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1.
J Am Chem Soc ; 146(18): 12799-12807, 2024 May 08.
Article in English | MEDLINE | ID: mdl-38662638

ABSTRACT

Alkyl cyclopropyl ketones are introduced as versatile substrates for catalytic formal [3 + 2] cycloadditions with alkenes and alkynes and previously unexplored enyne partners, efficiently delivering complex, sp3-rich products. The key to effectively engaging this relatively unreactive new substrate class is the use of SmI2 as a catalyst in combination with substoichiometric amounts of Sm0; the latter likely acting to prevent catalyst deactivation by returning SmIII to the catalytic cycle. In the absence of Sm0, background degradation of the SmI2 catalyst can outrun product formation. For the most recalcitrant alkyl cyclopropyl ketones, catalysis is "switched-on" using these new robust conditions, and otherwise unattainable products are delivered. Combined experimental and computational studies have been used to identify and probe reactivity trends among alkyl cyclopropyl ketones, including more complex bicyclic alkyl cyclopropyl ketones, which react quickly with various partners to give complex products. In addition to establishing alkyl cyclopropyl ketones as a new substrate class in a burgeoning field of catalysis, our study provides vital mechanistic insight and robust, practical approaches for the nascent field of catalysis with SmI2.

2.
Nat Chem ; 16(3): 478, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38448506
3.
Neurooncol Adv ; 5(1): vdad123, 2023.
Article in English | MEDLINE | ID: mdl-37841698

ABSTRACT

Background: Neurofibromatosis type 2 (NF2)-related schwannomatosis is an autosomal dominant tumor-predisposition syndrome characterized by bilateral vestibular schwannomas (VS). In patients with VS associated with NF2, vascular endothelial growth factor A inhibitor, bevacizumab, is a systemic treatment option. The aim of this study is to retrospectively evaluate NF2 patient responses to bevacizumab on VS growth and symptom progression. Methods: This is a retrospective analysis of patients seen at the Mayo Clinic Rochester Multidisciplinary NF2 Clinic. Results: Out of 76 patients with NF2 evaluated between 2020 and 2022, we identified 19 that received treatment with bevacizumab. Thirteen of these patients discontinued bevacizumab after median treatment duration of 12.2 months. The remaining 6 patients are currently receiving bevacizumab treatment for a median duration of 9.4 months as of March, 2023. Fifteen patients had evaluable brain MRI data, which demonstrated partial responses in 5 patients, stable disease in 8, and progression in 2. Within 6 months of bevacizumab discontinuation, 5 patients had rebound growth of their VS greater than 20% from their previous tumor volume, while 3 did not. Three patients with rebound growth went on to have surgery or irradiation for VS management. Conclusions: Our single-institution experience confirms prior studies that bevacizumab can control progression of VS and symptoms associated with VS growth. However, we note that there is the potential for rapid VS growth following bevacizumab discontinuation, for which we propose heightened surveillance imaging and symptom monitoring for at least 6 months upon stopping anti-VEGF therapy.

