, 2011) Given the paucity of studies on plant–plant interactions

, 2011). Given the paucity of studies on plant–plant interactions in TAE, a research priority is to apply the methodologies that have developed by plant community ecologists in other alpine ecosystems and, more generally, in other stressful

ecosystems (see Callaway, 2007, Brooker et al., 2008 and Lortie, 2010 for reviews). This would allow ranking the Selleckchem AZD5363 many potential factors specific to TAE that may change the outcome of plant–plant interactions (see, e.g. Baumeister and Callaway, 2006). Key approaches include (1) studying interactions at community level (Cavieres and Badano, 2009 and Maestre et al., 2009), (2) using the most appropriate interaction indices (Armas selleck compound et al., 2004 and Seifan et al., 2010), and (3) considering intraspecific variability in nurses in the outcome of interactions (Albert et al.,

2011 and Violle et al., 2012), especially by measuring plant functional traits (e.g. at leaf level: SLA, LDMC) to quantify more thoroughly the specific effect of TAE on plants (Violle et al., 2007 and Gross et al., 2009). We present in more details two key methodological approaches, which may evidence specific outcome of plant–plant interactions in TAE: studies along gradients and in situ manipulative experiments. (1) Studies along gradients. One particularly relevant method to examine the effects of environmental Bay 11-7085 variables on the outcome of plant–plant interactions at a local level is to examine plant performance along altitudinal gradients ( Körner, 2007 and Lortie, 2010). This would be relevant for example when considering the variable “annual rainfall amount” which is expected to increase with altitude at high latitude, but has a reverse pattern at low latitudes.

In parallel, variation in slope aspect through north-south comparisons close to the tropics or with East–West comparisons close to the Equator may provide interesting local comparisons by generating abrupt shifts in water stress with potential effects on the outcome of plant–plant interactions ( Badano et al., 2005, Cavieres et al., 2006, Farji-Brener et al., 2009 and Soliveres et al., 2010). From a macro-ecological perspective, analyses or meta-analyses of the outcome of plant–plant interactions along large-scale latitudinal gradients (see Holzapfel et al., 2006, Cavieres and Badano, 2009 and Kikvidze et al., 2011), are required to yield a global view of TAE’s specific effects on plant–plant interactions.

Seeds of the cherry tomato variety ‘Season Red’ were sown in tray

Seeds of the cherry tomato variety ‘Season Red’ were sown in trays (40 × 30 cm) and seedlings

were grown for 40 days in a nursery in a shade house (30–32 °C, 60–80% RH, and 14:10 h L:D photoperiod) using the standard agronomic practices of the area (Schulub and Yudin, 2002). Experiments were conducted at the University of Guam Agricultural Experiment Station at Yigo (N 13° 31.930′ E 144° 52.351′) in northern Guam and at the Inarajan Experiment Station (N 13° 61.963′ E 144° 45.353′) in southern Guam. Treatment plots (8 × 8 m) were arranged in a randomized block design and separated from other plots by 1.0 m buffer zones to prevent contamination from pesticide drift. Identical trials were conducted from June–September 2012 at Yigo and Ibrutinib clinical trial August–November 2013 at Inarajan. Thirty five tomato seedlings per plot that were 40 days old were transplanted with 75 cm spacing between rows and an average of 91.4 cm between plants within rows. Three replicates of each of the 11 treatments resulted in a total of 33 plots for each experiment. Each plot consisted of 5 rows of 12 tomato plants, for a total of 60 plants per plot. The total area of the experimental tomato field was 480 m2

at each site. Fertilizer applications followed those of Schulub and Yudin (2002). Nine chemical application treatments learn more consisting of single products or combinations of products, a water spray control and a no spray control were applied to plots (Table 1). Carbaryl and malathion applications were

