Effects of region of birth, educational level and age on late presentation among men who have sex with men newly diagnosed with HIV in a network of STI/HIV counselling and testing clinics in Spain

This paper analyses late presentation (LP) of HIV infection, and its determinants, among men who have sex with men (MSM) in Spain, newly diagnosed with HIV (2003-2011) in 15 sexually transmitted infection/HIV counselling and testing clinics. LP was defined as <350 CD4 cells/µL or AIDS. In total, 3,081 MSM were included (2,499 having CD4/AIDS); overall LP was 25.3%. LP was higher in men older than 34 years, those not previously HIV-tested (adjusted odds ratio (aOR):3.1; 95% confidence intervals (CI):2.3-4.2) , and those tested > 12 months before diagnosis (12-24 months (aOR:1.4; 95% CI:1.0-2.0); > 24 months (aOR:2.2; 95% CI:1.7-3.0)). LP was less likely in MSM reporting a known HIV-infected partner as infection source or symptoms compatible with acute retroviral syndrome. 'Region of birth' interacted with 'educational level' and 'steady partner as infection source': only African and Latin-American MSM with low educational level were more likely to present late; Latin-American men attributing their infection to steady partner, but no other MSM, had LP more frequently. In Spain, HIV testing among MSM should be promoted, especially those > 34 years old and migrants with low educational level. The current recommendation that MSM be tested at least once a year is appropriate.

Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011

We assess the added value of a multisite, street-based HIV rapid testing programme by comparing its results to pre-existing services and assessing its potential to reduce ongoing transmission. Between 2008 and 2011, 8,923 individuals underwent testing. We compare outcomes with those of a network of 20 sexually transmitted infections (STI)/HIV clinics (EPI-VIH) and the Spanish National HIV Surveillance System (SNHSS); evaluate whether good visibility prompts testing and assess whether it reaches under-tested populations. 89.2% of the new infections were in men who have sex with men (MSM) vs 78.0% in EPI-VIH and 56.0% in SNHSS. 83.6% of the MSM were linked to care and 20.9% had <350 CD4 HIV prevalence was substantially lower than in EPI-VIH. 56.5% of the HIV-positive MSM tested because they happened to see the programme, 18.4% were previously untested and 26.3% had their last test ≥2 years ago. The programme provided linkage to care and early diagnosis mainly to MSM but attendees presented a lower HIV prevalence than EPI-VIH. From a cost perspective it would benefit from being implemented in locations highly frequented by MSM. Conversely, its good visibility led to reduced periods of undiagnosed infection in a high proportion of MSM who were not testing with the recommended frequency.

Ptychographic X-ray nanotomography quantifies mineral distributions in human dentine

Bones are bio-composites with biologically tunable mechanical properties, where a polymer matrix of nanofibrillar collagen is reinforced by apatite mineral crystals. Some bones, such as antler, form and change rapidly, while other bone tissues, such as human tooth dentine, develop slowly and maintain constant composition and architecture for entire lifetimes. When studying apatite mineral microarchitecture, mineral distributions or mineralization activity of bone-forming cells, representative samples of tissue are best studied at submicrometre resolution while minimizing sample-preparation damage. Here, we demonstrate the power of ptychographic X-ray tomography to map variations in the mineral content distribution in three dimensions and at the nanometre scale. Using this non-destructive method, we observe nanostructures surrounding hollow tracts that exist in human dentine forming dentinal tubules. We reveal unprecedented quantitative details of the ultrastructure clearly revealing the spatially varying mineralization density. Such information is essential for understanding a variety of natural and therapeutic effects for example in bone tissue healing and ageing.

