Determination of the Terbium-152 half-life from mass-separated samples from CERN-ISOLDE and assessment of the radionuclide purity

Terbium-152 is one of four terbium radioisotopes that together form a potential theranostic toolbox for the personalised treatment of tumours. As 152 Tb decay by positron emission it can be utilised for diagnostics by positron emission tomography. For use in radiopharmaceuticals and for activity measurements by an activity calibrator a high radionuclide purity of the material and an accurate and precise knowledge of the half-life is required. Mass-separation and radiochemical purification provide a production route of high purity 152Tb. In the current work, two mass-separated samples from the CERN-ISOLDE facility have been assayed at the National Physical Laboratory to investigate the radionuclide purity. These samples have been used to perform four measurements of the half-life by three independent techniques: high-purity germanium gamma-ray spectrometry, ionisation chamber measurements and liquid scintillation counting. From the four measurement campaigns a half-life of 17.8784(95) h has been determined. The reported half-life shows a significant difference to the currently evaluated half-life (ζ-score = 3.77), with a relative difference of 2.2 % and an order of magnitude improvement in the precision. This work also shows that under controlled conditions the combination of mass-separation and radiochemical separation can provide high-purity 152Tb.

The international reference system for beta-particle emitting radionuclides: Validation through the pilot study CCRI(II)-P1.Co-60

The Bureau International des Poids et Mesures (BIPM) is developing a new transfer instrument to extend its centralized services for assessing the international equivalence of radioactive standards to new radionuclides. A liquid scintillation counter using the triple/double coincidence ratio method is being studied and tested in the CCRI(II)-P1.Co-60 pilot study. The pilot study, involving 13 participating laboratories with primary calibration capabilities, validated the approach against the original international reference system based on ionization chambers, which has been in operation since 1976. The results are in agreement and an accuracy suitable for purpose, below 5×10-4, is achieved. The pilot study also reveals an issue when impurities emitting low-energy electrons are present in the standard solution, which have a different impact on liquid scintillation counting compared to other primary measurement methods.

Deep Learning-Based Natural Language Processing to Automate Esophagitis Severity Grading from the Electronic Health Records

PURPOSE/OBJECTIVE(S)

Radiotherapy (RT) toxicities can impair survival and quality-of-life, yet their risk factors and optimal management are under-studied. Real-world evidence holds enormous potential to improve our understanding of RT adverse events, but this information is often only documented in clinic notes and cannot, at present, be automatically extracted. To address this unmet need, we developed natural language processing (NLP) algorithms to automatically identify the presence and severity of esophagitis from notes of patients treated with thoracic RT.

MATERIALS/METHODS

Our corpus consisted of (1) a gold-labeled dataset of 1524 clinic notes from 124 lung cancer patients treated with RT (in-domain), manually annotated for CTCAE v5.0 esophagitis grade, and (2) a silver-labeled dataset of 2420 notes from 1832 patients on whom toxicity grades had been collected as structured data during clinical care. We developed a fine-tuning pipeline for pre-trained BERT-based neural models for 3 tasks: 1) classifying the presence of esophagitis, 2) classifying grade 0-1 vs. > = 2 esophagitis and 3) classifying grade 0 vs. 1 vs. 2-3. A note sectionizer was used to let the model focus on the most informative sections. Independent validation in a separate clinical cohort of esophageal cancer patients was selected for out-of-domain transferability testing. Such cohorts consist of a manually annotated dataset of 345 notes from 75 esophageal cancer patients treated with RT. We also report patient-level results by evaluating the maximum predicted grade per patient.

RESULTS

Fine-tuning PubmedBERT yielded the best-performing models. Performance is shown in the table. Selecting the most informative note sections (primarily Interval History, Assessment & Plan) during fine-tuning improved macro-F1 by > = 2% for all tasks. Including silver-labeled data improved the macro-F1 by > = 3% across all tasks.

CONCLUSION

To the best of our knowledge, this is the first effort to automatically extract toxicity severity according to CTCAE guidelines from clinic notes, providing proof-of-concept for NLP to support detailed toxicity reporting. Fine-tuning on note sections and leveraging silver-labeled data enabled promising performance despite small datasets, informing future research into NLP for automated toxicity monitoring. Future work will extend these methods to other cancer diagnoses and toxicities, and to toxicity risk prediction.