4.
PLoS Med ; 20(5): e1004227, 2023 05.
Article in English | MEDLINE | ID: mdl-37220111

ABSTRACT

BACKGROUND: Despite possible benefits for growth, milk is costly to include in foods for undernourished children. Furthermore, the relative effects of different milk components, milk protein (MP), and whey permeate (WP) are unclear. We aimed to assess the effects of MP and WP in lipid-based nutrient supplement (LNS), and of LNS itself, on linear growth and body composition among stunted children. METHODS AND FINDINGS: We performed a randomized, double-blind, 2 × 2 factorial trial among 12 to 59 months old stunted children in Uganda. Children were randomized to 4 formulations of LNS with MP or soy protein isolate and WP or maltodextrin (100 g/day for 12 weeks) or no supplementation. Investigators and outcome assessors were blinded; however, participants were only blinded to the ingredients in LNS. Data were analyzed based on intention-to-treat (ITT) using linear mixed-effects models adjusted for age, sex, season, and site. Primary outcomes were change in height and knee-heel length, and secondary outcomes included body composition by bioimpedance analysis (ISRCTN13093195). Between February and September 2020, we enrolled 750 children with a median age of 30 (interquartile range 23 to 41) months, with mean (± standard deviation) height-for-age z-score (HAZ) -3.02 ± 0.74 and 12.7% (95) were breastfed. The 750 children were randomized to LNS (n = 600) with or without MP (n = 299 versus n = 301) and WP (n = 301 versus n = 299), or no supplementation (n = 150); 736 (98.1%), evenly distributed between groups, completed 12-week follow-up. Eleven serious adverse events occurred in 10 (1.3%) children, mainly hospitalization with malaria and anemia, all deemed unrelated to the intervention. Unsupplemented children had 0.06 (95% confidence interval, CI [0.02, 0.10]; p = 0.015) decline in HAZ, accompanied by 0.29 (95% CI [0.20, 0.39]; p < 0.001) kg/m2 increase in fat mass index (FMI), but 0.06 (95% CI [-0.002; 0.12]; p = 0.057) kg/m2 decline in fat-free mass index (FFMI). There were no interactions between MP and WP. The main effects of MP were 0.03 (95% CI [-0.10, 0.16]; p = 0.662) cm in height and 0.2 (95% CI [-0.3, 0.7]; p = 0.389) mm in knee-heel length. The main effects of WP were -0.08 (95% CI [-0.21, 0.05]; p = 220) cm and -0.2 (95% CI [-0.7; 0.3]; p = 403) mm, respectively. Interactions were found between WP and breastfeeding with respect to linear growth (p < 0.02), due to positive effects among breastfed and negative effects among non-breastfed children. Overall, LNS resulted in 0.56 (95% CI [0.42, 0.70]; p < 0.001) cm height increase, corresponding to 0.17 (95% CI [0.13, 0.21]; p < 0.001) HAZ increase, and 0.21 (95% CI [0.14, 0.28]; p < 0.001) kg weight increase, of which 76.5% (95% CI [61.9; 91.1]) was fat-free mass. Using height-adjusted indicators, LNS increased FFMI (0.07 kg/m2, 95% CI [0.0001; 0.13]; p = 0.049), but not FMI (0.01 kg/m2, 95% CI [-0.10, 0.12]; p = 0.800). Main limitations were lack of blinding of caregivers and short study duration. CONCLUSIONS: Adding dairy to LNS has no additional effects on linear growth or body composition in stunted children aged 12 to 59 months. However, supplementation with LNS, irrespective of milk, supports linear catch-up growth and accretion of fat-free mass, but not fat mass. If left untreated, children already on a stunting trajectory gain fat at the expense of fat-free mass, thus nutrition programs to treat such children should be considered. TRIAL REGISTRATION: ISRCTN13093195.


Subject(s)
Milk Proteins , Whey , Child , Humans , Infant , Child, Preschool , Uganda , Nutrients , Body Composition , Lipids
5.
Oper Neurosurg (Hagerstown) ; 25(1): 72-80, 2023 07 01.
Article in English | MEDLINE | ID: mdl-37166197

ABSTRACT

BACKGROUND: Although not a technically difficult operation, cranioplasty is associated with high rates of complications. The optimal timing of cranioplasty to mitigate complications remains the subject of debate. OBJECTIVE: To report outcomes between patients undergoing cranioplasty at ultra-early (0-6 weeks), intermediate (6 weeks to 6 months), and late (>6 months) time frames. We report a novel craniectomy contour classification (CCC) as a radiographic parameter to assess readiness for cranioplasty. METHODS: A single-institution retrospective analysis of patients undergoing cranioplasty was performed. Patients were stratified into ultra-early (within 6 weeks of index craniectomy), intermediate (6 weeks to 6 months), and late (>6 months) cranioplasty cohorts. We have devised CCC scores, A, B, and C, based on radiographic criteria, where A represents those with a sunken brain/flap, B with a normal parenchymal contour, and C with "full" parenchyma. RESULTS: A total of 119 patients were included. There was no significant difference in postcranioplasty complications, including return to operating room ( P = .212), seizures ( P = .556), infection ( P = .140), need for shunting ( P = .204), and deep venous thrombosis ( P = .066), between the cohorts. Univariate logistic regression revealed that ultra-early cranioplasty was significantly associated with higher rate of functional independence at >6 months (odds ratio 4.32, 95% CI 1.39-15.13, P = .015) although this did not persist when adjusting for patient selection features (odds ratio 2.90, 95% CI 0.53-19.03, P = .234). CONCLUSION: In appropriately selected patients, ultra-early cranioplasty is not associated with increased rate of postoperative complications and is a viable option. The CCC may help guide decision-making on timing of cranioplasty.


