Upright proton therapy for esthesioneuroblastoma: a single-institution experience

Aim

This study presents an analysis (efficacy and toxicity) of outcomes in patients with esthesioneuroblastoma after pencil beam proton therapy with a fixed beamline in the upright position.

Background

Esthesioneuroblastoma (ENB) is an extremely rare tumor of sinonasal area located in critical proximity to vital structures. Proton therapy (PT) is often considered the optimal radiation treatment for head-and-neck tumors, although of limited availability. Upright PT delivered using fixed pencil beamline and rotating chair is a fairly promising option.

Methods

This is a single-center experience describing the outcomes of PT in 14 patients with ENB treated between January 2016 and October 2022; half of the cases had a history of previous irradiation. The therapy was applied using a fixed pencil beamline with 6D-chair for positioning. The median dose was 63 GyRBE (total range 48-70 GyRBE; based on 1.1 RBE multiplier for protons) with 2.0 GyRBE per fraction. The mean gross tumor volume was 109.5 cm3 (17.1-257.7 cm3). Patient demography, pathology, treatment parameters and toxicity data were analyzed. Radiation-induced reactions were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v 4.0.

Results

The median follow-up time was 28 months. The 1- and 2-year locoregional control rates constituted 100% and 88.9%, respectively; the median duration of local control was 52 months. The 1- and 2-year progression-free survival (PFS) rates constituted 92.9% and 75.0%, respectively; the median PFS duration was 52 months. The 1- and 2-year overall survival (OS) rates constituted 92.9% and 84.4%, respectively. Two patients died of non-cancer-related causes (coronavirus-induced pneumonia) and 1 patient died of tumor progression. All patients tolerated PT well without any treatment gaps. Serious late toxicity reactions included glaucoma in 1 patient and cataract in 2 patients, in over half a year since irradiation.

Conclusion

PT with upright design of the unit affords promising outcomes in terms of disease control and toxicity rates in ENB, a sinonasal tumor of complicated localization.

Pitstop-2 and its novel derivative RVD-127 disrupt global cell dynamics and nuclear pores integrity by direct interaction with small GTPases

Clathrin-mediated endocytosis (CME) is an essential cell physiological process of broad biomedical relevance. Since the recent introduction of Pitstop-2 as a potent CME inhibitor, we and others have reported on substantial clathrin-independent inhibitory effects. Herein, we developed and experimentally validated a novel fluorescent derivative of Pitstop-2, termed RVD-127, to clarify Pitstop-2 diverse effects. Using RVD-127, we were able to trace additional protein targets of Pitstop-2. Besides inhibiting CME, Pitstop-2 and RVD-127 proved to directly and reversibly bind to at least two members of the small GTPase superfamily Ran and Rac1 with particularly high efficacy. Binding locks the GTPases in a guanosine diphosphate (GDP)-like conformation disabling their interaction with their downstream effectors. Consequently, overall cell motility, mechanics and nucleocytoplasmic transport integrity are rapidly disrupted at inhibitor concentrations well below those required to significantly reduce CME. We conclude that Pitstop-2 is a highly potent, reversible inhibitor of small GTPases. The inhibition of these molecular switches of diverse crucial signaling pathways, including nucleocytoplasmic transport and overall cell dynamics and motility, clarifies the diversity of Pitstop-2 activities. Moreover, considering the fundamental importance and broad implications of small GTPases in physiology, pathophysiology and drug development, Pitstop-2 and RVD-127 open up novel avenues.

Ordering motivation and Likert scale ratings: When a numeric scale is not necessarily better

Measuring psychological attributes, such as motivation, typically involves rating scales, assuming that an attribute can be ordered, and that ratings represent this order. Previously, only the first assumption had been tested, albeit limited. First, we checked the ordinal structure of motivation, looking at whether people can establish transitive relations between motivation levels in pairwise comparisons; and we found different ordering patterns: strict transitive, weak transitive, changing order, and intransitivity. The rate of intransitivity was similar to that found previously and was somewhat higher than we obtained when we asked participants to compare definitely quantitative attributes (such as weight). Second, we checked if specific ordering patterns were related to individual interpretations of the statements that deviated from expected motivation types. Indeed, about a third of participants miscategorized statements, and these deviant interpretations were related to intransitivity as well as weak transitivity. Third, we checked whether Likert ratings represent the order of motives obtained from pairwise comparisons. We found rather homomorphic representation: ratings correlated with the order, but they did not differentiate between different ordering patterns and hierarchies of motives. We conclude that the Likert rating scale provides less information about respondents than pairwise ordering. The findings question the mainstream practice of using rating scales without testing underlying assumptions.

