P10.12.A CDK12/CDK13 inhibition disrupts a transcriptional program critical for glioblastoma survival

Background

Glioblastoma multiforme (GBM) is the most prevalent and aggressive malignant tumor of the central nervous system. With a median survival of only one year, GBM patients have a particularly poor prognosis, highlighting a clear need for novel therapeutic strategies to target this disease. Transcriptional cyclin-dependent kinases (CDK), which phosphorylate key residues of RNA polymerase II (RNAPII) C-terminal domain (CTD), play a major role in sustaining aberrant transcriptional programs that are key to development and maintenance of cancer cells.

Material and Methods

We used pharmacological inhibition and genetic ablation to study effects of CDK12/CDK13 depletion on the proliferatory and migratory capacity of GBM cells and mouse xenografts. SLAM-seq, CUT&RUN and cell cycle assays were used to study the mechanistic effects of CDK12/CDK13 depletion in GBM cells.

Results

CDK12/CDK13 depletion markedly reduced the proliferatory and migratory capacity of GBM cells, as well as in vivo growth. CDK12/CDK13 inhibition potentiated existing chemotherapeutic treatments. Mechanistically, inhibition of CDK12/CDK13 leads to a genome-wide abrogation of RNAPII CTD phosphorylation, which in turn disrupts transcription and cell cycle progression in GBM cells.

Conclusion

These results provide proof-of-concept for the potential of CDK12 and CDK13 as therapeutic targets for GBM.

Health among immigrants in Norway, results from the Living Condition Survey among immigrants 2016

Introduction

To manage immigrants` health needs is an important challenge for the society. This report gives knowledge about the status of immigrant health in Norway, which can be used in planning of health services.

Methods

Statistics Norway carried out a Living Condition Survey among immigrants in 2016. We report the prevalence of health outcomes (self-reported health, cardiovascular diseases, hypertension, diabetes, back- and neck problems, impaired functioning, mental health problems, problems with sleeping, overweight) and lifestyle (alcohol, smoking, physical activity) by country of origin and assess associations between health and sociodemographic (age, education, income) and migration related (age at immigration, duration of residence, Norwegian proficiency) variables, as well as discrimination and employment. Immigrants from twelve countries were interviewed. The questionnaire was translated into the main languages in the twelve countries and English. In this report, 4399 participants aged 16-66 years were included.

Results

There were large variations in health according to country of origin and gender. Immigrants experienced a deterioration in health at younger age than non-immigrants did. The educational gradient in health was less pronounced among immigrants than among others. Perceived discrimination was related to mental health problems. Some immigrant groups had a high proportion of smokers. In most groups a considerable proportion was drinking alcohol and a low proportion were physically active.

Conclusions

Future research should take into account differences in health according to country of origin and gender. The importance of physical and social circumstances for immigrant health emphasizes the need for structural population-based initiatives to promote health.

Key messages

Immigrant health varies by country of origin and gender. Physical and social environment is important for immigrant health.

Guidelines for health and welfare monitoring of fish used in research

The aim of this paper is to provide background material necessary for the development of international guidelines for the health and welfare monitoring of fish used in research. It provides an overview of present guidelines and discusses why more detailed and species-specific guidelines are needed. A major issue within fish research is to document the situation today and point out areas where improvements are needed.

Functional outcome in sarcomas treated with limb-salvage surgery or amputation

Purpose. In all patients treated at the Centre for Bone and Soft Tissue Sarcomas of Aarhus the functional outcome is prospectively evaluated by use of the Enneking system for the functional evaluation after surgical treatment of tumours of the musculoskeletal system. This system has been accepted by the Musculoskeletal Tumour Society and the International Symposium on Limb Salvage.

Patients/methods. In the present study the functional outcome after limb-salvage surgery (89 patients) and amputation (58 patients) was compared. In the limb-salvage group the treatment was surgery alone in 50% and surgery combined with either radiotherapy in 39% or chemotherapy in 11%. Inclusion criteria were: Deep seated extremity sarcomas, age >14 years, more than 1 year post-treatment follow-up time and alive at the end of the study. Median age was 49 years (range 14–88 years). Median tumour diameter was 8 cm (range 1–20 cm), median follow-up time was 4.8 years (range 1–11 years). Wilcoxon and ^χ2-tests were used for statistical analyses.