Subject(s)
Decompressive Craniectomy , Plastic Surgery Procedures , Humans , Retrospective Studies , Patient Selection , Decompressive Craniectomy/adverse effects , Surgical Flaps
6.
J Nutr ; 153(2): 426-434, 2023 02.
Article in English | MEDLINE | ID: mdl-36894235

ABSTRACT

BACKGROUND: BIA represents an important tool in body composition (BC) assessment, especially in low-income settings in which simple and affordable options are preferred. There is a particular need to measure BC in stunted children, in which cases population-specific BIA estimating equations are lacking. OBJECTIVES: We calibrated an equation to estimate body composition from BIA using deuterium dilution (2H) as the criterion method in stunted children. METHODS: We measured BC with 2H and performed BIA in stunted Ugandan children (n = 50). Multiple linear regression models were constructed to predict 2H-derived FFM from BIA-derived whole-body impedance and other relevant predictors. Model performance was expressed as adjusted R2 and RMSE. Prediction errors were also calculated. RESULTS: Participants were aged 16-59 mo, of whom 46% were girls, and their median (IQR) height-for-age z-score (HAZ) was -2.58 (-2.92 to -2.37) according to the WHO growth standards. Impedance index (height2/impedance measured at 50 kHz) alone explained 89.2% variation in FFM and had an RMSE of 583 g (precision error 6.5%). The final model contained age, sex, impedance index, and height-for-age z-score as predictors and explained 94.5% variation in FFM with an RMSE of 402 g (precision error 4.5%). CONCLUSIONS: We present a BIA calibration equation for a group of stunted children with a relatively low prediction error. This may help evaluate the efficacy of nutritional supplementation in large-scale trials in the same population. J Nutr 20XX;xxx:xx.


Subject(s)
Body Composition , Female , Humans , Child , Male , Deuterium , Electric Impedance , Calibration , Uganda , Reproducibility of Results
7.
Cell Rep ; 41(8): 111686, 2022 11 22.
Article in English | MEDLINE | ID: mdl-36417868

ABSTRACT

Using spatial cell-type-enriched transcriptomics, we compare plaque-induced gene (PIG) expression in microglia-touching plaques, neighboring plaques, and far from plaques in an aged Alzheimer's mouse model with late plaque development. In 18-month-old APPNL-F/NL-F knockin mice, with and without the Alzheimer's disease risk mutation Trem2R47H/R47H, we report that expression of 38/55 PIGs have plaque-induced microglial upregulation, with a subset only upregulating in microglia directly contacting plaques. For seven PIGs, including Trem2, this upregulation is prevented in APPNL-F/NL-FTrem2R47H/R47H mice. These TREM2-dependent genes are all involved in phagocytic and degradative processes that we show correspond to a decrease in phagocytic markers and an increase in the density of small plaques in Trem2-mutated mice. Furthermore, despite the R47H mutation preventing increased Trem2 gene expression, TREM2 protein levels and microglial density are still marginally increased on plaques. Hence, both microglial contact with plaques and functioning TREM2 are necessary for microglia to respond appropriately to amyloid pathology.


Subject(s)
Alzheimer Disease , Amyloidosis , Animals , Mice , Microglia/metabolism , Alzheimer Disease/metabolism , Plaque, Amyloid/metabolism , Amyloidogenic Proteins/metabolism , Membrane Glycoproteins/genetics , Membrane Glycoproteins/metabolism , Receptors, Immunologic/genetics , Receptors, Immunologic/metabolism
8.
Spine (Phila Pa 1976) ; 47(15): 1055-1061, 2022 Aug 01.
Article in English | MEDLINE | ID: mdl-35797595