made at the set time intervals normally practiced by Guam farmers (Table 2). The amount of spray solution per application was 95 L/ha for small plants (up to 45 days after transplanting/DAT) and 190.0 L/ha mafosfamide for larger ones (45 DAT until harvest). All the chemicals were applied with motorized backpack sprayers (Solo Brand; Forestry Suppliers, Jackson, Mississippi) equipped with an adjustable, flat spray, hollow cone, jet stream nozzle, with pressure (45 psi = 310 kPa) calibrated to deliver desired quantity of spray per hectare. To determine T. marianae population levels, 10 plants were selected randomly per plot and for each plant, three leaves were checked, one from the top, middle and bottom of the plant ( Reddy et al., 2013). On the underside of each leaf, mites were counted using a magnifying lens. Leaf counts were repeated weekly, and in addition the number of leaves (mite-infested leaves) infested by T. marianae of the 30 leaves examined per plot was also recorded. The term “mite-infested leaves” means a leaf is characterized as “infested” when one or more mite individuals of any developmental stage was recorded on the underside. In practice such a leaf (with only 1-2 mites) may not be regarded as “infested” by tomato growers. Larval infestation levels were estimated by randomly examining 60 unripe fruit per plot (one fruit per plant) and recording the number of H. armigera larvae and damaged fruit ( Kuhar et al., 2006).

The selection was made taking into account the relevance of the t

The selection was made taking into account the relevance of the target organ and the nature of the test article. The human lung-derived BEAS-2B cell line was first described in 1988, when normal bronchial epithelial cells obtained from autopsy of non-cancerous individuals were isolated, then infected with a replication-defective 12-SV40/adenovirus hybrid and cloned to create an immortalized phenotype (Reddel et al., 1988). The non-cancerous phenotype of BEAS-2B

cells is an advantage Apitolisib research buy in the investigation of carcinogenic processes such as DNA damage and cell transformation (Sun et al., 2011). Therefore, BEAS-2B cells have been considered as a relevant cell line for in vitro toxicology testing in the field of pollutants, tobacco products and nanomaterials ( Persoz et al., 2012, Veljkovic et al., 2011 and Haniu et al., 2011). Although, several studies have employed BEAS-2B cells to evaluate the effect of some pro-toxicants such as B[a]P and 4-(N-methylnitrosamino)-1-(3-pyridinyl)-1-butanone (NNK), the metabolic capacity of this particular cell line has not been fully

characterized ( Ovrevik et al., 2010 and Proulx Cabozantinib supplier et al., 2005). Here, BEAS-2B cells were tested and compared to the lung-derived A549 cells broadly used as pulmonary in vitro system but with no cytochrome P450 expression reported for CYP1A2 and the CYP2A family, and inducibility documented for CYP1A1/1B1 genes ( Hukkanen et al., 2002 and Castell et al., 2005). Phosphoribosylglycinamide formyltransferase Cells derived from hepatocarcinomas considered

to have a more extensive cytochrome P450 enzyme activity (HepG2 and HepaRG) were used as a more comprehensive control for our CYP assays ( Jennen et al., 2010). Moreover, the results were contrasted to those reported in primary human bronchial epithelium culture ( Newland et al., 2011 and Courcot et al., 2012). The results of this study are considered to be useful for in vitro toxicological testing using the cell line BEAS-2B as cell system. Furthermore, we propose that the outlined strategy can be incorporated in the characterization of cell systems used in in vitro testing. The human bronchial epithelial cell line (BEAS-2B), purchased from ATCC (United States), was seeded into culture vessels that had been pre-coated with 0.03 mg/mL PureCol® bovine collagen solution (Nutacon, The Netherlands). Cells were maintained in Bronchial Epithelial Growth Medium (BEGM®) at 37 °C and 5% CO2 in a humidified incubator. BEGM® was prepared by supplementing Bronchial Epithelial Basal Medium with growth supplements provided in the manufacturer’s BEGM® SingleQuot® kit (Lonza Group Ltd., Belgium) containing: bovine pituitary extract, hydrocortisone, human epidermal growth factor, epinephrine, insulin, triiodothyronine, transferrin, gentamicin/amphotericin-B and retinoic acid.

Such heuristic genetic patterns may correlate with ASD endophenot

Such heuristic genetic patterns may correlate with ASD endophenotypes and/or overlap with other brain and developmental disorders. The incremental advances

in discovery of genes associated with ASD risk are already influencing clinical progress in early detection and intervention. Moreover, as a more definitive catalogue of ASD risk variants is generated – in particular through genome sequencing projects Selleckchem BTK inhibitor – it is our opinion a platform will emerge for the proper design to dissect the roles of gene–gene and potential gene–environment interactions in ASD. Papers of particular interest, published within the period of review, have been highlighted as: • of special interest The authors wish to thank Anath C. Lionel