Strong and Flexible: Developing a Three-Tiered Curriculum for the Regional Central America Field Epidemiology Training Program

Field Epidemiology Training Programs (FETPs) are recognized worldwide as an effective means to strengthen countries' capacity in epidemiology, surveillance, and outbreak response. FETPs are field-based, with minimum classroom time and maximum time in the field, providing public health services while participants achieve competency. The Central America FETP (CAFETP) uses a three-level pyramid model: basic, intermediate, and advanced. In 2006, a multidisciplinary team used a methodical process based on adult learning practices to construct a competency-based curriculum for the CAFETP. The curriculum was designed based on the tasks related to disease surveillance and field epidemiology that public health officers would conduct at multiple levels in the system. The team used a design process that engaged subject matter experts and considered the unique perspective of each country. The designers worked backwards from the competencies to define field activities, evaluation methods, and classroom components. The 2006 pyramid curriculum has been accredited for a master's of science in field epidemiology by the Universidad del Valle de Guatemala and has been adapted by programs around the world. The team found the time and effort spent to familiarize subject matter experts with key adult learning principles was worthwhile because it provided a common framework to approach curriculum design. Early results of the redesigned curriculum indicate that the CAFETP supports consistent quality while allowing for specific country needs.

Strong and Flexible

Field Epidemiology Training Programs (FETPs) are recognized worldwide as an effective means to strengthen countries’ capacity in epidemiology, surveillance, and outbreak response. FETPs are field-based, with minimum classroom time and maximum time in the field, providing public health services while participants achieve competency. The Central America FETP (CAFETP) uses a three-level pyramid model: basic, intermediate, and advanced. In 2006, a multidisciplinary team used a methodical process based on adult learning practices to construct a competency-based curriculum for the CAFETP. The curriculum was designed based on the tasks related to disease surveillance and field epidemiology that public health officers would conduct at multiple levels in the system. The team used a design process that engaged subject matter experts and considered the unique perspective of each country. The designers worked backwards from the competencies to define field activities, evaluation methods, and classroom components. The 2006 pyramid curriculum has been accredited for a master’s of science in field epidemiology by the Universidad del Valle de Guatemala and has been adapted by programs around the world. The team found the time and effort spent to familiarize subject matter experts with key adult learning principles was worthwhile because it provided a common framework to approach curriculum design. Early results of the redesigned curriculum indicate that the CAFETP supports consistent quality while allowing for specific country needs.

Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009

During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35–39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.

A low-cost, sustainable, second generation system for surveillance of people living with HIV in Spain: 10-year trends in behavioural and clinical indicators, 2002 to 2011

A second-generation surveillance system of people infected with human immunodeficiency virus (HIV) has been implemented in Spain. Behavioural and clinical data were collected between 2002 and 2011 through an annual one-day, cross-sectional survey in public hospitals, including all in- and outpatients receiving HIVrelated care on the survey day. Mean age increased over time (from 38.7 years in 2002 to 43.8 years in 2011) and 68.4% of the 7,205 subjects were male. The proportion of migrants increased from 6.1% to 15.9%, while people who inject or used to inject drugs (PWID and Ex-PWID) decreased and men who have sex with men (MSM) and heterosexuals increased. Unprotected intercourse at last sex increased among MSM and PWID/Ex-PWID. Patients receiving antiretroviral treatment increased significantly from 76.0% to 88.2% as did those with CD4 T-cell counts ≥350 (from 48.2% to 66.9%) and viral copies <200 (from 47.0% to 85.2%). HIV-infected people with hepatitis C virus RNA decreased from 36.0% in 2004 to 29.9% in 2011, while those with HBsAg remained stable at around 4.4%. Implementation of a low-cost, sustainable system for second-generation surveillance in people living with HIV is feasible. In Spain, the information obtained has helped to define and refine public health policy and document treatment effectiveness.

X-ray ptychographic computed tomography at 16 nm isotropic 3D resolution

X-ray ptychography is a scanning variant of coherent diffractive imaging with the ability to image large fields of view at high resolution. It further allows imaging of non-isolated specimens and can produce quantitative mapping of the electron density distribution in 3D when combined with computed tomography. The method does not require imaging lenses, which makes it dose efficient and suitable to multi-keV X-rays, where efficient photon counting, pixelated detectors are available. Here we present the first highly resolved quantitative X-ray ptychographic tomography of an extended object yielding 16 nm isotropic 3D resolution recorded at 2 Å wavelength. This first-of-its-kind demonstration paves the way for ptychographic X-ray tomography to become a promising method for X-ray imaging of representative sample volumes at unmatched resolution, opening tremendous potential for characterizing samples in materials science and biology by filling the resolution gap between electron microscopy and other X-ray imaging techniques.

