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The urgency to develop vaccines against Covid-19 is putting pressure on the long and expensive development timelines that are normally required for development of lifesaving vaccines. There is a unique opportunity to take advantage of new technologies, the smart and flexible design of clinical trials, and evolving regulatory science to speed up vaccine development against Covid-19 and transform vaccine development altogether.Ex vivo expansion is critical in facilitating the application of hematopoietic/progenitor stem cells (HSPCs) for regenerative therapies. Wnt signaling is implicated in the expansion and self-renewal maintenance of HSPCs. However, a reasonable method to regulate Wnt signaling in ex vivo cultures to achieve robust expansion of HSPCs has not yet been investigated. this website Here, cord blood-derived CD34+ cells were cultured with the activator of Wnt signaling 6-bromoindirubin-3'-oxime (BIO) under the following conditions vehicle control (group A); BIO was added to the culture on days 0, 4, and 7 (group B); and BIO was added to the culture on days 0 and 7 (group C). Initial BIO treatment promoted the expansion of CD34+ cells on day 4. However, BIO supplementation on days 0 and 4 in group B attenuated HSPC expansion on day 7, while enhancing the multilineage commit potential and secondary expansion ability of expanded CD34+ cells. Based on this finding, an optimized BIO feeding strategy (group C) was proposed to support substantial expansion of HSPCs. After 10 days of culture, the expansion fold of CD34+ cells was 28.70 ± 0.46-folds, which was significantly higher than group A (16.20 ± 0.72-folds, p less then 0.05). Moreover, the optimized BIO feeding strategy achieved increased primitive HSPC expansion without the loss of biological functions. Mechanistically, the optimized BIO feeding strategy avoided the excessive activation of Wnt observed in group B while maintaining a moderate level of intracellular β-catenin. These results provide an experimental and theoretical basis for Wnt regulation in ex vivo culture process and a potential strategy to expand HSPCs for transplantation.The present study was undertaken to investigate the suitability of alternative internal target volume (ITV) delineation strategies based on maximum intensity projection (MIP), average intensity projection (AIP), 2 extreme phases and 4 phases images relative to the ITV10phase in stereotactic body radiation therapy (SBRT) for lung cancer. The 4-dimensional computed tomography (4DCT) data of 15 lung cancer patients treated with SBRT in our clinic were used. Five different ITVs were generated as follows merging GTVs from 10 phases (ITV10Phase); merging GTVs from 2 extreme phases (0%, 50%) (ITV2Phase); merging GTVs from 4 phases (0%, 20%, 50%, and 70%) (ITV4Phase); delineating GTV on MIP (ITVMIP), and delineating GTV on AIP (ITVAIP). PTV10Phase, PTV2Phase, PTV4Phase, PTVMIP, and PTVAIP were generated by adding a 5-mm margin around the related ITV. Volumetric analyses were performed for 4 ITVs and PTVs relative to ITV10phase and PTV10phase. SBRT plans made for all PTVs were evaluated for dosimetric effect of alternative ITV delineation strategies. The mean percentage overlap volume (POV) for PTV2phase, PTV4phase, PTVMIP, and PTVAIP relative to PTV10phase were 84.2 ± 5.4%, 92.0 ± 2.9%, 82.2 ± 5.7%, and 73.8 ± 9.3%, for lower-lobe tumors, respectively. The mean POV for PTV2phase, PTV4phase, PTVMIP, and PTVAIP relative to PTV10phase were 93.2 ± 2.5%, 95.9 ± 1.0%, 87.5 ± 6.7%, and 83.3 ± 6.8% for upper-lobe, respectively. For lower-lobe tumors the mean differences in V20 and MLD for plans based on PTV2phase and PTV4phase were less then 0.5% and less then 10 cGy, compared with a plan based on PTV10phase. The use of PTV based on 4 respiratory phases and a 5-mm margin is a safe approach to reduce the workload of target delineation for tumors located in both lower and upper lobes.Next generation sequencing (NGS) has allowed the titin gene (TTN) to be identified as a major contributor to neuromuscular disorders, with high clinical heterogeneity. The mechanisms underlying the phenotypic variability and the dominant or recessive pattern of inheritance are unclear. Titin is involved in the formation and stability of the sarcomeres. The effects of the different TTN variants can be harmless or pathogenic (recessive or dominant) but the interpretation is tricky because the current bioinformatics tools can not predict their functional impact effectively. Moreover, TTN variants are very frequent in the general population. The combination of deep phenotyping associated with RNA molecular analyses, western blot (WB) and functional studies is often essential for the interpretation of genetic variants in patients suspected of titinopathy. In line with the current guidelines and suggestions, we implemented for patients with skeletal myopathy and with potentially disease causing TTN variant(s) an integrated genotype-transcripts-protein-phenotype approach, associated with phenotype and variants segregation studies in relatives and confrontation with published data on titinopathies to evaluate pathogenic effects of TTN variants (even truncating ones) on titin transcripts, amount, size and functionality. We illustrate this integrated approach in four patients with recessive congenital myopathy.To address progressive respiratory muscle weakness in late-onset Pompe disease (LOPD), we developed a 12-week respiratory muscle training (RMT) program. In this exploratory, double-blind, randomized control trial, 22 adults with LOPD were randomized to RMT or sham-RMT. The primary outcome was maximum inspiratory pressure (MIP). Secondary and exploratory outcomes included maximum expiratory pressure (MEP), peak cough flow, diaphragm ultrasound, polysomnography, patient-reported outcomes, and measures of gross motor function. MIP increased 7.6 cmH2O (15.9) in the treatment group and 2.7 cmH2O (7.6) in the control group (P = 0.4670). MEP increased 14.0 cmH2O (25.9) in the treatment group and 0.0 cmH2O (12.0) in the control group (P = 0.1854). The only statistically significant differences in secondary/exploratory outcomes were improvements in time to climb 4 steps (P = 0.0346) and daytime sleepiness (P = 0.0160). The magnitude of changes in MIP and MEP in the treatment group were consistent with our pilot findings but did not achieve statistical significance in comparison to controls.

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