Serious Illness Conversations With Outpatient Oncology Clinicians: Understanding the Patient Experience

PURPOSE

Guidelines recommend earlier advance care planning discussions focused on goals and values (serious illness communication) among oncology patients. We conducted a prospective, cross-sectional quality improvement evaluation of patients who had a serious illness conversation (SIC) with an oncology clinician using the Serious Illness Conversation Guide to understand patient perceptions of conversations using a structured guide.

METHODS

We contacted 66 oncology patients with an SIC documented in the electronic health record. Thirty-two patients (48%) responded to survey and/or structured interview questions by telephone. We used summary statistics and thematic analysis to analyze results.

RESULTS

Twenty-eight respondents (90%) reported that the SIC was worthwhile. Seventeen respondents (55%) reported that the conversation increased their understanding of their future health, and 18 (58%) reported that the conversation increased their sense of closeness with their clinician. Although the majority of respondents (28 [90%]) reported that the conversation increased (13 [42%]) or had no effect (15 [48%]) on their hopefulness, a small minority (3 [10%]) reported a decrease in hopefulness. Qualitative analysis revealed 6 themes: clinician-patient relationship, impact on well-being, memorable characteristics of the conversation, improved prognostic understanding, practical planning, and family communication.

CONCLUSION

SICs are generally acceptable to oncology patients (nonharmful to the vast majority, positive for many). Our qualitative analysis suggests a positive impact on prognostic understanding and end-of-life planning, but opportunities for improvement in the delivery of prognosis and preparing patients for SICs. Our data also identify a small cohort who responded negatively, highlighting an important area for future study.

AB0050 EXTENDED POLYDIMENSIONAL IMMUNOME CHARACTERISATION (EPIC) PLATFORM AS A TOOL FOR TRANSLATIONAL RESEARCH

Background:

We created a high dimensionality healthy human Immunome atlas by interrogating the peripheral blood mononuclear cells (PBMC) of >200 healthy subjects (cord blood to adult) with 63 unique mechanistic and phenotypic markers per cell by mass cytometry (CyTOF). This database is built with an open source, web-based bioinformatics toolkit, enabling its mining and uploading of datasets for comparison with the EPIC healthy database.

Objectives:

Here, we demonstrate the platform’s ability to identify the immunological differences of mechanistically important cell subsets in the uploaded data in comparison with EPIC.

Methods:

CyTOF data from 37 healthy elderly (>60 years old) was uploaded onto the EPIC Discovery tool where down-sampling, normalising and FlowSOM (Flow analysis with Self-Organising Maps) clustering were done with the EPIC database for comparison. Online visualisation outputs include cluster frequency boxplots, correspondence analysis (CA) plot and markers expression heat-map. The CA 2-dimensional plot depicts the global differences in immune cells composition between subjects with proximity between points (subjects) denoting similarity. Kruskal-Wallis test was done to identify age groups differences.

Results:

Increasing distances on the CA plot with age were observed with the elderly being farthest from the new-borns. Notably, we observed significant changes in naive CD4+IL8+T cells (p<1×10-20), memory CD4+IL17A+T cells (p<1×10-20) and type 2 innate lymphoid cells (ILC2) (Lin-CD7+CD25+CD127+CD161+, p<1×10-17) with increasing age. The naive CD4+IL8+T cells (median: 0.68%, interquartile range: 0.415 to 1.055% of CD45+ PBMC) and ILC2 (0.09%, 0.065 to 0.12%) were lowest and memory IL17A+T cells (0.58%, 0.41 to 0.905%) highest in the elderly. Significantly, the memory IL17A+T cells and ILC2 have been implicated in the pathogenesis of auto-immune conditions1,2.

Conclusion:

With EPIC, we have created an online tool enabling data uploading for comparison to a healthy database, allowing the holistic characterisation of immunological changes in different clinical scenarios. Using it, we were able to identify mechanistically important differences in immune cells composition in a distinct clinical cohort (elderly) compared to the younger ages. Translationally, the EPIC platform can be utilised similarly to catalyse the discovery process in auto-immune diseases interrogated with the EPIC antibody panels.

References:

[1]Fasching P, Stradner M, Graninger W, Dejaco C, Fessler J. Therapeutic Potential of Targeting the Th17/Treg Axis in Autoimmune Disorders. Molecules. 2017 Jan 14;22(1). pii: E134.

[2]Klose CS, Artis D. Innate lymphoid cells as regulators of immunity, inflammation and tissue homeostasis. Nat Immunol. 2016 Jun 21; 17(7): 765-74.

Disclosure of Interests:

None declared

THU0237 UNCOVERING DIFFERENCES BETWEEN THE SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) AND HEALTHY IMMUNOMES USING MULTI-PARAMETRIC INTERROGATION

Background:

Systemic lupus erythematosus (SLE) is a complex, systemic autoimmune disease that interferes with the balance between regulation and immunity, resulting in immune system dysfunction. Disease course is unpredictable due to alternating remissions and flares1.

Disease activity and treatment response are measured with composite scores such as the SLE Disease Activity Index (SLEDAI)2. However, disease heterogeneity can impede reliable patient assessments. Mechanistic insights into SLE are required for better assessment.

Current studies are mainly descriptive, and a complex disease like SLE is best interrogated with multi-parametric, holistic approaches such as mass cytometry (CyTOF).

Objectives:

(1)To characterise immune signatures of newly diagnosed SLE patients and in the process:

a.Study the roles of B and T cells in SLE

b.Gain a holistic understanding of the adaptive immune response

(2)To compare immunological profiles of newly diagnosed SLE patients with age-matched healthy controls

We hypothesise that significant differences exist between immunomes of newly diagnosed SLE and healthy subjects.

Methods:

Peripheral blood mononuclear cells (PBMCs) of 5 SLE subjects (median age 125 months) were tested with CyTOF. Data was uploaded to an online analytical platform, the Extended Polydimensional Immunome Characterization (EPIC) discovery tool, for comparison with 51 age-matched controls in its database.

Subsequently, normalization and FlowSOM (Flow cytometry analysis by Self-Organising Maps) clustering to 50 nodes were performed with 37 functionally and phenotypically important immune markers. The Mann-Whitney U test identified significantly different cluster frequencies.

Results:

Correspondence analysis comparing global differences in cluster frequencies showed segregation of SLE subjects away from healthy controls. Multiple significant differences were identified (p < 0.05). Notably, a memory CD4+CD152+PD1+T cell subset (CD4+CD152+PD1+CD45RO+CD25-FoxP3-) was enriched in SLE (median: 2.17%, interquartile range: 1.66 to 7.74% of CD45+ PBMCs) versus control (1.34%, 1.06 - 1.58%; p = 0.00267). Expression of these known checkpoint inhibitors (PD1, CD152) could be important for SLE immunopathogenesis.

