HPV-associated oropharyngeal carcinomas in patients living with HIV on long-term antiretroviral therapy: Case reports

In the 1970s, human papillomaviruses (HPV) were ascertained as the aetiologic agents of cervical carcinoma. Subsequently, an association with HPV was established in other epithelial tumours, including squamous cell carcinoma of the head and neck (HNSCC). HPV has demonstrated a high potential for inducing oropharyngeal tumours, with HPV-16 infection posing a significant oncogenic risk. People living with HIV (PLWH) are identified as being at a higher risk of HPV infection and the subsequent development of HPV-associated tumours of the oropharynx. We present two patients under the care of the Department of AIDS with long-term HIV infections who were newly diagnosed with HPV-associated carcinomas of the tonsils. Both patients had been on antiretroviral therapy (ART) for over 15 years, achieving optimal viral suppression for more than 10 years. Chemotherapy and radiation therapy were employed in the treatment of the carcinomas. Throughout the neoplastic disease treatment, both patients maintained optimal viral suppression for HIV. The presented cases underscore the fact that despite achieving long-term optimal viral suppression of HIV, people living with HIV remain susceptible to the development of HPV-associated neoplasms.

Disseminated Mycobacterium avium Infection with Different Clinical Presentation in Two Human Immunodeficiency Virus-positive Patients

ABSTRACT

Microorganisms belonging to the Mycobacterium avium complex (MAC) are ubiquitous in the environment, but only a minority of infected persons develop disease. An underlying lung disease or immune deficiency is a prerequisite for clinical manifestation. However, disseminated MAC disease primarily manifests in people living with human immunodeficiency virus (HIV) in the severe immunodeficiency stage with a whole host of clinical symptoms. We present two cases of disseminated M. avium infection in people living with HIV in the stage of severe immunodeficiency. Both patients exhibited distinct disease progression, with the absence of pulmonary symptoms being a common characteristic. The first patient predominantly experienced high fever, accompanied by diarrhea and severe anemia. The normothermia in the second patient was incongruent with the presence of marked cachexia, severe abdominal pain, and magnetic resonance imaging evidence of abdominal lymph node involvement. The causative agent was isolated from both sputum and stools. The patients underwent treatment that comprised aminoglycoside, macrolide, ethambutol, and rifampicin. Although both patients achieved optimal viral suppression of HIV, the immunologic response to antiretroviral therapy was suboptimal. The first patient died in the setting of severe immunodeficiency due to the development of decompensated liver cirrhosis, while the second patient demonstrated a slight reverse course of the disease.

Antibody-Based and Cell Therapies for Advanced Mastocytosis: Established and Novel Concepts

Advanced systemic mastocytosis (SM) is a heterogeneous group of myeloid neoplasms characterized by an uncontrolled expansion of mast cells (MC) in one or more internal organs, SM-induced tissue damage, and poor prognosis. Advanced SM can be categorized into aggressive SM (ASM), MC leukemia (MCL), and SM with an associated hematologic neoplasm (SM-AHN). In a vast majority of all patients, neoplastic cells display a KIT mutation, mostly D816V and rarely other KIT variants. Additional mutations in other target genes, such as SRSF2, ASXL1, or RUNX1, may also be identified, especially when an AHN is present. During the past 10 years, improved treatment approaches have led to a better quality of life and survival in patients with advanced SM. However, despite the availability of novel potent inhibitors of KIT D816V, not all patients enter remission and others relapse, often with a multi-mutated and sometimes KIT D816V-negative disease exhibiting multi-drug resistance. For these patients, (poly)chemotherapy, antibody-based therapies, and allogeneic hematopoietic stem cell transplantation may be viable treatment alternatives. In this article, we discuss treatment options for patients with drug-resistant advanced SM, including novel KIT-targeting drugs, antibody-based drugs, and stem cell-eradicating therapies.

Vienna Cancer Stem Cell Club (VCSCC): 20 year jubilee and future perspectives

INTRODUCTION

The Vienna Cancer Stem Cell Club (VCSCC) was launched by a group of scientists in Vienna in 2002.

AREAS COVERED

Major aims of the VCSCC are to support research on cancer stem cells (CSC) in hematopoietic malignancies and to translate CSC-related markers and targets into clinical application. A primary focus of research in the VCSCC is the leukemic stem cell (LSC). Between 2013 and 2021, members of the VCSCC established a special research program on myeloproliferative neoplasms and since 2008, members of the VCSCC run the Ludwig Boltzmann Institute for Hematology and Oncology. In all these years, the VCSCC provided a robust intellectual platform for translational hematology and LSC research in Vienna. Furthermore, the VCSCC interacts with several national and international study groups and societies in the field. Representatives of the VCSCC also organized a number of international meetings and conferences on neoplastic stem cells, including LSC, in the past 15 years, and contributed to the definition and classification of CSC/LSC and related pre-malignant and malignant conditions.

EXPERT OPINION

The VCSCC will continue to advance the field and to develop LSC-detecting and LSC-eradicating concepts through which diagnosis, prognostication, and therapy of blood cancer patients should improve.

