Identification and expression analysis of two steamer-like retrotransposons in the Chilean blue mussel (Mytilus chilensis)

BACKGROUND

Disseminated neoplasia (DN) is a proliferative cell disorder of the circulatory system of bivalve mollusks. The disease is transmitted between individuals and can also be induced by external chemical agents such as bromodeoxyuridine. In Mya arenaria, we have cloned and characterized an LTR-retrotransposon named Steamer. Steamer mRNA levels and gene copy number correlates with DN and can be used as a marker of the disease. So far, the only mollusk where a retrotransposon expression relates to DN is Mya arenaria. On the other hand, it has been reported that the Chilean blue mussel Mytilus chilensis can also suffers DN. Our aim was to identify retrotransposons in Mytilus chilensis and to study their expression levels in the context of disseminated neoplasia.

RESULTS

Here we show that 7.1% of individuals collected in August 2018, from two farming areas, presents morphological characteristics described in DN. Using Steamer sequence to interrogate the transcriptome of M. chilensis we found two putative retrotransposons, named Steamer-like elements (MchSLEs). MchSLEs are present in the genome of M. chilensis and MchSLE1 is indeed an LTR-retrotransposon. Neither expression, nor copy number of the reported MchSLEs correlate with DN status but both are expressed at different levels among individual animals. We also report that in cultured M. chilensis haemocytes MchSLEs1 expression can be induced by bromodeoxyuridine.

CONCLUSIONS

We conclude that SLEs present in Mytilus chilensis are differentially expressed among individuals and do not correlate with disseminated neoplasia. Treatment of haemocytes with a stressor like bromodeoxyuridine induces expression of MchSLE1 suggesting that in Mytilus chilensis environmental stressors can induce activation of LTR-retrotransposon.

A Survey of AI-Based Anomaly Detection in IoT and Sensor Networks

Machine learning (ML) and deep learning (DL), in particular, are common tools for anomaly detection (AD). With the rapid increase in the number of Internet-connected devices, the growing desire for Internet of Things (IoT) devices in the home, on our person, and in our vehicles, and the transition to smart infrastructure and the Industrial IoT (IIoT), anomaly detection in these devices is critical. This paper is a survey of anomaly detection in sensor networks/the IoT. This paper defines what an anomaly is and surveys multiple sources based on those definitions. The goal of this survey was to highlight how anomaly detection is being performed on the Internet of Things and sensor networks, identify anomaly detection approaches, and outlines gaps in the research in this domain.

Assessment of progesterone levels on the day of pregnancy test determination: A novel concept toward individualized luteal phase support

RESEARCH QUESTION

The main objective of the study is to define the optimal trade-off progesterone (P4) values on the day of embryo transfer (ET), to identify low P4-human chorionic gonadotropin (hCG), and to establish whether P4 supplementation started on the hCG day can increase the success rate of the frozen embryo transfer (FET) cycle.

DESIGN

A single-center, cohort, retrospective study with 664 hormone replacement therapy (HRT)-FET cycles analyzed female patients who received vaginal 600 mg/day of P4 starting from 6 days before the FET, had normal P4 values on the day before ET, and whose P4 on the day of the pregnancy test was assessed.

RESULTS

Of the 664 cycles, 69.6% of cycles showed P4 ≥ 10.6 ng/ml, while 30.4% showed P4 < 10.6 ng/ml on the day of the hCG. Of the 411 chemical pregnancies detected, 71.8% had P4-hCG ≥ 10.6 ng/ml (group A), while 28.2% had P4-hCG < 10.6 ng/ml. Of the cycles with P4-hCG < 10.6 ng/ml, 64.7% (group B) were supplemented with a higher dose of vaginal P4 (1,000 mg/day), while 35.3% (group C) were maintained on the same dose of vaginal micronized P4. The live birth rate was 71.9%, 96%, and 7.3% for groups A, B, and C, respectively.

CONCLUSION

The likelihood to detect P4-hCG < 10.6 ng/ml decreased as the level of serum P4 the day before ET increased. The live birth rate (LBR) was shown to be significantly lower when P4 was low and not supplemented.

P-403 Progesterone supplementation in frozen embryo transfer with hormonal replacement therapy is associated with a higher incidence of macrosomia

Study question

Is there an impact of increased progesterone (P4) supplementation in hormone replacement therapy (HRT) frozen embryo transfer (FET) on obstetrical and neonatal outcomes?

