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Artificial intelligence-powered spatial analysis of tumor microenvironment in patients with non-small cell lung cancer with acquired resistance to EGFR tyrosine kinase inhibitor.

PURPOSE: This study evaluated the dynamic changes in the tumor microenvironment (TME) in patients with non-small cell lung cancer (NSCLC) and acquired resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) using an artificial intelligence (AI)-powered spatial TME analyzer. We then assessed the predictive efficacy of immune-checkpoint inhibitors (ICIs)-based treatment. EXPERIMENTAL DESIGN: An AI-powered whole-slide image analyzer was used to segment cancer areas (CAs) and cancer stroma and to identify tumor-infiltrating lymphocytes (TILs), tertiary lymphoid structures, fibroblasts, and endothelial cells (ECs) in the tumor tissue. We analyzed 143 NSCLC samples after resistance to EGFR-TKIs from two cohorts: (1) 89 patients treated with ICI monotherapy and (2) 54 patients from the ATTLAS phase III trial comparing atezolizumab plus bevacizumab, paclitaxel, and carboplatin (ABCP) versus pemetrexed plus carboplatin. RESULTS: Post-TKI samples showed reduced TILs in the CA (p=0.045) and increased ECs in the CA (p=0.005) compared with pre-TKI samples. These changes differed according to EGFR mutation subtype. Higher TILs in CA were associated with a better overall response rate (ORR) and progression-free survival (PFS). Similarly, higher EC levels in CA correlated with improved ORR and PFS. In the ATTLAS cohort, these factors were associated with clinical benefits from ABCP, with a significant association with TILs and a marginal association with ECs. CONCLUSION: Our findings suggest that EGFR-TKIs affect the immune landscape of patients with EGFR-mutated NSCLC. Higher TILs or ECs in the CA were significantly associated with a favorable response to subsequent ICI-based treatment. TRIAL REGISTRATION NUMBER: NCT03991403.

Aged

Spatial analysis of transcriptional activation in fetal rat jejunal and ileal gut epithelium.

In the week before birth (days 15-21 of the 22-day gestation period), the fetal rat small intestinal epithelium undergoes rapid proliferation and differentiation. The developing gut changes from a mesenchymal tube lined by endoderm to a complex absorptive surface composed of differentiated epithelium overlying nascent villi. To begin to characterize the molecular events that take place in nascent intestinal epithelial cells as cytodifferentiation proceeds from jejunum to ileum, we examined spatial, temporal, and cellular patterns of transcriptional activation of the rat liver fatty acid-binding protein (L-FABP) and apolipoprotein (apo) AIV genes. In situ hybridization analyses revealed that transcription of both genes is activated in the jejunum between fetal days 17 and 18, yet their expression is not initiated in the ileum until 1-2 days later. Transcriptional activation proceeds in a "wavelike" fashion along the horizontal length of the gut and coincides with villus morphogenesis. As nascent villi emerge, heterogeneous cellular accumulation of L-FABP mRNA occurs in both fetal jejunal and ileal epithelium, but persists only in the ileum. In contrast, cellular expression of apo AIV mRNA in nascent epithelium is predominantly homogeneous in both regions of the gut. These results indicate that transcriptional activation in the fetal gut epithelium is a complex, dynamic process that is spatially regulated along the horizontal axis of the intestine. Initiation of transcription in enterocytes is closely linked to villus morphogenesis and histological cytodifferentiation.

Animals

Temporal and spatial analysis of cartilage proteoglycan core protein gene expression during limb development by in situ hybridization.