for assistance. BD is supported by MH057881. SWS holds the GlaxoSmithKline Canadian Institutes of Health Research (CIHR) Endowed Chair in Genome Sciences. “
“Current Opinion in Genetics & Development 2012, 22:283–289 This review comes from a themed issue on Molecular and genetic bases of disease Edited by Beverly Emanuel and Steve Warren For a complete overview see the Issue and the Editorial 0959-437X/$ – see front matter, © 2012 Elsevier Ltd. All rights reserved. DOI 10.1016/j.gde.2012.02.005 Genomic selleck kinase inhibitor imprinting is an epigenetic process that controls parent-of-origin expression of an estimated 3-oxoacyl-(acyl-carrier-protein) reductase 1–2% of genes in the mammalian genome [1 and 2•]. Although few in number, many imprinted genes play important roles in development and growth, often in a dose-dependent manner [3]. Imprinted genes mostly occur in

clusters in the genome controlled by a CpG rich region known as an Imprint Control Element (ICE). This ICE shows differential DNA methylation, which is established in the germ cells of one parent and maintained on this parental chromosome throughout life. The ICE on the other parental allele remains unmethylated. The unmethylated ICE activates a macro non-coding (nc) RNA in cis, while methylation prevents activation on the other allele. Macro ncRNAs are inefficiently processed long ncRNAs whose main product is unspliced [ 1]. In three of four cases where the function of the imprinted macro ncRNA has been tested, it acts as a cis-silencer to prevent upregulation of flanking imprinted genes in the cluster [ 4, 5, 6 and 7••]. A hallmark of imprinted genes is that they show developmental and tissue-specific regulation of imprinted expression [ 8]. For example, the Dlk1 gene is paternally expressed and plays a dose-dependent role in regulating growth of the embryo, but switches to biallelic expression in neural stem cells and niche astrocytes where it is required for normal postnatal neurogenesis [ 9 and 10••].

1 ± 23 2 SFU/106 cells; Life Technologies: 338 9 ± 21 3 SFU/106 c

1 ± 23.2 SFU/106 cells; Life Technologies: 338.9 ± 21.3 SFU/106 cells, n = 9 (Supplementary Fig. 2D)). Following intranasal infection of Line O birds with LPAI H7N7, buccal swab samples were analyzed for the presence of influenza M1 transcript

by qRT-PCR. These were found to be positive from the earliest sampling time point at day 4 post-infection. Viral transcript was still detectable albeit at a lower level (p < 0.05) in the buccal swabs at day 6, and was undetectable at day 10 (data not shown). Challenged birds exhibited significantly higher HI titers compared to non-infected controls (Fig. 1A, p < 0.01). All subsequent experiments were performed in Line O birds, with the exception of the vaccine cohort (Line 15, final figure). We tested our antibody OSI-744 molecular weight pair for use in ELISpot with live or beta propiolactone inactivated

challenge-strain virus to stimulate splenocyte responses (Fig. 1B). Splenocytes from control (non-infected) birds did not produce IFNγ when exposed to either live or inactivated virus. In contrast, splenocytes from infected birds did produce IFNγ (p < 0.05) following exposure to both live (72.0 ± 15.4 SFU/106 cells) and inactivated virus (155.2 ± 42.3 SFU/106 cells), as expected. The use of live virus consistently yielded lower responses than the use of inactivated virus in all samples, although this difference was not statistically significant. To identify epitope-specific responses, we employed an NP peptide library corresponding to HSP inhibitor the challenge virus. We analyzed responses to pooled peptides at 1 week post-infection (Supplementary Fig. 3) and to individual peptides 2 weeks after infection (Fig. 1C). Responses to individual peptides were low, not consistent between birds, and not statistically significantly different between control and infected birds. In the following experiments, an alternative strategy to detect specific IFN responses was developed. To potentiate the detection of influenza-specific CD8 T cell responses,

we generated a CKC cell line expressing only MHC class I. We passaged CKC from Line O birds a minimum of eight times. We then analyzed the cells by flow cytometry for the expression of MHC classes I and II. The passaged CKC were Branched chain aminotransferase found to exclusively express MHC class I (Fig. 2). Having validated the necessary individual components we introduced the method of co-culture of responding cells with infected CKCs. Despite the fact that so many antigen specific cells were detectable in co-culture with infected CKCs, the background response for this assay was extremely low (control and INFγ only data, Fig. 3), demonstrating its specificity and sensitivity. Splenocytes from infected birds (2 weeks post-infection) produced extremely high (mean: 833 ± 134 SFU/106 cells) numbers of spot forming units when co-cultured with infected CKC (Fig. 3). This response was significantly different (p < 0.