Secondly, the innate lymphoid cell 2 (ILC2) subset (Lin-CD7+CD25+CD127+GATA3+) was markedly depressed in SLE (0.11%, 0.1 - 0.255%) versus control (0.41%, 0.25 - 0.55%; p = 0.0293). ILC2s protect epithelial integrity; a reduction suggests impaired protective roles in SLE.

Supervised cell frequencies from bivariate analysis correlate strongly with unsupervised cell frequencies, validating these results (Pearson’s correlation coefficient r = 0.9926, p < 0.001 (CD4+CD152+PD1+CD45RO+CD25-FoxP3-); r = 0.8863, p < 0.05 (ILC2)).

Conclusion:

With a multi-parametric, unbiased approach comparing SLE subjects to a large database of age-matched healthy controls, we identified two immune subsets of potential immunopathogenic importance. With this information, the CyTOF panel can be redesigned to probe more specifically into the SLE immunome, facilitating disease-specific interrogation.

References:

[1]Tsokos,G.C. (2011). Systemic lupus erythematosus.N Engl J Med365(22), 2110-2121.

[2]Bombardier, C., Gladman, D.D., Urowitz, M.B., Caron, D., Chang, C.H. (1992). Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE.Arthritis Rheum35(6), 630-640.

Disclosure of Interests: :

None declared

THU0047 THE SYNOVIUM REWIRES AN IMMUNOLOGICAL RHEOSTAT THAT DEFINES TWO FUNCTIONALLY DISPARATE PATHOGENIC CD4+HLA-DR+ SUBSETS IN HUMAN ARTHRITIS

Background:

Despite advances in understanding how the adaptive T cell landscape is affected in human arthritis, specific T cell subset knowledge has yet to be utilised in clinical settings. We have previously discovered within active arthritic patients, a circulating pathogenic-like lymphocyte (CPLs; CD4+HLA-DR+) within the T-effector compartment, that is phenotypically similar to their synovial counterparts. CPLs are inflammatory, correlate with disease activity and overlap in synovial TCR repertoire. A similar inflammation-associated T-regulatory (iaTreg; CD4+HLA-DR+) subset, that is activated, poised to migrate to inflamed site and sharing synovial TCR overlap, suggest a common disease ontogeny that may exist between CPLs and iaTregs.

Objectives:

Here we seek to determine whether and how the synovial microenvironment plays a role in modulating these two functionally divergent (Teff/Treg compartments) yet pathogenically homologous subsets. This modulation, akin to an immunological rheostat, may be a feature of the disease process.

Methods:

We examined CD45+ immune cells from synovial and PBMCs (active JIA, inactive JIA, paediatric healthy) through mass cytometry (CyToF). CD4 T cells were sorted into CPLs, iaTregs, Teff and Treg through FACS Aria II, from active JIA PBMCs, paired JIA SFMCs and healthy paediatric PBMCs and examined through ngRNASEQ.

Results:

Mass cytometric analysis reveal a significant enrichment of synovium signatures in both circulatory CPLs and iaTregs subsets from active arthritic PBMCs, as compared with the conventional pool of Teff/Tregs. This immunological relationship between CPLs/iaTregs is reaffirmed by comparative differential gene expression (DEG) and phylogenetic tree analysis, which indicated transcriptomic convergence between circulatory pathogenic CPLs/iaTreg subsets and divergence from their respective conventional Teff/Treg pools. Circulatory CPLs/iaTregs exhibit (a) common pathway dysregulation in T cell signalling, (b) restriction in TCR oligoclonality and (c) common transcription factor drivers within the gene regulatory network, suggesting a common pathogenic mechanism acting on these two disparate compartments.

To understand how the microenvironment plays a role in modulating these two subsets, we compared the transcriptome of CPLs/iaTreg and conventional Teff/Treg subsets from (a) healthy PBMCs, (b) JIA PBMCs and (c) paired JIA SFMCs. The convergence between CPLs/iaTreg increases across the spatial/disease continuum, culminating in 7 key common dysregulated pathways within synovium CPLs/iaTregs. Importantly we detected higher clonotypic sharing of TCRs in CPLs/iaTregs across the spatial and disease continuum, suggesting a common precursor driven by antigenic selection.

Conclusion:

Our data suggest that CPLs/iaTregs are dichotomic components of a systemic immune rheostat, shape through the synovium environment, modulating autoimmunity in human arthritis. As iaTreg and CPL most likely have the capacity to morph into each other, the molecular crossroads which control this plasticity represent novel therapeutic targets.

Disclosure of Interests:

None declared

FRI0328 PROFILING OF THE IMMUNE COMPARTMENT IN THE TISSUE ENVIRONMENT OF PSORIATIC ARTHRITIS USING RNASEQ

Background:

Psoriasis is a chronic inflammatory disease of the skin with a reported prevalence of 0.09-11.4% of the population (1). 1 in 4 psoriasis patients also have psoriatic arthritis (PsA) (2), with additional joint involvement that can be associated with significant morbidity. Despite its relative commonness, the aetiology of psoriasis is not well understood, and there is no cure for this disease. Additionally, up to 30% of PsA patients with active disease are recalcitrant to treatment. Thus it remains a prerogative to understand the immune mechanisms contributing to the development of the disease in order to inform strategies for novel therapies.

Objectives:

Our aim was to identify perturbations in local tissue immune networks that could contribute to the pathology of psoriasis and psoriatic arthritis. We hypothesise that psoriasis is driven by a disrupted tissue microenvironment, which then provides cues to a susceptible peripheral immune system to drive pathology. Thus as the first part of our study, we investigated the transcriptional profiles of normal and lesional skin.

Methods:

Skin punch biopsies were obtained from both lesional and morphologically normal skin of 4 PsA patients with active disease. CD45+ cells were isolated using magnetic enrichment for RNA purification and subsequent RNAseq. Differently expressed genes (DEG) were identified and pathway analysis performed using the integrated Differential Expression and Pathway (iDEP) analysis tool. Gene set enrichment analysis was performed using GSEA.

Results:

Transcriptomic analyses of skin revealed that lesional skin, compared to non-lesional sites, was enhanced for expression of genes associated with immune processes (including genes such as such asIL17A,FCN1, andCTLA4) anti-microbial responses (such asDEF4BAandS100A8) and immune cell chemotaxis (notablyCXCL13andSELPLG), suggesting a possible inflammatory response to skin microbiota. Interestingly, lesional skin showed a deficiency in expression of genes associated with tRNA metabolic processes (includingAARS,YARS, and other aminoacyl tRNA synthetases), suggesting a possible defect in protein translation. Similarly, pathway analysis revealed an enrichment in humoral immune response pathways in PsA lesional skin, and a comparative deficiency in RNA metabolic pathways.