Phenotypic characterization of disease-initiating stem cells in JAK2- or CALR-mutated myeloproliferative neoplasms

Myeloproliferative neoplasms (MPN) are characterized by uncontrolled expansion of myeloid cells, disease-related mutations in certain driver-genes including JAK2, CALR, and MPL, and a substantial risk to progress to secondary acute myeloid leukemia (sAML). Although behaving as stem cell neoplasms, little is known about disease-initiating stem cells in MPN. We established the phenotype of putative CD34+ /CD38- stem cells and CD34+ /CD38+ progenitor cells in MPN. A total of 111 patients with MPN suffering from polycythemia vera, essential thrombocythemia, or primary myelofibrosis (PMF) were examined. In almost all patients tested, CD34+ /CD38- stem cells expressed CD33, CD44, CD47, CD52, CD97, CD99, CD105, CD117, CD123, CD133, CD184, CD243, and CD274 (PD-L1). In patients with PMF, MPN stem cells often expressed CD25 and sometimes also CD26 in an aberrant manner. MPN stem cells did not exhibit substantial amounts of CD90, CD273 (PD-L2), CD279 (PD-1), CD366 (TIM-3), CD371 (CLL-1), or IL-1RAP. The phenotype of CD34+ /CD38- stem cells did not change profoundly during progression to sAML. The disease-initiating capacity of putative MPN stem cells was confirmed in NSGS mice. Whereas CD34+ /CD38- MPN cells engrafted in NSGS mice, no substantial engraftment was produced by CD34+ /CD38+ or CD34- cells. The JAK2-targeting drug fedratinib and the BRD4 degrader dBET6 induced apoptosis and suppressed proliferation in MPN stem cells. Together, MPN stem cells display a unique phenotype, including cytokine receptors, immune checkpoint molecules, and other clinically relevant target antigens. Phenotypic characterization of neoplastic stem cells in MPN and sAML should facilitate their enrichment and the development of stem cell-eradicating (curative) therapies.

Antibody Conjugates Bispecific for Pollen Allergens and ICAM-1 with Potential to Prevent Epithelial Allergen Transmigration and Rhinovirus Infection

Allergy and rhinovirus (RV) infections are major triggers for rhinitis and asthma, causing a socioeconomic burden. As RVs and allergens may act synergistically to promote airway inflammation, simultaneous treatment strategies for both causative agents would be innovative. We have previously identified the transmembrane glycoprotein intercellular adhesion molecule 1 (ICAM-1) as an anchor for antibody conjugates bispecific for ICAM-1 and Phleum pratense (Phl p) 2, a major grass pollen allergen, to block allergen transmigration through the epithelial barrier. Since ICAM-1 is a receptor for the major group RVs, we speculated that our bispecific antibody conjugates may protect against RV infection. Therefore, we created antibody conjugates bispecific for ICAM-1 and the major grass pollen allergen Phl p 5 and analyzed their capacity to affect allergen penetration and RV infection. Bispecific antibody conjugates significantly reduced the trans-epithelial migration of Phl p 5 and thus the basolateral Phl p 5 concentration and allergenic activity as determined by humanized rat basophilic leukemia cells and inhibited RV infection of cultured epithelial cells. A reduction in allergenic activity was obtained only through the prevention of allergen transmigration because the Phl p 5-specific IgG antibody did not block the allergen-IgE interaction. Our results indicate the potential of allergen/ICAM-1-specific antibody conjugates as a topical treatment strategy for allergy and RV infections.

Characterization data of reference materials used for phase II of the priority program DFG SPP 2005 "Opus Fluidum Futurum - Rheology of reactive, multiscale, multiphase construction materials"

A thorough characterization of base materials is the prerequisite for further research. In this paper, the characterization data of the reference materials (CEM I 42.5 R, limestone powder, calcined clay and a mixture of these three components) used in the second funding phase of the priority program 2005 of the German Research Foundation (DFG SPP 2005) are presented under the aspects of chemical and mineralogical composition as well as physical and chemical properties. The data were collected based on tests performed by up to eleven research groups involved in this cooperative program.

Identification of CD203c as a New Basophil-Specific Flow-Marker in Ph+ Chronic Myeloid Leukemia

Basophilia is a crucial prognostic variable in Ph-chromosome-positive chronic myeloid leukemia (CML). The ectoenzyme CD203c is an activation-linked surface antigen that is expressed specifically on basophil-committed progenitor cells and mature basophils. We examined the expression of CD203c on progenitors and/or basophils in 21 healthy donors and 44 patients with CML. As expected, the numbers of CD203c⁺ blood leukocytes were significantly higher in CML patients compared to controls (percentage of CD203c⁺ cells among viable cells in CML at diagnosis: 4.19 ± 3.68% vs. controls: 0.53 ± 0.23%, p < 0.05). Moreover, CML basophils expressed higher levels of CD203c compared to normal basophils (median staining-index in CML at diagnosis: 29.41 ± 19.14 versus controls: 20.44 ± 13.45). We also found that the numbers and percentage of circulating CD203c⁺ cells at diagnosis correlate with the disease-related risk-profile. Incubation of CML basophils with an anti-IgE-antibody resulted in further upregulation of CD203c. After successful treatment with imatinib and/or other BCR::ABL1 inhibitors leading to major or complete molecular responses, the numbers of CD203c⁺ basophils decreased substantially in our CML patients compared to pre-treatment values. Together, CD203c is overexpressed on CML basophils, is further upregulated by IgE receptor cross-linking, and may serve as a biomarker to quantify basophilia in patients with CML at diagnosis and during therapy.

Association between early cumulative fluid balance and successful liberation from invasive ventilation in COVID-19 ARDS patients — insights from the PRoVENT-COVID study: a national, multicenter, observational cohort analysis

Background

Increasing evidence indicates the potential benefits of restricted fluid management in critically ill patients. Evidence lacks on the optimal fluid management strategy for invasively ventilated COVID-19 patients. We hypothesized that the cumulative fluid balance would affect the successful liberation of invasive ventilation in COVID-19 patients with acute respiratory distress syndrome (ARDS).

