Salivary duct carcinoma (SDCa) is a rare cancer with high rate of metastases and poor survival despite aggressive multimodality treatment. This study analyzes the genetic changes in SDCa, their ...impact on cancer pathways, and evaluates whether molecular patterns can identify subgroups with distinct clinical characteristics and outcome. Clinicopathologic details and tissue samples from 66 patients (48 males, 18 females) treated between 1995 and 2018 were obtained from multiple institutions. Androgen receptor (AR) was assessed by immunohistochemistry, and the Illumina TruSight 170 gene panel was used for DNA sequencing. Male gender, lympho-vascular invasion, lymph node metastasis, and smoking were significant predictors of disease-free survival. AR was present in 79%. Frequently encountered alterations were mutations in TP53 (51%), PIK3CA (32%) and HRAS (22%), as well as amplifications of CDK4/6 (22%), ERBB2 (21%), MYC (16%), and deletions of CDKN2A (13%). TP53 mutation and MYC amplifications were associated with decreased disease-free survival. Analysis of cancer pathways revealed that the PI3K pathway was most commonly affected. Alterations in the cell cycle pathway were associated with impaired disease-free survival (HR 2.6, P = 0.038). Three subgroups based on AR and ERBB2 status were identified, which featured distinct molecular patterns and outcome. Among AR positive SDCa, HRAS mutations were restricted to AR positive tumors without ERBB2 amplification and HRAS mutations featured high co-occurrence with PIK3CA alterations, which seems specific to SDCa. AR negative SDCa were associated with poor disease-free survival in multivariate analysis (HR 4.5, P = 0.010) and none of these tumors exhibited ERBB2 amplification or HRAS mutations. AR and ERBB2 status in SDCa thus classifies tumors with distinct molecular profiles relevant to future targeted therapy. Furthermore, clinical factors such as smoking and molecular features such as MYC amplification may serve as markers of poor prognosis of SDCa.
Detailed knowledge of the structure and degree of oxidation of platinum surfaces under operando conditions is essential for understanding catalytic performance. However, experimental investigations ...of platinum surface oxides have been hampered by technical limitations, preventing in situ investigations at relevant pressures. As a result, the time‐dependent evolution of oxide formation has only received superficial treatment. In addition, the amorphous structures of many surface oxides have hindered realistic theoretical studies. Using near‐ambient pressure X‐ray photoelectron spectroscopy (NAP‐XPS) we show that a time scale of hours (t≥4 h) is required for the formation of platinum surface oxides. These experimental observations are consistent with ReaxFF grand canonical Monte Carlo (ReaxFF‐GCMC) calculations, predicting the structures and coverages of stable, amorphous surface oxides at temperatures between 430–680 K and an O2 partial pressure of 1 mbar.
Stable surface oxides: Stable surface oxides on Pt(111) at near‐ambient pressure were theoretically predicted and their existence was confirmed by X‐ray photoelectron spectroscopy. The presence of these stable surface oxides has severe implications for Pt catalysts, since their catalytic properties differ markedly from those of bare Pt surfaces.
Excessively devaluing delayed reinforcers co-occurs with a wide variety of clinical conditions such as drug dependence, obesity, and excessive gambling. If excessive delay discounting is a ...trans-disease process that underlies the choice behavior leading to these and other negative health conditions, efforts to change an individual's discount rate are arguably important. Although discount rate is often regarded as a relatively stable trait, descriptions of interventions and environmental manipulations that successfully alter discount rate have begun to appear in the literature. In this review, we compare published examples of procedures that change discount rate and classify them into categories of procedures, including therapeutic interventions, direct manipulation of the executive decision-making system, framing effects, physiological state effects, and acute drug effects. These changes in discount rate are interpreted from the perspective of the competing neurobehavioral decision systems theory, which describes a combination of neurological and behavioral processes that account for delay discounting. We also suggest future directions that researchers could take to identify the mechanistic processes that allow for changes in discount rate and to test whether the competing neurobehavioral decision systems view of delay discounting is correct.