Here, we show that NGF is effectively incorporated into monocytes

Here, we show that NGF is effectively incorporated into monocytes. Following confocal microscopy, we observed that NGF staining was mostly localized in perinuclear and cytoplasmic regions. It appears that some cells are quicker at NGF uptake (perinuclear staining) compared to other cells (cytoplasmic staining). Since we

did not perform further staining of lysosomes or endosomes, we cannot identify the exact location of NGF. However, these two different stainings patterns could indicate that these cells exhibit differential abilities at taking up and secreting NGF. However, further analysis is needed to determine to what extent this occurs and how it differs within each group. Most importantly, however, these cells secrete bioactive NGF. DNA Damage inhibitor We have previously demonstrated that the production of NGF in primary rat monocytes enhances the number of cholinergic neurons in organotypic brain slices (Fig. 4). This is important to evaluate since proNGF, the uncleaved precursor of NGF, has been implicated in neuronal cell death (Fortress et al., 2011). Our data indicate that conditioned medium from NGF-secreting cells can promote the survival of cholinergic neurons, as measured by choline acetyltransferase (ChAT)-positive neurons. In addition, we investigated the functional capabilities of these cells following Bioporter treatment. These analyses

were only carried out in Bioporter-transduced monocytes and not in lentiviral-transduced cells. A recent study has published that haematopoietic stem cells transduced by lentiviral vector do not this website present any alterations in monocytic differentiation and function (Magga et al., 2012). However, lentiviral modification still poses potential problematic side effects, such as high viral titers and immunogenic effects that we wish to avoid in our future in vivo studies. Here, we show that Bioporter-loaded monocytes can phagocytose Aβ and appear to develop morphological changes (i.e. larger cytoplasm,

Tryptophan synthase appearance of processes) indicative of differentiation. Although seven days are needed for monocytes to become fully differentiated into macrophages in culture, we were only interested in their short-term functional capabilities. This is due to the fact that these cells exhibit rather short life-spans once in circulation in vivo. This present work extends our earlier studies of the potential therapeutic use of peripheral monocytes for the delivery of NGF to the brain (Zassler and Humpel, 2006 and Böttger et al., 2010). Despite extensive evidence supporting the therapeutic potency of NGF (Tuszynski et al., 2005 and Nagahara et al., 2009), its use in the treatment of CNS disorders has been limited due to its inability to penetrate the blood–brain barrier (BBB) and the adverse and intolerable side effects (e.g. nociceptor activation) that appear upon broad NGF distribution (Covaceuszach et al., 2009).

Cp is the heat capacity, i e , 4200 J (kg °C)−1, and ρo is the re

Cp is the heat capacity, i.e., 4200 J (kg °C)−1, and ρo is the reference density of sea water, i.e., 103 kg m−3. Then the total heat loss from the WMB (Floss,WMB) can then be roughly estimated Selleck INNO-406 to be approximately −9 W m−2, which has the same sign but is slightly lower than the value indicated in Table 3 (−12.66 W m−2). Similarly, the total heat loss (neglecting heat from rivers) from the EMB (Floss,EMB) can roughly be written as: Floss,EMBAsur,EMB≈ρoCp(Qin,sur,SciTin,sur,WMB−Qout,deep,SciTout,deep,EMB)Floss,EMBAsur,EMB≈ρoCp(Qin,sur,SciTin,sur,WMB−Qout,deep,SciTout,deep,EMB)The

total heat loss from the EMB (Floss,EMB) can then be roughly approximately 11 W m−2, which is near the value indicated in Table 3 (10.85 W m−2). The final test to evaluate the PROBE-MED 2.0 model results was to compare the modelled annual changes in the heat and salt content for the whole WMB/EMB water column with the MEDAR reanalysed data (data not shown). For the WMB, there was a bias in the heat content www.selleckchem.com/products/icg-001.html of approximately 9% but an insignificant bias in the salt content. For the EMB, there was an insignificant bias in the heat content and a bias of 2% in the salt content. Clearly, the PROBE-MED version 2.0 model realistically captures the general water and heat cycles of the Mediterranean Sea as well as the differences between the western and eastern parts of the sea. The