Interleukin-6 induces an epithelial-mesenchymal transition phenotype in human breast cancer cells

Breast tumor interleukin-6 (IL-6) levels increase with tumor grade, and elevated serum IL-6 correlates with poor breast cancer patient survival. Epithelial-mesenchymal transition (EMT) phenotypes such as impaired E-cadherin expression or aberrant Vimentin induction are associated with enhanced metastasis and unfavorable clinical outcome in breast cancer. Despite this fact, few tumor microenvironment-derived extracellular signaling factors capable of provoking such a phenotypic transition have been identified. In this study, we showed that IL-6 promoted E-cadherin repression among a panel of estrogen receptor-alpha-positive human breast cancer cells. Furthermore, ectopic stable IL-6 expressing MCF-7 breast adenocarcinoma cells (MCF-7(IL-6)) exhibited an EMT phenotype characterized by impaired E-cadherin expression and induction of Vimentin, N-cadherin, Snail and Twist. MCF-7(IL-6) cells formed xenograft tumors that displayed loss of E-cadherin, robust Vimentin induction, increased proliferative indices, advanced tumor grade and undifferentiated histology. Finally, we showed aberrant IL-6 production and STAT3 activation in MCF-7 cells that constitutively express Twist, a metastatic regulator and direct transcriptional repressor of E-cadherin. To our knowledge, this is the first study that shows IL-6 as an inducer of an EMT phenotype in breast cancer cells and implicates its potential to promote breast cancer metastasis.

Predictive value of Ile105Val polymorphism of the gluthatione-S-transferase P1 in patients with metastatic colorectal cancer (m CRC) treated with the triplet combination of irinotecan, oxaliplatin, and capecitabine

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Background: Several phase I/II trials have shown that the triplet combination of oxaliplatin, irinotecan and capecitabine is a feasible and active in solid tumors. We aimed to investigate whether germline polymorphisms may be predictors of clinical outcome in mCRC pts treated with this combination. Methods: The following genetic polymorphisms were analysed: glutathione S-transferase (GSTP1-Ile105Val, GSTT1 and GSTM1 deletion), TYMS (TS-5´UTR 2R/3R; TS-5´G/C; TS-3´UTR 6-bp deletion), MTHFR 1298A>C, UGT1A1, ERCC1, XPD. Polymorphisms from peripheral lymphocytes were detected using the TaqMan genotyping assays (Applied Biosystems, CA). Univariate analysis (Fisher´s exact test for response; log-rank test for TTP and OS) was performed to examine associations between polymorphisms and clinical outcome. Results: Blood samples for 63 out of 72 prospectively enrolled pts were tested for genomic analysis. Median age was 57 (32–78), median ECOG 1(0–2), median number of cycles administered 6 (1–13), median number of metastatic sites was 1 (1–4). M/F: 50/22. Risk according to Köhne classification was low (52.8% of pts), intermediate (26.4%) and high (8.3%). Overall response rate (ORR) was 62.5%. Median progression-free survival (PFS) was 9.87 months (95% CI; 7.6–12) and median overall survival was 24.6 months (95% CI; 19.5–29.7). A significant association was observed between MTHFR 1298A>C and haematological toxicity, with C/C genotype pts being at higher risk of grade 3–4 neutropenia (50% vs. 28%, p = 0.035) and leucopenia (50% vs. 15%, p = 0.04). Heterozygous and homozygous GSTP-105Val showed a significant superior response rate (80%) compared to only 40% in pts harbouring the GSTP1–105Ile/Ile genotype (p = 0.008, Fisher´s exact test). PFS was also adversely affected in pts with GSTP1–105Ile/Ile (5.2 months vs. 12.3 months in those pts with at least one GSTP1–105Val allele, p = 0.001). In the multivariate analysis, the relative risk for progression was 3.4 (95% CI; 1.3–9.1) for the GSTP1–105Ile/Ile genotype (p = 0.01). Conclusions: The GSTP1-Ile105Val polymorphism is a strong predictor of clinical outcome for XELOXIRI therapy in mCRC pts.