Study objective We aim to prospectively validate the diagnostic accuracy of the recently developed 0-h/1-h algorithm, using high-sensitivity cardiac troponin T (hs-cTnT) for the early rule-out and ...rule-in of acute myocardial infarction. Methods We enrolled patients presenting with suspected acute myocardial infarction and recent (<6 hours) onset of symptoms to the emergency department in a global multicenter diagnostic study. Hs-cTnT (Roche Diagnostics) and sensitive cardiac troponin I (Siemens Healthcare) were measured at presentation and after 1 hour, 2 hours, and 4 to 14 hours in a central laboratory. Patient triage according to the predefined hs-cTnT 0-hour/1-hour algorithm (hs-cTnT below 12 ng/L and Δ1 hour below 3 ng/L to rule out; hs-cTnT at least 52 ng/L or Δ1 hour at least 5 ng/L to rule in; remaining patients to the “observational zone”) was compared against a centrally adjudicated final diagnosis by 2 independent cardiologists (reference standard). The final diagnosis was based on all available information, including coronary angiography and echocardiography results, follow-up data, and serial measurements of sensitive cardiac troponin I, whereas adjudicators remained blinded to hs-cTnT. Results Among 1,282 patients enrolled, acute myocardial infarction was the final diagnosis for 213 (16.6%) patients. Applying the hs-cTnT 0-hour/1-hour algorithm, 813 (63.4%) patients were classified as rule out, 184 (14.4%) were classified as rule in, and 285 (22.2%) were triaged to the observational zone. This resulted in a negative predictive value and sensitivity for acute myocardial infarction of 99.1% (95% confidence interval CI 98.2% to 99.7%) and 96.7% (95% CI 93.4% to 98.7%) in the rule-out zone (7 patients with false-negative results), a positive predictive value and specificity for acute myocardial infarction of 77.2% (95% CI 70.4% to 83.0%) and 96.1% (95% CI 94.7% to 97.2%) in the rule-in zone, and a prevalence of acute myocardial infarction of 22.5% in the observational zone. Conclusion The hs-cTnT 0-hour/1-hour algorithm performs well for early rule-out and rule-in of acute myocardial infarction.
A precise measurement of the proton flux in primary cosmic rays with rigidity (momentum/charge) from 1 GV to 1.8 TV is presented based on 300 million events. Knowledge of the rigidity dependence of ...the proton flux is important in understanding the origin, acceleration, and propagation of cosmic rays. We present the detailed variation with rigidity of the flux spectral index for the first time. The spectral index progressively hardens at high rigidities.
The rapid and aggressive spread of artemisinin-resistant Plasmodium falciparum carrying the C580Y mutation in the kelch13 gene is a growing threat to malaria elimination in Southeast Asia, but there ...is no evidence of their spread to other regions. We conducted cross-sectional surveys in 2016 and 2017 at two clinics in Wewak, Papua New Guinea (PNG) where we identified three infections caused by C580Y mutants among 239 genotyped clinical samples. One of these mutants exhibited the highest survival rate (6.8%) among all parasites surveyed in ring-stage survival assays (RSA) for artemisinin. Analyses of kelch13 flanking regions, and comparisons of deep sequencing data from 389 clinical samples from PNG, Indonesian Papua and Western Cambodia, suggested an independent origin of the Wewak C580Y mutation, showing that the mutants possess several distinctive genetic features. Identity by descent (IBD) showed that multiple portions of the mutants' genomes share a common origin with parasites found in Indonesian Papua, comprising several mutations within genes previously associated with drug resistance, such as mdr1, ferredoxin, atg18 and pnp. These findings suggest that a P. falciparum lineage circulating on the island of New Guinea has gradually acquired a complex ensemble of variants, including kelch13 C580Y, which have affected the parasites' drug sensitivity. This worrying development reinforces the need for increased surveillance of the evolving parasite populations on the island, to contain the spread of resistance.