Scanning SAXS–WAXS microscopy on osteoarthritis-affected bone – an age-related study

Osteoarthritis (OA), among other bone pathologies, is expected to determine supramolecular changes at the level of the mineralized collagen fiber. In a proof-of-principle study, bone biopsies were collected from six coxarthritis-affected patients, aged 62–87 years, during hip prosthesis implant surgery, sliced down to 100 µm-thick tissues, and investigated using scanning small-angle and wide-angle X-ray scattering (SAXS and WAXS) transmission microscopy. A multi-modal imaging evaluation of the SAXS and WAXS data, combined with principal component and canonical correlation analyses, allowed the transformation of the raw data into microscopy images and inspection of the nanoscale structure of the mineralized collagen fibers across mm2tissue areas. The combined scanning SAXS and WAXS microscopy is shown to be a suitable choice for characterizing and quantifying the nanostructural properties of collagen over extended areas. The results suggest the existence of a correlation between age and cross-linking-induced rigidity of collagen fibers.

Region-specific regulation of 5-HT1B receptors in the rat brain by chronic venlafaxine treatment

RATIONALE

Venlafaxine is a non-selective serotonin and noradrenaline reuptake inhibitor antidepressant drug for which clinical studies have suggested a high level efficacy and a possible early action onset compared to the classical antidepressants. Its therapeutic effects might be due, at least in part, to adaptive changes in serotonergic neurotransmission, through the activation of the different 5-HT receptor subtypes. 5-HT(1B) receptors are located in the axon terminals of both serotonergic and non-serotonergic neurons, where they act as inhibitory autoreceptors or heteroreceptors, respectively. However, the information about the involvement of this subtype in the mechanism of action of antidepressants is limited and quite controversial.

OBJECTIVES

The aim of this study was to evaluate the effect of venlafaxine (10 mg kg⁻¹ day⁻¹, p.o.) after 21 days of treatment on the density of 5-HT(1B) receptors and their functionality in rat brain.

METHODS

Effects of chronic venlafaxine were evaluated at different levels of 5-HT(1B) receptor by using receptor autoradiography, [³⁵S]GTPγS binding, and the regulation of body temperature induced by selective 5-HT(1B) agonist.

RESULTS

Our results show that venlafaxine induced an increase in sensitivity of 5-HT(1B) receptors in hypothalamus both at G-protein level and the control of core temperature without affecting the receptor density.

CONCLUSIONS

These results demonstrate that adaptive changes on 5-HT(1B) receptors induced by chronic administration of venlafaxine exhibit regional differences suggesting that the hypothalamus might be an important site of drug action.

Longitudinal relationship between personal CO and personal PM2.5 among women cooking with woodfired cookstoves in Guatemala

Household air pollution (HAP) due to solid fuel use is a major public health threat in low-income countries. Most health effects are thought to be related to exposure to the fine particulate matter (PM) component of HAP, but it is currently impractical to measure personal exposure to PM in large studies. Carbon monoxide (CO) has been shown in cross-sectional analyses to be a reliable surrogate for particles<2.5 µm in diameter (PM_2.5) in kitchens where wood-burning cookfires are a dominant source, but it is unknown whether a similar PM_2.5-CO relationship exists for personal exposures longitudinally. We repeatedly measured (216 measures, 116 women) 24-hour personal PM_2.5 (median [IQR] = 0.11 [0.05, 0.21] mg/m³) and CO (median [IQR] = 1.18 [0.50, 2.37] mg/m³) among women cooking over open woodfires or chimney woodstoves in Guatemala. Pollution measures were natural-log transformed for analyses. In linear mixed effects models with random subject intercepts, we found that personal CO explained 78% of between-subject variance in personal PM_2.5. We did not see a difference in slope by stove type. This work provides evidence that in settings where there is a dominant source of biomass combustion, repeated measures of personal CO can be used as a reliable surrogate for an individual's PM_2.5 exposure. This finding has important implications for the feasibility of reliably estimating long-term (months to years) PM_2.5 exposure in large-scale epidemiological and intervention studies of HAP.