ABSTRACT

STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To compare health-related quality of life outcomes at one-year follow-up between patients who did and did not develop surgical site infection (SSI) after thoracolumbar spinal fusion. SUMMARY OF BACKGROUND DATA: SSI is among the most common healthcare-associated complications. As healthcare systems increasingly emphasize the value of delivered care, there is an increased need to understand the clinical impact of SSIs. MATERIALS AND METHODS: A retrospective 3:1 (control:SSI) propensity-matched case-control study was conducted for adult patients who underwent thoracolumbar fusion from March 2014 to January 2020 at a single academic institution. Exclusion criteria included less than 18 years of age, incomplete preoperative and one-year postoperative patient-reported outcome measures, and revision surgery. Continuous and categorical data were compared via independent t tests and χ 2 tests, respectively. Intragroup analysis was performed using paired t tests. Regression analysis for ∆ patient-reported outcome measures (postoperative minus preoperative scores) controlled for demographics. The α was set at 0.05. RESULTS: A total of 140 patients (105 control, 35 SSI) were included in final analysis. The infections group had a higher rate of readmission (100% vs. 0.95%, P <0.001) and revision surgery (28.6% vs. 12.4%, P =0.048). Both groups improved significantly in Physical Component Score (control: P =0.013, SSI: P =0.039), Oswestry Disability Index (control: P <0.001, SSI: P =0.001), Visual Analog Scale (VAS) Back (both, P <0.001), and VAS Leg (control: P <0.001, SSI: P =0.030). Only the control group improved in Mental Component Score ( P <0.001 vs. SSI: P =0.228), but history of a SSI did not affect one-year improvement in ∆MCS-12 ( P =0.455) on regression analysis. VAS Leg improved significantly less in the infection group (-1.87 vs. -3.59, P =0.039), which was not significant after regression analysis (ß=1.75, P =0.050). CONCLUSION: Development of SSI after thoracolumbar fusion resulted in increased revision rates but did not influence patient improvement in one-year pain, functional disability, or physical and mental health status.


Subject(s)
Spinal Fusion , Adult , Case-Control Studies , Follow-Up Studies , Humans , Lumbar Vertebrae/surgery , Quality of Life , Retrospective Studies , Spinal Fusion/adverse effects , Spinal Fusion/methods , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Treatment Outcome
9.
Nutrients ; 14(7)2022 Mar 22.
Article in English | MEDLINE | ID: mdl-35405943

ABSTRACT

Most people with cystic fibrosis (pwCF) develop pancreatic insufficiency and are treated with pancreatic enzyme replacement therapy (PERT). We aimed to describe the use of PERT and assess the correlates of PERT dose in adult pwCF. In a cross-sectional study at the Copenhagen CF Centre, the participants reported PERT intake, gastrointestinal (GI) symptoms and the use of concomitant treatments. Demographic and clinical characteristics were extracted from the Danish CF Registry. We used linear regression to assess the correlates of PERT dose per kg bodyweight (U-lipase/kg). We included 120 pwCF with a median age of 32.9 years, 46% women and 72% F508delta homozygote. The PERT dose ranged from 0 to 6160 U-lipase/kg per main meal (mean 1828; SD 1115). The PERT dose was associated with participants' sex (men vs. women: 661; 95% CI: 302; 1020 U-lipase/kg), age (-16; 95% CI: -31; -1 U-lipase/kg per year) and weight (-45; 95% CI: -58; -31 U-lipase/kg per kg). Having less frequent constipation and being lung transplanted were also associated with a higher PERT dose. A third of participants did not take PERT for snacks, and this was associated with the frequency of diarrhoea. These findings indicate that PERT intake may be improved to reduce GI symptoms.


Subject(s)
Cystic Fibrosis , Exocrine Pancreatic Insufficiency , Gastrointestinal Diseases , Adult , Cross-Sectional Studies , Cystic Fibrosis/complications , Enzyme Replacement Therapy/methods , Exocrine Pancreatic Insufficiency/complications , Exocrine Pancreatic Insufficiency/drug therapy , Female , Gastrointestinal Diseases/drug therapy , Humans , Lipase , Male , Pancreatic Hormones
10.
Acta Paediatr ; 111(7): 1427-1434, 2022 07.
Article in English | MEDLINE | ID: mdl-35357724

ABSTRACT

AIM: We investigated associations between newborn body composition and anthropometry and body composition at 3 years in Danish children born from obese mothers. METHODS: Analyses are based on data from the observational cohort study SKOT II (SKOT; small children's diet and well-being (Danish)). Body composition at birth and at 3 years was assessed by dual-energy X-ray absorptiometry (DXA) scans and bioelectrical impedance analysis (BIA), respectively. Multiple linear regression models were applied to determine associations between newborn body composition and anthropometry and body composition at 3 years. RESULTS: Birthweight z-score (BWZ) was positively associated with fat-free mass (FFM), height, fat-free mass index (FFMI), fat mass (FM) and fat mass index (FMI) at 3 years. Newborn FFM was positively associated with FFM, height, FFMI and FM at 3 years, and positive trends were seen between newborn FM and FM and FMI at 3 years. CONCLUSION: We showed that infants born with a higher BWZ go on to be taller at 3 years. They also grow to be heavier, to which FM and FFM both contribute, independently of linear growth. Additionally, it seems that FFM tracks into early childhood, thus supporting intrauterine programming of later health.