Results. The two groups were comparable according to age, sex, size of tumour, type of tumour, location of tumour, as well as post-treatment follow-up time. The functional scores were significantly higher after limb-salvage surgery as compared to amputation, the median scores being 85 and 47, respectively (p<0.001). A similar difference was observed if the Enneking scores were subdivided into general health-related scores and extremity-related scores. No association was found between functional scores and the following factors by use of univariate analysis: size of tumour, radiation therapy, localization of tumour and surgical margin.

Discussion. We conclude that this study indicates that limb-salvage surgery is associated with a better functional outcome than that observed after amputation. However, whether this also indicates a difference in quality of life needs further studies.

A review of the need and possible uses for genetically standardized Atlantic salmon (Salmo salar) in research

Large numbers of Atlantic salmon ( Salmo salar) are used as research animals in basic research and to solve challenges related to the fish-farming industry. Most of this research is performed on farmed animals provided by local breeders or national breeding companies. The genetic constitution of these animals is usually unknown and highly variable. As a result, large numbers of fish are often needed to produce significant results, and results from one study are often impossible to reproduce in another facility. The production of standardized salmon could in many cases reduce the number of animals used in research and at the same time provide more reproducible results. This paper provides an overview of the methods available for the production of standardized Atlantic salmon, and discusses the pros and cons of each technique. The use of zebrafish and other well-defined laboratory fish species as a model for salmon is also discussed. Access to genetically defined fish would greatly benefit the scientific community, in the same way as genetically defined lines of rodents have revolutionized mammalian research.

Characterization of nodavirus and viral encephalopathy and retinopathy in farmed turbot, Scophthalmus maximus (L.)

An outbreak of nodavirus infection in turbot larvae is described with respect to histopathology, immunohistochemistry, cell culture cultivation, RT-PCR amplification and sequence analysis of the capsid protein gene RNA2. Affected turbot developed classical signs of viral encephalopathy and retinopathy (VER) with abnormal swimming behaviour and high mortality levels. In the acute stage of infection, light microscopy revealed vacuolation of the central nervous system (CNS), with positive immunohistochemical staining for nodavirus. Later in the infection, CNS lesions appeared more chronic and contained clusters of cells immunopositive for nodavirus. Bacterial overgrowth in the intestines of the fish may have provoked or influenced the course of the nodavirus infection. We were unable to propagate the virus in cell culture. While RT-PCR using primers designed to detect Atlantic halibut nodavirus gave negative results, further testing with primers complementary to a more conserved region of RNA2 resulted in amplification of a product of the expected size. The entire RNA2 segment was cloned and sequenced. Sequence alignment showed that the turbot nodavirus (TNV) was different from previously described fish nodaviruses. In addition, phylogenetic analysis based on an 823 nt region of the sequence indicated that TNV clustered outside the four established fish nodavirus genotypes, suggesting a fifth genotype within the betanodaviruses.

A sequential study of pathological findings in Atlantic halibut, Hippoglossus hippoglossus (L), throughout one year after an acute outbreak of viral encephalopathy and retinopathy

Following a natural outbreak of viral encephalopathy and retinopathy (VER) at a commercial farm in Norway, surviving Atlantic halibut, Hippoglossus hippoglossus, were sequentially studied for distribution of nodavirus, immune response and histopathology over 1 year. Typical clinical signs and histopathology of VER were observed during the acute stage of the disease. Most of the surviving fish became subclinical carriers of nodavirus with clusters of nodavirus-containing cells in the central nervous system. Four random samplings of presumably healthy fish were performed from two fish groups, with low and high growth rates respectively, over a 7-month period. Immunohistochemical (IHC) examination revealed a higher number of nodavirus-positive cells in fish with a low growth rate than in fish with a high growth rate. All IHC positive fish were also reverse transcriptase polymerase chain reaction (RT-PCR) positive for nodavirus and for nodavirus antibodies detected by enzyme-linked immunosorbent assay (ELISA) at all sampling points. The percentage of PCR- and ELISA-positive fish remained high throughout the year, while the number of IHC-positive fish decreased, especially in the group with a high growth rate. Several other histopathological changes were observed, including pericarditis, steatitis, changes in liver and kidney, and necrosis of the intestinal wall. None of these findings seemed to be related to the nodavirus infection. Nodavirus was reisolated in cell culture from subclinically infected fish one year after the acute VER outbreak, which indicates that the virus was still infectious.