Conclusion:

Our transcriptional approach provides a comprehensive overview of localised immunity in psoriasis and predicts intimate interactions with the peripheral immune system. Further studies are ongoing to uncover cell types involved, as well as parallels at other disease sites (joints). These findings will facilitate the identification of novel targets for treatment of PsA.

References:

[1]World Health Organization (2016).Global report on psoriasis. [Online] (https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189_eng.pdf.psoriasis;jsessionid=54912784D28C9F36ECCD45471AC5775B?sequence=1,accessed 24 January 2020)

[2]Alinaghi F., Calov M., Kristensen L.E., Gladman D.D, Coates L.C., Julien D., Gottlieb A.B., Gisondi P., Wu J.J., Thyssen J.P., Egeberg A. (2019) Prevalence of psoriatic arthritis in patients with psoriasis: A systemic review and meta-analysis of observational and clinical studies.Journal of the American Academy of Dermatology.,80(1), 251-265.

Disclosure of Interests:

Gladys Ang: None declared, Pavanish Kumar: None declared, Dianyan Guo: None declared, Ahmad Lajam: None declared, Warren Fong Consultant of: Abbvie, Janssen, Novartis, Speakers bureau: Abbvie, Janssen, Novartis, Ying Ying Leung Speakers bureau: Novartis, Janssen, Eli Lilly, Salvatore Albani: None declared

FRI0525 INFLUENZA VACCINATION COMPLIANCE AND RESPONSE IN AUTOIMMUNE INFLAMMATORY RHEUMATIC DISEASE PATIENTS: A COHORT STUDY

Background:

Patients diagnosed with autoimmune inflammatory rheumatic diseases (AIIRD) have higher risk of developing infections due to immunological dysfunction and immunosuppressive treatments. Current guidelines recommend annual influenza vaccination to reduce infection risk in this group of patients. However, vaccination response in these patients is uncertain.

Objectives:

To study influenza vaccination compliance and response in a Danish AIIRD patient population.

Methods:

AIIRD patients on biological treatment ± synthetic disease-modifying antirheumatic drugs (sDMARDs) in our department of rheumatology and registered in the Danish Rheumatology database (DANBIO) were included in the current study. The patients were encouraged to be vaccinated against influenza in the 2018/19 winter season. Status of influenza vaccination for the period of 1.9.2018 to 31.12.2018 was reviewed in each patient using the Danish Vaccination Register (DDV) and Danish Electronic Medicine Module (FMK). Patient data were collected by review of the medical files. Serum samples from each patient were collected on two occasions: 1) from 1.6.2017 to 15.5.2018 (before vaccination) and 2) from 1.11.2018 to 1.3.2019 (after vaccination), respectively. Antibody titers against the three antigens included in the trivalent 2018/2019 seasonal influenza vaccine were measured by hemagglutination inhibition assay followed by determination of geometric mean titers (GMT).

Results:

Among a total of 226 study eligible AIIRD patients, 111 (49%) had been influenza vaccinated. In the remaining group of 115 (51%) non-vaccinated patients, 50 were randomly contacted by telephone to ensure the accuracy of DDV registration. All 50 confirmed non-vaccinated status. Median age of vaccinated group was 65 years while of non-vaccinated group was 57 years (p≤0.00001). Median GMT increased from 10 to 22 in the group of vaccinated patients versus from 6 to 10 in the group of non-vaccinated patients (p<0.0001). GMT increased ≥2-fold in 79 (71%) of 111 influenza vaccinated in comparison to 60 (52%) of 115 non-vaccinated patients (p≤0.003). Among influenza vaccinated patients, median age of responders (≥2-fold increase in GMT) was 66 years versus non-responders 63 years (p=0.3). In the influenza vaccinated group, ≥2-fold increase in GMT was seen in 51 (73%) of 70 patients receiving methotrexate compared to 28 (68%) of 41 in patients not receiving methotrexate (p=0,6).

Conclusion:

Only half of the patients were compliant to the vaccination recommendations in the 2018/2019 influenza season despite the information campaign. Response rate of influenza vaccination (≥2-fold GMT increase) was 71% in AIIRD patients receiving immunosuppressive treatments. In contrast to other studies, concurrent methotrexate treatment did not attenuate serological response of influenza vaccination. We are still exploring the causes of increased influenza antibody titers in non-vaccinated group.

References:

[1] Kapetanovic MC, Kristensen LE, Saxne T, et al. Impact of anti-rheumatic treatment on immunogenicity of pandemic H1N1 influenza vaccine in patients with arthritis. Arthritis Res Ther 2014;16:R2.

[2] Hua C, Barnetche T, Combe B, et al. Effect of methotrexate, anti-tumor necrosis factor α, and rituximab on the immune response to influenza and pneumococcal vaccines in patients with rheumatoid arthritis: a systematic review and meta-analysis. Arthritis Care Res 2014;66:1016–26.

[3] Furer V, et al. 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2020;79:39–52. doi:10.1136/annrheumdis-2019-215882

Disclosure of Interests:

None declared

Prospective validation of a machine learning algorithm to predict short-term mortality among outpatients with cancer

2009

Background: Oncologists accurately identify only 35% of patients with cancer who will die in six months. There is an urgent need for automated, accurate prognostic systems to inform treatment and advance care planning in oncology. We assessed the prospective performance of a previously described ML algorithm (Parikh et al, JAMA Netw Open, 2019) to predict short-term mortality in a cohort of general oncology outpatients. Methods: Our prospective cohort consisted of patients aged ≥18 years who had a medical or gynecologic oncology encounter between March 1 and April 30, 2019 in either a tertiary academic practice or one of twelve community practices within a large academic cancer system. We used a retrospectively validated gradient-boosting ML algorithm, based on 559 structured electronic health record (EHR) variables, to predict 180-day mortality prior to each oncology encounter. For patients with multiple encounters, we selected the last encounter to assess performance. We assessed several performance metrics, including area under the receiver operating curve (AUC), area under the precision-recall curve (AUPRC), scaled Brier score (sBrier; a measure of calibration ranging from 0 [random] to 1 [perfect]), and positive predictive value (PPV). Results: Of 25,537 unique patients, median age was 64.4 (interquartile range 53.3 – 73.0), 76.8% were White, 56.5% were treated at a community center, and 4.1% died within 180 days. The ML algorithm had an AUC of 0.89 (95% confidence interval [CI] 0.88-0.90), AUPRC 0.34, and sBrier 0.29. At a prespecified threshold of 40%, observed 180-day mortality was 44.5% (95% CI 40.7 – 48.4%) in the high-risk group vs. 3.0% (95% CI 2.8% – 3.3%) in the low-risk group. There was an 85-fold difference in mortality (13.6% vs. 0.16%) in the top vs. bottom risk quartiles. The model was well-calibrated for mortality risks ≤40% and slightly under-calibrated for mortality risks > 40%. Performance varied across cancer types in the tertiary hospital but did not vary by race or practice type (Table). Conclusions: In this prospective cohort study among outpatients with cancer, a ML prognostic algorithm based on EHR data had better discrimination and calibration that published cancer-specific models. This is one of the first ML prognostic models to be prospectively validated in oncology. [Table: see text]

Split bolus dual-energy CT urography after urine dilution: a one-stop shop for detection and characterisation of urolithiasis

AIM

To determine the diagnostic performance of split-bolus dual-energy computed tomography (CT) urography (SBDECTU) in the detection and characterisation of urolithiasis.