Subject(s)
Body Composition , Mothers , Absorptiometry, Photon , Birth Weight , Body Mass Index , Child , Child, Preschool , Denmark , Electric Impedance , Female , Humans , Infant , Infant, Newborn , Obesity
11.
ESMO Open ; 7(1): 100342, 2022 02.
Article in English | MEDLINE | ID: mdl-34896762

ABSTRACT

BACKGROUND: Alectinib, a second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI), is highly effective in advanced ALK-rearranged non-small-cell lung cancer and represents a standard first-line therapy. New strategies are needed, however, to delay resistance. We conducted a phase I/II study to assess the safety and efficacy of combining alectinib with bevacizumab, a monoclonal antibody against vascular endothelial growth factor. PATIENTS AND METHODS: Patients with advanced ALK-rearranged non-squamous non-small-cell lung cancer were enrolled. The phase I portion employed a dose de-escalation strategy with alectinib and bevacizumab starting at the individual standard doses. The primary objective was to determine the recommended phase II dose (RP2D). In phase II, the primary objective was to evaluate the safety of the combination at the RP2D; the secondary objective was to determine extracranial and intracranial efficacy. RESULTS: Eleven patients were enrolled between September 2015 and February 2020. Most patients (82%) had baseline brain metastases. Six patients (55%) were treatment-naive; five (46%) had received prior ALK TKIs (crizotinib, n = 3; ceritinib, n = 1; crizotinib then brigatinib, n = 1). No dose-limiting toxicities occurred. RP2D was determined as alectinib 600 mg orally twice daily plus bevacizumab 15 mg/kg intravenously every 3 weeks. Three patients experienced grade 3 treatment-related adverse events: pneumonitis related to alectinib, proteinuria related to bevacizumab, and hypertension related to bevacizumab. Treatment-related intracranial hemorrhage was not observed. Six (100%) of six treatment-naive patients and three (60%) of five ALK TKI-pretreated patients had objective responses; median progression-free survival was not reached (95% confidence interval, 9.0 months-not reached) and 9.5 months (95% confidence interval, 4.3 months-not reached), respectively. Intracranial responses occurred in four (100%) of four treatment-naive and three (60%) of five TKI-pretreated patients with baseline brain metastases. The study was stopped prematurely because of slow accrual. CONCLUSIONS: Alectinib plus bevacizumab was well tolerated without unanticipated toxicities or dose-limiting toxicities.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Anaplastic Lymphoma Kinase/genetics , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bevacizumab/adverse effects , Carbazoles , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Piperidines , Receptor Protein-Tyrosine Kinases/metabolism , Receptor Protein-Tyrosine Kinases/therapeutic use , Vascular Endothelial Growth Factor A/therapeutic use
12.
Small Bus Econ (Dordr) ; 58(2): 769-805, 2022.
Article in English | MEDLINE | ID: mdl-38624606

ABSTRACT

Drawing on minority enclave theory and resilience theory in entrepreneurship, we test whether, with the onset of the COVID-19 pandemic, the self-employed lost more hours than the employed and whether traditionally disadvantaged self-employed racial minorities faced harsher penalties in the form of reduced hours of work. Though spatially concentrated ethnic minority colocations could improve business outcomes in the non-crisis period, with the pandemic affecting all the members in the enclave, the very dependencies in minority enclaves could be a liability. Using a large-scale survey during the COVID-19 pandemic conducted by the Brazilian government, we draw on a one-to-one nearest neighbor matched pair sample of 19,626 employed (public or private sector) and self-employed individuals, and control for industry-sector-interview-location fixed effects. The results show that self-employed people, compared to employed, reported a greater loss of hours. At the sample level, black self-employed people on aggregate lost 9,051 hours per month, and mixed race self-employed people on aggregate lost 27,880 hours per month. The disproportionate loss of work hours by the self-employed from racial minority groups during the COVID-19 pandemic in a developing country context calls for a closer examination and assessment of the long-term impact of COVID-19 on racial minorities.

