Discovery and validation of a colorectal cancer classifier in a new blood test with improved performance for high-risk subjects

Background

The aim was to improve upon an existing blood-based colorectal cancer (CRC) test directed to high-risk symptomatic patients, by developing a new CRC classifier to be used with a new test embodiment. The new test uses a robust assay format—electrochemiluminescence immunoassays—to quantify protein concentrations. The aim was achieved by building and validating a CRC classifier using concentration measures from a large sample set representing a true intent-to-test (ITT) symptomatic population.

Methods

4435 patient samples were drawn from the Endoscopy II sample set. Samples were collected at seven hospitals across Denmark between 2010 and 2012 from subjects with symptoms of colorectal neoplasia. Colonoscopies revealed the presence or absence of CRC. 27 blood plasma proteins were selected as candidate biomarkers based on previous studies. Multiplexed electrochemiluminescence assays were used to measure the concentrations of these 27 proteins in all 4435 samples. 3066 patients were randomly assigned to the Discovery set, in which machine learning was used to build candidate classifiers. Some classifiers were refined by allowing up to a 25% indeterminate score range. The classifier with the best Discovery set performance was successfully validated in the separate Validation set, consisting of 1336 samples.

Results

The final classifier was a logistic regression using ten predictors: eight proteins (A1AG, CEA, CO9, DPPIV, MIF, PKM2, SAA, TFRC), age, and gender. In validation, the indeterminate rate of the new panel was 23.2%, sensitivity/specificity was 0.80/0.83, PPV was 36.5%, and NPV was 97.1%.

Conclusions

The validated classifier serves as the basis of a new blood-based CRC test for symptomatic patients. The improved performance, resulting from robust concentration measures across a large sample set mirroring the ITT population, renders the new test the best available for this population. Results from a test using this classifier can help assess symptomatic patients’ CRC risk, increase their colonoscopy compliance, and manage next steps in their care.

     

Life Cycle Impacts and Benefits of Wood along the Value Chain: The Case of Switzerland

Sustainable use of wood may contribute to coping with energy and material resource challenges. The goal of this study is to increase knowledge of the environmental effects of wood use by analyzing the complete value chain of all wooden goods produced or consumed in Switzerland. We start from a material flow analysis of current wood use in Switzerland. Environmental impacts related to the material flows are evaluated using life cycle assessment–based environmental indicators. Regarding climate change, we find an overall average benefit of 0.5 tonnes carbon dioxide equivalent per cubic meter of wood used. High environmental benefits are often achieved when replacing conventional heat production and energy‐consuming materials in construction and furniture. The environmental performance of wood is, however, highly dependent on its use and environmental indicators. To exploit the mitigation potential of wood, we recommend to (1) apply its use where there are high substitution benefits like the replacement of fossil fuels for energy or energy‐intensive building materials, (2) take appropriate measures to minimize negative effects like particulate matter emissions, and (3) keep a systems perspective to weigh effects like substitution and cascading against each other in a comprehensive manner. The results can provide guidance for further in‐depth studies and prospective analyses of wood‐use scenarios.     

Increase of methane formation by ethanol addition during continuous fermentation of biogas sludge

Very recently, it was shown that the addition of acetate or ethanol led to enhanced biogas formation rates during an observation period of 24 h. To determine if increased methane production rates due to ethanol addition can be maintained over longer time periods, continuous reactors filled with biogas sludge were developed which were fed with the same substrates as the full-scale reactor from which the sludge was derived. These reactors are well reflected conditions of a full-scale biogas plant during a period of 14 days. When the fermenters were pulsed with 50–100 mM ethanol, biomethanation increased by 50–150 %, depending on the composition of the biogas sludge. It was also possible to increase methane formation significantly when 10–20 mM pure ethanol or ethanolic solutions (e.g. beer) were added daily. In summary, the experiments revealed that “normal” methane production continued to take place, but ethanol led to production of additional methane.     