Acute and persistent experimental nodavirus infection in spotted wolffish Anarhichas minor

Spotted wolffish Anarhichas minor (approx. 0.7 g) were found to be susceptible to infection with a nodavirus isolated from Atlantic halibut (AHNV) by bath-challenge. During the acute stage of infection, 4 to 8 wk post-challenge, viral encephalopathy and retinopathy (VER) were diagnosed by histopathology, immunohistochemistry (IHC) and reverse transcriptase-polymerase chain reaction (RT-PCR). Accumulated mortality was 52% in the challenged group. The surviving fish were sampled 16 wk post-challenge, by which time they had grown to approximately 17 g. No clinical signs of VER were observed in these fish. RT-PCR examination revealed the presence of nodavirus in several organs of the survivors, but no immunopositive cells were detected by IHC. Nodavirus was reisolated from fish at the last sampling in SSN-1 cells, showing that nodavirus retains virulence in persistently infected wolffish for at least 16 wk post-bath-challenge.

Experimental infection of Atlantic halibut Hippoglossus hippoglossus with nodavirus: tissue distribution and immune response

Atlantic halibut Hippoglossus hippoglossus, age 8 mo and weighing 20 g, were challenged by either intraperitoneal injection (i.p.) or by bath exposure using nodavirus isolated from Atlantic halibut. Fish were sampled at intervals over a 41 d period, starting on Day 5 post-challenge. Although no clinical disease or mortality was recorded, the data show that nodavirus did successfully propagate in i.p.-challenged fish. Using conventional end-point reverse transcription (RT)-PCR, nodavirus was detected in the kidney of all examined i.p.-challenged fish, and further in the head, heart, liver and posterior intestine of most of these individuals. Quantitative real-time RT-PCR revealed that the amount of virus in head samples from the i.p.-challenged group increased during the experiment. The presence of nodavirus in nervous tissue of i.p.-challenged fish was detected by immunohistochemistry from Day 13 post-challenge. In the retina, virus positive cells were found adjacent to the circumferential germinal zone at the ciliary margin towards the iris. In the brain, a few positive cells were detected in the tectum opticum. An ELISA was developed to detect anti-nodavirus activity in plasma. The method included an optimized coating procedure, which allowed the use of non-purified nodavirus as the coating antigen in a simple indirect ELISA. An anti-nodavirus antibody response was detected from Day 19 post-challenge in i.p.-challenged fish, while a response was not detected in the bath-challenged or control fish. This experiment demonstrates a subclinical nodavirus infection in Atlantic halibut at a post-juvenile stage induced by i.p. injection of virus.

Pericarditis and myocarditis in farmed Atlantic halibut Hippoglossus hippoglossus

Farming of Atlantic halibut Hippoglossus hippoglossus is a growing industry in Norway. This study comprises the first description of heart morphology in fish from one Atlantic halibut farm. Fish with no clinical signs of disease were randomly sampled (8 to 12 mo old, weight 1 to 50 g). The hearts were studied by light and electron microscopy and samples were taken from the kidney and pericardial cavity for bacteriological examination. Slight to severe changes were found in most hearts at all samplings. The most serious pericardial and myocardial changes were seen in larger fish (15 to 50 g). In some of the hearts the affected pericardium formed multifocal protrusions. Eight fish had an adhesion between the apex of the ventricle and the parietal wall of the pericardial cavity. Results of bacteriology and immunohistochemistry investigations for common disease agents were negative.

