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Tumor mutation screening is standard of care for patients with stage IV NSCLC. Since a couple of years, widespread NGS approaches used in routine diagnostics to detect driver mutations such as EGFR, KRAS, BRAF or MET allows the identification of other alterations that could modulated the intensity or duration of response to targeted therapies. The prevalence of co-occurring alterations that could affect response or prognosis as not been largely analyzed in clinical settings and large cohorts of patients. Thanks to the IFCT program "Biomarkers France", a collection of samples and data at a nation-wide level was available to test the impact of co-mutations on first line EGFR TKI in patients with EGFR mutated cancers.
Targeted NGS was assessed on available (n = 208) samples using the Ion AmpliSeq™ Cancer Hotspot Panel v2 to screen for mutations in 50 different cancer genes.
This study showed that PTEN inactivating mutations, ATM alterations, IDH1 mutations and complex EGFR mutations were predictors of short PFS in patients with a stage 4 lung adenocarcinoma receiving first line EGFR TKI and that PTEN, ATM, IDH1 and KRAS mutations as well as alterations in the MAPK pathway were related to shorter OS.
These findings may lead to new treatment options in patients with unfavorable genotypes to optimize first line responses.
These findings may lead to new treatment options in patients with unfavorable genotypes to optimize first line responses.Within diverse global populations, validated tools are needed to assess common mental disorders. The Patient Health Questionnaire-9 (PHQ-9) is one of the most commonly used depression screeners. However, the PHQ-9 has not been structurally validated among female migrant domestic workers (MDWs). Female MDWs constitute a population numbering 11.5 million, and commonly report depression. This study aimed to structurally validate the PHQ-9 among Filipina and Indonesian female MDWs in Macao Special Administrative Region of China. Participants were recruited using respondent driven sampling. Participants were adult female MDWs from The Philippines (N=1375) or Indonesia (N=367) and legally working in Macao. We used confirmatory factor analysis (CFA) to test five structural models of depression using all PHQ-9 items with the Filipina and Indonesian samples. We applied multi-group CFA to test measurement invariance across samples. A two-factor (cognitive/affective, somatic) model yielded the best fit within both samples, and the multi-group CFA demonstrated invariance across samples. The two-factor model best represents the factor structure of the PHQ-9 among Filipina and Indonesian female MDWs.
To examine national-level differences in management strategies and outcomes in patients with autoimmune rheumatic disease (AIRD) with acute myocardial infarction (AMI) from 2004 through2014.
All AMI hospitalizations were analyzed from the National Inpatient Sample, stratified according to AIRD diagnosis into 4 groups no AIRD, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSC). The associations between AIRD subtypes and (1) receipt of coronary angiography and percutaneous coronary intervention (PCI) and (2) clinical outcomes were examined compared with patients without AIRD.
Of 6,747,797 AMI hospitalizations, 109,983 patients (1.6%) had an AIRD diagnosis (RA 1.3%, SLE 0.3%, and SSC 0.1%). The prevalence of RA rose from 1.0% (2004) to 1.5% (2014), and SLE and SSC remained stable. Patients with SLE were less likely to receive invasive management (odds ratio [OR] [95% CI] coronary angiography-0.87; 0.84 to 0.91; PCI-0.93; 0.90 to 0.96), whereas no statistically significant differences were found in the RA and SSC groups. Subsequently, the ORs (95% CIs) of mortality (1.15; 1.07 to 1.23) and bleeding (1.24; 1.16 to 1.31) were increased in patients with SLE; SSC was associated with increased ORs (95% CIs) of major adverse cardiovascular and cerebrovascular events (1.52; 1.38 to 1.68) and mortality (1.81; 1.62 to 2.02) but not bleeding or stroke; the RA group was at no increased risk for any complication.
In a nationwide cohort of AMI hospitalizations we found lower use of invasive management in patients with SLE and worse outcomes after AMI in patients with SLE and SSC compared with those without AIRD.