Summary answer

Increased P4 supplementation from the day of FET is associated with a significantly higher risk of macrosomia and a slightly higher risk of preeclampsia.

What is known already

The most widely used method for endometrial preparation prior to FET is HRT, a sequential regimen with E2 and P4, which aims to mimic the endocrine exposure of the endometrium of the physiological cycle. However, in ∼40% of the patients undergoing HRT-FET cycles P4 levels before FET remain low and this may negatively affect pregnancy rates. Although recent prospective studies have shown that additional P4 supplementation in case of low serum P4 levels results in excellent reproductive outcomes, no data exist concerning the potential effect of this extra amount of P4 on obstetrical and neonatal outcomes

Study design, size, duration

This is a single-centre, retrospective-observational study. Women undergoing HRT-FET treatment meeting the inclusion criteria were allocated to one of the 2 study groups according to the P4 supplementation. Group A (277) included women with adequate levels (&gt;10.6 ng/ml) of P4, while group B (129) included women who received P4 supplementation due to inadequate levels of P4 (&lt;10.6 ng/ml) on the day before the FET. All FET-HRT cycles were performed between February 2018 and December 2020.

Participants/materials, setting, methods

All patients received micronized P4 (200 mg trice a day) starting six days prior to the FET and continued until 10 weeks of pregnancy. In case P4&lt;10.6 ng/ml, P4 supplementation was initiated rather with 400mg more micronized P4 (15%) or with subcutaneous P4 (25mg more/once a day) (85%). Only patients with day5-embryos, known P4 levels prior to FET, known obstetrical and neonatal outcomes were included. Multivariable-logistic-model was fitted for macrosomia after adjusting for confounding variables.

Main results and the role of chance

Patients’ age at oocyte retrieval was 33.5 and 33.6 years (p = 0.833), while the age at delivery was 39.9 and 39.1 years (p = 0.099), respectively for groups A and B. The incidence of diabetes, hypertension, autoimmune diseases, coagulation, and kidney disorders was comparable for both arms. The mean value of P4 was 16 ± 7.7 and 8.2 ± 1.9, respectively for groups A and B. The mean gestational length was 39 weeks in both arms, with comparable rates of premature deliveries (delivery &lt;37 weeks respectively 4.3% and 3.1 % for group A and B; p = 0.553). The rate of cesarean-section was 56% vs 47.3%, respectively for groups A and B (p = 0.103); there were 5 cases of pre-eclampsia in group A and 7 in group B (1.8% vs 5.4%; p = 0.059). The incidence of macrosomia was significantly higher in group B (6.1% vs 12.4%; P = 0.031). Similarly, group B had a higher rate of BGA-big for gestational age- babies (9.7 vs 15.5, p = 0.091). In terms of weight at delivery, pH, Apgar, and sex the two groups were comparable. Multivariable-logistic regression showed an association between macrosomia and P4 supplementation, adjusting for potential confounders such as sex, gestational diabetes, and weeks of gestation (OR 2.3, 95% CI 1.1-4.8).

Limitations, reasons for caution

The main limitation of this study is its retrospective nature. Other potential limitations are the small sample size to detect obstetrical diseases with low incidence, such as preeclampsia. Furthermore, in our study population the PE rate is lower than in the general population, due to socioeconomic-conditions, race, and previous morbidity.

Wider implications of the findings

P4-supplemented patients have a higher risk of macrosomia and a tendency for a higher risk of preeclampsia. However, more studies are needed to confirm the present exploratory findings and explain the possible physiological mechanisms underlying the association between progesterone supplementation on macrosomia and preeclampsia.