Methods

We analyzed data from the multicenter observational ‘PRactice of VENTilation in COVID-19 patients’ study. Patients with confirmed COVID-19 and ARDS who required invasive ventilation during the first 3 months of the international outbreak (March 1, 2020, to June 2020) across 22 hospitals in the Netherlands were included. The primary outcome was successful liberation of invasive ventilation, modeled as a function of day 3 cumulative fluid balance using Cox proportional hazards models, using the crude and the adjusted association. Sensitivity analyses without missing data and modeling ARDS severity were performed.

Results

Among 650 patients, three groups were identified. Patients in the higher, intermediate, and lower groups had a median cumulative fluid balance of 1.98 L (1.27–7.72 L), 0.78 L (0.26–1.27 L), and − 0.35 L (− 6.52–0.26 L), respectively. Higher day 3 cumulative fluid balance was significantly associated with a lower probability of successful ventilation liberation (adjusted hazard ratio 0.86, 95% CI 0.77–0.95, P = 0.0047). Sensitivity analyses showed similar results.

Conclusions

In a cohort of invasively ventilated patients with COVID-19 and ARDS, a higher cumulative fluid balance was associated with a longer ventilation duration, indicating that restricted fluid management in these patients may be beneficial.

Trial registration Clinicaltrials.gov (NCT04346342); Date of registration: April 15, 2020.

Graphical abstract

Dynamics of emotional reactions among Russian students during the COVID-19 pandemic

Introduction

The pandemic of a new coronavirus infection can be considered as a long-term traumatic event. It is known that chronic stress is characterized by dynamics of emotional state caused by processes of adaptation and maladaptation.

Objectives

Our study aimed to investigate the dynamics of depression, anxiety, and stress levels among Russian students during the COVID-19 pandemic.

Methods

Data were collected from May to July 2020 (the first pandemic wave) and from October 2020 to April 2021 (the second wave). A total of 170 non-medical university students participated in the study. We used the DASS-21 to determine levels of depression, anxiety, and stress.

Results

We found that during the first wave of the pandemic, 57 % of students showed no symptoms of depression, 77 % had no symptoms of anxiety, and 76 % showed no signs of stress. In the second wave, 50 % of students showed no depression, 65 % no anxiety and 67 % no stress. Analysis of mean values showed that the second pandemic wave provoked higher levels of anxiety (M = 3.32±4.25 vs M = 4.71±4.71, p < 0.05) and stress (M = 6.50±4.50 vs M = 7.99±4.97, p < 0.05) .

Conclusions

The second wave of the new coronavirus pandemic provoked more severe emotional reactions among Russian students than the first. By these results we suggest that the duration of the pandemic harms the emotional state of the general population. Therefore, it is essential to develop and implement psychotherapeutic programs to restore the mental health of Russian citizens.

Disclosure

No significant relationships.

Emotional reactions and hardiness among Russian students during the first wave of the COVID-19 pandemic

Introduction

The COVID-19 pandemic provoked emotional reactions in Russian student populations. Hardiness is seen as a personality predisposition that increases individuals’ resilience to stress.

Objectives

The study aimed to determine the severity of depression, anxiety, stress, and various components of hardiness in Russian students. In addition, the correlations between emotional reactions and hardiness components were also analysed.

Methods

Data collection was carried out between 29 May and 06 July 2020. A total of 129 medical and non-medical students participated in the study. The DASS-21 was used to measure depression, anxiety, and stress levels, while the Personal Views Survey-III examined hardiness. Both questionnaires were adapted for use in Russia.

Results

We found that medical students were less likely to be depressed than non-medical students (M = 4.03 and M = 6.01 respectively, p < 0.05). Medical students had higher levels of the component of hardiness such as commitment (M = 20.95 and M = 18.43 respectively, p < 0.05). In both groups, all hardiness components have negative relationships with depression, anxiety, and stress, but in the medical group control is associated only with depression (r_x = -0.446, p < 0.01), whereas the other group also has associations with anxiety (r_x = -0.356, p < 0.01) and stress (r_x = -0.407, p < 0.01).

Conclusions

Hardiness was negatively related to depression, anxiety, and stress in a pandemic setting. Medical students were more adaptable to the pandemic than non-medical students.

Disclosure

No significant relationships.

Baseline beliefs, depression, anxiety, and stress in humanities students in the context of the COVID-19 pandemic

Introduction

The COVID-19 pandemic can be seen as mental trauma. The concept of baseline beliefs helps to explain the extent to which mental trauma affects individuals.

Objectives

The study aimed to investigate baseline beliefs in humanities students in Russian universities and analyse the relationship between baseline beliefs and emotional reactions.

Methods

Data collection was carried out between May and July 2020 using a Google form that we developed. A total of 92 humanities students participated in the study. The WAS-37 was used to examine baseline beliefs, and the DASS-21 was used to determine depression, anxiety, and stress levels.

Results

We found that the mean values of the scales “Benevolence in the World” (M = 34.8±6.5), “Self-image” (M = 27.2±4.4), “Luck” (M = 32.7±5.7) and “Controlling beliefs” (M = 27.9±4.0) were above the normative mean values for the Russian population and only the values of the scale “Justice” (M = 20.8±3.8) were below these. All components of baseline beliefs had negative associations with depression, anxiety, and stress; only “Benevolence in the World” was associated exclusively with anxiety (r_s = -0.223, p < 0.05), and “Justice” with depression (r_s = -0.223, p < 0.05).

Conclusions

In a pandemic, the world around them is perceived by humanities students as less fair. Trust in the world, beliefs about the fairness of the world and a positive self-image are correlated with a more favourable emotional state. By this, we support the view that individuals’ implicit beliefs (baseline beliefs) are related to the severity of the traumatic event.

Disclosure

No significant relationships.

