Randomized Phase II Trial of Imiquimod with or without 9-Valent HPV Vaccine versus Observation in Patients with High-grade Pre-neoplastic Cervical Lesions (NCT02864147).

PURPOSE: We report the results of a randomized phase II trial of imiquimod, a topical immune-response modulator versus imiquimod plus a 9-valent human papillomavirus (HPV) vaccine (9vHPV) versus clinical surveillance in cervical intraepithelial neoplasia (CIN2/3) patients. PATIENTS AND METHODS: We randomly allocated 133 patients with untreated CIN2/3 in equal proportions to a 4-month treatment with self-applied vaginal suppositories containing imiquimod (Arm B) or imiquimod plus a 9vHPV (Arm C) versus clinical surveillance (Arm A). The main outcome was efficacy, defined as histologic regression to CIN1 or less. Secondary outcomes were HPV clearance and tolerability. Exploratory objectives included the comparison of cervical CD4/CD8 T-cell infiltration at baseline, mid-study, and posttreatment by flow cytometry among study arms. RESULTS: Of the 114 evaluable patients 77% and 23% harbored CIN2 and CIN3, respectively. Regression to CIN1 or less was observed in 95% of patients in the imiquimod group (Arm B) compared with 79% in the control/surveillance (Arm A); P = 0.043 and 84% in the imiquimod+9vHPV group (Arm C; P = 0.384 vs. Arm A). Neither of the treatment-arm differences from Arm A reached the prespecified α = 0.025 significance level. No significant differences were noted in the secondary outcome of rate of HPV clearance. The number of tissue-resident memory CD4/CD8 T cells in cytobrush samples demonstrated a >5-fold increase in Arm B/imiquimod when compared with Arm A/surveillance (P < 0.01). In contrast, there was no significant difference in T-cell responses among participants in Arm C when compared with Arm A. Imiquimod treatment was well tolerated. CONCLUSIONS: Although imiquimod induced a higher regression to CIN1 or less and significant increases in CD4/CD8 T cells infiltrating the cervix, it did not meet its prespecified statistical outcome for efficacy. A higher regression rate than expected was observed in the surveillance arm of this prospective trial. Future clinical trials with imiquimod targeting CIN3 patients are warranted.

Unstable osmolality of microdrops cultured in non-humidified incubators.

PURPOSE: To investigate the stability of osmolality in non-humidified and humidified incubators for assisted reproductive technologies (ART). METHODS: Drops of three single-step culture media (media A, B, and C) were incubated for 5 or 6 days covered with four different mineral oils (oils A, B, C, and D) in non-humidified incubator A, non-humidified incubator B, or humidified incubator C to investigate the effects of incubator environment (humidification), drop volume, culture media, and mineral oil on the stability of osmolality in microdrops. RESULTS: A significant and linear increase was shown in the osmolality of 50-µL and 200-µL microdrops covered with mineral oil during 5 days incubation in non-humidified benchtop incubators. The maximum increase was 20 mOsm/kg, and the extent of the increase was affected by microdrop volume and possibly by the type of mineral oil used to cover the drops. In contrast, the osmolality of 50-µL and 200-µL microdrops did not change during 5 days incubation in a humidified benchtop incubator. CONCLUSIONS: Mineral oil alone may not adequately prevent gradual changes in the osmolality of low-volume microdrops during extended in vitro culture of human embryos in non-humidified incubators. As a result, the osmolality may increase to high enough levels to stress some human embryos and adversely affect clinical outcomes. We therefore recommend that the stability of osmolality should be given more consideration to ensure optimal culture conditions for ART.

From specular reflectivity to time-resolved grazing incidence X-ray scattering out of the specular plane (GISAXS): equilibrium and nonequilibrium states of organic/inorganic monolayers at liquid surfaces.

The grazing incidence diffuse X-ray scattering out of the specular plane technique (GISAXS) is presented, and its capabilities are compared to the more classical X-ray specular reflectivity technique (XSR). Three experimental illustrations are given to prove the efficiency of GISAXS. First, the structure of a DPPC phospholipid monolayer is analyzed. Second, the time-resolved kinetics of lipid desorption from a monolayer interacting with a mineral gel subphase is studied. Third, the structural evolution of biomembranes at extremely low temperatures is illustrated. The GISAXS technique appears to compete efficiently with neutron reflection techniques by taking advantage of remarkably short acquisition times crucial in kinetics experiments.

Self-assembly of organic monolayers below the freezing threshold.

One measure that arctic fish and amphibians use to minimize damage to cellular membranes during cooling and freezing processes is the production of cryo-protective substances. We have mimicked this biological "trick" by using the surface of a cryo-protectant as a liquid subphase for the preparation of organic membranes. Following this innovative approach, quasi two-dimensional amphiphilic monolayers were cooled to -40 degrees C at a liquid/gas interface. To date, the low temperature region of the generic phase diagram for alkane chain molecules has been only "virtually" accessible by tuning the molecular chain length. By extending the temperature range well below the freezing point of water, we gained new insights into membrane stability, morphology, and reorganization at low temperatures. Upon cooling relaxed monolayers at a surface pressure of 4.5 mN/m, we find a transition from a mesophase with tilted chains at ambient temperature toward a crystalline phase with upright chains at low temperatures. Structure factor calculations reveal that the chain alignment in the crystalline phase differs from the classical herringbone configuration.