State-of-the art data normalization methods improve NMR-based metabolomic analysis

Extracting biomedical information from large metabolomic datasets by multivariate data analysis is of considerable complexity. Common challenges include among others screening for differentially produced metabolites, estimation of fold changes, and sample classification. Prior to these analysis steps, it is important to minimize contributions from unwanted biases and experimental variance. This is the goal of data preprocessing. In this work, different data normalization methods were compared systematically employing two different datasets generated by means of nuclear magnetic resonance (NMR) spectroscopy. To this end, two different types of normalization methods were used, one aiming to remove unwanted sample-to-sample variation while the other adjusts the variance of the different metabolites by variable scaling and variance stabilization methods. The impact of all methods tested on sample classification was evaluated on urinary NMR fingerprints obtained from healthy volunteers and patients suffering from autosomal polycystic kidney disease (ADPKD). Performance in terms of screening for differentially produced metabolites was investigated on a dataset following a Latin-square design, where varied amounts of 8 different metabolites were spiked into a human urine matrix while keeping the total spike-in amount constant. In addition, specific tests were conducted to systematically investigate the influence of the different preprocessing methods on the structure of the analyzed data. In conclusion, preprocessing methods originally developed for DNA microarray analysis, in particular, Quantile and Cubic-Spline Normalization, performed best in reducing bias, accurately detecting fold changes, and classifying samples.

     

Evolution under pH stress and high population densities leads to increased density-dependent fitness in the protist Tetrahymena thermophila

Abiotic stress is a major force of selection that organisms are constantly facing. While the evolutionary effects of various stressors have been broadly studied, it is only more recently that the relevance of interactions between evolution and underlying ecological conditions, that is, eco-evolutionary feedbacks, have been highlighted. Here, we experimentally investigated how populations adapt to pH-stress under high population densities. Using the protist species Tetrahymena thermophila, we studied how four different genotypes evolved in response to stressfully low pH conditions and high population densities. We found that genotypes underwent evolutionary changes, some shifting up and others shifting down their intrinsic rates of increase (r₀). Overall, evolution at low pH led to the convergence of r₀ and intraspecific competitive ability (α) across the four genotypes. Given the strong correlation between r₀ and α, we argue that this convergence was a consequence of selection for increased density-dependent fitness at low pH under the experienced high density conditions. Increased density-dependent fitness was either attained through increase in r₀, or decrease of α, depending on the genetic background. In conclusion, we show that demography can influence the direction of evolution under abiotic stress.     

Monovalent ion-phosphatidylcholine interactions: an electron paramagnetic resonance study

The apparent Mn2+ binding constant for L-alpha-dipalmitoylphosphatidylcholine (DPPC) bilayers dispersed in monovalent salt and MnCl2 dispersions was determined as a function temperature using electron paramagnetic resonance (ERP). Reproducibility in the data sets requires the use of a standard salt solution and dual cavity techniques. Changes in the binding constant at different phase states and temperatures were observed and correlated to the influence of monovalent salts on the thermal properties of DPPC. The turning points (i.e. changes in slope) in the curves of the apparent Mn2+ binding constant versus temperature can be understood in terms of differences in ion binding to headgroups with different bilayer surface areas. The influence of Li+ and SCN- on Mn2+ binding is viewed as a function of their presence in the ionic media in contact with the bilayer rather than as a competitive event. Other monovalent ions studied appear to have little effect on the measured apparent Mn2+ binding constants for DPPC headgroups.     