Trial registration number

NA

Morphological and ultrasonographic characterization of the three zones of supratesticular region of testicular artery in Assaf rams

To fully understand the histological, morphometrical and heamodynamic variations of different supratesticular artery regions, 20 mature and healthy Assaf rams were examined through ultrasound and morphological studies. The testicular artery images of the spermatic cord as shown by B-mode analysis indicated a tortuous pattern along its course toward the testis, although it tends to be less tortuous close to the inguinal ring. Doppler velocimetric values showed a progressive decline in flow velocity, in addition to pulsatility and vessel resistivity when entering the testis, where there were significant differences in the Doppler indices and velocities among the different regions. The peak systolic velocity, pulsatility index and resistive index were higher in the proximal supratesticular artery region, followed by middle and distal ones, while the end diastolic velocity was higher in the distal supratesticular region. The total arterial blood flow and total arterial blood flow rate reported a progressive and significant increase along the testicular cord until entering the testis. Histological examination revealed presence of vasa vasorum in the tunica adventitia, with their diameter is higher in the proximal supratesticular zone than middle and distal ones. Morphometrically, the thickness of the supratesticular artery wall showed a significant decline downward toward the testis; meanwhile, the outer arterial diameter and inner luminal diameter displayed a significant increase distally. The expression of alpha smooth muscle actin and vimentin was higher in the tunica media of the proximal supratesticular artery zone than in middle and distal ones.

Genetic and phenotypic characteristics of Clostridium (Clostridioides) difficile from canine, bovine, and pediatric populations

Objectives:

Carriage of Clostridioides difficile by different species of animals has led to speculation that animals could represent a reservoir of this pathogen for human infections. The objective of this study was to compare C. difficile isolates from humans, dogs, and cattle from a restricted geographic area.

Methods:

C. difficile isolates from 36 dogs and 15 dairy calves underwent whole genome sequencing, and phenotypic assays assessing growth and virulence were performed. Genomes of animal-derived isolates were compared to 29 genomes of isolates from a pediatric population as well as 44 reference genomes.

Results:

Growth rates and relative cytotoxicity of isolates were significantly higher and lower, respectively, in bovine-derived isolates compared to pediatric- and canine-derived isolates. Analysis of core genes showed clustering by host species, though in a few cases, human strains co-clustered with canine or bovine strains, suggesting possible interspecies transmission. Geographic differences (e.g., farm, litter) were small compared to differences between species. In an analysis of accessory genes, the total number of genes in each genome varied between host species, with 6.7% of functional orthologs differentially present/absent between host species and bovine-derived strains having the lowest number of genes. Canine-derived isolates were most likely to be non-toxigenic and more likely to carry phages. A targeted study of episomes identified in local pediatric strains showed sharing of a methicillin-resistance plasmid with dogs, and historic sharing of a wide range of episomes across hosts. Bovine-derived isolates harbored the widest variety of antibiotic-resistance genes, followed by canine

Conclusions:

While C. difficile isolates mostly clustered by host species, occasional co-clustering of canine and pediatric-derived isolates suggests the possibility of interspecies transmission. The presence of a pool of resistance genes in animal-derived isolates with the potential to appear in humans given sufficient pressure from antibiotic use warrants concern.

P–672 Higher pregnancy outcomes in patients undergoing embryo transfer-under hormonal replacement therapy where an individualised Progesterone supplementation was applied on the day of β-hCG

Study question

Does progesterone-supplementation (PS) from the day of β-hCG assessment improve pregnancy rates in embryo transfer-under hormonal replacement therapy (ET-HRT) in patient with Progesterone (P)&lt;10.6 ng/mL?

Summary answer

Reduced P on the β-hCG day is associated with lower pregnancy-rates and higher miscarriage-rate. PS from the same day showed significant increase of reproductive outcomes.

What is known already

Up until now, in ART, very little has been done to understand whether the P intake should be personalized during the luteal phase. Most recent studies on the topic showed that low P levels on the day of ET-HRT or on the day before are associated with decreased pregnancy rates; however, when low P values are supplemented from the day before embryo-transfer (ET), similar results to cases with adequate P are reported. Nevertheless, little is known about the association between low P level, on the day of β-hCG (P- β-hCG) and PS from this day in ET-HRT, and pregnancy outcomes.

Study design, size, duration

This is a single centre, cohort, retrospective study conducted at a university-affiliated fertility centre between January 2018 and June 2020 where PS took place from the day of positive β-hCG determination when P &lt; 10.6 ng/mL. In total 789 ET-HRT cycles were analysed of which 239 were performed in both fresh and frozen heterologous ET-HRT (het-ET), 336 in homologous ET-HRT (hom-FET) and 214 in euploid ET-HRT (eu-FET) after preimplantation genetic testing for aneuploidies IVF cycles (PGT-A).

