Final outcomes analysis of the cell product SQZ-PBMC-HPV Phase 1 trial in incurable HPV16+ solid tumors shows improved overall survival in patients with increased CD8+ T cell tumor infiltration.

Cancer vaccines strive to induce robust, antigen-targeted, T-cell-mediated immune responses but have struggled to produce meaningful regression in solid tumors. An autologous cell vaccine, SQZ-PBMC-HPV, was developed by SQZ Biotechnologies using microfluidic squeezing technology to load PBMCs with HPV16 E6 and E7 antigens in HLA-A*02+ patients. The SQZ-PBMC-HPV-101 Phase 1 trial (NCT04084951) enrolled patients with incurable HPV16+ cancers. Here, we present a post hoc analysis of the relationship between Posttreatment CD8+ T cell infiltration and patient outcomes. SQZ-PBMC-HPV was administered as monotherapy every 3 weeks. Tumor samples were collected pre-dose and post-dose 4 weeks after treatment start. Biomarkers including CD8, MHC-I, E6, E7, GZMB, and Ki67 were evaluated by immunohistochemistry, immunofluorescence, and RNA in situ hybridization, and were correlated with clinical response, survival, and drug product composition. Eighteen patients had paired pre- and post-dose biopsies. Six (33%) had an increase in CD8+ T cell density in tumor parenchyma between screening and C2D8. Patients with increased CD8+ T cell density had improved disease control rate (66.7% vs 16.7%) and median overall survival (606.5 days vs 170.0 days, p = 0.0078). Drug product was significantly enriched for higher T cells and lower monocytes in the increased CD8+ T cell density group. In patients with incurable HPV16+ solid tumors treated with SQZ-PBMC-HPV, an increase in CD8+ T cell density within the tumor parenchyma was associated with superior disease control rate and overall survival. The product composition for patients with increased CD8+ T cell density was enriched for T cells.

Staff Perspectives: Why are adolescent inpatients secluded and what causes changes in rates of seclusion on a unit?

BACKGROUND: The use of seclusion in Adolescent Inpatient Psychiatric Units is being heavily scrutinised due to its forceful nature and potential to cause harm. This study aimed to understand staff perspectives on reasons for seclusion in an Adolescent Inpatient Psychiatric Unit. METHOD: A mixed methods approach that included the Attitudes to Seclusion Survey followed by a semi-structured interview on the reasons for seclusion was used. We recruited 31 participants who worked on the unit of which 27 were involved in seclusion. RESULTS: The findings showed that the majority of staff view seclusion as undesirable and believe it should only be used out of necessity. However, there was disagreement among staff about the reasons why adolescents were secluded and whether those reasons were justified. Staff identified factors that contributed to increases in seclusion but also provided several ways in which seclusion could be reduced. CONCLUSIONS: These findings highlight a need for precision on what constitutes justifiable use of seclusion to reduce the potential for misuse. It also shows opportunities exist for further reduction in seclusion through teamwork and communication.

Pandemic Procedures: Adapting Problem-Solving Court (PSC) Operations and Treatment Protocols During COVID-19.

With an ongoing pandemic claiming hundreds of lives a day, it is unclear how COVID-19 has affected court operations, particularly problem-solving courts (PSCs) which have goals rooted in rehabilitation for participants in their programs. Even with practical recommendations from national organizations directing courts on how to manage COVID-19, whether and how PSCs met the needs of PSC participants during this time is underexplored. This study, drawn from a larger national study using a survey of PSC coordinators, examines the COVID-19 responses of PSCs to remain safely operational for participants. A sub-sample of survey respondents (n = 82 PSC coordinators) detailed how the COVID-19 pandemic led to changes to their court and treatment operations amidst the constraints of the pandemic. The courts' shifts in policy and practice have important impacts for court participants' treatment retention and success in the PSC program, and these shifts need more in-depth research in the future.

Medication-Assisted Treatment in Problem-solving Courts: A National Survey of State and Local Court Coordinators.

Problem-solving courts (PSCs) are a critical part of a societal effort to mitigate the opioid epidemic's devastating consequences. This paper reports on a national survey of PSCs (N = 42 state-wide court coordinators; N = 849 local court coordinators) and examines the structural factors that could explain the likelihood of a local PSC authorizing medication-assisted treatment (MAT) and MAT utilization. Results of the analyses indicate that MAT availability at the county level was a significant predictor of the likelihood of local courts authorizing MAT. The court's location in a Medicaid expansion state was also a significant predictor of local courts allowing buprenorphine and methadone, but not naltrexone. Problem-solving courts are in the early stages of supporting the use of medications, even when funding is available through Medicaid expansion policies. Adoption and use of treatment innovations like MAT are affected by coordinators' perceptions of MAT as well as structural factors such as the availability of the medications in the community and funding resources. The study has important implications for researchers, policymakers, and practitioners.

Adolescent psychiatric inpatients' perceptions of treatment and seclusion.