No significant financial relationships to disclose.

Pharmacogenomic analysis of the triplet combination of gemcitabine, oxaliplatin, and cetuximab as salvage therapy for metastatic colorectal cancer (mCRC) patients

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Background: We have previously reported that biweekly gemcitabine-based therapy was active in pretreated mCRC pts (De la Cruz et al, ASCO GI 2008, abstr 377). We aimed to investigate whether germ line polymorphisms may be predictors of clinical outcome in mCRC pts treated with this combination. Methods: We evaluated SNPs of genes involved in gemcitabine metabolism (CDA, dCDK, RRM1, DCTD, SLC28A1), DNA repair (XRCC1, XRCC 3, ERCC1, XPD) and two IgG Fcγ R polymorphisms (Fcγ RIIa- H131R and Fcγ RIIIa-V158F), reported to be predictive of cetuximab-based therapy, even in K-ras mutated pts. Whole blood was collected and DNA extracted from peripheral lymphocytes using a DNA isolation Kit (Qiagen, CA). Polymorphisms were detected using the TaqMan genotyping assays (Applied Biosystems, CA). Clinical response was evaluated according to RECIST criteria. Univariate analysis (Fisher´s exact test for response; log-rank test for TTP and OS) was performed to examine associations between polymorphisms and clinical outcome. Results: Blood samples of 35 out of 39 enrolled pts were tested for genomic analysis. Patient‘s characteristics are as follows; M/F: 26/13, median age: 59 years, median number of prior chemotherapy lines: 2 (1–4), Köhne risk groups; low: 8 pts, intermediate: 18 pts, high: 13 pts. After a median follow-up of 20 months, median progression-free survival (PFS) is 6.7 months (95% CI; 5.2–8.3) and median overall survival 15.4 m (95% CI; 14.7–16.1). Overall response rate (ORR) was 53.8%. RRM1 R284R SNPs (p=0.06), T741T (p=0.02) and RRM1–524CT (p=0.04) were linked to clinical responsiveness. All pts possessing 2 or 3 favourable RRM1 SNPs responded. ORR was 53.3% for pts with no favourable SNPs versus 85% for pts with any favourable SNP (p=0.04). ORR was also significantly higher in pts with any histidine allele in the Fcγ RIIa polymorphism (93% vs. 60%, p=0.034). Median PFS was adversely affected in pts harbouring no favourable RRM1 SNPs (4.2m versus 6.7 months, p=0.019) and in those pts with homozygous Fcγ RIIa-131R allele (4.4 vs. 7.5 months, p=0.007). Conclusions: Polymorphic variants of RRM1 and Fcγ RIIa may play a key role in the efficacy of gemcitabine and cetuximab-based therapy for mCRC pts.

No significant financial relationships to disclose.

Lower weight gain with the orally disintegrating olanzapine than with standard tablets in first-episode never treated psychotic patients

OBJECTIVE

A post-hoc analysis of the data from a randomised clinical trial involving prescription of antipsychotic treatment to never treated first-onset psychotic patients was used to compare the weight change after 6-week olanzapine treatment (standard tablets vs. orally disintegrating formulation).

METHOD

In the subgroup of 38 patients randomised to olanzapine, standard olanzapine tablets were non-randomly and consecutively prescribed to the first 19 patients, with the orally disintegrating formulation being prescribed to the following 19 patients.

RESULTS

After 6-week treatment with olanzapine, a significant higher increase in weight was noted in those patients on standard tablets (mean weight increase 6.3 +/- 1.9 Kg) as compared to those on orally disintegrating olanzapine (mean weight increase 3.3 +/- 3.2 Kg) (F = 7.7; p = 0.009). BMI increase was also significantly higher in the olanzapine tablet group (mean increase of 2.1 Kg/m(2) as compared with 1.1 Kg/m(2) in the orally disintegrating group) (F = 4.7; p = 0.036). Substantial weight gain (SWG) (> or =7% increase from baseline weight) was noted in 84.2% (n = 16) of the olanzapine tablet patients and in 31.6% (n = 6) of the orally disintegrating olanzapine patients, with the olanzapine tablet group showing a significant increase in the mean percentage of weight gain (F = 4.0; p = 0.014).