MATERIALS AND METHODS

This single-centre Institute Ethics Committee (IEC)-approved prospective study was conducted from April 2014 to November 2015. One hundred and thirty consenting adults with microscopic haematuria underwent dual-energy true non-enhanced CT (DETNE) of the whole abdomen followed by a SBDECTU. The SBDECTU protocol consisted of synchronous nephrogram-urogram acquisition following urine dilution by oral hydration and normal saline injection. Calculi were detected and characterised using virtual non-enhanced (VNE) images derived from SBDECT were compared with DETNE (the reference standard). The subjective image quality and radiation dose were compared.

RESULTS

Twenty-six participants had one or more calculi (total 129 calculi) detected on DETNE CT. The sensitivity and specificity of VNE on a per-patient basis were 100%. Of the 129 calculi, 118 were detected on VNE, with a sensitivity of 91.47% and an accuracy of 91.47%. Of the calculi, 83.9% (99/118) could be characterised on SBDECTU images. On VNE images, complete iodine subtraction was seen in 73.1% (19/26). By omitting DETNE CT, the mean dose-length product of 537.6±152.9 mGy and volume CT dose index of 10.9±2.9 mGy•cm² could have been saved.

CONCLUSION

SBDECTU has high diagnostic accuracy in the detection and characterisation of clinically significant urinary calculi at potentially half the radiation dose.

Depth resolved defect characterization of energetic ion irradiated ZnO by positron annihilation techniques and photoluminescence

Depth resolved positron annihilation spectroscopy (PAS) has been employed to characterize the 1.2 MeV Ar and 800 keV O ion beam induced defects in ZnO. The first extraordinary result was the observation of defects in ion beam irradiated ZnO beyond the maximum penetration depth of the respective ions. The positron annihilation results revealed the formation of vacancy clusters consisting of both V_Zn and V_O in ZnO which are saturated at a threshold radiation dose (defined as nuclear energy loss, S_n  ×  fluence). From the photoluminescence (PL) spectra it has been observed that the PL intensity at the band edge degraded with the increase of open volume defects in ZnO. The evolution of the 2.4 eV PL, which is linked with the oxygen vacancies, is more significant due to Ar irradiation than the oxygen irradiation.

AML1 protein interacts with influenza A virus neuraminidase and upregulates IFN-β response in infected mammalian cells

Neuraminidase (NA) is an integral membrane protein of influenza A virus (IAV) and primarily aids in the release of progeny virions, following the intracellular viral replication cycle. In an attempt to discover new functions of NA, we conducted a classical yeast two-hybrid screen and found acute myeloid leukaemia marker 1 (AML1) as a novel interacting partner of IAV-NA. The interaction was further validated by co-immunoprecipitation in IAV-infected cells and in an in vitro coupled transcription/translation system. Interestingly, we found an increase in the expression of AML1 upon IAV infection in a dose-dependent manner. As expected, we also observed an increase in the IFN-β levels, the first line of defence against viral infections. Subsequently, when AML1 was downregulated using siRNA, the IFN-β levels were found to be remarkably reduced. Our study also shows that AML1 is induced upon IAV infection and results in the induction of IFN-β. Thus, AML1 is proposed to be an important player in IFN induction and has a role in an antiviral response against IAV infection. SIGNIFICANCE AND IMPACT OF THE STUDY: Influenza epidemics and pandemics are constant threats to human health. Development of antiviral therapeutics has focused on important and major IAV proteins as targets. However, the rate at which this virus mutates makes the task challenging. Thus, next-generation approaches aim at host cellular proteins that aid the virus in its replication. This study reports a new host-virus interaction, of acute myeloid leukaemia marker 1 (AML1) with influenza A neuraminidase (IAV-NA). We have found that this interaction has a direct effect on the upregulation of host IFN-β response. Further studies may lead to a greater understanding of this new innate defence pathway in infected cells.

Smoking Status and Survival Among a National Cohort of Lung and Colorectal Cancer Patients

INTRODUCTION

The purpose of this study was to explore the association of smoking status and clinically relevant duration of smoking cessation with long-term survival after lung cancer (LC) or colorectal cancer (CRC) diagnosis. We compared survival of patients with LC and CRC who were never-smokers, long-term, medium-term, and short-term quitters, and current smokers around diagnosis.

METHODS

We studied 5575 patients in Cancer Care Outcomes Research and Surveillance (CanCORS), a national, prospective observational cohort study, who provided smoking status information approximately 5 months after LC or CRC diagnosis. Smoking status was categorized as: never-smoker, quit >5 years prior to diagnosis, quit between 1-5 years prior to diagnosis, quit less than 1 year before diagnosis, and current smoker. We examined the relationship between smoking status around diagnosis with mortality using Cox regression models.

RESULTS

Among participants with LC, never-smokers had lower mortality risk compared with current smokers (HR 0.71, 95% CI 0.57 to 0.89). Among participants with CRC, never-smokers had a lower mortality risk as compared to current smokers (HR 0.79, 95% CI 0.64 to 0.99).

CONCLUSIONS

Among both LC and CRC patients, current smokers at diagnosis have higher mortality than never-smokers. This effect should be further studied in the context of tumor biology. However, smoking cessation around the time of diagnosis did not affect survival in this sample.

IMPLICATIONS

The results from our analysis of patients in the CanCORS consortium, a large, geographically diverse cohort, show that both LC and CRC patients who were actively smoking at diagnosis have worse survival as compared to never-smokers. While current smoking is detrimental to survival, cessation upon diagnosis may not mitigate this risk.