Hard X-ray imaging of bacterial cells: nano-diffraction and ptychographic reconstruction

Ptychographic coherent X-ray diffractive imaging (PCDI) has been combined with nano-focus X-ray diffraction to study the structure and density distribution of unstained and unsliced bacterial cells, using a hard X-ray beam of 6.2keV photon energy, focused to about 90nm by a Fresnel zone plate lens. While PCDI provides images of the bacteria with quantitative contrast in real space with a resolution well below the beam size at the sample, spatially resolved small angle X-ray scattering using the same Fresnel zone plate (cellular nano-diffraction) provides structural information at highest resolution in reciprocal space up to 2nm(-1). We show how the real and reciprocal space approach can be used synergistically on the same sample and with the same setup. In addition, we present 3D hard X-ray imaging of unstained bacterial cells by a combination of ptychography and tomography.

An instrument for 3D x-ray nano-imaging

We present an instrument dedicated to 3D scanning x-ray microscopy, allowing a sample to be precisely scanned through a beam while the angle of x-ray incidence can be changed. The position of the sample is controlled with respect to the beam-defining optics by laser interferometry. The instrument achieves a position stability better than 10 nm standard deviation. The instrument performance is assessed using scanning x-ray diffraction microscopy and we demonstrate a resolution of 18 nm in 2D imaging of a lithographic test pattern while the beam was defined by a pinhole of 3 μm in diameter. In 3D on a test object of copper interconnects of a microprocessor, a resolution of 53 nm is achieved.

Transmission of influenza A virus in pigs

Influenza A virus infections cause respiratory disease in pigs and are a risk to public health. The pig plays an important role in influenza ecology because of its ability to support replication of influenza viruses from avian, swine and human species. Influenza A virus is widespread in pigs worldwide, and influenza A virus interspecies transmission has been documented in many events. Influenza A virus is mostly transmitted through direct pig-to-pig contact and aerosols although other indirect routes of transmission may also exist. Several factors contribute to differences in the transmission dynamics within populations including among others vaccination, pig flow, animal movement and animal introduction which highlights the complexity of influenza A transmission in pigs. In addition, pigs can serve as a reservoir of influenza A viruses for other pigs and other species and understanding mechanisms of transmission within pigs and from pigs to other species and vice versa is crucial. In this paper, we review the current understanding of influenza virus transmission in pigs. We highlight the ubiquity of influenza A virus in the pig population and the widespread distribution of pandemic H1N1 virus worldwide while emphasizing an understanding of the routes of transmission and factors that contribute to virus spread and dissemination within and between pig populations. In addition, we describe transmission events between pigs and other species including people. Understanding transmission is crucial for designing effective control strategies and for making well-informed recommendations for surveillance.

Impact of reduced maternal exposures to wood smoke from an introduced chimney stove on newborn birth weight in rural Guatemala

BACKGROUND

A growing body of evidence indicates a relationship between household indoor air pollution from cooking fires and adverse neonatal outcomes, such as low birth weight (LBW), in resource-poor countries.

OBJECTIVE

We examined the effect of reduced wood smoke exposure in pregnancy on LBW of Guatemalan infants in RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects).

METHODS

Pregnant women (n = 266) either received a chimney stove (intervention) or continued to cook over an open fire (control). Between October 2002 and December 2004 we weighed 174 eligible infants (69 to mothers who used a chimney stove and 105 to mothers who used an open fire during pregnancy) within 48 hr of birth. Multivariate linear regression and adjusted odds ratios (ORs) were used to estimate differences in birth weight and LBW (< 2,500 g) associated with chimney-stove versus open-fire use during pregnancy.

RESULTS

Pregnant women using chimney stoves had a 39% reduction in mean exposure to carbon monoxide compared with those using open fires. LBW prevalence was high at 22.4%. On average, infants born to mothers who used a stove weighed 89 g more [95% confidence interval (CI), -27 to 204 g] than infants whose mothers used open fires after adjusting for maternal height, diastolic blood pressure, gravidity, and season of birth. The adjusted OR for LBW was 0.74 (95% CI, 0.33-1.66) among infants of stove users compared with open-fire users. Average birth weight was 296 g higher (95% CI, 109-482 g) in infants born during the cold season (after harvest) than in other infants; this unanticipated finding may reflect the role of maternal nutrition on birth weight in an impoverished region.

CONCLUSIONS

A chimney stove reduced wood smoke exposures and was associated with reduced LBW occurrence. Although not statistically significant, the estimated effect was consistent with previous studies.