CONCLUSIONS

Partial sublingual absorption occurring with orally disintegrating olanzapine may bypass gastrointestinal metabolisation and hence lead to differences in metabolite versus parent compound ratios. However, the need arises to replicate the present study with a longer follow-up.

Identification by Real-time PCR of 13 mature microRNAs differentially expressed in colorectal cancer and non-tumoral tissues

MicroRNAs (miRNAs) are short non-coding RNA molecules playing regulatory roles by repressing translation or cleaving RNA transcripts. Although the number of verified human miRNA is still expanding, only few have been functionally described. However, emerging evidences suggest the potential involvement of altered regulation of miRNA in pathogenesis of cancers and these genes are thought to function as both tumours suppressor and oncogenes. In our study, we examined by Real-Time PCR the expression of 156 mature miRNA in colorectal cancer. The analysis by several bioinformatics algorithms of colorectal tumours and adjacent non-neoplastic tissues from patients and colorectal cancer cell lines allowed identifying a group of 13 miRNA whose expression is significantly altered in this tumor. The most significantly deregulated miRNA being miR-31, miR-96, miR-133b, miR-135b, miR-145, and miR-183. In addition, the expression level of miR-31 was correlated with the stage of CRC tumor. Our results suggest that miRNA expression profile could have relevance to the biological and clinical behavior of colorectal neoplasia.

Pyrene biodegradatin in aqueous solutions and soil slurries by Mycobacterium PYR-1 and enriched consortium

To better understand complex bioavailability issues, pyrene degradation was examined in aqueous and soil slurry solutions using pure Mycobacterium sp. PYR-1 and a microbial consortium. The intrinsic rates of the aqueous pyrene degradation were very similar, 1.3 x 10(-9) microg pyrene/CFU-h for Mycobacterium sp. PYR-1 and 1.1 x 10(-9) microg pyrene/CFU-h for the consortium. Rates were much lower with the soil-slurry experiments, ranging from 1.2 x 10(-12) to 7.8 x 10(-10) microg/CFU-h, depicting the strong negative effects of soils on bioavailability. Supernatants from the slurry experiments were found to increase the aqueous-phase pyrene solubility significantly. Pyrene solubility was increased from 120.5 to over 230 microg/l. However, the linear adsorption constants of pyrene on the soil were reduced.

Distal third fibular aneurysmal bone cyst: en bloc resection and proximal third fibular reconstruction

Treatment of aneurysmal bone cysts (ABCs) located in the distal third fibula adjacent to the growth plate, can be problematic. The first choice of treatment for these lesions has been cyst curettage and bone graft. Complications include the high recurrence rate, possible growth-plate injury, and possible ankle instability associated with that treatment led to the development of other surgical options. We used en bloc resection and proximal third fibular bone reconstruction to treat an 8-year-old female patient with a distal third fibular ABC close to the growth plate. There was no recurrence, growth-plate injury, or ankle instability at 30-month follow-up.

International development of the Quality of Life in Depression Scale (QLDS)

BACKGROUND

The Quality of Life in Depression Scale (QLDS) employs the needs-based model of quality of life (QoL) and was developed in the UK and The Netherlands as an outcome measure for clinical trials. This paper describes the production and psychometric assessment of nine new language versions for Canada (French and English), Denmark, France, Germany, Italy, Morocco, Spain and the US.

METHODS

Three adaptation stages were employed; production of conceptually equivalent translations, field-test interviews and assessment of reliability and construct validity by survey of patients with major depression.

RESULTS

Few problems were experienced with producing conceptually equivalent translations, except in Morocco. Patients in the field-test interviews found the instrument to have appropriate content and to be easy to complete. Internal consistency and test-retest reliability were excellent for all language versions and scores were found to relate appropriately to measures of depression severity and health status.

LIMITATIONS

Further investigation is required of the ability of the measure to assess individuals at the extremes of the QoL continuum. Data collected with the Arabic QLDS should not be combined with those from other countries.