Health status, health conditions, and health behaviors among Amish women. Results from the Central Pennsylvania Women's Health Study (CePAWHS).

We performed one of the first systematic, population-based surveys of women in Amish culture. We used these data to examine health status and health risks in a representative sample of 288 Amish women ages 18-45 living in Lancaster County, Pennsylvania, in particular for risks associated with preterm and low birthweight infants, compared with a general population sample of 2,002 women in Central Pennsylvania. Compared with women in the general population, Amish women rated their physical health approximately at the same level, but reported less stress, fewer symptoms of depression, and had higher aggregate scores for mental health. Amish women reported low levels of intimate partner violence, high levels of social support, and they perceived low levels of unfair treatment owing to gender compared with the general population. Amish women also reported higher fertility, fewer low birthweight babies, but the same number of preterm births as the general population. The findings suggest that these outcomes may be due to higher levels of social support and better preconceptional behavior among Amish women.

Grazing incidence X-ray scattering to probe the self-assembly of phthalocyanine nanorods on a liquid surface.

The structural properties of Langmuir monolayers on aqueous substrates of a metal free phthalocyanine, 2,9,16,23-tetrakis(phenylthio)-29H,31H-phthalocyanine and an Aluminum centered phthalocyanine, Aluminum 2,9,16,23-tetrakis(phenylthio)-29H,31H-phthalocyanine chloride are reported here. Their structure is investigated under progressive lateral compression by grazing incidence diffuse X-ray scattering out of the specular plane to determine specular reflectivity-like information where the phase change of the molecules from "flat-lying" on the surface to "edge-standing" perpendicular to the surface was directly observed. Furthermore grazing incident X-ray diffraction is used to investigate the in-plane ordering of the system where it has been found that at high density states the systems can be considered as monolayers consisting of arrays of side-by-side cofacially aggregated cylindrical rodlike entities.

Observation of zinc phthalocyanine aggregates on a water surface using grazing incidence X-ray scattering.

Reported here are the structural properties of a zinc 2,9,16,23-tetra-tert-butyl-29H,31H-phthalocyanine Langmuir monolayer on a water surface under progressive lateral compression investigated by grazing incidence X-ray scattering. Grazing incidence diffuse X-ray scattering out of the specular plane (GIXOS) is exploited to determine specular reflectivity-like information where the phase change of flat-lying molecules on the surface to edge-standing molecules perpendicular to the surface is directly observed. Furthermore, grazing incident X-ray diffraction (GIXD) is used to investigate the in-plane ordering of the system where it has been found that in the high-density state (approximately 0.35 nm2 per molecule) the system can be considered to be a monolayer consisting of arrays of side-by-side lying cofacially aggregated cylindrical rodlike entities.

Nanocrystal induced organization of a langmuir phospholipid monolayer.

The influence of crystal surface charge on the thermodynamic and structural behavior of phospholipid monolayers has been investigated. We present how charged nanocrystals in the vicinity of an inherently nonordered lipid membrane provoke strong effects on the molecular arrangement within the monolayer. Apart from the induction of phase shifts and nucleation processes, the molecules were forced to adopt an ordered phase. A very recently developed X-ray scattering method is used for the first time to replace time-consuming specular reflectivity measurements. We conclude on the potential effects of crystal surface charge on cellular membranes.

An embryonic poly(A)-binding protein (ePAB) is expressed in mouse oocytes and early preimplantation embryos.

Gene expression during oocyte maturation, fertilization, and early embryo development until zygotic gene activation is regulated mainly by translational activation of maternally derived mRNAs. This process requires the presence of a poly(A)-binding protein. However, the cytoplasmic somatic cell poly(A)-binding protein (PABP1) is not expressed until later in embryogenesis. We recently identified an embryonic poly(A)-binding protein (ePAB) in Xenopus. ePAB is the predominant cytoplasmic PABP in Xenopus oocytes and early embryos and prevents deadenylation of mRNAs, suggesting its importance in the regulation of gene expression during early Xenopus development. Here we report the identification of the mouse ortholog of Xenopus ePAB. The mouse ePAB gene on chromosome 2 contains 14 exons that specify an alternatively spliced mRNA encoding a protein of 608 or 561 aa with approximately 65% identity to Xenopus ePAB. Mouse ePAB mRNA is expressed in ovaries and testis but not in somatic tissues. In situ hybridization localizes ePAB RNA to oocytes and confirms its absence from surrounding somatic cells in the mouse ovary. During early development, mouse ePAB is expressed in prophase I and metaphase II oocytes and one-cell and two-cell embryos and then becomes undetectable in four-or-more-cell embryos. In contrast, PABP1 mRNA expression is minimal in oocytes and early embryos until the eight-cell stage when it increases, becoming predominant at the blastocyst stage. The expression of mouse ePAB before zygotic gene activation argues for its importance in translational activation of maternally derived mRNAs during mammalian oocyte and early preimplantation embryo development.

