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Introduction:
Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin’s lymphoma in a real-life clinical setting.
Methods:
Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators.
Results:
A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician’s visual analogue scale; mean improvement from baseline of 12.1 mm)
Forest fragmentation and selective logging are two main drivers of global environmental change and modify biodiversity and environmental conditions in many tropical forests. The consequences of these changes for the functioning of tropical forest ecosystems have rarely been explored in a comprehensive approach. In a Kenyan rainforest, we studied six animal-mediated ecosystem processes and recorded species richness and community composition of all animal taxa involved in these processes. We used linear models and a formal meta-analysis to test whether forest fragmentation and selective logging affected ecosystem processes and biodiversity and used structural equation models to disentangle direct from biodiversity-related indirect effects of human disturbance on multiple ecosystem processes. Fragmentation increased decomposition and reduced antbird predation, while selective logging consistently increased pollination, seed dispersal and army-ant raiding. Fragmentation modified species richness or community composition of five taxa, whereas selective logging did not affect any component of biodiversity. Changes in the abundance of functionally important species were related to lower predation by antbirds and higher decomposition rates in small forest fragments. The positive effects of selective logging on bee pollination, bird seed dispersal and army-ant raiding were direct, i.e. not related to changes in biodiversity, and were probably due to behavioural changes of these highly mobile animal taxa. We conclude that animal-mediated ecosystem processes respond in distinct ways to different types of human disturbance in Kakamega Forest. Our findings suggest that forest fragmentation affects ecosystem processes indirectly by changes in biodiversity, whereas selective logging influences processes directly by modifying local environmental conditions and resource distributions. The positive to neutral effects of selective logging on ecosystem processes show that the functionality of tropical forests can be maintained in moderately disturbed forest fragments. Conservation concepts for tropical forests should thus include not only remaining pristine forests but also functionally viable forest remnants.
The objective was to determine the mRNA expression and protein levels of uPA system components in tissue specimens and serum samples, respectively, from prostate cancer (PCa) patients and to assess their association with clinicopathological parameters and overall survival (OS). The mRNA expression levels of uPA, its receptor (uPAR), and its inhibitor type 1 (PAI-1) were analyzed in corresponding malignant and adjacent nonmalignant tissue specimens from 132 PCa patients by quantitative PCR. Preoperative serum samples from 81 PCa patients were analyzed for antigen levels of uPA system members by ELISA. RNA levels of uPA system components displayed significant correlations with each other in the tumor tissues. A significantly decreased uP AmRNA expression in PCa compared to the corresponding nonmalignant tissue was detected. High uPA mRNA level was significantly associated with a high Gleason score. Elevated concentration of soluble uPAR (suPAR) in serum was significantly associated with a poor OS of PCa patients (P = 0.022). PCa patients with high suPAR levels have a significantly higher risk of death (multivariate Cox's regression analysis; IIR - 7.12, P - 0.027). The association of high suPAR levels with poor survival of PCa patients suggests a prognostic impact of suPAR levels in serum of cancer patients.
Squamous cell carcinomas (SCC) frequently have an exceptionally high mutational burden. As consequence, they rapidly develop resistance to platinum-based chemotherapy and overall survival is limited. Novel therapeutic strategies are therefore urgently required. SCC express ∆Np63, which regulates the Fanconi Anemia (FA) DNA-damage response in cancer cells, thereby contributing to chemotherapy-resistance. Here we report that the deubiquitylase USP28 is recruited to sites of DNA damage in cisplatin-treated cells. ATR phosphorylates USP28 and increases its enzymatic activity. This phosphorylation event is required to positively regulate the DNA damage repair in SCC by stabilizing ∆Np63. Knock-down or inhibition of USP28 by a specific inhibitor weakens the ability of SCC to cope with DNA damage during platin-based chemotherapy. Hence, our study presents a novel mechanism by which ∆Np63 expressing SCC can be targeted to overcome chemotherapy resistance. Limited treatment options and low response rates to chemotherapy are particularly common in patients with squamous cancer. The SCC specific transcription factor ∆Np63 enhances the expression of Fanconi Anemia genes, thereby contributing to recombinational DNA repair and Cisplatin resistance. Targeting the USP28-∆Np63 axis in SCC tones down this DNA damage response pathways, thereby sensitizing SCC cells to cisplatin treatment.
Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice.
Reduced Recombination Losses in Evaporated Perovskite Solar Cells by Postfabrication Treatment
(2021)
The photovoltaic perovskite research community has now developed a large set of tools and techniques to improve the power conversion efficiency (PCE). One such arcane trick is to allow the finished devices to dwell in time, and the PCE often improves. Herein, a mild postannealing procedure is implemented on coevaporated perovskite solar cells confirming a substantial PCE improvement, mainly attributed to an increased open-circuit voltage (V\(_{OC}\)). From a V\(_{OC}\) of around 1.11 V directly after preparation, the voltage improves to more than 1.18 V by temporal and thermal annealing. To clarify the origin of this annealing effect, an in-depth device experimental and simulation characterization is conducted. A simultaneous reduction of the dark saturation current, the ideality factor (n\(_{id}\)), and the leakage current is revealed, signifying a substantial impact of the postannealing procedure on recombination losses. To investigate the carrier dynamics in more detail, a set of transient optoelectrical methods is first evaluated, ascertaining that the bulk carrier lifetime is increased with device annealing. Second, a drift-diffusion simulation is used, confirming that the beneficial effect of the annealing has its origin in effective bulk trap passivation that accordingly leads to a reduction of Shockley–Read–Hall recombination rates.
Lung cancer is the most common cancer worldwide and the leading cause of cancer-related deaths in both men and women. Despite the development of novel therapeutic interventions, the 5-year survival rate for non-small cell lung cancer (NSCLC) patients remains low, demonstrating the necessity for novel treatments. One strategy to improve translational research is the development of surrogate models reflecting somatic mutations identified in lung cancer patients as these impact treatment responses. With the advent of CRISPR-mediated genome editing, gene deletion as well as site-directed integration of point mutations enabled us to model human malignancies in more detail than ever before. Here, we report that by using CRISPR/Cas9-mediated targeting of Trp53 and KRas, we recapitulated the classic murine NSCLC model Trp53fl/fl:lsl-KRasG12D/wt. Developing tumors were indistinguishable from Trp53fl/fl:lsl-KRasG12D/wt-derived tumors with regard to morphology, marker expression, and transcriptional profiles. We demonstrate the applicability of CRISPR for tumor modeling in vivo and ameliorating the need to use conventional genetically engineered mouse models. Furthermore, tumor onset was not only achieved in constitutive Cas9 expression but also in wild-type animals via infection of lung epithelial cells with two discrete AAVs encoding different parts of the CRISPR machinery. While conventional mouse models require extensive husbandry to integrate new genetic features allowing for gene targeting, basic molecular methods suffice to inflict the desired genetic alterations in vivo. Utilizing the CRISPR toolbox, in vivo cancer research and modeling is rapidly evolving and enables researchers to swiftly develop new, clinically relevant surrogate models for translational research.
In time-sensitive networks (TSN) based on 802.1Qbv, i.e., the time-aware Shaper (TAS) protocol, precise transmission schedules and, paths are used to ensure end-to-end deterministic communication. Such resource reservations for data flows are usually established at the startup time of an application and remain untouched until the flow ends. There is no way to migrate existing flows easily to alternative paths without inducing additional delay or wasting resources. Therefore, some of the new flows cannot be embedded due to capacity limitations on certain links which leads to sub-optimal flow assignment. As future networks will need to support a large number of lowlatency flows, accommodating new flows at runtime and adapting existing flows accordingly becomes a challenging problem. In this extended abstract we summarize a previously published paper of us [1]. We combine software-defined networking (SDN), which provides better control of network flows, with TSN to be able to seamlessly migrate time-sensitive flows. For that, we formulate an optimization problem and propose different dynamic path configuration strategies under deterministic communication requirements. Our simulation results indicate that regularly reconfiguring the flow assignments can improve the latency of time-sensitive flows and can increase the number of flows embedded in the network around 4% in worst-case scenarios while still satisfying individual flow deadlines.
Background
Despite advances in treatment of patients with non-small cell lung cancer, carriers of certain genetic alterations are prone to failure. One such factor frequently mutated, is the tumor suppressor PTEN. These tumors are supposed to be more resistant to radiation, chemo- and immunotherapy.