coupling between the large-scale atmospheric circulation and the Mediterranean Sea water balance was examined by analysing the relationship between the winter North Atlantic Oscillation Index (NAOI; extracted from the KNMI climate explorer database, climexp.knmi.nl) and the winter net precipitation (Table 4). The t-test was used to

examine the significant correlations at a 95% significance level. Table 4 shows a significant inverse correlation between the NAOI and winter net precipitation rates over the WMB. The relationship between the NAOI and WMB evaporation rates is insignificant, but between the NAOI and WMB precipitation is significant. For the EMB, no significant relationships with the NAOI could be found. The NAOI influences the net precipitation over the WMB and therefore the water balance of the Mediterranean Sea. This agrees with the previous Rebamipide findings of Philandras et al. (2011), who stated that the precipitation over the Mediterranean region is inversely correlated with NAOI, especially in the western and northern regions. Similar to Shaltout and Omstedt (2012), the present work realistically reproduces the large-scale physical features of the WMB and EMB. However, several small-scale features such as deep-water convection and coastal–land interactions have not yet been included in the modelling. Instead, the present approach is based on a two-basin model that horizontally averages the sea into its western and eastern parts.

Organic carbon is known to increase aggregate stability and accor

Organic carbon is known to increase aggregate stability and according to Dal Ferro et al. (2012), ultramicropores enhanced aggregate stability and organic carbon influenced pore size distribution in their study using a 3D network model. This corroborates the data here since the 10−6 dilution (bare soil) had a larger proportion of organic C, smaller and more uniform pore distribution and greater aggregate stability. Since microbial biomass-C was similar in those two treatments, it can be concluded that (fungal) species richness was the primary cause

of the increased porosity and of reduced aggregate stability in the bare 10−1 soil, probably because of increased metabolic activity of the fungi and of the bacterial constituents. In the planted selleck inhibitor systems, root activity changed the dynamic, so that larger pores were observed in the 10−6 dilution amended soils with greater distances between them than in the 10−1 treatments. This affected porosity of the mycorrhizal planted soils but not of the NM planted soils,

where porosity was similar irrespective of dilution. Overall (all data combined), the AM planted soils had smaller pore sizes and lower total porosity than the NM planted soils, but greater aggregate stability. This is in agreement with Bearden (2001) who concluded that AMF hyphae led to soils with groups of small pores. There is a trend in this study between smaller pore sizes and increased aggregate stability. Feeney et al. (2006) reported increased Antidiabetic Compound Library research buy soil porosity within bulk and rhizosphere soil over a 30 day period and concluded that the soil biota altered their

habitat in favour of a more porous and aggregated structure. The findings here for porosity in the unplanted (bare) soils are in agreement with Feeney et al. (2006), although data relating to porosity in the rhizosphere and mycorrhizosphere do not corroborate Feeney et al. (2006). Total porosity in planted soils with AMF was consistently lower than that of the NM planted HSP90 and bare soils from months 3 to 7. Feeney et al. (2006) worked at a resolution of 4.4 μm, whilst the smallest pores imaged here were 65 μm. Whilst the coarser resolution here may have been a factor in explaining the different findings, the complexity of soil-plant-microbial dynamics in influencing soil structural properties should be highlighted and caution applied when interpreting data from pot experiments. Changes in porosity generally take place over much longer periods than aggregate turn over, particularly at a field scale, where the development of soil structure can take many months to years (Elliott and Coleman, 1988 and Boersma and Kooistra, 1994). The dilution method used here resulted in altered microbial species richness, which was influenced primarily by planting regime and mycorrhizal colonisation. The design of the experiment made it possible to determine the relative influences of these parameters on soil porosity and aggregate stability in addition to soil organic carbon.