Meaningful orientations and asthenia in pregnant women and young mothers during the first COVID-19 pandemic wave

Introduction

Pregnancy and childcare are naturally stressful for women, often accompanied by the asthenic syndrome. In a pandemic situation, this type of stress may be potentiated by external conditions.

Objectives

The study aimed to investigate the life-state orientations and asthenia levels of pregnant women and young mothers in the context of a pandemic. We also analyzed the correlations between the life-state orientations and the different types of asthenias.

Methods

Data collection was carried out in June 2020 using a Google form that we developed. Pregnant women and young mothers with children under seven years of age participated in the study with 47 respondents. We used the Purpose-in-Life Test to investigate the meaningful orientations and the MFI-20 to determine the level of asthenia. Both questionnaires were adapted for use in Russia.

Results

We found that the mean overall MFI-20 score (M = 58.0±5.9) exceeded the mean values in our sample, indicating the presence of the asthenic syndrome. Physical asthenia (M = 12.9±1.4) and decreased activity (M = 12.0±1.7) were the strongest, with the lowest score on the general asthenia scale (M = 10.6±1.8). Correlation analysis showed that all components of meaningful orientations had multiple positive correlations with different types of asthenias, and the overall asthenia score was 100 % related to life meaningfulness (p < 0.01).

Conclusions

Pregnant women and young mothers are at risk for asthenia in the COVID-19 pandemic. This is obviously due to many responsibilities of mothers raising children.

Disclosure

No significant relationships.

Russian medical students in the first wave of the COVID-19 pandemic: emotional reactions and baseline beliefs

Introduction

During the pandemic of new coronavirus infection, some medical students were actively recruited to work with infected patients, which could provoke depression, anxiety, and stress. The concept of baseline beliefs predicts characteristics of individuals’ experience of trauma.

Objectives

The study aimed to determine depression, anxiety, and stress levels in medical students and examine their baseline beliefs, as well as the relationship between baseline beliefs and emotional reactions.

Methods

Data were collected in the spring and summer of 2020 using a Google form that we developed. Thirty-seven medical students participated in the study. The WAS-37 questionnaire was used to examine baseline beliefs and the DASS-21 to measure depression, anxiety, and stress. Both questionnaires were adapted for use in Russia.

Results

We found that 78 % of the respondents had no depression, 86 % had no manifestations of anxiety, and 83 % felt stress-free. The mean values on the “Benevolence in the World” scale (M = 32.3±8.0) were within the average normative values, those on the “Justice” scale (M = 19.8±5.0) were below them, and those on the “Self-Image” scale (M = 29.6±5.9), “Luck” (M = 32.5±6.9) and “Controlling Beliefs” (M = 27.3±4.1) were above the average normative values. We found only one statistically significant relationship between emotional reactions and baseline beliefs, a negative correlation between depression and luck (r_x = -0.360, p < 0.05).

Conclusions

In pandemic medical students, beliefs about one’s luck were associated with lower levels of depression.

Disclosure

No significant relationships.

PD-L1 overexpression correlates with JAK2-V617F mutational burden and is associated with 9p uniparental disomy in myeloproliferative neoplasms

Myeloproliferative neoplasms (MPN) are chronic stem cell disorders characterized by enhanced proliferation of myeloid cells, immune deregulation, and drug resistance. JAK2 somatic mutations drive the disease in 50–60% and CALR mutations in 25–30% of cases. Published data suggest that JAK2‐V617F‐mutated MPN cells express the resistance‐related checkpoint PD‐L1. By applying RNA‐sequencing on granulocytes of 113 MPN patients, we demonstrate that PD‐L1 expression is highest among polycythemia vera patients and that PD‐L1 expression correlates with JAK2‐V617F mutational burden (R = 0.52; p < .0001). Single nucleotide polymorphism (SNP) arrays showed that chromosome 9p uniparental disomy (UPD) covers both PD‐L1 and JAK2 in all MPN patients examined. MPN cells in JAK2‐V617F‐positive patients expressed higher levels of PD‐L1 if 9p UPD was present compared to when it was absent (p < .0001). Moreover, haplotype‐based association analyses provided evidence for germline genetic factors at PD‐L1 locus contributing to MPN susceptibility independently of the previously described GGCC risk haplotype. We also found that PD‐L1 is highly expressed on putative CD34⁺CD38⁻ disease‐initiating neoplastic stem cells (NSC) in both JAK2 and CALR‐mutated MPN. PD‐L1 overexpression decreased upon exposure to JAK2 blockers and BRD4‐targeting agents, suggesting a role for JAK2‐STAT5‐signaling and BRD4 in PD‐L1 expression. Whether targeting of PD‐L1 can overcome NSC resistance in MPN remains to be elucidated in forthcoming studies.

Value of ultra-high field MRI in patients with suspected focal epilepsy and negative 3 T MRI (EpiUltraStudy): protocol for a prospective, longitudinal therapeutic study

PURPOSE

Resective epilepsy surgery is a well-established, evidence-based treatment option in patients with drug-resistant focal epilepsy. A major predictive factor of good surgical outcome is visualization and delineation of a potential epileptogenic lesion by MRI. However, frequently, these lesions are subtle and may escape detection by conventional MRI (≤ 3 T).

METHODS

We present the EpiUltraStudy protocol to address the hypothesis that application of ultra-high field (UHF) MRI increases the rate of detection of structural lesions and functional brain aberrances in patients with drug-resistant focal epilepsy who are candidates for resective epilepsy surgery. Additionally, therapeutic gain will be addressed, testing whether increased lesion detection and tailored resections result in higher rates of seizure freedom 1 year after epilepsy surgery. Sixty patients enroll the study according to the following inclusion criteria: aged ≥ 12 years, diagnosed with drug-resistant focal epilepsy with a suspected epileptogenic focus, negative conventional 3 T MRI during pre-surgical work-up.