Amplitude Dependence of Nonlinear Precipitation Blocking of Relativistic Electrons by Large Amplitude EMIC Waves

Recent work has shown that ElectroMagnetic Ion Cyclotron (EMIC) waves tend to occur in four distinct regions, each having their own characteristics and morphology. Here, we use nonlinear test-particle simulations to examine the range of energetic electron scattering responses to two EMIC wave groups that occur at low L-shells and overlap the outer radiation belt electrons. The first group consists of low-density, H-band region b waves, and the second group consists of high-density, He-band region c waves. Results show that while low-density EMIC waves cannot precipitate electrons below ∼16 MeV, the high density EMIC waves drive a range of linear and nonlinear behaviors including phase bunching and trapping. In particular, a nonlinear force bunching effect can rapidly advect electrons at low pitch-angles near the minimum resonant energy to larger pitch angles, effectively blocking precipitation and loss. This effect contradicts conventional expectations and may have profound implication for observational campaigns.

Structure- and Interaction-Based Design of Anti-SARS-CoV-2 Aptamers

Aptamer selection against novel infections is a complicated and time-consuming approach. Synergy can be achieved by using computational methods together with experimental procedures. This study aims to develop a reliable methodology for a rational aptamer in silico et vitro design. The new approach combines multiple steps: (1) Molecular design, based on screening in a DNA aptamer library and directed mutagenesis to fit the protein tertiary structure; (2) 3D molecular modeling of the target; (3) Molecular docking of an aptamer with the protein; (4) Molecular dynamics (MD) simulations of the complexes; (5) Quantum-mechanical (QM) evaluation of the interactions between aptamer and target with further analysis; (6) Experimental verification at each cycle for structure and binding affinity by using small-angle X-ray scattering, cytometry, and fluorescence polarization. By using a new iterative design procedure, structure- and interaction-based drug design (SIBDD), a highly specific aptamer to the receptor-binding domain of the SARS-CoV-2 spike protein, was developed and validated. The SIBDD approach enhances speed of the high-affinity aptamers development from scratch, using a target protein structure. The method could be used to improve existing aptamers for stronger binding. This approach brings to an advanced level the development of novel affinity probes, functional nucleic acids. It offers a blueprint for the straightforward design of targeting molecules for new pathogen agents and emerging variants.

Nitrobacter sp. extract mediated biosynthesis of Ag2O NPs with excellent antioxidant and antibacterial potential for biomedical application

In this study, extracellular extract of plant growth promoting bacterium, Nitrobacter sp. is used for the bioconversion of AgNO3 (silver nitrate) into Ag2O (silver oxide nanoparticles). It is an easy, ecofriendly and single step method for Ag2O NPs synthesis. The bio-synthesized nanoparticles were characterized using different techniques. UV-Vis results showed the maximum absorbance around 450 nm. XRD result shows the particles to have faced centered cubic (fcc) crystalline nature. FTIR analysis reveals the functional groups that are involved in bioconversion such as C-N, N-H and C=O. Energy-dispersive X-ray spectroscopy (EDAX) spectrum confirms that the prepared nanoparticle is Ag2O NPs. Particle size distribution result reveals that the average particle size is around 40 nm. The synthesized Ag2O NPs found to be almost spherical in shape. Biosynthesized Ag2O NPs possess good antibacterial activity against selected Gram positive and Gram negative bacterial strains namely Salmonella typhimurium, Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae when compared to standard antibiotic. In addition, Ag2O NPs exhibits excellent free radical scavenging activity with respect to dosage. Thus, this study is a new approach to use soil bacterial extract for the production of Ag2O NPs for biomedical application.