The precipitation of topologically close packed (TCP) phases is detrimental for the high temperature strength of high refractory Ni-based superalloys. The beneficial influence of Ru with respect to ...this so called instability is nowadays well accepted. In the present paper the precipitation of topologically close packed (TCP) phases is studied quantitatively in two experimental alloys (one Ru-free and one with addition of Ru) to clarify the mechanism of the Ru effect. It is confirmed that the TCP phase precipitates undergo sequential phase transformation with the tetragonal σ-phase precipitating first. Ru retards the phase transformation and leads to decreased equilibrium volume fraction of TCP phases. The results clearly indicate that Ru decreases the driving force for TCP phase precipitation. Investigations of crystallography and chemistry of the TCP/matrix interface point to an additional effect by increase of misfit strain energy.
The Solar Orbiter mission Müller, D.; St. Cyr, O. C.; Zouganelis, I. ...
Astronomy and astrophysics (Berlin),
10/2020, Letnik:
642
Journal Article
Recenzirano
Odprti dostop
Aims.
Solar Orbiter, the first mission of ESA’s Cosmic Vision 2015–2025 programme and a mission of international collaboration between ESA and NASA, will explore the Sun and heliosphere from close up ...and out of the ecliptic plane. It was launched on 10 February 2020 04:03 UTC from Cape Canaveral and aims to address key questions of solar and heliospheric physics pertaining to how the Sun creates and controls the Heliosphere, and why solar activity changes with time. To answer these, the mission carries six remote-sensing instruments to observe the Sun and the solar corona, and four in-situ instruments to measure the solar wind, energetic particles, and electromagnetic fields. In this paper, we describe the science objectives of the mission, and how these will be addressed by the joint observations of the instruments onboard.
Methods.
The paper first summarises the mission-level science objectives, followed by an overview of the spacecraft and payload. We report the observables and performance figures of each instrument, as well as the trajectory design. This is followed by a summary of the science operations concept. The paper concludes with a more detailed description of the science objectives.
Results.
Solar Orbiter will combine in-situ measurements in the heliosphere with high-resolution remote-sensing observations of the Sun to address fundamental questions of solar and heliospheric physics. The performance of the Solar Orbiter payload meets the requirements derived from the mission’s science objectives. Its science return will be augmented further by coordinated observations with other space missions and ground-based observatories.
The predictive value of tumor mutational burden (TMB), alone or in combination with an immune gene expression profile (GEP), for response to neoadjuvant therapy in early triple negative breast cancer ...(TNBC) is currently not known, either for immune checkpoint blockade (ICB) or conventional chemotherapy.
We obtained both whole exome sequencing and RNA-Seq data from pretreatment samples of 149 TNBC of the recent neoadjuvant ICB trial, GeparNuevo. In a predefined analysis, we assessed the predictive value of TMB and a previously developed immune GEP for pathological complete remission (pCR).
Median TMB was 1.52 mut/Mb (range 0.02–7.65) and was significantly higher in patients with pCR (median 1.87 versus 1.39; P = 0.005). In multivariate analysis, odds ratios for pCR per mut/Mb were 2.06 95% confidence intervals (CI) 1.33–3.20, P = 0.001 among all patients, 1.77 (95% CI 1.00–3.13, P = 0.049) in the durvalumab treatment arm, and 2.82 (95% CI 1.21–6.54, P = 0.016) in the placebo treatment arm, respectively. We also found that both continuous TMB and immune GEP (or tumor infiltrating lymphocytes) independently predicted pCR. When we stratified patients in groups based on the upper tertile of TMB and median GEP, we observed a pCR rate of 82% (95% CI 60% to 95%) in the group with both high TMB and GEP in contrast to only 28% (95% CI 16% to 43%) in the group with both low TMB and GEP.
TMB and immune GEP add independent value for pCR prediction. Our results recommend further analysis of TMB in combination with immune parameters to individually tailor therapies in breast cancer.
•Tumor mutational burden (TMB) predicts pCR after neoadjuvant treatment in early triple negative breast cancer.•The predictive value of TMB was found both for immune checkpoint inhibition with chemotherapy and for chemotherapy alone.•Both TMB and an immune gene expression profile add independent value for pCR prediction in multivariate analysis.
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