13.
ACS Appl Electron Mater ; 3(1): 445-450, 2021 Jan 26.
Article in English | MEDLINE | ID: mdl-33615233

ABSTRACT

Visible light communications (VLC) require III-nitride visible micro-light-emitting diodes (µLEDs) with a high-modulation bandwidth. Such µLEDs need to be driven at a high injection current density on a kA/cm2 scale, which is about 2 orders of magnitude higher than those for normal visible LED operation. µLEDs are traditionally fabricated by dry-etching techniques where dry-etching-induced damages are unavoidable, leading to both a substantial reduction in performance and a great challenge to viability at a high injection current density. Furthermore, conventional biasing (which is simply applied across a p-n junction) is good enough for normal LED operation but generates a great challenge for a single µLED, which needs to be modulated at a high injection current density and at a high frequency. In this work, we have proposed a concept for an epitaxial integration and then demonstrated a completely different method that allows us to achieve an epitaxial integration of a single µLED with a diameter of 20 µm and an AlGaN/GaN high-electron-mobility transistor (HEMT), where the emission from a single µLED is modulated by tuning the gate voltage of its HEMT. Furthermore, such a direct epitaxial approach has entirely eliminated any dry-etching-induced damages. As a result, we have demonstrated an epitaxial integration of monolithic on-chip µLED-HEMT with a record modulation bandwidth of 1.2 GHz on industry-compatible c-plane substrates.

14.
Ann Oncol ; 31(12): 1725-1733, 2020 12.
Article in English | MEDLINE | ID: mdl-33007380

ABSTRACT

BACKGROUND: Rearranged during transfection (RET) gene fusions are a validated target in non-small-cell lung cancer (NSCLC). RET-selective inhibitors selpercatinib (LOXO-292) and pralsetinib (BLU-667) recently demonstrated favorable antitumor activity and safety profiles in advanced RET fusion-positive NSCLC, and both have received approval by the US Food and Drug Administration for this indication. Insights into mechanisms of resistance to selective RET inhibitors remain limited. PATIENTS AND METHODS: This study was performed at five institutions. Tissue and/or cell-free DNA was obtained from patients with RET fusion-positive NSCLC after treatment with selpercatinib or pralsetinib and assessed by next-generation sequencing (NGS) or MET FISH. RESULTS: We analyzed a total of 23 post-treatment tissue and/or plasma biopsies from 18 RET fusion-positive patients who received an RET-selective inhibitor (selpercatinib, n = 10; pralsetinib, n = 7; pralsetinib followed by selpercatinib, n = 1, with biopsy after each inhibitor). Three cases had paired tissue and plasma samples, of which one also had two serial resistant tissue specimens. The median progression-free survival on RET inhibitors was 6.3 months [95% confidence interval 3.6-10.8 months]. Acquired RET mutations were identified in two cases (10%), both affecting the RET G810 residue in the kinase solvent front. Three resistant cases (15%) harbored acquired MET amplification without concurrent RET resistance mutations, and one specimen had acquired KRAS amplification. No other canonical driver alterations were identified by NGS. Among 16 resistant tumor specimens, none had evidence of squamous or small-cell histologic transformation. CONCLUSIONS: RET solvent front mutations are a recurrent mechanism of RET inhibitor resistance, although they occurred at a relatively low frequency. The majority of resistance to selective RET inhibition may be driven by RET-independent resistance such as acquired MET or KRAS amplification. Next-generation RET inhibitors with potency against RET resistance mutations and combination strategies are needed to effectively overcome resistance in these patients.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Mutation , Protein Kinase Inhibitors/therapeutic use , Proto-Oncogene Proteins c-ret/genetics , Pyrazoles , Pyridines , Pyrimidines , Tyrosine
15.
World Neurosurg ; 139: e293-e296, 2020 07.
Article in English | MEDLINE | ID: mdl-32298833