Cardiac MRI for the evaluation of cardiac neoplasms

Primary cardiac neoplasms are extremely rare and are far outnumbered by metastases. These are difficult to diagnose and differentiate clinically due to lack of specific clinical manifestations. Technological advances have revolutionised cardiac imaging, with the cardiac magnetic resonance imaging (CMRI) showing promising results in the non-invasive evaluation of cardiac masses. Further, CMRI may envisage the malignant potential of a lesion based on its location, morphology, and signal characteristics, in addition to determining its impact on cardiac function. With the ever-increasing application of CMRI in the evaluation of neoplasms, comprehensive knowledge of their imaging characteristics becomes crucial.

56 Mammalian pre-implantation embryos at the single cell level: The bovine as a model for early human embryonic development

Single-cell transcriptomics and gene editing on human pre-implantation embryos have proved that mechanisms previously identified and well characterised in mouse pre-implantation development may not hold true in the human embryo. However, ethical and legal concerns limit the availability of surplus human embryos for research, resulting in the need for novel animal models. Bovine embryos share morphological and temporal resemblance with human early development; still, key molecular and cellular developmental mechanisms need to be further explored. In the present study, we performed a comparative single-cell RNA sequencing analysis across multiple pre-implantational developmental stages of invitro-derived bovine, human (Petropoulos et al. 2016 Cell 165, 1012-1026; https://doi.org/10.1016/j.cell.2016.03.023), and mouse embryos (Cheng et al. 2019 Cell Rep. 26, 2593-2607, https://doi.org/10.1016/j.celrep.2019.02.031; Posfai et al. 2017 eLife 6, e22906, https://doi.org/10.7554/eLife.22906; Chen et al. 2016 Genome Res. 26, 1342-1354). In total 497 blastomeres corresponding to embryonic days (E) E4-E8 were prepared using Smart sEqn 2, Illumina HiSEqn 2500 sequencing with 50-bp single-end reads. Embryonic stage was defined by cell numbers and morphology as multicellular stage (Mu, ~E4), morulae (M; E5), early blastocysts (EB, ~6), mid-expanded blastocysts, (MB, ~E7), and late expanded/hatched blastocysts (LB, ~E8). We found top differentially expressed genes elucidating how lineage specification and pluripotency is controlled in the early bovine embryo. Our transcriptomic data showed that the first lineage segregation in the pre-implantation bovine embryo occurs after cavitation at E6 in the early blastocyst, suggesting a similarity with the early human blastocyst. In addition, E7 showed distinctive and more mature inner cell mass (ICM) and trophectoderm (TE) profiles. Different from the mouse, where the first lineage segregation of TE-ICM is suggested to occur at the morula stage due to CDX2-OCT4 antagonism, we found that the expression of OCT4 protein cattle expanded blastocysts is not restricted to the ICM, similar to what has been reported to occur in the human embryo. Interestingly, we also found that the second lineage segregation, which segregates the epiblast from the primitive endoderm within the ICM, starts in bovine at E8 expanded hatched late blastocysts, suggesting a potential difference with humans, where TE-ICM and epiblast-primitive endoderm has previously been reported to occur almost concurrently. We are now complementing our findings with genome editing in bovine embryos by generating knockout embryos of different target genes part of an evolutionarily conserved signaling pathway to study their effects in the early pre-implantation embryo. We aim to elucidate how early lineage specification and pluripotency establishment occurs while offering theoretical support for efficient derivation and culture of bovine embryonic stem cells.

Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA

We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star-black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 10 5 , 10 6 , 10 7 Mpc 3 for binary neutron star, neutron star-black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1 - 1 + 12 ( 10 - 10 + 52 ) for binary neutron star mergers, of 0 - 0 + 19 ( 1 - 1 + 91 ) for neutron star-black hole mergers, and 17 - 11 + 22 ( 79 - 44 + 89 ) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers.

Search for Subsolar Mass Ultracompact Binaries in Advanced LIGO's Second Observing Run

We present a search for subsolar mass ultracompact objects in data obtained during Advanced LIGO's second observing run. In contrast to a previous search of Advanced LIGO data from the first observing run, this search includes the effects of component spin on the gravitational waveform. We identify no viable gravitational-wave candidates consistent with subsolar mass ultracompact binaries with at least one component between 0.2  M_{⊙}-1.0  M_{⊙}. We use the null result to constrain the binary merger rate of (0.2  M_{⊙}, 0.2  M_{⊙}) binaries to be less than 3.7×10^{5}  Gpc^{-3} yr^{-1} and the binary merger rate of (1.0  M_{⊙}, 1.0  M_{⊙}) binaries to be less than 5.2×10^{3}  Gpc^{-3} yr^{-1}. Subsolar mass ultracompact objects are not expected to form via known stellar evolution channels, though it has been suggested that primordial density fluctuations or particle dark matter with cooling mechanisms and/or nuclear interactions could form black holes with subsolar masses. Assuming a particular primordial black hole (PBH) formation model, we constrain a population of merging 0.2  M_{⊙} black holes to account for less than 16% of the dark matter density and a population of merging 1.0  M_{⊙} black holes to account for less than 2% of the dark matter density. We discuss how constraints on the merger rate and dark matter fraction may be extended to arbitrary black hole population models that predict subsolar mass binaries.

Polydopamine -aminoglycoside nanoconjugates: Synthesis, characterization, antimicrobial evaluation and cytocompatibility

Development of nanoparticle- and self-assembled nanomaterial-based therapeutics has become a rapidly growing area in the field of nanotechnology. One of the natural compounds, dopamine, presents as a neurotransmitter in the human brain serving as a messenger and deals with the behavioural responses, has provided an ideal platform through self-polymerization under aerobic conditions leading to the formation of a beneficial organic biopolymer, polydopamine (PDA). This polymer provides sufficient reactive functionalities, which can further be use to attach amine- or thiol-containing ligands to obtain conjugates. In the present study, self-polymerized polydopamine nanoparticles have been synthesized and tethered to aminoglycosides (AGs: Gentamicin, Kanamycin and Neomycin) through amino moieties to obtain PDA-AG nanoconjugates. These nanoconjugates are characterized by physicochemical techniques and evaluated for their antimicrobial potency against various bacterial strains including resistant ones. Simultaneously, cytocompatibility was also assessed for PDA-AG nanoconjugates. Of these three nanoconjugates (PDA-Gentamicin, PDA-Kanamycin and PDA-Neomycin), PDA-Kanamycin (PDA-K) nanoconjugate exhibited the highest activity against potent pathogens, least toxicity in human embryonic kidney (HEK 293) cells and intense toxic effects on human glioblastoma (U87) cells. Together, these results advocate the promising potential of these nanoconjugates to be used as potent antimicrobials in future applications.