Objectives: A great deal of attention is being directed at the use of seclusion in adolescent inpatient psychiatric units due to its forceful nature and negative impact on inpatients and staff. This mixed methods study aimed to explore and compare the level of satisfaction with the services received and perspectives on seclusion in secluded and non-secluded adolescent inpatients.Methods: This study included 188 participants, across three adolescent inpatient psychiatric units in Australia; 17% reported having experienced seclusion. A mixed methods approach was employed. Participants completed the Consumer Satisfaction Questionnaire-8 and Perceptions of Treatment and Seclusion Questionnaire shortly before or at discharge. Qualitative data was analysed using thematic analysis.Results: Secluded participants were more likely to report issues with broader care experiences on the Consumer Satisfaction Questionnaire-8. Secluded individuals reported ongoing negative effects from seclusion but were more likely than non-secluded participants to believe seclusion is necessary. Qualitative analyses showed that both secluded and non-secluded individuals considered seclusion to be traumatic, many did not agree with its use.Conclusions: Communication between inpatients and staff regarding seclusion needs to be improved and there needs to be ongoing support in relation to seclusion during and after discharge. Many adolescent inpatients acknowledge the necessity of seclusion whilst advocating for reduced seclusion.

Photoactivation of Millimeters Thick Liquid Crystal Elastomers with Broadband Visible Light Using Donor-Acceptor Stenhouse Adducts.

Light-responsive liquid crystal elastomers (LCEs) are stimuli-responsive materials that facilitate the conversion of light energy into a mechanical response. In this work, a novel polysiloxane-based LCE with donor-acceptor Stenhouse adduct (DASA) side-chains is synthesized using a late-stage functionalization strategy. It is demonstrated that this approach does not compromise the molecular alignment observed in the traditional Finkelmann method. This easy, single-batch process provides a robust platform to access well-aligned, light-responsive LCE films with thickness ranging from 400 µm to a 14-layer stack that is 5 mm thick. Upon irradiation with low-intensity broadband visible light (100-200 mW cm-2), these systems undergo 2D planar actuation and complete bleaching. Conversely, exposure to higher-intensity visible light induces bending followed by contraction (300 mW cm-2). These processes are repeatable over several cycles. Finally, it is demonstrated how light intensity and the resulting heat generation influences the photothermal stationary state equilibrium of DASA, thereby controlling its photoresponsive properties. This work establishes the groundwork for advancement of LCE-based actuators beyond thin film and UV-light reliant systems.

The psychology of precarity: A critical framework.

This article presents the rationale and a new critical framework for precarity, which reflects a psychosocial concept that links structural inequities with experiences of alienation, anomie, and uncertainty. Emerging from multiple disciplines, including anthropology, cultural studies, sociology, political science, and psychology, the concept of precarity provides a conceptual scaffolding for understanding the complex causes of precarious life circumstances while also seeking to identify how people react, adapt, and resist the forces that evoke such tenuous psychosocial experiences. We present a critical conceptual framework as a nonlinear heuristic that serves to identify and organize relevant elements of precarity in a presumably infinite number of contexts and applications. The framework identifies socio-political-economic contexts, material conditions, and psychological experiences as key elements of precarity. Another essential aspect of this framework is the delineation of interrelated and nonlinear responses to precarity, which include resistance, adaptation, and resignation. We then summarize selected implications of precarity for psychological interventions, vocational and organizational psychology, and explorations and advocacy about race, gender, and other systems of inequality. Future research directions, including optimal methodologies to study precarity, conclude the article. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Taste cells expressing Ionotropic Receptor 94e reciprocally impact feeding and egg laying in Drosophila.

Chemosensory cells across the body of Drosophila melanogaster evaluate the environment to prioritize certain behaviors. Previous mapping of gustatory receptor neurons (GRNs) on the fly labellum identified a set of neurons in L-type sensilla that express Ionotropic Receptor 94e (IR94e), but the impact of IR94e GRNs on behavior remains unclear. We used optogenetics and chemogenetics to activate IR94e neurons and found that they drive mild feeding suppression but enhance egg laying. In vivo calcium imaging revealed that IR94e GRNs respond strongly to certain amino acids, including glutamate, and that IR94e plus co-receptors IR25a and IR76b are required for amino acid detection. Furthermore, IR94e mutants show behavioral changes to solutions containing amino acids, including increased consumption and decreased egg laying. Overall, our results suggest that IR94e GRNs on the fly labellum discourage feeding and encourage egg laying as part of an important behavioral switch in response to certain chemical cues.

Dynamic Manipulation of Droplets on Liquid-Infused Surfaces Using Photoresponsive Surfactant.