ABSTRACT

BACKGROUND: Decompressive hemicraniectomy (DHC) is well established as an effective life-saving intervention. Although literature documents a correlation between mortality and hemicraniectomy flap size, no literature exists demonstrating whether a larger flap may be achieved with 3-pin fixation devices versus nonfixed positioning (e.g., occipital headrest, gel donut). Therefore, positioning for DHC remains the preference of the institution and attending physician. METHODS: Patients undergoing DHC during 2005-2016 were identified using Current Procedural Terminology codes. Inclusion criteria were: operative note available in the electronic medical record and postoperative head computed tomography (hCT). Exclusion criteria were: age <18 years, missing data in electronic medical record, no postoperative hCT performed, and craniectomy not done with intention of performing a hemicraniectomy (i.e., craniotomy converted to craniectomy). Anteroposterior diameter of the hemicraniectomy flap was measured in millimeters on the postoperative hCT. The average diameter was compared between the fixed positioning and nonfixed positioning groups. RESULTS: Analysis included 522 patients who met inclusion criteria; 363 were in the fixed positioning group, and 159 were in the nonfixed positioning group. The average hemicraniectomy diameter was 132.17 mm in the fixed positioning group, and 129.74 mm in the nonfixed positioning group, which was statistically significant (P = 0.027). CONCLUSIONS: This is the first large-scale single-institution study evaluating whether operative positioning for DHC affects the size of a hemicraniectomy flap. Positioning in 3-point fixation led to a statistically significant larger average diameter compared with nonfixed positioning. This indicates that the risks associated with pin fixation as well as additional time spent in positioning in this fashion are offset by the ability to obtain a larger hemicraniectomy flap, which is associated with decreased mortality.


Subject(s)
Decompressive Craniectomy/methods , Patient Positioning/methods , Surgical Flaps , Adult , Decompressive Craniectomy/mortality , Female , Humans , Male , Retrospective Studies , Treatment Outcome
16.
Ethn Dis ; 30(1): 33-40, 2020.
Article in English | MEDLINE | ID: mdl-31969781

ABSTRACT

In this article, we report on an 11-year study that explores approaches to improve student success in college by a five-week summer program in Mathematics and Language Arts for entering freshmen. To recruit students into the program, we invited students accepted at the university and listed as underrepresented and economically disadvantaged (Pell-eligible) by the Office of Institutional Research at California State University, Northridge. The program consisted of all-day Math and English enhancement in mixed ability groups. Results of this program examining Math and English performance at California State University, Northridge showed that students completing the summer programs during the 11-year study period had improved pass rates in Math and English at California State University, Northridge compared with students in a control group who did not participate in the summer program. The results show that intensive pre-college enhancement for entering freshmen can improve student success in college. Student graduation data from the early cohorts (2010, 2011, 2012) were obtained from Institutional Research. The summary results showed that students from the accepted/attending group had substantially increased GPAs and graduation rates, essentially closing the achievement gap. Increased interest in biomedical research careers was also developed by the program, as demonstrated by a five-fold number of summer enrichment participants entering the PhD, MARC (Minority Access to Research Careers) and RISE (Research Initiative for Scientific Enhancement) programs than students who did not attend summer enrichment.


Subject(s)
Biomedical Research/education , Career Choice , Minority Groups/education , Humans , Mathematics/education , Students/statistics & numerical data , Technology/education , Universities
17.
Mol Reprod Dev ; 84(12): 1285-1295, 2017 12.
Article in English | MEDLINE | ID: mdl-29064589

ABSTRACT

The molecular and cellular characteristics of male germ cell development remain largely unknown in corals. This study focused on the expression pattern of acetylated α-tubulin (Ac-α-Tu), which is involved in male germ cell development in various animals across taxa, to gain a better understanding of male germ cell development in the stony coral Euphyllia ancora. Immunohistochemical analysis of the different stages of male germ cells showed the presence of filamentous Ac-α-Tu in the early to late stages of male germ cells-such as spermatogonia, spermatocytes, and spermatids-as well as in the flagella of mature sperm. Immunocytochemical and transmission electron microscope analyses demonstrated that early-stage male germ cells possess long flagella containing Ac-α-Tu. The presence of filamentous Ac-α-Tu was also immunohistochemically demonstrated in the male germ cells from 14 other coral species, implying that possession of flagella with Ac-α-Tu is a common characteristic of male germ cells in stony corals. Therefore, as a distinctive cellular characteristic of male germ cells, Ac-α-Tu could be used as a male germ cell marker in stony corals; indeed, immunolabeling for Ac-α-Tu may be a useful method to aid in the identification and morphological observation of male germ cells in various corals in basic and applied biology (e.g., aquaculture) as well as in ecological studies.