Multichannel processing of vibrational measurements: A constrained subspace application

Monitoring mechanical systems operating in uncertain environments contaminated with both environmental disturbances and noise lead directly to low signal-to-noise-ratios, creating an extremely challenging processing problem, especially in real-time. In order to estimate the performance of a particular system from uncertain vibrational data, it is necessary to identify its unique resonant (modal) frequency signature. The monitoring of structural modes to determine the condition of a device under investigation is essential, especially if it is a critical entity of an operational system. The development of a model-based scheme capable of the on-line tracking of the inherent structural modal frequencies by applying both constrained subspace identification techniques to extract the modal frequencies and state estimation methods to track the evolution is discussed. An application of this approach to a cylindrical structural device (pipe-in-air) is analyzed based on theoretical simulations along with controlled validation experiments, including injected anomalies illustrate the approach and performance. Statistics are gathered to bound potential processors for real-time performance employing these constrained techniques.

Elastic fusion biopsy versus systematic biopsy for prostate cancer detection: Results of a multicentric study on 1,119 patients

OBJECTIVES

To assess the accuracy of targeted and systematic biopsies for the detection of prostate cancer (PCa) and clinically significant PCa (csPCa) in the everyday practice, evaluating the need for additional systematic biopsies at the time of targeted biopsy.

PATIENTS AND METHODS

From our multicentric database gathering data on 2,115 patients who underwent fusion biopsy with Koelis™ system between 2010 and 2017, we selected 1,119 patients who received targeted biopsies (a median of 3 for each target), followed by systematic sampling of the prostate (12 to 14 cores). Overall and clinically significant cancer detection rate (CDR) of Koelis™ fusion biopsies were assessed, comparing target and systematic biopsies. Secondary endpoint was the identification of predictors of PCa detection.

RESULTS

The CDR of targeted biopsies only was 48% for all cancers and 33% for csPCa. The performance of additional, systematic prostate sampling improved the CDR of 15% for all cancers and of 12% for csPCa. PCa was detected in 35%, 69%, and 92% of patients with lesions scored as PI-RADS 3, 4 and 5, respectively. Elevated PI-RADS score and positive digital rectal examination were predictors of PCa, whereas biopsy-naïve status was associated with csPCa.

CONCLUSION

In the everyday practice target biopsy with Koelis™ achieves a good CDR for all PCa and csPCa, which is significantly improved by subsequent systematic sampling of the prostate. The outstanding outcomes of fusion biopsy are confirmed also in biopsy-naïve patients. Elevated PI-RADS score and positive digital rectal examination are strongly associated with presence of PCa.

In silico design of diacylglycerol acyltransferase-1 (DGAT1) inhibitors based on SMILES descriptors using Monte-Carlo method

Diabetes, obesity and other diseases related to metabolism are worldwide health problems. These syndromes can be well treated when a particular enzyme-based therapy is developed. Diacylglycerol acyltransferase (DGAT; EC 2.3.1.20) is a microsomal enzyme which is responsible for the synthesis of triglycerides from 1,2-diacylglycerol by catalyzing the acyl-CoA-dependent acylation. The obesity and type-II diabetes can be checked by the inhibition of DGAT1 enzyme. Quantitative structure-activity relationship (QSAR) modelling is an essential technique in drug design and development. To study the aspect of DGAT1 inhibitors, Monte-Carlo method-based QSAR was developed for 197 DGAT1 inhibitors. QSAR models were derived by using the optimal descriptor based on SMILES notation. Different statistical parameters including the novel index of ideality of correlation were applied to validate the generated QSAR models. Four random splits were prepared from the data set. The statistical criteria r² = 0.8129, CCC = 0.8979 and Q² = 0.7962 of the validation set of split 1 were the best; therefore, the developed QSAR model of split 1 was decided to be the leading model. The molecular fragments, which were promoter of endpoint increase or decrease were also determined. Thirteen new DGAT1 inhibitors were designed from the lead compound DGAT011.

Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.

Tests of General Relativity with GW170817

The recent discovery by Advanced LIGO and Advanced Virgo of a gravitational wave signal from a binary neutron star inspiral has enabled tests of general relativity (GR) with this new type of source. This source, for the first time, permits tests of strong-field dynamics of compact binaries in the presence of matter. In this Letter, we place constraints on the dipole radiation and possible deviations from GR in the post-Newtonian coefficients that govern the inspiral regime. Bounds on modified dispersion of gravitational waves are obtained; in combination with information from the observed electromagnetic counterpart we can also constrain effects due to large extra dimensions. Finally, the polarization content of the gravitational wave signal is studied. The results of all tests performed here show good agreement with GR.

Effect of patient education on palliative care knowledge and acceptability of outpatient palliative care service among gynecologic oncology patients

11583

Background: This was a randomized control trial to estimate the effect of an interventional video on improving palliative care knowledge and acceptability of outpatient services in gynecologic oncology patients. Methods: Women receiving active treatment for gynecologic malignancy (persistent or progressive disease despite primary treatment) were recruited at an academic tertiary care center from 2/2018 to 1/2019 and randomized to: palliative care educational video or non-directive cancer center informational video (control). The primary outcome was desire for referral to palliative care. Function and knowledge were assessed using the Functional Assessment of Cancer Therapy (FACT-G) and the Palliative Care Knowledge Scales. Data analyses were performed using t-tests, Wilcoxon rank sum or Fisher’s exact tests with significance level of α=0.05. Results: 111 women were enrolled. Demographic characteristics were equally distributed between groups (mean age 63.4 vs 65.4 years; 78% vs 82% Caucasian, 58% vs 68% stage III, 71% vs 64% ovarian cancer, 65% vs 72% platinum-sensitive). There was no statistical difference in knowledge scores or in desire for referral to palliative care (29% vs 27%; p=0.79). Secondary analysis showed a statistically significant increase in utilization of palliative care services compared to historic institutional data (8.8% to 29.7%; p=<0.001). Further, those that desired referral had significantly worse FACT-G scores at time of referral choice (table). Conclusions: Use of a palliative care educational video did not increase knowledge or acceptability of palliative care services within this RCT. However, the rate of patients seeking palliative care referral tripled compared to historic rates. Further studies should investigate whether discussion regarding palliative care services alone may increase desire for referral, and if use of Fact-G scores may identify patients in greatest need of services. [Table: see text]

Numerical solution of generalized DPL model using wavelet method during thermal therapy applications

In this paper, generalized dual-phase-lag (DPL) model has been studied for the numerical analysis of spatial variation of temperature within living biological tissues during thermal therapy applications. A new hybrid numerical scheme based on finite difference scheme and Chebyshev wavelet Galerkin method are used to solve the generalized DPL model with constant heat flux boundary condition. Multi-resolution and multi-scale computational property of Chebyshev wavelet in the present case localizes small scale variations of solution and fast switching of functional bases. Our study demonstrates that due to presence of coupling factor (convection–perfusion), generalized DPL model predicts lower temperature than classical DPL and Pennes model at the tumor position. Higher values of phase lag times results in lower temperature at the tumor position. But, in case of variation of phase lag time due to temperature gradient, the nature of temperature profile also depends on the spatial coordinate. The effect of the blood temperature, porosity and interfacial convective heat transfer on temperature distribution has been investigated. It is found that larger values of porosity and interfacial convective heat transfer results in lower temperature at the tumor position. Also, both porosity and interfacial convective heat transfer are pronounced more at higher values. The whole analysis is presented in dimensionless form.

