative therapeutic screens with in vitro 3D cultures using optical coherence tomography to gain insights into therapeutic mechanisms and build more effective treatment regimens.

Origin of spectral purity and tuning sensitivity in a spin transfer vortex nano-oscillator.

We investigate the microwave characteristics of a spin transfer nano-oscillator (STNO) based on coupled vortices as a function of the perpendicular magnetic field H(⊥). Interestingly, we find that our vortex-based oscillator is quasi-isochronous independently of H(⊥) and for a dc current ranging between 18 and 25 mA. It means that the severe nonlinear broadening usually observed in STNOs can be suppressed on a broad range of bias. Still, the generation linewidth displays strong variations on H(⊥) (from 40 kHz to 1 MHz), while the frequency tunability in current remains almost constant (7 MHz/mA). This demonstrates that isochronicity does not necessarily imply a loss of frequency tunability, which is here governed by the current induced Oersted field. It is not sufficient either to achieve the highest spectral purity in the full range of H(⊥). We show that the observed linewidth broadenings are due to the excited mode interacting with a lower energy overdamped mode, which occurs at the successive crossings between harmonics of these two modes. These findings open new possibilities for the design of STNOs and the optimization of their performance.

Full control of the spin-wave damping in a magnetic insulator using spin-orbit torque.

It is demonstrated that the threshold current for damping compensation can be reached in a 5 µm diameter YIG(20 nm)|Pt(7 nm) disk. The demonstration rests upon the measurement of the ferromagnetic resonance linewidth as a function of I(dc) using a magnetic resonance force microscope (MRFM). It is shown that the magnetic losses of spin-wave modes existing in the magnetic insulator can be reduced or enhanced by at least a factor of 5 depending on the polarity and intensity of an in-plane dc current I(dc) flowing through the adjacent normal metal with strong spin-orbit interaction. Complete compensation of the damping of the fundamental mode by spin-orbit torque is reached for a current density of ∼3×10(11) A·m(-2), in agreement with theoretical predictions. At this critical threshold the MRFM detects a small change of static magnetization, a behavior consistent with the onset of an auto-oscillation regime.

Changes in procoagulants track longitudinally with insulin resistance: findings from the coronary artery risk development in young adults (CARDIA) study.

AIMS: To examine the association between changes in procoagulants (fibrinogen factors VII and VIII and von Willebrand factor) and the risk of insulin resistance. METHODS: Using data from the Coronary Artery Risk Development in Young Adults study, we followed 2398 black and white adults without diabetes, aged 25-37 years at year 7, to year 20. Levels of fibrinogen factors VII and VIII and von Willebrand factor were divided in tertiles (low/middle/high) at years 7 and 20 and four groups reflecting changes were defined: 'low' (low at years 7 and 20), 'stable' (low/middle at years 7 and 20, but not both low at years 7 and 20), 'high' (high at year 7 and low/middle at year 20; or low/middle at year 7 and high at year 20) and 'highest' (high at years 7 and 20). Linear regression models were used to evaluate 13-year changes (year 20-year 7) in fibrinogen level and factors VII, VIII and von Willebrand change groups in relation to insulin resistance measures. RESULTS: Homeostasis model assessment of insulin resistance (year 20) and changes in log homeostasis model assessment of insulin resistance (year 20-year 7) were significantly associated with the 13-year increase in fibrinogen (P < 0.001). Compared with participants in the low group, those in the high group had significantly higher levels of homeostasis model assessment of insulin resistance (year 20) and changes in homeostasis model assessment of insulin resistance (year 20-year 7) for fibrinogen factor VII and von Willebrand factor (P < 0.017). No significant associations were observed between fibrinogen VIII and insulin resistance measures. CONCLUSIONS: An increase in fibrinogen level and persistently high levels of factor VII and von Willebrand factor are significantly associated with increased risk of insulin resistance. These findings provide new insight into the mechanisms to explain the heightened risk for thrombosis in adults with insulin resistance/diabetes.

An analytical strategy for challenging members of the microplastic family: Particles from anti-corrosion coatings.