RESULTS

All patients will be evaluated by 7 T MRI; ten patients will undergo an additional 9.4 T MRI exam. Images will be evaluated independently by two neuroradiologists and a neurologist or neurosurgeon. Clinical and UHF MRI will be discussed in the multidisciplinary epilepsy surgery conference. Demographic and epilepsy characteristics, along with postoperative seizure outcome and histopathological evaluation, will be recorded.

CONCLUSION

This protocol was reviewed and approved by the local Institutional Review Board and complies with the Declaration of Helsinki and principles of Good Clinical Practice. Results will be submitted to international peer-reviewed journals and presented at international conferences.

TRIAL REGISTRATION NUMBER

www.trialregister.nl : NTR7536.

Cytotoxicity of the Fusarium mycotoxin deoxynivalenol on mammalian and avian cell lines

Trichothecenes are mycotoxins that occur in grains and can lead to acute and chronic poisoning in animals and humans. Deoxynivalenol (DON) is a type B trichothecene affecting protein synthesis, immune system, leading to brain, blood and kidney disorders. The aim of this work was to evaluate in vitro the cytotoxicity and the pathological effects of DON in short-term experiments on cells from non-tumour and tumour permanent cell lines and to compare their sensitivity. Cell cultivation of BALB/c 3T3, DEC 99, MDA-MB-231, MCF-7 and Hela cells was performed. Quantitative and qualitative methods evaluating cytotoxicity on the base of statistical and morphological analyses for determining the impact on the viability and proliferative activity were used: Neutral Red Uptake (NRU) cytotoxicity test, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and fluorescence microscopy. The cytotoxic effect of DON was assessed after an exposure period of 24 h. DON treatment induced significant alterations in the growth and morphology of the cells, involving early and late apoptosis and necrosis signs. Statistically significant decrease of the viability of all cell lines was established at concentrations of DON starting from 1.9 µg/mL to 3.7 µg/mL, the mean IC50 concentrations were calculated. According to the IC50 values the hierarchical order of cell lines’ sensitivity was determined.

Machine-learning-based classification of Stokes-Mueller polarization images for tissue characterization

The microstructural analysis of tissues plays a crucial role in the early detection of abnormal tissue morphology. Polarization microscopy, an optical tool for studying the anisotropic properties of biomolecules, can distinguish normal and malignant tissue features even in the absence of exogenous labelling. To facilitate the quantitative analysis, we developed a polarization-sensitive label-free imaging system based on the Stokes-Mueller calculus. Polarization images of ductal carcinoma tissue samples were obtained using various input polarization states and Stokes-Mueller images were reconstructed using Matlab software. Further, polarization properties, such as degree of linear and circular polarization and anisotropy, were reconstructed from the Stokes images. The Mueller matrix obtained was decomposed using the Lu-Chipman decomposition method to acquire the individual polarization properties of the sample, such as depolarization, diattenuation and retardance. By using the statistical parameters obtained from the polarization images, a support vector machine (SVM) algorithm was trained to facilitate the tissue classification associated with its pathological condition.

Ultra-high field magnetic resonance imaging in human epilepsy: A systematic review

RATIONALE

Resective epilepsy surgery is an evidence-based curative treatment option for patients with drug-resistant focal epilepsy. The major preoperative predictor of a good surgical outcome is detection of an epileptogenic lesion by magnetic resonance imaging (MRI). Application of ultra-high field (UHF) MRI, i.e. field strengths ≥ 7 Tesla (T), may increase the sensitivity to detect such a lesion.

METHODS

A keyword search strategy was submitted to Pubmed, EMBASE, Cochrane Database and clinicaltrials.gov to select studies on UHF MRI in patients with epilepsy. Follow-up study selection and data extraction were performed following PRISMA guidelines. We focused on I) diagnostic gain of UHF- over conventional MRI, II) concordance of MRI-detected lesion, seizure onset zone and surgical decision-making, and III) postoperative histopathological diagnosis and seizure outcome.

RESULTS

Sixteen observational cohort studies, all using 7T MRI were included. Diagnostic gain of 7T over conventional MRI ranged from 8% to 67%, with a pooled gain of 31%. Novel techniques to visualize pathological processes in epilepsy and lesion detection are discussed. Seizure freedom was achieved in 73% of operated patients; no seizure outcome comparison was made between 7T MRI positive, 7T negative and 3T positive patients. 7T could influence surgical decision-making, with high concordance of lesion and seizure onset zone. Focal cortical dysplasia (54%), hippocampal sclerosis (12%) and gliosis (8.1%) were the most frequently diagnosed histopathological entities.

SIGNIFICANCE

UHF MRI increases, yet variably, the sensitivity to detect an epileptogenic lesion, showing potential for use in clinical practice. It remains to be established whether this results in improved seizure outcome after surgical treatment. Prospective studies with larger cohorts of epilepsy patients, uniform scan and sequence protocols, and innovative post-processing technology are equally important as further increasing field strengths. Besides technical ameliorations, improved correlation of imaging features with clinical semiology, histopathology and clinical outcome has to be established.

Switching from healthy to unhealthy oxidative stress - does the radical type can be used as an indicator?