Impact Scenario for an Introduced Decapod on Arctic Epibenthic Communities

The intentional introduction of a species for the enhancement of stock or establishment of new fisheries, often has unforeseen effects. The red king crabs, Paralithodes camtschaticus, which was introduced into the Barents Sea by Russian scientists, has established a self-sustaining population that has expanded into Norwegian waters. As top benthic predators, the introduced red king crabs may have possible effects upon native epifaunal scallop (Chlamys islandica) communities. These benthic communities may be a source of prey species in late spring, when the red king crabs feed most intensively. Foraging rates (consumption, killing or severely damaging) of red king crab on native prey organisms were measured by factorial manipulation of crab density (0.5, 1.5 and 3 per m ²), size classes (immature, small mature, and large mature crabs), and by evaluating prey consumption after 48 h, in order to extrapolate a scenario of the likely impacts. Foraging rates of the red king crab on scallops ranged between 150 and 335 g per m² within 48 h. These rates did not change when crab density was altered, though an increased amount of crushed scallops left uneaten at the tank floor, were correlated with high density of small mature crabs. Foraging rate changed significantly with crab size. Consequently, the susceptibility of native, shallow water epibenthic communities to red king crab predation in the early life history stages, and during the post-mating/molting spring period, must be considered significant when foraging rates are contrasted with natural scallop biomass between 400 and 1200 g scallops per m².     

Genome duplication and the origin of angiosperms

Despite intensive research, little is known about the origin of the angiosperms and their rise to ecological dominance during the Early Cretaceous. Based on whole-genome analyses of Arabidopsis thaliana, there is compelling evidence that angiosperms underwent two whole-genome duplication events early during their evolutionary history. Recent studies have shown that these events were crucial for the creation of many important developmental and regulatory genes found in extant angiosperm genomes. Here, we argue that these ancient polyploidy events might have also had an important role in the origin and diversification of the angiosperms.     

Divergence of the mitochondrial electron transport chains from the green alga Chlamydomonas reinhardtii and its colorless close relative Polytomella sp.

Compelling evidence exists that the colorless algae of the genus Polytomella arose from a green Chlamydomonas-like ancestor by losing its functional photosynthetic apparatus. Due to the close relationship between the colorless and the green chlorophyte, Polytomella sp. appeared as a useful indicative framework for structural studies of Chlamydomonas reinhardtii mitochondria. However, comparative studies reported here unexpectedly revealed significant differences between the mitochondrial respiratory systems of the two algae. Two-dimensional blue native/SDS-PAGE of isolated mitochondria indicated that cytochrome-containing respiratory complexes III and IV in the two chlorophytes contrast in size, subunit composition and relative abundance. Complex IV in Polytomella is smaller than its counterpart in C. reinhardtii and occurs in two forms that differ presumably in the presence of subunit COXIII. The cytochrome c and the iron-sulfur Rieske protein of both chlorophytes revealed structural differences on the amino acid sequence level. Under comparable culture conditions, the colorless alga exhibits lower levels of cytochrome c and complex IV but a higher respiratory activity than the green alga. Cytochrome c levels were also found to be differently regulated by the growth conditions in both algae. The divergence between the respiratory systems in the two related chlorophytes can be viewed as a consequence of the loss of photosynthetic activity and/or of the adaptation to the environment via the acquisition of a more flexible, heterotrophic metabolism. Our understanding of mitochondrial function and evolution is expected to be greatly enhanced via further parallel studies of photosynthetic/non-photosynthetic algae, for which this study forms an incentive.     

M line-deficient titin causes cardiac lethality through impaired maturation of the sarcomere

Titin, the largest protein known to date, has been linked to sarcomere assembly and function through its elastic adaptor and signaling domains. Titin's M-line region contains a unique kinase domain that has been proposed to regulate sarcomere assembly via its substrate titin cap (T-cap). In this study, we use a titin M line-deficient mouse to show that the initial assembly of the sarcomere does not depend on titin's M-line region or the phosphorylation of T-cap by the titin kinase. Rather, titin's M-line region is required to form a continuous titin filament and to provide mechanical stability of the embryonic sarcomere. Even without titin integrating into the M band, sarcomeres show proper spacing and alignment of Z discs and M bands but fail to grow laterally and ultimately disassemble. The comparison of disassembly in the developing and mature knockout sarcomere suggests diverse functions for titin's M line in embryonic development and the adult heart that not only involve the differential expression of titin isoforms but also of titin-binding proteins.