Subject(s)
Anthozoa/metabolism , Sperm Tail/metabolism , Tubulin/metabolism , Animals , Anthozoa/cytology , Male , Spermatids/cytology , Spermatids/metabolism , Spermatocytes/cytology , Spermatocytes/metabolism , Spermatogonia/cytology , Spermatogonia/metabolism
18.
Clin Pharmacol Ther ; 101(5): 625-633, 2017 May.
Article in English | MEDLINE | ID: mdl-28182271

ABSTRACT

In the 9 years since the initial discovery of anaplastic lymphoma kinase (ALK) gene rearrangements in non-small cell lung cancer (NSCLC), there has been tremendous progress, culminating in an ever-expanding repertoire of agents that have activity in this disease. This review article provides an overview of currently approved ALK inhibitors, other ALK inhibitors in development, and commonly described mechanisms of resistance to ALK inhibitors. We also discuss emerging controversies in treatment of patients with ALK-positive lung cancer, including the choice of first-line ALK inhibitor and the role of tyrosine kinase inhibitors in the treatment of central nervous system metastases.


Subject(s)
Antineoplastic Agents/therapeutic use , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Lymphoma, Large-Cell, Anaplastic/drug therapy , Lymphoma, Large-Cell, Anaplastic/genetics , Anaplastic Lymphoma Kinase , Antineoplastic Agents/administration & dosage , Enzyme Inhibitors/administration & dosage , Enzyme Inhibitors/therapeutic use , Humans , Lung Neoplasms/pathology , Lymphoma, Large-Cell, Anaplastic/pathology , Precision Medicine , Prognosis , Receptor Protein-Tyrosine Kinases/antagonists & inhibitors , Receptor Protein-Tyrosine Kinases/genetics
19.
Concussion ; 2(4): CNC49, 2017 Dec.
Article in English | MEDLINE | ID: mdl-30202590

ABSTRACT

Post-traumatic headache is the most common symptom of postconcussion syndrome and becomes a chronic neurological disorder in a substantial proportion of patients. This review provides a brief overview of the epidemiology of postconcussion headache, research models used to study this disorder, as well as the proposed mechanisms. An objective of this review is to enhance the understanding of how the endogenous cannabinoid system is essential for maintaining the balance of the CNS and regulating inflammation after injury, and in turn making the endocannabinoid system a potential modulator of the trigeminal response to concussion. The review describes the role of endocannabinoid modulation of pain and the potential for use of phytocannabinoids to treat pain, migraine and concussion.

20.
Ann Oncol ; 27 Suppl 3: iii42-iii50, 2016 09.
Article in English | MEDLINE | ID: mdl-27573756

ABSTRACT

In 2007, a chromosomal rearrangement resulting in a gene fusion leading to expression of a constitutively active anaplastic lymphoma kinase (ALK) fusion protein was identified as an oncogenic driver in non-small-cell lung cancer (NSCLC). ALK rearrangements are detected in 3%-7% of patients with NSCLC and are particularly enriched in younger patients with adenocarcinoma and a never or light smoking history. Fortuitously, crizotinib, a small molecule tyrosine kinase inhibitor initially developed to target cMET, was able to be repurposed for ALK-rearranged (ALK+) NSCLC. Despite dramatic and durable initial responses to crizotinib; however, the vast majority of patients will develop resistance within a few years. Diverse molecular mechanisms underlie resistance to crizotinib. This review will describe the clinical activity of crizotinib, review identified mechanisms of crizotinib resistance, and end with a survey of emerging therapeutic strategies aimed at overcoming crizotinib resistance.


Subject(s)
Protein Kinase Inhibitors/therapeutic use , Pyrazoles/therapeutic use , Pyridines/therapeutic use , Receptor Protein-Tyrosine Kinases/antagonists & inhibitors , Anaplastic Lymphoma Kinase , Brain Neoplasms/secondary , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/pathology , Crizotinib , Drug Resistance, Neoplasm , Epithelial-Mesenchymal Transition , Gene Rearrangement , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Pyrazoles/pharmacology , Pyridines/pharmacology , Receptor Protein-Tyrosine Kinases/genetics
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