Training nurses to support carers of relatives with schizophrenia

Carers have an enormous amount of responsibility for the welfare and management of people with a mental illness in Britain, and many require help if they are to continue caring. Mental health nurses may be in a key position to offer support, but they are often unclear of what is required and how it should be delivered. Existing UK nurse-led psychosocial interventions for families often focus on the needs of the patient rather than the carer. This article describes a needs-led support service that has been designed for carers whose relatives are diagnosed with schizophrenia. It recognizes the importance of a collaborative partnership between carers and nurses. In 2000, 10 mental health nurses were trained to deliver this support to carers. An evaluation is currently underway. This article outlines the principles of the training programme and how it might enable nurses to meet the carers' needs.

[Nerve biopsy]

Nerve biopsy, if undertaken at centres with appropriate expertise, may be a valuable diagnostic procedure in selected patients with peripheral neuropathy. Sural nerve biopsy and skin biopsy for evaluation of epidermal nerves are described. Indications, surgical procedure, preparation and transport are reviewed. Usually the patient has to be admitted to a hospital with the necessary resources for a comprehensive battery of nerve tissue processing, including teasing and electron microscopical examination, and other investigative procedures. Another option, when practically and economically feasible, is to obtain sural nerve biopsy from several (2-4) patients performed by a skilled surgeon at the local (central) hospital. A technician from a neuromuscular centre or laboratory of neuropathology should be at the site to provide immediate and proper preparation and transport of the tissue samples. An example of peripheral nerve vasculitis with teased nerve fibers in early and late axonal degeneration is presented as an illustration. Sural nerve biopsy is useful in selected cases, particularly in order to demonstrate peripheral nerve vasculitis. For detection of small fiber neuropathy in the investigation of painful neuropathies, skin biopsy for evaluation of epidermal nerves may be an appropriate alternative.

Responsiveness of leg alignment changes associated with articular pressure testing to spinal manipulation: the use of a randomized clinical trial design to evaluate a diagnostic test with a dichotomous outcome

OBJECTIVE

A study was undertaken to assess the stability of leg alignment reaction to a pressure challenge and its responsiveness to an adjustive intervention.

DESIGN

Prospective, double-blind clinical trial of a diagnostic test.

SETTING

Laboratory: Center for Technique Research.

PARTICIPANTS

Forty-two chiropractic college students, faculty and staff.

INTERVENTIONS

A high-velocity, low-amplitude, short lever adjustment of a single vertebra from among C1 and T3-T7; or a sham adjustment similar to a manual diagnostic pressure test at C1, T3-T7 or T9-T10.

MAIN OUTCOME MEASURES

Leg alignment reactivity: An increase in leg alignment discrepancy (yes or no) following a metered pressure challenge to a vertebra.

RESULTS

On average, stability was poor at T3-T7 (Kappa = 0.04), moderate at C1 (K = 0.47), and fair for sham pressure tests (K = 0.30). Responsiveness: The proportion of positive baseline leg alignment reactions that responded (became negative) to sham adjustment was 95% at T3-T7 and 55% at C1. Further analysis was untenable since too few vertebrae were implicated for an adjustment.

CONCLUSIONS

For the population investigated, the majority of the responsiveness of the leg alignment diagnostic test to a rotatory adjustment appears to be a diagnostic illusion (i.e., background noise unrelated to a treatment intervention). Further research with different subject populations, regions of investigation, leg alignment measurement techniques and vertebral challenge techniques are indicated.

Reactivity of leg alignment to articular pressure testing: evaluation of a diagnostic test using a randomized crossover clinical trial approach

OBJECTIVE

A study was undertaken to assess the reliability of detecting leg alignment changes (reactivity) and to determine if the observed leg alignment reactivity can be attributed to a rotatory articular pressure challenge.

DESIGN

Prospective double-blind crossover trial of a diagnostic test.

SETTING

Laboratory: Center for Technique Research.

PARTICIPANTS

Forty-two chiropractic college students, faculty and staff.

INTERVENTIONS

A standardized force of 2 or 3 kg was applied with a 1 cm2 rubber-tipped pressure algometer on the lateral aspect of the T3-T7 spinous processes and the posterior aspect of the lateral masses of C1.

MAIN OUTCOME MEASURES

Leg alignment reactivity: an increase in leg alignment discrepancy (yes or no) following a diagnostic intervention.