Changes in middle ear transmission characteristics secondary to altered bone remodelling

Alteration in the process of bone remodelling results in conditions like osteopenia and osteoporosis in which the bones become susceptible to fracture. The functioning of middle ear bones in such individuals were assessed in this study and it was found that the middle ear bones are equally susceptible to micro-fractures and can cause reduction in the transmission of sound energy.

INTRODUCTION

Alteration in the process of bone remodelling or increase in the number of osteoclasts cells as it occurs in osteoporosis and osteopenia are likely to affect the middle ear bones in the same way it affects the skeletal bones. Whether these micro-structural changes occurring at the level of the middle ear secondary to altered bone remodelling cause any significant impairment in its functioning is not explored. Thus, the present study aimed at assessing the different aspects of middle ear functioning in individuals with reduced BMD.

METHODS

The study included 25 normal, 39 osteopenic and 40 osteoporotic participants. The participants underwent pure-tone audiometry, otoscopic examination, conventional immittance evaluation using a 226 Hz probe tone, multi-component and multi-frequency tympanometry and acoustic reflex threshold testing. None of the participants had any current or previous history of middle ear effusion.

RESULTS

A significantly higher proportion of participants in the clinical group had hearing loss compared to the normal group. The clinical group participants also had reduced middle ear resonance frequency, elevated static compliance values and elevated or absent acoustic reflexes compared to the normal participants. There was no difference among the three groups for the proportion of participants having conductive hearing loss.

CONCLUSIONS

There is a detrimental impact of reduction in bone mineral density on middle ear transmission characteristics which may go unnoticed initially. Treatment of osteoporosis may potentially mitigate hearing loss from middle ear fractures due to reduced bone mineral density. Absence of significant air-bone gap with the presence of reduced middle ear resonance frequency may be early signs of reduced BMD.

Development of prediction model for fructose- 1,6- bisphosphatase inhibitors using the Monte Carlo method

Fructose-1,6-bisphosphatase (FBPase) is an enzyme important for regulation of gluconeogenesis, which is a major process in the liver responsible for glucose production. Inhibition of FBPase enzyme causing blockage of the gluconeogenesis process represents a newer scheme in the progress of anti-diabetic drugs. The current research describes the development of hybrid optimal descriptors-based quantitative structure-activity relationship (QSAR) models intended for a set of 62 FBPase inhibitors with the Monte Carlo method. The molecular structures were expressed by the simplified molecular input line entry system (SMILES) notation. Three splits were prepared by random division of the molecules into training set, calibration set and validation set. Statistical parameters obtained from QSAR modelling were good for various designed splits. The best QSAR model showed the following parameters: the values of r² for calibration set and validation set of the best model were 0.6837 and 0.8623 and of Q² were 0.6114 and 0.8036, respectively. Based on the results obtained for correlation weights, different structural attributes were described as promoter of the endpoint. Further, these structural attributes were used in designing of new FBPase inhibitors and a molecular docking study was completed for the determination of interactions of the designed molecules with the enzyme.

Hypothesis: Can drug-loaded platelets be used as delivery vehicles for blood-brain barrier penetration?

Neurovascular conditions are disorders associated with the blood vessels of the brain that are extremely difficult to treat successfully due to the selectivity and fastidious nature of the blood- brain barrier. Consequently, the efficacy of the pharmacological treatments for these conditions are greatly reduced thereby resulting in large amounts of neurovascular-related morbidity and mortality. Platelets are an important component of blood that actively respond to neurovascular distress in the body. Recent research has proven the effectiveness of platelets as drug delivery vehicles, during circumstances where the body naturally elicits a platelet response. This hypothesis highlights the theoretical use of platelets as drug delivery vehicles, able to penetrate the blood-brain barrier, for the treatment of two neurovascular conditions; glioblastoma multiforme and ischemic stroke. The success of the hypothesised system may lead to the development of a novel and extremely necessary delivery mechanism.

Constraining the p-Mode-g-Mode Tidal Instability with GW170817

We analyze the impact of a proposed tidal instability coupling p modes and g modes within neutron stars on GW170817. This nonresonant instability transfers energy from the orbit of the binary to internal modes of the stars, accelerating the gravitational-wave driven inspiral. We model the impact of this instability on the phasing of the gravitational wave signal using three parameters per star: an overall amplitude, a saturation frequency, and a spectral index. Incorporating these additional parameters, we compute the Bayes factor (lnB_{!pg}^{pg}) comparing our p-g model to a standard one. We find that the observed signal is consistent with waveform models that neglect p-g effects, with lnB_{!pg}^{pg}=0.03_{-0.58}^{+0.70} (maximum a posteriori and 90% credible region). By injecting simulated signals that do not include p-g effects and recovering them with the p-g model, we show that there is a ≃50% probability of obtaining similar lnB_{!pg}^{pg} even when p-g effects are absent. We find that the p-g amplitude for 1.4  M_{⊙} neutron stars is constrained to less than a few tenths of the theoretical maximum, with maxima a posteriori near one-tenth this maximum and p-g saturation frequency ∼70  Hz. This suggests that there are less than a few hundred excited modes, assuming they all saturate by wave breaking. For comparison, theoretical upper bounds suggest ≲10^{3} modes saturate by wave breaking. Thus, the measured constraints only rule out extreme values of the p-g parameters. They also imply that the instability dissipates ≲10^{51}  erg over the entire inspiral, i.e., less than a few percent of the energy radiated as gravitational waves.

Anthropometric measures as biomarkers of neurodevelopmental outcomes of newborns with moderate to severe hypoxic ischemic encephalopathy

BACKGROUND

Perinatal asphyxia is a prominent cause of neonatal mortality in the developing world. Growth in head circumference is associated with improved neurodevelopment. Previous studies found a positive correlation between additional dietary supplementation and growth in head circumference among newborns with perinatal brain injury. This study aims to evaluate the association between anthropometric parameters and developmental outcomes in newborns with hypoxic ischemic encephalopathy (HIE).