As limb mesenchymal cells differentiate into chondrocytes they initiate the synthesis of a cartilage-specific sulfated proteoglycan, cartilage-characteristic type II collagen, and other cartilage-specific proteins. In the present study, in situ hybridization with a 32P-labeled cloned cDNA probe complementary to mRNA encoding the core protein of cartilage proteoglycan has been used to visualize and localize the accumulation of cartilage proteoglycan core protein mRNA sequences during development of the chick limb bud in vivo. When the probe was hybridized to sections through 7-day (stage 32) limbs, an intense hybridization signal was observed over the well-differentiated cartilage rudiments of the limb, while no signal above background was observed over nonchondrogenic tissues including muscle, loose connective tissue, and epidermis. At early stages of limb development, an accumulation of silver grains representing hybridizable core protein mRNA first became detectable in the proximal central core of the limb where the prechondrogenic condensation of mesenchymal cells that characterizes the onset of cartilage differentiation was occurring. In fact, the pattern of silver grain accumulation closely followed the pattern of mesenchymal cell condensation, and no hybridizable core protein mRNA sequences were detectable in the limb bud prior to condensation. Cartilage-characteristic type II collagen mRNA was colocalized with core protein mRNA in the condensing central core of the limb suggesting that the genes for these two major constituents of cartilage matrix are coordinately regulated at the onset of chondrogenesis. Furthermore, the appearance of hybridizable core protein mRNA was closely followed by the appearance of the protein for which it codes as detected by immunohistochemical staining with monospecific antibody. These observations support the hypothesis that at the initial stages of limb chondrogenesis core protein gene expression is controlled primarily at the transcriptional level.

Aggrecans

Journey patterns of the elderly and disabled in the Cotswolds: a spatial analysis.

The decline of services and transport provision in the North Cotswolds has led to a progressive deterioration in the welfare of the elderly and disabled. This study, based on interviews with 498 individuals in eight typical parishes, relates the travel behaviour of these groups to health status, personal circumstances, the grade and location of services, and mode of transport. The repercussions of the 1985 Transport Act for the car-less and severely disabled are then examined. Given the increased loadings on domiciliary support systems, the case is argued for coordinated initiatives in alternative transport provision which relate, sensitively, to the needs of the different groups among the elderly and disabled.

Activities of Daily Living

A spatial analysis of the blood-brain barrier damage in experimental allergic encephalomyelitis.

Experimental allergic encephalomyelitis was induced in young male Lewis rats. Following the development of neurological signs, the local distribution of perivascular inflammatory cellular infiltrates and the local blood-to-tissue transfer constants (K1) of alpha-aminoisobutyric acid (AIB) were determined, and these results were compared. Perivascular infiltrative lesions were generally found near areas of the CNS that normally lack an effective blood-brain barrier (BBB) such as the choroid plexus and the entry zones of the cranial and spinal nerve roots. This distribution pattern indicates that the entry of the causative agent into CNS tissue may be by way of the permeable microvessels of these structures. In tissue around inflamed veins, the mean transfer constant was slightly but significantly increased (2.8 +/- 1.5 microliter g-1 min-1) compared with uninvolved regions (0.9 +/- 0.2 microliter g-1 min-1) and similar areas in control animals (0.9 +/- 0.3 microliter g-1 min-1). Analysis of the autoradiographic method of determining transfer constants suggested that the AIB influx rate in the lesion areas may actually be manyfold larger than measured, that BBB permeability may be greatly increased at such sites, and that the areas of lymphocytic infiltration and increased K values may be virtually identical.

Aminoisobutyric Acids

[Spatial analysis of tonal superthreshold signals in dolphins].

Hearing characteristics under the conditions of spacial indetermination of overthreshold tonic signal were studied on dolphins Tursiops truncatus by the method of motordigestive conditional reflexes. High efficiency of spacial analysis on the frequencies 5, 20, 80, 100 kHz was shown. The criterium of relative loss of information in the channel was used for evaluating integral index of efficiency of dolphin spacial hearing.

Animals

[Spatial analysis of the electrophysiological changes in ventricular loading].

Space analysis methods of the changes in heart electromotive force are described (EMF). The size of the space vector in millivolts, azimuth and elevation are obtained by formula substitution in the mathematical analysis. The same values, in graphis analysis, are obtained by the "Circle for space vectors determination", proposed by the authors. Axial and space analysis of the changes in the electrogenesis of right ventricle was performed in 27 patients with pulmonary stenosis, confirmed by catheterization, on the base of the corrective orthogonal electrocardiogram according to Frank. The axial indices, indicating the size of the forces directed to the right (Sxmv) and forward (Qzmv) are compared as well as the size, elevation and azimuth of the maximal space vector, directed to the right (Vmax.sp-x) and forward (Vmax.sp-z). The index from the axial analysis (sensitivity 62%, r = 0.65) shows a priority for the forces, directed to the right. The priority is on the side of the indices from space analysis (sensitivity 33%, r = 0.78) in case of forces directed forward. There is no statistically significant difference in the diagnostic value of the two methods.

Adult