Potentially hazardous particles from paints and functional coatings are an overlooked fraction of microplastic (MP) pollution since their accurate identification and quantification in environmental samples remains difficult. We have applied the most relevant techniques from the field of microplastic analysis for their suitability to chemically characterize anti-corrosion coatings containing a variety of polymer binders (LDIR, Raman and FTIR spectroscopy, Py-GC/MS) and inorganic additives (ICP-MS/MS). We present the basis of a possible toolbox to study the release and fate of coating particles in the (marine) environment. Our results indicate that, due to material properties, spectroscopic methods alone appear to be unsuitable for quantification of coating/paint particles and underestimate their environmental abundance. ICP-MS/MS and an optimized Py-GC/MS approach in combination with multivariate statistics enables a straightforward comparison of the multi-elemental and organic additive fingerprints of paint particles. The approach can improve the identification of unknown particles in environmental samples by an assignment to different typically used coating types. In future, this approach may facilitate allocation of emission sources of different environmental paint/coating particles. Indeed, future work will be required to tackle various remaining analytical challenges, such as optimized particle extraction/separation of environmental coating particles.

Craniofacial and dental development in cardio-facio-cutaneous syndrome: the importance of Ras signaling homeostasis.

Cardio-facio-cutaneous syndrome (CFC) is a RASopathy that is characterized by craniofacial, dermatologic, gastrointestinal, ocular, cardiac, and neurologic anomalies. CFC is caused by activating mutations in the Ras/mitogen-activated protein kinase (MAPK) signaling pathway that is downstream of receptor tyrosine kinase (RTK) signaling. RTK signaling is known to play a central role in craniofacial and dental development, but to date, no studies have systematically examined individuals with CFC to define key craniofacial and dental features. To fill this critical gap in our knowledge, we evaluated the craniofacial and dental phenotype of a large cohort (n = 32) of CFC individuals who attended the 2009 and 2011 CFC International Family Conferences. We quantified common craniofacial features in CFC which include macrocephaly, bitemporal narrowing, convex facial profile, and hypoplastic supraorbital ridges. In addition, there is a characteristic dental phenotype in CFC syndrome that includes malocclusion with open bite, posterior crossbite, and a high-arched palate. This thorough evaluation of the craniofacial and dental phenotype in CFC individuals provides a step forward in our understanding of the role of RTK/MAPK signaling in human craniofacial development and will aid clinicians who treat patients with CFC.

Detection of microwave spin pumping using the inverse spin Hall effect.

We report on the electrical detection of the dynamical part of the spin-pumping current emitted during ferromagnetic resonance using inverse spin Hall effect methods. The experiment is performed on a YIG|Pt bilayer. The choice of yttrium iron garnet (YIG), a magnetic insulator, ensures that no charge current flows between the two layers and only the pure spin current produced by the magnetization dynamics is transferred into the adjacent strong spin-orbit Pt layer via spin pumping. To avoid measuring the parasitic eddy currents induced at the frequency of the microwave source, a resonance at half the frequency is induced using parametric excitation in the parallel geometry. Triggering this nonlinear effect allows us to directly detect on a spectrum analyzer the microwave component of the inverse spin Hall effect voltage. Signals as large as 30 µV are measured for precession angles of a couple of degrees. This direct detection provides a novel efficient means to study magnetization dynamics on a very wide frequency range with great sensitivity.

Probing the anharmonicity of the potential well for a magnetic vortex core in a nanodot.

The anharmonicity of the potential well confining a magnetic vortex core in a nanodot is measured dynamically with a magnetic resonance force microscope (MRFM). The stray field of the MRFM tip is used to displace the equilibrium core position away from the nanodot center. The anharmonicity is then inferred from the relative frequency shift induced on the eigenfrequency of the vortex core translational mode. An analytical framework is proposed to extract the anharmonic coefficient from this variational approach. Traces of these shifts are recorded while scanning the tip above an isolated nanodot, patterned out of a single crystal FeV film. We observe a +10% increase of the eigenfrequency when the equilibrium position of the vortex core is displaced to about one-third of its radius. This calibrates the tunability of the gyrotropic mode by external magnetic fields.