In a nationwide cohort of AMI hospitalizations we found lower use of invasive management in patients with SLE and worse outcomes after AMI in patients with SLE and SSC compared with those without AIRD.Biological barriers hamper the efficient delivery of drugs and genes to targeted sites. Cell penetrating peptides (CPP) have the ability to rapidly internalize across biological membranes. CPP have been effective for delivery of various chemotherapeutic agents used to combat cancer. CPP can enhance delivery of drugs to a targeted site when combined with tumor targeting peptides. CPP can be linked with various cargos like nanoparticles, micelles and liposomes to deliver drugs and genes to the cancer cell. Here, we focus on CPP mediated delivery of drugs to the tumor sites, delivery of genes (siRNA,pDNA) and co-delivery of drugs and genes to combat drug resistance.Identifying novel therapeutic targets for Chagas disease is a scientific priority. Recently, Hossain et al. used an innovative metabolomic approach to define disease tolerance mechanisms and identify therapeutic targets for Chagas disease. This is the first study translating metabolomic data to develop novel treatments for Chagas disease.Loss of somatosensory feedback after amputation inflicts a serious challenge to achieve postural stability. Improving motor skills by incorporating sensory feedback in rehabilitation protocols for persons with lower limb amputation has been gaining traction over time. However, the control mechanisms involved in this regarding time-frequency analysis have not been investigated yet. The purpose of this study was to explore the frequencies/time-scales responsible for postural stability in trans-femoral amputees with vibrotactile feedback. Center of Pressure (COP) signals were collected from 5 trans-femoral amputees and 10 healthy subjects during weight shifting balance tasks. A customized foot insole was used to estimate the COP for actuation of vibratory feedback. The evaluation of postural sway fluctuations by means of COP excursions with vibrotactile feedback was computed by wavelet transform method. Vibrotactile feedback was found to be effective in controlling low frequency postural sway in amputees. learn more We found significantly higher energy (p = 0.004, 0.0007) at shorter time-scales (j = 6,7, freq. = 0.6-1.25 Hz) and lower energy (p = 0.0006) at longer time-scale (j = 10, freq. = 0.078 Hz) in amputees with vibrotactile feedback in comparison to healthy subjects using Coif 1 wavelet. We also found significant increase in energy (p = 0.003) during forward weight shifting with vibrotactile feedback in the sound limb of amputees in comparison to no feedback session at frequency/time-scales corresponding to somatosensory acuity (j = 6-8, freq. = 0.3-1.5 Hz) using Haar wavelet. These findings reflect the higher contribution of somatosensory receptors in amputees with vibrotactile feedback and may provide a better understanding of the mechanisms associated with standing balance in terms of time-frequency analysis.It has been suggested that residual force enhancement (RFE) contributes to the work enhancement observed in stretch-shortening cycles (SSC). Based on recent findings that RFE was preserved in the reduced force state, one may speculate that the SSC effect may be preserved in the reduced force state as well. The purpose of this study was to examine the magnitude of the SSC effect in inhibited skeletal muscle force states. Normal and inhibited force conditions were analyzed using skinned rabbit soleus fibres (N = 18). The inhibited force condition was achieved by adding 2,3-Butanedione monoxime into the activating solution. For both conditions, a SSC test and a pure shortening test were performed. In the SSC tests, fibres were activated at an average sarcomere length of 2.4 μm, and then stretched to 3.0 μm. Immediately after the end of the stretch, fibres were shortened to 2.4 μm. In the pure shortening tests, fibres were activated at an average sarcomere length of 3.0 μm and then shortened to 2.4 μm. The relative increase in mechanical work in the shortening phase of the SSC compared to the pure shortening condition was defined as the SSC effect index, and the magnitude of the SSC effect was compared between the normal and the inhibited force condition. The SSC effect was greater in the inhibited compared to the normal force condition (p less then 0.001). We conclude that the SSC effect is at least in part preserved in the reduced force state.The ability to control adhesion and the spatial organization of cells over nanoscale surfaces is essential in tissue engineering, regenerative medicine, the growth of organoids and spheroids as an in-vitro-model of human development and disease. Nonetheless, despite the several different works that have explored the influence of nanotopography on cell adhesion and clustering, little is known about how the forces arising from membrane conformational change developing during cell adaptation to a nanorough surface, and the cell-cell adhesion forces, interact to guide cell assembly. Here, starting from the works of Decuzzi and Ferrari, who examined how the energy of a cell varies while adhering to a nanoscale surface, and of Armstrong and collaborators, who developed a continuous model of cell-cell adhesion and morphogenesis, we provide a description of how nanotopography can modulate cellular clustering. In simulations where the parameters of the model were varied over large intervals, we found that nanoroughness may induce cell aggregation from a homogenous, uniform state, also for weak cell-cell adhesion. Results of the model are relevant in bio-engineering and biomedical nanotechnology, and may be of interest for those involved in the design and fabrication of biomaterials and scaffolds for tissue formation and repair.Pedestrians represent one of the most vulnerable road user groups worldwide. Children and adult pedestrians with neurodevelopmental disorders may be at greater risk due to deficits in a range of domains, such as attention, social communication, motor control and executive function. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychological Association, 2013), neurodevelopmental disorders include individuals with a diagnosis of Autism Spectrum Disorders, Attention Deficit Hyperactivity Disorder, Specific Learning Disorder, Motor Difficulties, Communication Disorders and Intellectual Disabilities. The purpose of this systematic review and meta-analysis was to explore existing literature relating to determine the nature of the risk faced by pedestrians with neurodevelopmental disorders. Relevant databases including Web of Science, PhysInfo and CINAHL were searched up to July 2019. All peer reviewed journals that presented data focusing on neurodevelopmental diso differences in behaviour / understanding at the roadside. In general, co-occurrence between neurodevelopmental disorders has been largely ignored in the current literature relating to pedestrian risk and future research could consider this along with executive functioning.
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