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.

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.

Evaluation of the Phase-Dependent Rhythm Control of Human Walking Using Phase Response Curves.

Humans and animals control their walking rhythms to maintain motion in a variable environment. The neural mechanism for controlling rhythm has been investigated in many studies using mechanical and electrical stimulation. However, quantitative evaluation of rhythm variation in response to perturbation at various timings has rarely been investigated. Such a characteristic of rhythm is described by the phase response curve (PRC). Dynamical simulations of human skeletal models with changing walking rhythms (phase reset) described a relation between the effective phase reset on stability and PRC, and phase reset around touch-down was shown to improve stability. A PRC of human walking was estimated by pulling the swing leg, but such perturbations hardly influenced the stance leg, so the relation between the PRC and walking events was difficult to discuss. This research thus examines human response to variations in floor velocity. Such perturbation yields another problem, in that the swing leg is indirectly (and weakly) perturbed, so the precision of PRC decreases. To solve this problem, this research adopts the weighted spike-triggered average (WSTA) method. In the WSTA method, a sequential pulsed perturbation is used for stimulation. This is in contrast with the conventional impulse method, which applies an intermittent impulsive perturbation. The WSTA method can be used to analyze responses to a large number of perturbations for each sequence. In the experiment, perturbations are applied to walking subjects by rapidly accelerating and decelerating a treadmill belt, and measured data are analyzed by the WSTA and impulse methods. The PRC obtained by the WSTA method had clear and stable waveforms with a higher temporal resolution than those obtained by the impulse method. By investigation of the rhythm transition for each phase of walking using the obtained PRC, a rhythm change that extends the touch-down and mid-single support phases is found to occur.

Validating the feedback control of intersegmental coordination by fluctuation analysis of disturbed walking.

A walking motion is established by feedforward control for rhythmic locomotion and feedback control for adapting to environmental variations. To identify the control variables that underlie feedback control, uncontrolled manifold (UCM) analysis has been proposed and adopted for analyzing various movements. UCM analysis searches the controlled variables by comparing the fluctuation size of segmental groups related and unrelated to the movement of candidate variables, based on the assumption that a small fluctuation size indicates a relationship with the feedback control. The present study was based on UCM analysis and evaluated fluctuation size to determine the control mechanism for walking. While walking, the subjects were subjected to floor disturbances at two different frequencies, and the fluctuation sizes of the segmental groups related to characteristic variables were calculated and compared. The characteristic variables evaluated were the motion of the center of mass, limb axis, and head, and the intersegmental coordination of segmental groups with simultaneous coupled movements. Results showed that the fluctuations in intersegmental coordination were almost equally small for any segment, while fluctuations in the other variables were large in certain segments. Moreover, a comparison of the fluctuation sizes among the evaluated variables showed that the fluctuation size for intersegmental coordination was the smallest. These results indicate a possible relationship between intersegmental coordination and the control of walking.

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.

Contributions of phase resetting and interlimb coordination to the adaptive control of hindlimb obstacle avoidance during locomotion in rats: a simulation study.

Obstacle avoidance during locomotion is essential for safe, smooth locomotion. Physiological studies regarding muscle synergy have shown that the combination of a small number of basic patterns produces the large part of muscle activities during locomotion and the addition of another pattern explains muscle activities for obstacle avoidance. Furthermore, central pattern generators in the spinal cord are thought to manage the timing to produce such basic patterns. In the present study, we investigated sensory-motor coordination for obstacle avoidance by the hindlimbs of the rat using a neuromusculoskeletal model. We constructed the musculoskeletal part of the model based on empirical anatomical data of the rat and the nervous system model based on the aforementioned physiological findings of central pattern generators and muscle synergy. To verify the dynamic simulation by the constructed model, we compared the simulation results with kinematic and electromyographic data measured during actual locomotion in rats. In addition, we incorporated sensory regulation models based on physiological evidence of phase resetting and interlimb coordination and examined their functional roles in stepping over an obstacle during locomotion. Our results show that the phase regulation based on interlimb coordination contributes to stepping over a higher obstacle and that based on phase resetting contributes to quick recovery after stepping over the obstacle. These results suggest the importance of sensory regulation in generating successful obstacle avoidance during locomotion.

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.

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.

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 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.

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.

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.

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.

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.

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.

Forward dynamic simulation of bipedal walking in the Japanese macaque: investigation of causal relationships among limb kinematics, speed, and energetics of bipedal locomotion in a nonhuman primate.

Japanese macaques that have been trained for monkey performances exhibit a remarkable ability to walk bipedally. In this study, we dynamically reconstructed bipedal walking of the Japanese macaque to investigate causal relationships among limb kinematics, speed, and energetics, with a view to understanding the mechanisms underlying the evolution of human bipedalism. We constructed a two-dimensional macaque musculoskeletal model consisting of nine rigid links and eight principal muscles. To generate locomotion, we used a trajectory-tracking control law, the reference trajectories of which were obtained experimentally. Using this framework, we evaluated the effects of changes in cycle duration and gait kinematics on locomotor efficiency. The energetic cost of locomotion was estimated based on the calculation of mechanical energy generated by muscles. Our results demonstrated that the mass-specific metabolic cost of transport decreased as speed increased in bipedal walking of the Japanese macaque. Furthermore, the cost of transport in bipedal walking was reduced when vertical displacement of the hip joint was virtually modified in the simulation to be more humanlike. Human vertical fluctuations in the body's center of mass actually contributed to energy savings via an inverted pendulum mechanism.

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.