Solubility of Mo6S4.5I4.5 nanowires in common solvents: a sedimentation study.

Due to their ease of fabrication and monodisperse, metallic nature, molybdenum-sulfur-iodine nanowires are an interesting alternative to carbon nanotubes for some applications. However very little is known about the solubility of these materials. In this work we have investigated the solubility of Mo(6)S(4.5)I(4.5) nanowire soot in a range of common solvents by performing sedimentation studies and microscopic and spectroscopic characterization. A sedimentation equation was derived showing that the concentration of any insoluble dispersed phase decreases exponentially with time. We find that in all solvents, Mo(6)S(4.5)I(4.5) nanowire soot contains three phases, two of which are insoluble with one stable phase. Microscopy and spectroscopy show that the first insoluble phase is associated mainly with spherical impurities and sediments rapidly out of solution resulting in purification. The second phase appears to consist of insoluble nanowire bundles and sediments more slowly, eventually leaving a stable dispersion of nanowire bundles. The stably dispersed bundles tend to be smaller than their insoluble counterparts. The best solvents studied were 2-propanol and dimethylformamide. Microscopy studies showed that, in the case of 2-propanol, sonication significantly reduced the bundle size relative to the unsonicated bulk. However, during sedimentation, large quantities of bundles were observed to reaggregate to form larger bundles which subsequently sedimented out of solution. In general, the sedimentation properties of the various phases did not vary significantly with concentration indicating that the insoluble nanowires are intrinsically insoluble. However, the diameter of the stably dispersed bundles decreased with concentration, until very small bundles consisting of only two or three nanowires were observed at concentrations below 0.003 mg/mL. In addition, stable composite dispersions were produced by mixing the nanowires with poly(vinylpyrrolidone) in 2-propanol opening the way for the formation of polymer/inorganic nanowire composites.

Synthesis and optical limiting properties of axially bridged phthalocyanines: [(tBu4PcGa)2O] and [(tBu4PcIn)2O].

Highly soluble [(tBu(4)PcM)(2)O] phthalocyanine dimers (M=Ga(III) (3), In(III) (4)) were prepared by the reaction of [tBu(4)PcMCl] (M=Ga(III) (1), In(III) (2)) with excess of concentrated H(2)SO(4) at -20 degrees C. The Mbond;Obond;M linkages in 3 and 4 are not stable against concentrated H(2)SO(4) at room temperature, 6 n HCl at reflux, or during isolation under column chromatographic conditions (e.g. silica gel/toluene). The stability of 3 in solution is considerably higher than that of 4. The mu-oxo-bridged phthalocyanine dimers 3 and 4 have a more intense photoluminescence emission in the red region than the monomers 1 and 2. The gallium phthalocyanines 1 and 3 have fluorescence lifetimes of a few nanoseconds, while those of the indium phthalocyanines 2 and 4 last for only several hundred picoseconds. Comparison of the fluorescence lifetimes of monomers 1 and 3 with dimers 2 and 4, reveals that the dimers have longer lifetimes of the excited singlet states. The transient absorption spectrum is similar for all of the compounds, and the transient absorption band at about 520 nm, observed by nanosecond laser irradiation, can be assigned to the transition from the lowest triplet excited state to the upper triplet excited states (T-T absorption). The magnitude of the optical limiting exhibited by 1, 2, 3, and 4 in toluene at 532 nm laser pulse irradiation is in the order: 4>3>2>1 [corrected]. The values of the imaginary third-order nonlinear susceptibility Im[chi((3))] of the above compounds at 532 nm in toluene are also reported. These results demonstrate that these compounds are candidates for optical limiting applications.

Investigation of capillary electrophoresis-laser induced fluorescence as a tool in the characterization of sewage effluent for fluorescent acids: determination of salicylic acid.

The investigation of emerging contaminant issues is a proactive effort in environmental analysis. As a part of this effort, sewage effluent is of current analytical interest because of the presence of pharmaceuticals and their metabolites and personal care products. The environmental impact of these components is still under investigation but their constant perfusion into receiving waters and their potential effect on biota is of concern. This paper examines a tool for the characterization of sewage effluent using capillary electrophoresis-laser induced fluorescence (CE-LIF) with a frequency-doubled laser operated in the ultraviolet (UV). Fluorescent acidic analytes are targeted because they present special problems for techniques such as gas chromatography-mass spectrometry (GC-MS) but are readily accessible to CE-LIF. As an example of the application of this tool, salicylic acid is determined near the 100 ng/L (7 x 10(-10) M) level in sewage effluent. Salicylic acid is a metabolite of various analgesics. Relatively stable in the environment, it is a common contaminant of municipal sewage systems. Salicylic acid was recovered from freshly collected samples of the effluent by liquid-liquid extraction. Confirmation of identity was by electron ionization GC-MS after conversion of the salicylic acid to the methyl ester by means of trimethylsilyldiazomethane. CE-LIF in the UV has revealed more than 50 individual peaks in the extract and a background response that suggests a large and indeterminate number of additional compounds are present. These data together with complementary techniques provide information on the complexity and components in these effluent streams.