RESULTS

The reliability for detecting leg alignment reactivity was poor: on average, Kappa = 0.05 in the thoracics and 0.06 at C1. On average, the attributable risk of leg alignment reactivity (pressure test risk--sham test risk) was less than 4%. In many cases, the sham rate was greater than the pressure test rate.

CONCLUSIONS

For the population investigated, leg alignment reactivity to rotatory pressure testing can, in the majority of cases, be attributable to background noise. This procedure was not found to be viable for identifying vertebrae for adjustment. Further research with different subject populations, regions of investigation, leg alignment measurement techniques and vertebral challenge techniques are indicated.

Artefacts and morphological changes during chemical fixation

The normally 'condensed' (darkly stained) chromosomes of dinoflagellates decondense by swelling. This occurs in an increasing number of cells when the concentration of added OsO4 is decreased. With different fixatives other types of disintegration can be observed, which vary with the concentration. With cryofixation and freeze-substitution the chromosomes are most 'condensed'. Escherichia coli infected with bacteriophage T4, with or without active lysozyme production, were studied by optical densitometry for partial lysis and by light and electron microscopy for observing swelling. When active lysozyme is present some of the acrolein (2.5%)-glutaraldehyde (2%)-fixed cells swell at 0 degrees C, but do not in the absence of lysozyme nor when fixed at room temperature. If OsO4 is added at concentrations < or = 0.5%, partial lysis occurs when lysozyme is present. The optical density decreases, the cells lose some matter and swell slightly. The corresponding electron micrographs show gap formation by curdling and/or a decreased concentration of the cytoplasm which reveals certain phage-related particles.

Coralline shape of the bacterial nucleoid after cryofixation

A new procedure of immunostaining sections of cryofixed and freeze-substituted Escherichia coli shows that DNA extends from its bulk into small ribosome-free spaces throughout the cytoplasm, resulting in a coralline-shaped nucleoid. Low-resolution imaging of a bacterium reconstructed from serial sections demonstrated that the small excrescencies are not resolved. The resulting photograph shows the same features as phase-contrast light micrographs.

Effect of cooling on the intracellular concentrations of Na+, K+ and Cl- in cultured human endothelial cells

Cooling is accepted as a practical way of lowering cell metabolism in vein grafts during coronary by-pass surgery. We have previously shown that low temperature causes endothelial cells to become detached, both in in vitro and in vein graft. In this study we have looked at the effect of cold on the concentrations of intra- and extracellular electrolytes. Human endothelial cells were grown on titanium grids for electron microscopy. The cells were incubated for 30 min at 37 degrees, 20 degrees, and 4 degrees C with cell culture medium containing human serum, and at 20 degrees and 4 degrees C with heparinized sodium acetate solution with serum, frequently used for flushing and distending vein grafts. Freeze-dried cells were then subjected to elemental X-ray microanalysis. The ambient fluid was analysed by flame photometry. At 20 degrees and 4 degrees C, intracellular concentration of sodium increased, and potassium decreased, compared with controls (37 degrees C). The changes in sodium concentrations were aggravated when cell culture medium was replaced by heparinized sodium acetate. The intracellular chloride concentration did not change when cells were stored in cold cell culture medium. The extracellular concentration of potassium increased with increasing incubation time at 4 degrees C. The connection between these findings and cell detachment is discussed.

What to expect from teleconferencing

Like other marvels of the electronic age, teleconferencing has been both oversold and underused. Though it has many potential uses, what managers know, or think they know, about it is generally based on misconceptions. Rather than relying only on vendors of teleconferencing, potential purchasers should first decide what their communication needs are, then choose the system that suits them best. These authors explain the new teleconferencing options and give guidelines for adapting them to a particular company.

A family systems approach to home dialysis

Dramatic increases in the cost of the end stage renal disease program are producing an emphasis on home dialysis with the patient and his family carrying the responsibility for this treatment. This requires an adjustment of the family's emotional system and role assignment to sustain members through the continued stress of chronic catastrophic illness. We are suggesting a model of intervention in which family members are encouraged to recognize stress caused by one member's illness and to make necessary changes in the family functioning.