Participants/materials, setting, methods

Women undergoing ET-HRT with normal P (&gt;10.6ng/mL) on the day before ET were screened for P on the day of β-hCG. All women received vaginal P 200 mg/8 hours for the second part of HRT. PS was performed by adding P to the HRT when P- β-hCG was considered low (&lt;10.6 ng/mL). Primary outcome: ongoing-pregnancy-rate (OPR); secondary outcome: miscarriage-rate (MR). Both were evaluated by considering PS on the day of β-hCG as a categorical variable.

Main results and the role of chance

Patients characteristics were comparable between groups (het-ET, hom-FET and eu-FET) although significantly lower body mass index was found when P- β-hCG&gt;10.6 ng/mL compared to the subgroup with P- β-hCG&lt;10.6 ng/mL and no PS (p = 0.012). Overall clinical pregnancy rate was 52.1% with no-significant differences between groups (48.5% in het-ET, 52.9% in hom-FET and 54.7% in eu-FET). P- β-hCG was considered as adequate in 75.7% (311/411) ET-HRT with positive β-hCG and low in 24.3% (100/411), with no differences between groups. In case of positive β-hCG and P- β-hCG &gt;10.6 ng/mL, OPR was 83.6% and MR was 16.4%, with no-significant differences between groups. Among the 100 low P- β-hCG, 80 ET-HRT received PS. In this subgroup OPR was 96.2% and MR was 3.8%, with no-significant differences between groups. In 20 out of 100 ET with P- β-hCG &lt;10.6 ng/mL, no PS was added for different reasons. This group showed the lowest OPR (30%) and the highest MR (70%), again with no between-group differences according to het-ET, hom-FET or eu-FET. Miscarriage rate was significantly higher (p &lt; 0.001) when P- β-hCG was &lt;10.6 ng/mL and no PS was added to HRT compared to P- β-hCG &lt;10.6 ng/mL but with PS, and also compared to the P- β-hCG &gt;10.6 ng/mL group.

Limitations, reasons for caution

The main limitation of the study is due to its retrospective nature and the small sample of patients with P- β-hCG&lt;10.6 ng/mL that was not supplemented. Furthermore, the cut-off of P- β-hCG was arbitrarily decided upon previous studies, and lastly different routes of administration were considered for the PS.

Wider implications of the findings: The results of this study showed that individualization of Progesterone supplementation in ET-HRT may be a crucial turn point in order to increase the pregnancy rates and decrease the miscarriage rates. An adequate PS should be considered in case of low P- β-hCG levels for both het-ET, hom-FET and eu-FET.

Trial registration number

Not applicable

Intramuscular oxytocin versus Syntometrine® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double-blinded clinical trial of effectiveness, side effects and quality of life

OBJECTIVE

To compare intramuscular oxytocin, Syntometrine^® and carbetocin for prevention of postpartum haemorrhage after vaginal birth.

DESIGN

Randomised double-blinded clinical trial.

SETTING

Six hospitals in England.

POPULATION

A total of 5929 normotensive women having a singleton vaginal birth.

METHODS

Randomisation when birth was imminent.

MAIN OUTCOME MEASURES

Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life.

RESULTS

Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby.

CONCLUSIONS

Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine.

TWEETABLE ABSTRACT

IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.

Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018

Background

The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.

Methods

This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.

Results

From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.

Conclusions

A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.

Clinical Trials Registration. NCT02898987.

Delimiting cryptic morphological variation among human malaria vector species using convolutional neural networks

Deep learning is a powerful approach for distinguishing classes of images, and there is a growing interest in applying these methods to delimit species, particularly in the identification of mosquito vectors. Visual identification of mosquito species is the foundation of mosquito-borne disease surveillance and management, but can be hindered by cryptic morphological variation in mosquito vector species complexes such as the malaria-transmitting Anopheles gambiae complex. We sought to apply Convolutional Neural Networks (CNNs) to images of mosquitoes as a proof-of-concept to determine the feasibility of automatic classification of mosquito sex, genus, species, and strains using whole-body, 2D images of mosquitoes. We introduce a library of 1, 709 images of adult mosquitoes collected from 16 colonies of mosquito vector species and strains originating from five geographic regions, with 4 cryptic species not readily distinguishable morphologically even by trained medical entomologists. We present a methodology for image processing, data augmentation, and training and validation of a CNN. Our best CNN configuration achieved high prediction accuracies of 96.96% for species identification and 98.48% for sex. Our results demonstrate that CNNs can delimit species with cryptic morphological variation, 2 strains of a single species, and specimens from a single colony stored using two different methods. We present visualizations of the CNN feature space and predictions for interpretation of our results, and we further discuss applications of our findings for future applications in malaria mosquito surveillance.