Ultraviolet (UV) radiation leads to the formation of free radicals, which may cause immunological modulations, skin aging or skin cancer. Sunlight exposure in the UVA region according to CIE 85 promotes almost 46% of radical formation in skin. A critical radical concentration characterized by the inversion of the domination of primary ROS (reactive oxygen species) to an excess of secondary LOS (lipid oxygen species) is proven for the spectral regions UV and or VIS light and is intended to be a marker for an imbalance in the redox system, which can no longer compensate harmful effects. To investigate whether this transition point is also universally valid for one spectral region, the radical formation during and after targeted UVA in situ-irradiation at 365 ± 5 nm and three different irradiances (31, 94 and 244 mW/cm²) was investigated in ex vivo porcine skin using x-band electron paramagnetic resonance (EPR) spectroscopy. The quantification was performed with the spin probe 3-(carboxy)-2,2,5,5-tetramethylpyrrolidin-1-oxyl (PCA), the spin trap 5,5-Dimethyl-1-Pyrroline-N-Oxide (DMPO) was used to characterize the radical species. Furthermore, the viability of the skin cells after irradiation was controlled by an MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, skin integrity was examined by histological analysis. A significant dose dependence in the radical formation is given at higher irradiance. The transition point was detected in the range of 0.5 MED after irradiation with the highest irradiance. From this point on the proportion of LOS increases with increasing dose and the proportion of ROS decreases. After switching off the UVA irradiation no further quantitative changes were detected, but rapid changes in the radical pattern were observed demonstrating the importance of in situ irradiation during the use of spin traps. Heat-pre-stressed skin showed more LOS than ROS already at the beginning of the irradiation, leading to the assumption that the transition point to the distress-level has already been reached. In summary, a postulated transition point could be verified for the UVA spectral region using only one spin trap combined with in-situ irradiation. A certain degree of stress is necessary to detect an inversion of the ratio of ROS to LOS. This reversal indicates an imbalance in the redox status. However, at low intensities no changes at all in radical pattern appeared over time (dose), probably it can be compensated by adaptation processes of the skin.

Using deep learning to enhance event geometry reconstruction for the telescope array surface detector

The extremely low flux of ultra-high energy cosmic rays (UHECR) makes their direct observation by orbital experiments practically impossible. For this reason all current and planned UHECR experiments detect cosmic rays indirectly by observing the extensive air showers (EAS) initiated by cosmic ray particles in the atmosphere. The world largest statistics of the ultra-high energy EAS events is recorded by the networks of surface stations. In this paper we consider a novel approach for reconstruction of the arrival direction of the primary particle based on the deep convolutional neural network. The latter is using raw time-resolved signals of the set of the adjacent trigger stations as an input. The Telescope Array (TA) Surface Detector (SD) is an array of 507 stations, each containing two layers plastic scintillator with an area of 3 m2. The training of the model is performed with the Monte-Carlo dataset. It is shown that within the Monte-Carlo simulations, the new approach yields better resolution than the traditional reconstruction method based on the fitting of the EAS front. The details of the network architecture and its optimization for this particular task are discussed.

Cell-based and antibody-mediated immunotherapies directed against leukemic stem cells in acute myeloid leukemia: Perspectives and open issues

Despite new insights in molecular features of leukemic cells and the availability of novel treatment approaches and drugs, acute myeloid leukemia (AML) remains a major clinical challenge. In fact, many patients with AML relapse after standard therapy and eventually die from progressive disease. The basic concept of leukemic stem cells (LSC) has been coined with the goal to decipher clonal architectures in various leukemia-models and to develop curative drug therapies by eliminating LSC. Indeed, during the past few years, various immunotherapies have been tested in AML, and several of these therapies follow the strategy to eliminate relevant leukemic subclones by introducing LSC-targeting antibodies or LSC-targeting immune cells. These therapies include, among others, new generations of LSC-eliminating antibody-constructs, checkpoint-targeting antibodies, bi-specific antibodies, and CAR-T or CAR-NK cell-based strategies. However, responses are often limited and/or transient which may be due to LSC resistance. Indeed, AML LSC exhibit multiple forms of resistance against various drugs and immunotherapies. An additional problems are treatment-induced myelotoxicity and other side effects. The current article provides a short overview of immunological targets expressed on LSC in AML. Moreover, cell-based therapies and immunotherapies tested in AML are discussed. Finally, the article provides an overview about LSC resistance and strategies to overcome resistance.

The TRACK-PD study: protocol of a longitudinal ultra-high field imaging study in Parkinson's disease

BACKGROUND

The diagnosis of Parkinson's Disease (PD) remains a challenge and is currently based on the assessment of clinical symptoms. PD is also a heterogeneous disease with great variability in symptoms, disease course, and response to therapy. There is a general need for a better understanding of this heterogeneity and the interlinked long-term changes in brain function and structure in PD. Over the past years there is increasing interest in the value of new paradigms in Magnetic Resonance Imaging (MRI) and the potential of ultra-high field strength imaging in the diagnostic work-up of PD. With this multimodal 7 T MRI study, our objectives are: 1) To identify distinctive MRI characteristics in PD patients and to create a diagnostic tool based on these differences. 2) To correlate MRI characteristics to clinical phenotype, genetics and progression of symptoms. 3) To detect future imaging biomarkers for disease progression that could be valuable for the evaluation of new therapies.

METHODS

The TRACK-PD study is a longitudinal observational study in a cohort of 130 recently diagnosed (≤ 3 years after diagnosis) PD patients and 60 age-matched healthy controls (HC). A 7 T MRI of the brain will be performed at baseline and repeated after 2 and 4 years. Complete assessment of motor, cognitive, neuropsychiatric and autonomic symptoms will be performed at baseline and follow-up visits with wearable sensors, validated questionnaires and rating scales. At baseline a blood DNA sample will also be collected.

DISCUSSION

This is the first longitudinal, observational, 7 T MRI study in PD patients. With this study, an important contribution can be made to the improvement of the current diagnostic process in PD. Moreover, this study will be able to provide valuable information related to the different clinical phenotypes of PD and their correlating MRI characteristics. The long-term aim of this study is to better understand PD and develop new biomarkers for disease progression which may help new therapy development. Eventually, this may lead to predictive models for individual PD patients and towards personalized medicine in the future.