METHODS

Newborns at ≥36 weeks gestation with moderate to severe HIE were included in the study and growth parameters were monitored. Newborns with life-threatening anomalies were excluded. None of the study participants received therapeutic hypothermia (TH). Developmental Assessment Scale for Indian Infants (DASII) was used to evaluate neurodevelopmental outcomes at 1 year of age.

RESULTS

Of 76 study participants, 46 were followed for 12 months, 28 died, and 2 were lost to follow-up. HIE stage III, Apgar score <5 at 5 minutes of age, pH ≤ 7.1 on first blood gas and base deficit > - 16 was associated with death or disability at 1 year of age. All anthropometric parameters were significantly lower in presence of death or disability. pH ≤ 7.1 at birth (odds ratio: 11.835, 95% CI 2.273-61.629, p = 0.003) and weight gain at one year (odds ratio 1.001, 95% CI 1.000-1.002, p = 0.03) were significantly associated with death and disability.

CONCLUSION

pH > 7.1 at birth, and weight gain were associated with better neurodevelopmental outcomes at 1 year of age. Thus, in addition to TH, nutritional interventions may potentially improve outcomes among newborns with HIE.

Racial Differences in Smoking-related Disease Risk Perceptions Among Adults Completing Lung Cancer Screening: Follow-up Results from the ACRIN/NLST Ancillary Study

Previous work suggests that, compared to white adults, black adults have lower perceived risk for smoking-related diseases (SRDs), which may influence cessation behavior and health outcomes; however, racial differences in SRD risk perceptions among high-risk patients (i.e., a group that exhibits elevated risk for SRDs) following lung screening remain unknown. This paper thus examined differences in risk perceptions for lung cancer and other SRDs among black and white National Lung Screening Trial (NLST) participants. We administered a 10-item measure of perceived lifetime risk of lung cancer and other SRD (Smoking Risk Perceptions Scale; SRPS) to NLST participants at 1 year following lung screening to (1) establish the internal consistency of the SRPS for both black and white participants, (2) compare smoking-related disease risk perceptions between black and white participants, and (3) identify predictors of risk perceptions for black and white participants using multivariable linear regression models. We determined the SRPS items loaded onto two factors (personal and comparative risks; Cronbach's alpha = 0.93 and 0.95 for 1743 white and 194 black participants, respectively), thus demonstrating high internal consistency for both black and white adults. Compared to white participants, black adults demonstrated lower SRD risk perceptions (SRPS range = 10-50, mean difference = 2.55, SE = 0.50, p < 0.001), even after adjusting for smoking status and sociodemographics. Younger age, female gender, higher education, white race, and current smoking status were independently associated with high risk perceptions. Sociodemographic factors associated with lower risk perceptions resemble factors related to continued smoking. Findings suggest current and former black smokers are at risk of having lower risk perceptions for lung cancer and SRDs than white adults following lung cancer screening; these differences may explain observed racial differences in cessation outcomes. Although similar factors influence black and white adults' beliefs, risk perceptions may differentially impact smoking behavior among these groups. Behavior change models that guide tobacco treatment approaches, particularly for high-risk black smokers, should consider the influence of cultural factors on risk perceptions and cessation efforts.

Design and development of novel focal adhesion kinase (FAK) inhibitors using Monte Carlo method with index of ideality of correlation to validate QSAR

Quantitative structure-activity relationship (QSAR) modelling of 55 focal adhesion kinase (FAK) (EC 2.7.10.2) inhibitors of triazinic nature was performed using the Monte Carlo method. The QSAR models were designed by CORAL software, and optimal descriptors were calculated with the simplified molecular input line entry system (SMILES). Four splits were made from the triazinic derivative data by random division into training, invisible training, calibration and validation sets. The QSAR results from these four random splits were robust, very simple, predictive and reliable. The best statistical parameters of the validation set (r² = 0.8398 and Q² = 0.7722) for the QSAR equation for split 3 with IIC = 0.9127 were obtained. The predictive potential of QSAR models of FAK inhibitors was explored by applying the index of ideality of correlation (IIC), which is a new criterion for the prediction of the potential for quantitative structure-property activity relationships (QSPRs/QSARs). The present method follows OECD principles.

Complexation of U(VI) with Cucurbit[5]uril: Thermodynamic and Structural investigation in aqueous medium

The assessment of cucurbituril (CBn) for selective removal of actinides from nuclear waste streams requires comprehensive understanding of binding parameters and coordination of these complexes. The present work is the first experimental report on complexation of actinide ion with Cucurbit[5]uril (CB5) in solution. The thermodynamic parameters (ΔG, ΔH and ΔS) for complexation of CB5 with U(VI) in formic acid water medium were determined using microcalorimetry and UV-Vis spectroscopy. The enthalpy and entropy of complexation revealed the partial binding of U(VI) to CB5 portal. The partial binding was confirmed by spectroscopic techniques viz. extended X absorption fine structure spectroscopy (EXAFS), ¹H and ¹³C NMR. The EXAFS χ(r) versus r spectra for U-CB5 complex has been fitted from 1.4 to 3.5 Å with two oxygen shells and a carbon shell. The presence of three carbon atom in secondary shell shows the involvement of only three carbonyl oxygens directly bonding to U(VI) which is in contrast to that calculated from gas phase DFT calculation of unhydrated system. The combined effect of hydration and formic acid encapsulation led to the enhanced stability of partially bound U(VI) to CB5. In the present work the binding of formic acid has also been studied by fluorescence spectroscopy. ESI-MS data shows the unusual stabilization of U(VI) by CB5 in gas phase.

Effect of Tris-egg Yolk, Soya Milk, and Liposome-based Extenders on Sahiwal (Bos indicus) Sperm Quality during Pre- and Post-Cryopreservation Stages

BACKGROUND

Even though there are plenty of semen cryopreservation extenders available, their adoption is limited. Although normal tris-based egg yolk (EYC) extender is widely used, it leads to compromised post-thaw sperm quality.

OBJECTIVE

To find a standard semen extender, six different semen extenders were validated.

METHODS

In a split study, six aliquots of zebu cattle fresh semen ejaculate were cryopreserved in extenders containing egg yolk obtained from hen which was reared either in 1) normal, 2) omega-3 enriched, and 3) herbal enriched diet supplementation, and egg yolk free extenders such as 4) soya lecithin, 5) Bioxcell and 6) Optixcell.

RESULT

Significantly poor sperm quality and kinematics were observed in extender containing herbal egg yolk. However, omega-3 enriched egg yolk extender was on par with EYC. Among all extenders, soya lecithin and bioxcell have shown better sperm quality. Sperm motility was significantly higher in semen extended in liposome-based extender Optixcell.

CONCULSION

Optixcell can be considered as a standard extender for cattle semen cryopreservation to maintain adequate sperm quality required for artificial insemination.