Measurements of a 2.1 MeV H- beam with an Allison scanner

Transverse 2D phase space distributions of a 2.1 MeV, 5 mA H^- beam are measured at the Proton Improvement Plan II Injector Test accelerator at Fermilab with an Allison scanner. This paper describes the design, calibration, and performance of the scanner along with the main results from beam measurements. Analyses of the recorded phase portraits are performed primarily in action-phase coordinates. The stability of the action under linear optics makes it easier to compare measurements taken under different beamline conditions. The amplitude of a single measured point ("pixel") is proportional to the phase density in the corresponding portion of the beam. When the Twiss parameters are calculated using only the high-phase density part of the beam, the pixel amplitude in the beam core is found to be decreasing approximately exponentially with action and to be phase-independent. Outside of the core, the amplitudes decrease with action at a slower rate than in the core. This "tail" comprises 10%-30% of the beam, with 0.1% of the total measured intensity extending beyond action 10-20 times larger than the rms emittance. The transition from the core to the tail is accompanied by the appearance of two "branches" that are separated in phase and extend beyond the core. A set of selected measurements shows that there is no measurable emittance dilution along the beamline; the beam parameters are practically constant over a 0.5 ms pulse; and scraping in various parts of the beamline is an effective way to decrease the transverse tails by removing the branches.

P506Brugada Syndrome: is the addition of the electrocardiographic risk markers the clue?

Background

Risk stratification in Brugada Syndrome (BS) remains a clinical challenge. Several electrocardiografic (ECG) risk markers had been described, as a spontaneous type 1 Brugada pattern (ST1B), maximal time interval between the peak and the end of the t wave in precordial leads (Tpe Max), the presence of an S Wave on DI, a PR interval (PRi) ≥ 200ms and fragmented QRS (f-QRS).

Purpose

Evaluate the association of ECG risk markers with sudden cardiac death (SCD) or appropriate shocks (A-Sh) by implantable cardioverter defibrillator (ICD) in patients (p) with BS.

Methods

From a registry of 97 p with BS with a median follow up of 2.3 years (Q1 0.7-Q3 7.8), 12 lead ECG were recorded in every p. QT peak interval (QTp) was measured between the QRS onset and the peak of the T wave. Tpe was calculated between the difference of QT and QTp in precordial leads (V1 to V6). TpeMax was defined as the most prolonged Tpe. If an S-DI was present, duration and amplitude was measured. PRi was measured on DII. Baseline characteristics: Age 44 ± 13 years, male 74 (76%), secondary prevention 2 (3%), malignant syncope 10 (10%), inducible electrophysiology study 22/43 (51%), SCD on first grade family &lt; 35 years 12 (12%) and ICD 34 (35%). A-Sh and SCD were compared among p with ST1B vs no ST1B, TpeMax≥100 vs &lt;100ms, S-DI ≥0.4 vs &lt;0.4ms, S-D ≥0.1 vs &lt;0.1mV, PRi≥200 vs &lt;200ms and presence of f-QRS ≥ 2 spike ≥ 2 leads. Variables that were associated with A-Sh or SCD were combined. For variables with significant difference sensibility (Sen) and specificity (Spe) was calculated.

Results

During follow up 6 p presented A-Sh and no p SCD. Results are described in the Table.

Conclusion

In our study population, there was a significant higher incidence of A-Sh in p with ST1B, Tpe Max ≥ 100ms and S-DI ≥ 0.1mV. We found that the presence of one ECG risk marker had a high sensibility to predict A-Sh. The presence of the 3 ECG risk markers highly increased specificity to predict A-Sh. Further trials should be carried out to asses if ECG risk markers would allow us to differentiate which asymptomatic patients could benefit from electrophysiological study for risk stratification (high sensibility - One ECG Risk marker) or would benefit from ICD implantation (high specificity - 3 ECG Risk markers).

Abstract Figure.

P634 Right atrial mechanics determined by speckle tracking strain as a more physiologic correlation in pulmonary hypertension

Introduction

Right atrial dilation has also been established as a marker of adverse outcomes in pulmonary hypertension (PH), while right atrial mechanics remain relatively understudied.