TRIAL REGISTRATION

Dutch Trial Register, NL7558 . Registered March 11, 2019.

Characterization data of reference cement CEM III/A 42.5N used for priority program DFG SPP 2005 "Opus Fluidum Futurum - Rheology of reactive, multiscale, multiphase construction materials"

Two types of cements were selected as the reference cement in the priority program 2005 of the German Research Foundation (DFG SPP 2005). A thorough characterization of CEM I 42.5 R has been made in a recent publication [1]. In this paper, the characterization data of the other reference cement CEM III/A 42.5 N are presented from the aspects of chemical and mineralogical compositions as well as physical and chemical properties. The characterization data of the slag, which is the second main constituent of this specific cement besides the clinker, are presented independently. For all data received, the mean values and the corresponding errors were calculated. The data shall be used for the ongoing research within the priority program. Also, researchers from outside this priority program can benefit from these data if the same materials are used.

Characterization data of reference cement CEM I 42.5 R used for priority program DFG SPP 2005 "Opus Fluidum Futurum - Rheology of reactive, multiscale, multiphase construction materials"

A thorough characterization of starting materials is the precondition for further research, especially for cement, which contains various phases and presents quite a complex material for fundamental scientific investigation. In the paper at hand, the characterization data of the reference cement CEM I 42.5 R used within the priority program 2005 of the German Research Foundation (DFG SPP 2005) are presented from the aspects of chemical and mineralogical compositions as well as physical and chemical properties. The data were collected based on tests conducted by nine research groups involved in this cooperative program. For all data received, the mean values and the corresponding errors were calculated. The results shall be used for the ongoing research within the priority program.

Covering the celestial sphere at ultra-high energies: Full-sky cosmic-ray maps beyond the ankle and the flux suppression

Despite deflections by Galactic and extragalactic magnetic fields, the distribution of ultra-high energy cosmic rays (UHECRs) over the celestial sphere remains a most promising observable for the identification of their sources. Thanks to a large number of detected events over the past years, a large-scale anisotropy at energies above 8 EeV has been identified, and there are also indications from the Telescope Array and Pierre Auger Collaborations of deviations from isotropy at intermediate angular scales (about 20 degrees) at the highest energies. In this contribution, we map the flux of UHECRs over the full sky at energies beyond each of two major features in the UHECR spectrum – the ankle and the flux suppression -, and we derive limits for anisotropy on different angular scales in the two energy regimes. In particular, full-sky coverage enables constraints on low-order multipole moments without assumptions about the strength of higher-order multipoles. Following previous efforts from the two Collaborations, we build full-sky maps accounting for the relative exposure of the arrays and differences in the energy normalizations. The procedure relies on cross-calibrating the UHECR fluxes reconstructed in the declination band around the celestial equator covered by both observatories. We present full-sky maps at energies above ~ 10 EeV and ~ 50 EeV, using the largest datasets shared across UHECR collaborations to date. We report on anisotropy searches exploiting full-sky coverage and discuss possible constraints on the distribution of UHECR sources.

Report on Tests and Measurements of Hadronic Interaction Properties with Air Showers

We present a summary of recent tests and measurements of hadronic interaction properties with air showers. This report has a special focus on muon density measurements. Several experiments reported deviations between simulated and recorded muon densities in extensive air showers, while others reported no discrepancies. We combine data from eight leading air shower experiments to cover shower energies from PeV to tens of EeV. Data are combined using the z-scale, a unified reference scale based on simulated air showers. Energy-scales of experiments are cross-calibrated. Above 10 PeV, we find a muon deficit in simulated air showers for each of the six considered hadronic interaction models. The deficit is increasing with shower energy. For the models EPOS-LHC and QGSJet-II.04, the slope is found significant at 8 sigma.

TA Anisotropy Summary

The Telescope Array (TA) is the largest ultra-high-energy cosmic-ray (UHECR) detector in the northern hemisphere. It consists of an array of 507 surface detectors (SD) covering a total 700 km2 and three fluorescence detector stations overlooking the SD array. In this proceedings, we summarize recent results on the search for directional anisotropy of UHECRs using the latest dataset collected by the TA SD array. We obtained hints of the anisotropy of the UHECRs in the northern sky from the various analyses.

Dimensional accuracy and surface roughness of polymeric dental bridges produced by different 3D printing processes

Purpose: To compare the dimensions accuracy and surface roughness of polymeric dental bridges produced by different 3D printers. Design/methodology/approach: Four-part dental bridges were manufactured by three printing systems working on the basis of digital light projection (DLP) stereolithography (SLA), laser-assisted SLA and fused deposition modeling (FDM). The materials used from SLA printers are liquid methacrylate photopolymer resins, while FDM printer use thin wire plastic polylactic acid. The accuracy of the external dimensions of dental bridges was evaluated and the surface roughness was measured. Findings: It was found that compared to the base model, the dimensions of the SLA printed bridges are bigger with 1.25%-6.21%, while the corresponding dimensions of the samples, made by FDM are smaller by 1.07%-4.71%, regardless the position of the object towards the substrate. The samples, produced by FDM, are characterized with the highest roughness. The average roughness deviation (Ra) values for DLP SLA and lase-assisted SLA are 2.40 μm and 2.97 μm, respectively. Research limitations/implications: For production of high quality polymeric dental constructions next research should be targeted to investigation of the polymerization degree, stresses and deformations. Practical implications: Our study shows that 3D printers, based on laser-assisted and DLP SLA, can be successfully used for manufacturing of polymeric dental bridges – temporary restorations or cast patterns, while FDM system is more suitable for training models. The results will help the dentists to make right choice of the most suitable 3D printer. Originality/value: One of the largest fixed partial dentures – four-part bridges, produced by three different commercial 3D printing systems, were investigated by comparative analysis. The paper will attract readers’ interest in the field of biomedical materials and application of new technologies in dentistry.