CONCLUSIONS

The QLDS is the first instrument designed to assess QoL in depression based on a coherent model of the construct. Each language version has been shown to be well accepted by respondents and to have excellent psychometric properties. As the instrument is now available in a large number of languages, the QLDS is the QoL instrument of choice for inclusion in clinical trials of interventions for depression.

Instrumentation and calibration protocol for imaging dynamic features in dense-scattering media by optical tomography

Instrumentation is described that is suitable for acquiring multisource, multidetector, time-series optical data at high sampling rates (up to 150 Hz) from tissues having arbitrary geometries. The design rationale, calibration protocol, and measured performance features are given for both a currently used, CCD-camera-based instrument and a new silicon-photodiode-based system under construction. Also shown are representative images that we reconstructed from data acquired in laboratory studies using the described CCD-based instrument.

Perceived quality of life in depression: Effect of clinical and demographic variables

The objective of the study was the evaluation of the influence of various clinical and sociodemographic factors on the perception of quality of life in 141 patients with depression (CIE-10). We used a multivariate analysis of logistic regression to predict lower quality of life and well-being. The best predictive variables for quality of life were the Hamilton Rating Scale for Depression (HAM-D) score, the number of episodes, personality disorder and gender. For well-being, the best predictive variables were HAM-D score, type of family environment, Hamilton Rating Scale for Anxiety (HAM-A) score, educational level and marital status. We conclude that the severity of the symptoms is the main factor influencing the appraisal of the quality of life, while sociodemographic variables play a more limited role.

Biosorption of nickel using filamentous fungi

Nickel (Ni) uptake capability from aqueous solutions was studied in a filamentous fungi strains group of Rhizopus sp., Penicillium sp. Aspergillus sp., Trichoderma sp., Byschoclamyss sp., and Mucor sp. The metal uptake of a Rhizopus sp. strain, which has the highest uptake capacity, was corroborated by electron microscopy; no Ni deposits were observed on the cell wall, but rather a homogeneous accumulation was seen on the cell surface. The influence on the capacity of metal uptake by environmental parameters such as pH, temperature, time, and the interference of other ions in the solution, was also studied. Nickel accumulation by the selected strains is fast, occurring in less than 30 min, and does not require a microorganism's active metabolism to take place. The sorption isotherms were established for the selected fungi, in order to determine the maximum metal uptake capacity. The sorption isotherms were fixed to the mathematical models of Freundlich and Langmuir, obtaining better performance on the Langmuir model.

Comparative pollination biology of Venezuelan columnar cacti and the role of nectar-feeding bats in their sexual reproduction

The floral biology, reproductive system, and visitation behavior of pollinators of four species of columnar cacti, Stenocereus griseus, Pilosocereus moritzianus, Subpilocereus repandus, and Subpilocereus horrispinus, were studied in two arid zones in the north of Venezuela. Our results support the hypothesis that Venezuelan species of columnar cacti have evolved toward specialization on bat pollination. Additional information on the floral biology of a fifth species, Pilosocereus lanuginosus, was also included. All species showed the typical traits that characterize the pollination syndrome of chiropterophily. All species but Pilosocereus moritzianus were obligate outcrossers. Nectar and pollen were restricted to nocturnal floral visitors. Two species of nectar-feeding bats, Leptonycteris curasoae Miller and Glossophaga longirostris Miller, were responsible for practically all the fruit set in these cacti. Frequency of bat visitation per flower per night was highly variable within and between species of cactus, with average frequencies varying between 27 and 78 visits/flower/night. In general terms, the pattern of floral visitation through the night was significantly correlated with the pattern of nectar production and nectar sugar concentration for all species of cactus. Under natural pollination, fruit:flower ratios varied from 0.46 in Subpilocereus repandus to 0.76 in Stenocereus griseus. The efficiency of bat pollination in terms of seed:ovule ratio was high in all species, varying between 0.70 and 0.94.