Coherent x-ray wavefront reconstruction of a partially illuminated Fresnel zone plate

A detailed characterization of the coherent x-ray wavefront produced by a partially illuminated Fresnel zone plate is presented. We show, by numerical and experimental approaches, how the beam size and the focal depth are strongly influenced by the illumination conditions, while the phase of the focal spot remains constant. These results confirm that the partial illumination can be used for coherent diffraction experiments. Finally, we demonstrate the possibility of reconstructing the complex-valued illumination function by simple measurement of the far field intensity in the specific case of partial illumination.

113 EFFECT OF SOME FACTORS ON CONCEPTION RATE IN ALPACAS UNDER PERUVIAN HIGHLAND CONDITION

Alpacas are a domestic species of South American camelids with a great importance to highland people because of their high-quality fibre production. However, their reproductive performance has been reported to be poor, with a birth rate of 50% under the Andean community’s conditions. Two experiments were designed to evaluate the effect of some factors on the pregnancy rate of alpacas at first service in lactating, 3- to 8-years old, without parity problems. The objective of the first experiment (n = 85) was to evaluate the effect of age (G1: 3, G2: 4 to 5, G3: ≥ 6 years old); mating time (G1: 15 min, G2: 16–24 min, G3: ≥ 25 min), and interval from parturition to mating (G1: 20 days, G2: ≥ 20 days) on first service conception rate. A second experiment (n = 174) evaluated the effect of month of calving (January, February, or March) on conception rate in females with a postpartum interval ≥20 days. Animals were mated with male of good fertility after a receptivity test and confirmation of presence of a dominant follicle ≥7 mm by ultrasonography. Pregnancy was determined by ultrasonography 25 days after mating. Proportional data were compared by Fisher’s exact test. In the first experiment, conception rates were 57.9, 66.7, and 47.2% in females of G1, G2, and G3, respectively (P ≤ 0.05); 50.0, 54.5, and 59.0% in females with mating time of 15, 16–24, or ≥ 25 min of mating; 48.0 and 59.4% in those with a postpartum interval <20 days and ≥20 days (P ≤ 0.05). In the second experiment, conception rates were 58.3, 70.7, and 82.1% in alpacas calving in January, February, and March, respectively (P ≤ 0.05). The results suggest that age of female, postpartum interval, and month of calving are factors that affect conception rates in alpacas. Therefore, a reproductive management system that includes these factors would improve the pregnancy rate in alpacas under highland Peruvian conditions. Consejo Superior de Investigacion – UNMSM.

Abstract P3-11-09: Body Mass Index (BMI) and Survival: A Retrospective Review of Women with Triple Negative Breast Cancer (An Update)

Body Mass Index (BMI) has been reported as a risk factor for recurrence and decreased survival in women with breast cancer. At the Inter-American Breast Cancer Conference we presented data showing the effect BMI has on overall survival in women with triple negative breast cancer (TNBC). Here we present an update of this data which to our knowledge is the only study addressing the effect BMI has on outcomes in TNBC. We conducted a retrospective review of 170 patients with TNBC seen at the University of Miami Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital between December of 1999 and April 2010. Charts were reviewed looking at BMI at the time of diagnosis and overall survival defined as date of last contact or date of death when known. 163 patients were included in the study. BMI was defined as normal (BMI 18.5-24.9) and overweight or obese (25 or greater). The average age at diagnosis was 50.96 years with a mean OS of 44.67 months. 21 patients (13%) had stage I disease, 61 (37.4%) had stage II disease, 81 (49.6%) had stage III disease. In patients with stage I disease 33% had a normal BMI with a mean OS of 51.7 months. 67% were overweight or obese with a mean OS of 60.2 months. In patients with stage II disease 33% had a normal BMI with a mean OS of 30.8 months. 67% were overweight or obese with a mean OS of 48.4 months. In patients with stage III disease 28% had a normal BMI with a mean OS of 37.2 months. 72% were overweight or obese with a mean OS of 43.1 months.

Survival in patients with TNBC does not appear to be negatively impacted by the patients BMI at diagnosis. While not statistically significant (p=0.274) patients with stage I TNBC that were overweight or obese tended to have an increased OS compared to those with a normal BMI. In patients with stage II disease there was a statistically significant (p=0.010) increase in OS in overweight or obese patients compared to those with a normal BMI. In the patients with stage III disease there was no significant difference in the OS (p=0.458) between patients with a normal BMI and those that were overweight or obese.