Purpose

Transthoracic echocardiography is a practical and widely used tool for risk stratification in PH. We hypothesized that right atrial (RA) strain components [RA reservoir function (ƐR), peak RA contraction (ƐCT) and RA conduit function (ƐCD)] correlates better with strong prognostic parameters as 3D right ventricle ejection fraction (3D RV EF), 6 minutes walking test, systolic pulmonary artery pressure (SPAP) and B-type natriuretic peptide (BNP).

Methods

19 patients with diagnostic PH, type 2 patients were excluded. RA strain was analyzed and determined a correlation with right ventricle function and pulmonary variables.

Results

Morphology correlation was poor with all the variables as SPAP, 6 Minutes walking test, BNP, only RA/LA index has a good correlation with BNP (R = 0.76, P = 0.0004). Right atrial mechanics with strain has good correlation: ƐR correlates with BNP (R= -0.70, P = 0.001) and with SPAP (R= -0.68, P = 0.001). ƐCD correlates with BNP (R=-0.75;P = 0,0002) and with SPAP (R=-0.68, P = 0.001). ƐCT has no correlation with E/e, 3D RV EF, SPAP, pulmonary vascular resistance (PVR), 6 minutes walking test neither BNP. Right atrial deformation sum correlations with 3D RV EF (R= -0.70, P = 0.001), with SPAP (R= -0.72, P = 0.0005), with PVR (R= -0.68, P = 0.001) and with BNP (R=-0.71, P = 0.001).

Conclusion

Right atrium morphological characteristics have poor correlation with variables that evaluate right ventricle function and with variables that predicts outcomes, as BNP, in this patients population. Only RA/LA index as morphology parameter has good correlation with BNP level. Meanwhile right atrial mechanics analyzed by strain has strong correlation with other variables of severity at PH. Right atrial deformation sum has better correlation than other strain parameters in our study.

Abstract P634 Figure. RIGHT ATRIAL DEFORMATION SUM CORRELATION

Causes of death in patients with locally advanced head and neck cancer treated with radiotherapy and systemic therapy

BACKGROUND

To investigate the incidence of non-cancer mortalities and prognostic factors associated with competitive causes of death in a homogeneous cohort of patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment.

METHODS

This study included 284 patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment between 2005 and 2017. The cumulative incidence of death associated with tumour, second tumours, treatment, side effects and comorbidity was calculated. A Fine and Gray regression model was used to investigate factors associated with cancer and competitive mortality.

RESULTS

The cumulative incidence of tumoral death at 5 and 10 years were 35 and 47% respectively, whereas the cumulative incidence of competitive mortality were 10 and 12% respectively. In the multivariate analysis, age and comorbidity were independent factors for non-cancer mortality. Patients with a high risk of non-cancer mortality presented a cumulative incidence of 17.3% at 5 years and 18.4% at 10 years.

CONCLUSIONS

This study demonstrated a high incidence of competing mortality in older patients with comorbidities. Non-cancer deaths should be considered when selecting patients for combination therapies and in the study design ofclinical trials.

Color tunable pressure sensors based on polymer nanostructured membranes for optofluidic applications

We demonstrate an integrated optical pressure sensing platform for multiplexed optofluidics applications. The sensing platform consists in an array of elastomeric on-side nanostructured membranes -effectively 2D photonic crystal- which present colour shifts in response to mechanical stress that alter their nanostructure characteristical dimensions, pitch or orientation. The photonic membranes are prepared by a simple and cost-effective method based on the infiltration of a 2D colloidal photonic crystal (CPC) with PDMS and their integration with a microfluidic system. We explore the changes in the white light diffraction produced by the nanostructured membranes when varying the pneumatic pressure in the microfluidics channels as a way to achieve a power-free array of pressure sensors that change their reflective colour depending on the bending produced on each sensor. The structural characterization of these membranes was performed by SEM, while the optical properties and the pressure-colour relation were evaluated via UV-Vis reflection spectrometry. Maximum sensitivities of 0.17 kPa^-1 is obtained when measuring at Littrow configuration (θ_in = -θ_out), and close to the border of the membranes. The reflected colour change with pressure is as well monitorized by using a smartphone camera.