Results
We demonstrate that loss of PTEN led to altered expression of transcriptional programs which directly regulate therapy resistance, resulting in establishment of radiation resistance. While PTEN-deficient tumor cells were not dependent on DNA-PK for IR resistance nor activated ATR during IR, they showed a significant dependence for the DNA damage kinase ATM. Pharmacologic inhibition of ATM, via KU-60019 and AZD1390 at non-toxic doses, restored and even synergized with IR in PTEN-deficient human and murine NSCLC cells as well in a multicellular organotypic ex vivo tumor model.
Conclusion
PTEN tumors are addicted to ATM to detect and repair radiation induced DNA damage. This creates an exploitable bottleneck. At least in cellulo and ex vivo we show that low concentration of ATM inhibitor is able to synergise with IR to treat PTEN-deficient tumors in genetically well-defined IR resistant lung cancer models.
The transcription factor ∆Np63 is a master regulator of epithelial cell identity and essential for the survival of squamous cell carcinoma (SCC) of lung, head and neck, oesophagus, cervix and skin. Here, we report that the deubiquitylase USP28 stabilizes ∆Np63 and maintains elevated ∆NP63 levels in SCC by counteracting its proteasome‐mediated degradation. Impaired USP28 activity, either genetically or pharmacologically, abrogates the transcriptional identity and suppresses growth and survival of human SCC cells. CRISPR/Cas9‐engineered in vivo mouse models establish that endogenous USP28 is strictly required for both induction and maintenance of lung SCC. Our data strongly suggest that targeting ∆Np63 abundance via inhibition of USP28 is a promising strategy for the treatment of SCC tumours.
The fact that photovoltaics is a key technology for climate-neutral energy production can be taken as a given. The question to what extent perovskite will be used for photovoltaic technologies has not yet been fully answered. From a photophysical point of view, however, it has the potential to make a useful contribution to the energy sector. However, it remains to be seen whether perovskite-based modules will be able to compete with established technologies in terms of durability and cost efficiency. The additional aspect of ionic migration poses an additional challenge. In the present work, primarily the interaction between ionic redistribution, capacitive properties and recombination dynamics was investigated. This was done using impedance spectroscopy, OCVD and IV characteristics as well as extensive numerical drift-diffusion simulations. The combination of experimental and numerical methods proved to be very fruitful. A suitable model for the description of solar cells with respect to mobile ions was introduced in chapter 4.4. The formal mathematical description of the model was transferred by a non-dimensionalization and suitable numerically solvable form. The implementation took place in the Julia language. By intelligent use of structural properties of the sparse systems of equations, automatic differentiation and the use of efficient integration methods, the simulation tool is not only remarkably fast in finding the solution, but also scales quasi-linearly with the grid resolution. The software package was released under an open source license. In conventional semiconductor diodes, capacitance measurements are often used to determine the space charge density. In the first experimental chapter 5, it is shown that although this is also possible for the ionic migration present in perovskites, it cannot be directly understood as doping related, since the space charge distribution strongly depends on the preconditions and can be manipulated by an externally applied voltage. The exact form of this behavior depends on the perovskite composition. This shows, among other things, that experimental results can only be interpreted within the framework of conventional semiconductors to a very limited extent. Nevertheless, the built-in 99 potential of the solar cell can be determined if the experiments are carried out properly. A statement concerning the type and charge of the mobile ions is not possible without further effort, while their number can be determined. The simulations were applied to experimental data in chapter 6. Thus, it could be shown that mobile ions make a significant contribution to the OCVD of perovskite solar cells. j-V characteristics and OCVD transients measured as a function of temperature and illumination intensities could be quantitatively modeled simultaneously using a single global set of parameters. By the simulations it was further possible to derive a simple experimental procedure to determine the concentration and the diffusivity of the mobile ions. The possibility of describing different experiments in a uniform temperaturedependent manner strongly supports the model of mobile ions in perovskites. In summary, this work has made an important contribution to the elucidation of ionic contributions to the (photo)electrical properties of perovskite solar cells. Established experimental techniques for conventional semiconductors have been reinterpreted with respect to ionic mass transport and new methods have been proposed to draw conclusions on the properties for ionic transport. As a result, the published simulation tools can be used for a number of further studies.