Our study shows that increased BMI at the time of diagnosis may have a positive impact on OS in patients with TNBC. Overweight and obese patients with stage I and II TNBC have an increased OS compared to those with a normal BMI. In those with stage II disease the difference was statistically significant. Although this study was limited by small sample size, if confirmed, it might suggest a relationship between obesity and survival in TNBC. Further studies are needed to evaluate these findings.

Capture probability of released males of two Bactrocera species (Diptera: Tephritidae) in detection traps in California

The genus Bactrocera (Diptera: Tephritidae) includes approximately 70 polyphagous species that are major pests of fruit and vegetable crops. Most Bactrocera species have limited geographic distributions, but several species are invasive, and many countries operate continuous trapping programs to detect infestations. In the United States, California maintains approximately 25,000 traps (baited with male lures) specifically for Bactrocera detection distributed over an area of approximately 6,400 km2 (2,500 miles2) in the Los Angeles area. Although prior studies have used male lures to describe movement of Bactrocera males, they do not explicitly relate capture probability with fly distance from lure-baited traps; consequently, they do not address the relative effectiveness of male lures in detecting incipient populations of Bactrocera species. The objective of this study was to measure the distance-dependent capture probability of marked, released males of Bactrocera dorsalis (Hendel) and Bactrocera cucurbitae (Coquillett) (methyl eugenol- and cue lure-responding species, respectively) within the detection trapping grid operating in southern California. These data were then used to compute simple probability estimates for detecting populations of different sizes of the two species. Methyl eugenol was the more powerful attractant, and based on the mark-recapture data, we estimated that B. dorsalis populations with as few as approximately 50 males would always (>99.9%) be detected using the current trap density of five methyl eugenol-baited traps per 2.6 km2 (1 mile2). By contrast, we estimated that certain detection of B. cucurbitae populations would not occur until these contained approximately 350 males. The implications of the results for the California trapping system are discussed, and the findings are compared with mark-release-recapture data obtained for the same two species in Hawaii.

Activation of the EGFR/ERK pathway in high-grade mucoepidermoid carcinomas of the salivary glands

Background:

Mucoepidermoid carcinoma (MEC) shows differences in biological behaviour depending mainly on its histological grade. High-grade tumours usually have an aggressive biological course and they require additional oncological treatment after surgery.

Methods:

In a series of 43 MECs of the salivary glands, we studied the epidermal growth factor receptor (EGFR) gene by using dual-colour chromogenic in situ hybridisation (CISH). Moreover, we assessed the protein expressions of the EGFR and the activated extracellular signal-regulated kinases (pERK1/2) by using immunohistochemistry. These results were correlated with the histological grade of the tumours and the outcome of the patients.

Results:

The CISH study demonstrated a high-EGFR gene copy number, with balanced chromosome 7 polysomy, in 8 out of 11 high-grade MECs (72.7%), whereas 27 low-grade and 15 intermediate-grade tumours had a normal EGFR gene copy number (P<0.001). The EGFR gene gains correlated with disease-free interval (P=0.003) and overall survival of the patients (P=0.019). The EGFR protein expression had a significant correlation with the histological grade of the tumours but not with the outcome of the patients. The pERK1/2 expression correlated with histological grade of tumours (P<0.001), disease-free interval (P=0.004) and overall survival (P=0.001).

Conclusions:

The EGFR/ERK pathway is activated in high-grade MECs with aggressive behaviour. Patients with these tumours who require oncological treatment in addition to surgery could benefit from EGFR and mitogen-activated protein kinase pathway inhibitors.

Three-dimensional x-ray Fourier transform holography: the Bragg case

A novel approach to determine the structure of nanoscale crystals in three dimensions is proposed by the use of coherent x-ray Fourier transform holography in Bragg geometry. The full internal description is directly obtained by a single Fourier transform of the 3D intensity hologram. Together with the morphology, Bragg geometry gives access to the 3D displacement field within the crystal. This result opens great possibilities for the investigation of strain fields inside nanocrystals in a simple way.