The prevalence of back pain in children who have idiopathic scoliosis

A retrospective study of 2442 patients who had idiopathic scoliosis was performed to determine the prevalence of back pain and its association with an underlying pathological condition. Five hundred and sixty (23 per cent) of the 2442 patients had back pain at the time of presentation, and an additional 210 (9 per cent) had back pain during the period of observation. There was a significant association between back pain and an age of more than fifteen years, skeletal maturity (a Risser sign of 2 or more), postmenarchal status, and a history of injury. There was no association with gender, family history of scoliosis, limb-length discrepancy, magnitude or type of curve, or spinal alignment. At the latest follow-up evaluation, 324 (58 per cent) of the 560 patients who had had back pain at presentation had no additional symptoms. Forty-eight (9 per cent) of the 560 patients who had back pain had an underlying pathological condition: twenty-nine patients had spondylolysis or spondylolisthesis, nine had Scheurmann kyphosis, five had a syrinx, two had a herniated disc, one had hydromyelia, one had a tethered cord, and one had an intraspinal tumor. A painful left thoracic curve or an abnormal neurological finding was most predictive of an underlying pathological condition, although only eight of the thirty-three patients who had such findings were found to have such a condition. When a patient with scoliosis has back pain, a careful history should be recorded, a thorough physical examination should be performed, and good-quality plain radiographs should be made. If this initial evaluation reveals normal findings, a diagnosis of idiopathic scoliosis can be made, the scoliosis can be treated appropriately, and non-operative treatment can be initiated for the back pain. It is not necessary to perform extensive diagnostic studies to evaluate every patient who has scoliosis and back pain.

Complications after posterior spinal fusion in Duchenne's muscular dystrophy

Patients with Duchenne's muscular dystrophy often develop progressive scoliosis. Should spinal stabilization be necessary, these patients are considered at high risk for surgically related complications. This retrospective study of 30 patients with Duchenne's examined the prevalence and types of complications associated with posterior spinal fusion and determined the percentage of patients who lived > or = 2 years beyond surgery. Major complications related to cardiopulmonary compromise, infection, or hardware complications occurred in 27%, and minor complications occurred in another 16%. Seventy-seven percent of the patients lived > or = 2 years beyond their surgery. The majority of patients and their families, including half of those who had major complications, reported that surgery resulted in an improvement in their quality of life. Although complications are common, the benefits realized by the patient with Duchenne's muscular dystrophy with scoliosis reinforce the importance of surgical stabilization.

Effectiveness of TLSO bracing in the conservative treatment of idiopathic scoliosis

A clear understanding of the effectiveness of the thoracolumbosacral orthosis (TLSO) as a conservative treatment for idiopathic scoliosis is still necessary. In the past few years, the review of pertinent literature has emphasized the lack of properly matched control studies and erroneous interpretations of results due to the use of univariate analysis. Also, in a previous controlled study evaluating the bracing of idiopathic scoliosis, the researchers mixed different types of braces and patients. Therefore, their findings were not specific to any kind of orthosis. In our study, we responded to these criticisms by providing a homogeneous group of patients with a control group and by conducting a multivariate analysis to assess the effectiveness of the TLSO. All the patients at the University Pediatric Hospital Scoliosis Clinic aged 8 through 15 with initial Cobb's angle between 20 and 40 degrees and evidence of progression were assessed. All the patients who used the TLSO and showed full compliance with treatment (n = 54) were compared with a control group. The control group consisted of the patients who needed the treatment with the brace but did not use it for several reasons (n = 47). Neither group showed significant differences in sex, initial age, initial Cobb's angle, menarche, Risser sign, or curve pattern. The mean follow-up period was 3.3 years after skeletal maturity. The results were analyzed using a multivariate analysis because the natural history of scoliosis is determined by multiple factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Primitive neuroectodermal tumor of the brain associated with malignant rhabdoid tumor of the liver: a histologic, immunohistochemical, and electron microscopic study

A 14-day-old white male, born with a large primitive neuroectodermal tumor of the left cerebral hemisphere, was found to have a solitary rhabdoid tumor in the liver incidentally at autopsy. Cells resembling the liver rhabdoid cells were also found by histology, immunohistochemistry, and electron microscopy in the brain tumor. The concurrence of rhabdoid cells in the tumors of the brain and liver suggests a common histogenesis and further supports the previous suggestion that the rhabdoid tumor is of neuroectodermal origin. The rhabdoid tumor in the liver in this case is likely to be a metastatic tumor from the brain rather than a second primary tumor.