Nonetheless, it has to be kept in mind that the evaluation of the

Nonetheless, it has to be kept in mind that the evaluation of the degree of stenosis must always include the study of the vessel wall and cannot be excluded,

also SGI-1776 cost for its importance in analyzing plaque morphology, to identify the “unstable plaque” [19]. In this study, only the 3D reconstruction of the residual lumen detected with Power mode was applied. This method, even though images presented may seem impressive, have to be considered with caution, similarly to all the techniques that reconstruct imaging only from the inward flow. This is particularly true in cases of internal carotid stenosis, because if the plaque is not considered, degree quantification is based on the comparison of what we only suppose to be normal, and hence it may be underestimated. Moreover, in these cases of the 3D US reconstruction, the blood flow pulsating at each cardiac cycle or the acoustic shadow of calcific plaques may create further artifacts: even if the

persistence color setting is set to maximal values, blood flow slowing or stopping during diastole – especially in cases of very high resistive patterns as in the external carotid artery – induce the reduction or absence of signal, an artifact difficult to be eliminated even performing the scan as slow as possible (Fig. 4). Threedimensional ultrasound is a feasible technique when performed by experienced examiners. It can help in the general carotid axis imaging, better presenting the

vessels course and the caliber variations “at a glance”. Threedimensional US reconstructions from the inward flow Small molecule library can also provide imaging of stenosis, but its quantification must always take into account the assessment of plaque morphology CHIR-99021 datasheet and vessels wall, by the exact knowledge of the bidimensional images and of hemodynamic patterns. “
“The conventional ultrasound methods are widely used in ophthalmology for evaluating the eye structures (lens, vitreous, chambers, retina, optic discs and optic nerves) and eye circulation (ophthalmic arteries and veins) mainly in the presence of cataract or other processes, hindering the ophthalmoscopy [1], [2] and [3]. Recently the volume 3D/4D eye ultrasound imaging in adults has been introduced [4] which provides additional information for the structural and functional eye changes in normal and pathological conditions. The aim of the study was to demonstrate the diagnostic abilities of 4D ultrasound imaging in patients with eye pathology and neuro-ophthalmic syndromes. Fifteen healthy controls (10 women and 5 men, mean age 47 ± 10 years, age range 21–69 years) and 15 patients (9 women and 6 men, mean age 45 ± 17 years, age range 21–84 years) with visual problems were studied: 10 patients with papilledema, 3 patients with retinal detachment, 1 man with macular degeneration and 1 man with right intraocular choroidal metastasis.

The Social Security Death Index (Social Security Administration’s

The Social Security Death Index (Social Security Administration’s [SSA] Master Death File) was used to supplement documented vital status [8]. All data access, use, and reporting were conducted in a manner compliant with the Health Insurance Portability and Accountability Act, ensuring that confidentiality and privacy of patients were maintained. In addition, the use of patient data for this study was approved by an independent, central institutional hypoxia-inducible factor pathway review board. The target population was patients with advanced nonsquamous NSCLC who initiated first-line treatment

between January 2006 and December 2009 (i.e., study enrollment period). To be eligible for analysis, patients were required to meet the following criteria: (1) be at least 18 years of age, (2) have at least one International Classification of AZD6244 Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code for lung cancer (162.2, 162.3, 162.4, 162.5, 162.8,

162.9, 197.0, or 231.2) along with documented advanced disease (stage IIIB/IV or early stage with evidence of progression to advanced disease), and (3) initiate first-line chemotherapy with or without targeted therapy (i.e., Pem/Plat, Pac/Carbo, or Pac/Carbo/Bev after documentation of advanced disease). The date of first-line treatment was defined as the index date. Patients were excluded based on the following criteria: (1) receiving care for another primary cancer during the study period, (2) squamous cell histology, (3) enrollment in clinical trials during the study period, (4) follow-up time of less than 1 year and no evidence of disease progression/death. Eligible patients were placed into the following cohorts based on first-line treatment initiation: (1) many Pem/Plat, (2) Pac/Carbo doublet, or (3) Pac/Carbo/Bev triplet. To mitigate any potential bias due to differences in patient characteristics, a matching strategy was employed. Patients in each cohort were placed into specific strata based on five key variables listed in Table 1. Within each strata (e.g.,

index year 2007, advanced stage IV, male, performance status score of 1, and age bracket 40–49), a Pem/Plat patient was randomly matched to one Pac/Carbo patient and one Pac/Carbo/Bev patient. Patients were followed for 1 year after the index date to capture the outcomes of interest. The primary effectiveness measures included progression-free survival (PFS) and overall survival (OS). Progression was identified and/or verified through chart review and was defined as a treatment change indicative of disease progression or documented disease progression. In cases of uncertainty of disease progression, a clinical expert (Dr. Mark Green) confirmed progression status. Date of death was captured from the SSA Death Index Master File in combination with date of death in the ION EMR data.