Fast and programmable transport of droplets on a substrate is desirable in microfluidic, thermal, biomedical, and energy devices. Photoresponsive surfactants are promising candidates to manipulate droplet motion due to their ability to modify interfacial tension and generate "photo-Marangoni" flow under light stimuli. Previous works have demonstrated photo-Marangoni droplet migration in liquid media; however, migration on other substrates, including solid and liquid-infused surfaces (LIS), remains an outstanding challenge. Moreover, models of photo-Marangoni migration are still needed to identify optimal photoswitches and assess the feasibility of new applications. In this work, we demonstrate 2D droplet motion on liquid surfaces and on LIS, as well as rectilinear motion in solid capillary tubes. We synthesize photoswitches based on spiropyran and merocyanine, capable of tension changes of up to 5.5 mN/m across time scales as short as 1.7 s. A millimeter-sized droplet migrates at up to 5.5 mm/s on a liquid, and 0.25 mm/s on LIS. We observe an optimal droplet size for fast migration, which we explain by developing a scaling model. The model also predicts that faster migration is enabled by surfactants that maximize the ratio between the tension change and the photoswitching time. To better understand migration on LIS, we visualize the droplet flow using tracer particles, and we develop corresponding numerical simulations, finding reasonable agreement. The methods and insights demonstrated in this study enable advances for manipulation of droplets for microfluidic, thermal and water harvesting devices.

Botensilimab plus balstilimab in relapsed/refractory microsatellite stable metastatic colorectal cancer: a phase 1 trial.

Microsatellite stable metastatic colorectal cancer (MSS mCRC; mismatch repair proficient) has previously responded poorly to immune checkpoint blockade. Botensilimab (BOT) is an Fc-enhanced multifunctional anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) antibody designed to expand therapy to cold/poorly immunogenic solid tumors, such as MSS mCRC. BOT with or without balstilimab (BAL; anti-PD-1 antibody) is being evaluated in an ongoing expanded phase 1 study. The primary endpoint is safety and tolerability, which was evaluated separately in the dose-escalation portion of the study and in patients with MSS mCRC (using combined dose-escalation/dose-expansion data). Secondary endpoints include investigator-assessed RECIST version 1.1-confirmed objective response rate (ORR), disease control rate (DCR), duration of response (DOR) and progression-free survival (PFS). Here we present outcomes in 148 heavily pre-treated patients with MSS mCRC (six from the dose-escalation cohort; 142 from the dose-expansion cohort) treated with BOT and BAL, 101 of whom were considered response evaluable with at least 6 months of follow-up. Treatment-related adverse events (TRAEs) occurred in 89% of patients with MSS mCRC (131/148), most commonly fatigue (35%, 52/148), diarrhea (32%, 47/148) and pyrexia (24%, 36/148), with no grade 5 TRAEs reported and a 12% discontinuation rate due to a TRAE (18/148; data fully mature). In the response-evaluable population (n = 101), ORR was 17% (17/101; 95% confidence interval (CI), 10-26%), and DCR was 61% (62/101; 95% CI, 51-71%). Median DOR was not reached (NR; 95% CI, 5.7 months-NR), and median PFS was 3.5 months (95% CI, 2.7-4.1 months), at a median follow-up of 10.3 months (range, 0.5-42.6 months; data continuing to mature). The combination of BOT plus BAL demonstrated a manageable safety profile with no new immune-mediated safety signals and encouraging clinical activity with durable responses. ClinicalTrials.gov identifier: NCT03860272 .

Oral Sabizabulin for High-Risk, Hospitalized Adults with Covid-19: Interim Analysis.

BACKGROUND: Sabizabulin is an oral, novel microtubule disruptor that has dual antiviral and anti-inflammatory activities in preclinical models. METHODS: A randomized, multicenter placebo-controlled phase 3 clinical trial was conducted with hospitalized patients with moderate to severe Covid-19 who were at high risk for acute respiratory distress syndrome (ARDS) and death. Patients were randomly assigned (2:1) to 9 mg of oral sabizabulin or placebo daily (up to 21 days). The primary end point was all-cause mortality up to day 60. Key secondary end points were days in the intensive care unit (ICU), days on mechanical ventilation, and days in the hospital. RESULTS: A total of 204 patients were randomly assigned to treatment: 134 to sabizabulin and 70 to placebo. Baseline characteristics were similar. Sabizabulin superiority was demonstrated by a planned interim analysis for the first 150 randomized patients. Sabizabulin treatment resulted in a 24.9 percentage point absolute reduction and a 55.2% relative reduction in deaths compared with placebo (odds ratio, 3.23; 95% CI confidence interval, 1.45 to 7.22; P=0.0042). The mortality rate was 20.2% (19 of 94) for sabizabulin versus 45.1% (23 of 51) for placebo. For the key secondary end points, sabizabulin treatment resulted in a 43% relative reduction in ICU days (P=0.0013), a 49% relative reduction in days on mechanical ventilation (P=0.0013), and a 26% relative reduction in days in the hospital (P=0.0277) versus placebo. Adverse and serious adverse events were lower in the sabizabulin group compared with the placebo group. CONCLUSIONS: Sabizabulin treatment resulted in a 24.9% absolute reduction in deaths compared with placebo in hospitalized patients with moderate to severe Covid-19 at high risk for ARDS and death, with a lower incidence of adverse and serious adverse events compared with placebo. (Funded by Veru, Inc.; ClinicalTrials.gov number, NCT04842747.)