Monoplacophoran mitochondrial genomes: convergent gene arrangements and little phylogenetic signal

BACKGROUND

Although recent studies have greatly advanced understanding of deep molluscan phylogeny, placement of some taxa remains uncertain as different datasets support competing class-relationships. Traditionally, morphologists have placed Monoplacophora, a group of morphologically simple, limpet-like molluscs as sister group to all other conchiferans (shelled molluscs other than Polyplacophora), a grouping that is supported by the latest large-scale phylogenomic study that includes Laevipilina. However, molecular datasets dominated by nuclear ribosomal genes support Monoplacophora + Polyplacophora (Serialia). Here, we evaluate the potential of mitochondrial genome data for resolving placement of Monoplacophora.

RESULTS

Two complete (Laevipilina antarctica and Vema ewingi) and one partial (Laevipilina hyalina) mitochondrial genomes were sequenced, assembled, and compared. All three genomes show a highly similar architecture including an unusually high number of non-coding regions. Comparison of monoplacophoran gene order shows a gene arrangement pattern not previously reported; there is an inversion of one large gene cluster. Our reanalyses of recently published polyplacophoran mitogenomes show, however, that this feature is also present in some chiton species. Maximum Likelihood and Bayesian Inference analyses of 13 mitochondrial protein-coding genes failed to robustly place Monoplacophora and hypothesis testing could not reject any of the evaluated placements of Monoplacophora.

CONCLUSIONS

Under both serialian or aculiferan-conchiferan scenarios, the observed gene cluster inversion appears to be a convergent evolution of gene arrangements in molluscs. Our phylogenetic results are inconclusive and sensitive to taxon sampling. Aculifera (Polyplacophora + Aplacophora) and Conchifera were never recovered. However, some analyses recovered Serialia (Monoplacophora + Polyplacophora), Diasoma (Bivalvia + Scaphopoda) or Pleistomollusca (Bivalvia + Gastropoda). Although we could not shed light on deep evolutionary traits of Mollusca we found unique patterns of gene arrangements that are common to monoplacophoran and chitonine polyplacophoran species but not to acanthochitonine Polyplacophora. Complete mitochondrial genome of Laevipilina antarctica.

[INFLUENCE OF STIMULATION PROTOCOL ON MATURITY AND MORPHOLOGICAL FEATURES OF OOCYTES IN PATIENTS WITH LOW OVARIAN RESERVE: STUDY OF 72 IVF/ICSI TREATMENT CYCLES]

The current study presents the results of a retrospective and prospective observation of the maturity and morphological features of the oocytes and the way they are influenced by the therapeutic approaches and the protocol for controlled ovarian hypersimulation (COH) in patients with low ovarian reserve.

MATERIALS AND METHODS

The study includes 184 oocytes, derived from 72 patients with low ovarian reserve involved in an infertility treatment program through in vitro fertilization from February 2011 to February 2014. The applied therapeutic approaches and COH protocols are microdose agonist short protocol, antagonist short protocol, mild stimulation protocol and natural cycle in vitro fertilization.

RESULTS

Our study hasn't found a statistically significant dependence between the applied ovarian stimulation protocol and the maturity and morphology.

Novel Ru(III) Complexes with Some Benzothiazole Derivatives: Synthesis, Physicochemical and Pharmacological Investigations

In this work we present 3 new complexes of Ruthenium (III) with a general formula HL[Ru(L)2Cl4], where L=benzothiazole, 2-methylbenzothiazole and 2-mercaptobenzothiazole. The syntheses were carried out in polar medium under argon. The compounds obtained were characterised by IR-, (1)H-NMR- (13)C-NMR-, UV-VIS-spectroscopy and conductivity measurements. The ligands behaved as monodentate, bounding Ru(III) through the nitrogen atoms from the heterocycle. The cytotoxicity of the new complexes was tested against 2 human leukemic cell lines (K-562 and KE-37), using the MTT-dye reduction assay. The Ru(III) coordination compound with 2-methylbenzothiazole displayed superior activity compared to the other novel complexes. Its IC50 values were comparable to that of the reference cytotoxic drug cisplatin. In general, the ligands displayed only marginal inhibitory effects on the human leukemic cell lines. Moreover, the ability of the complexes to trigger apoptosis was evaluated using a commercially available DNA-fragmentation ELISA kit and the obtained data indicated that their proapoptotic effects well correlate to the MTT-bioassay data.

[Oocyte quality as a predictive marker for assessment of IVF/ICSI procedure outcome]

The technology of in vitro fertilization consists mainly of pick up, selection and insemination of oocytes, embryo culture and their transfer into recipient's womb. Before any further manipulation of oocytes their quality has to be accurately evaluated as it has direct impact on the monospermic fertilization, early development, establishment and maintenance of pregnancy. Criteria applied for oocyte quality assessment are subdivided into morphological, cellular and molecular. Morphological ones include the structure of oocyte: cumulus-oocyte complex, cytoplasm, firstpolarbody, perivitelline space, zona pellucida, and meiotic spindle. Morphological alterations may be related to the particular patient and the treatment cycle characteristics, to affect most or all oocytes in the cohort. The aim of the resent review is by summarizing available data from literature to investigate if non-invasive observation of any morphological feature or group of features of MII phase human oocytes has strong predictive value for further development and the in vitro procedure outcome.