Theoretical Framework and Guidelines for the Cyclic Voltammetry of Closed Bipolar Cells

Closed bipolar cells (cBPCs) can offer valuable platforms for the development of electrochemical sensors. On the other hand, such systems are more intricate to model and interpret than conventional systems with a single polarizable interface, with the applied potential "splitting" into two polarized interfaces where two coupled charge transfers take place concomitantly. As a result, the voltammetry of cBPCs shows peculiarities that can be misleading if analyzed under the framework of classic electrochemical cells. In this work, rigorous mathematical solutions are deduced for the cyclic voltammetry (CV) of cBPCs, including the current-potential response, the interfacial potentials, and the interfacial redox concentrations. With such theoretical tools, a comprehensive view of the behavior of cBPCs can be gained, and adequate diagnosis criteria are established on the basis of the shape, magnitude, and position of the CV signal as a function of the scan rate and of the experimental conditions in the anodic and cathodic compartments.

Transmission ratio distortion detection by neutral genetic markers in the Pura Raza Española horse breed

Transmission Ratio Distortion (TRD) is a genetic phenomenon widely demonstrated in several livestock species, but barely in equine species. The TRD occurs when certain genotypes are over- or under-represented in the offspring of a particular mating and can be caused by a variety of factors during gamete formation or during embryonic development. For this study, 126 394 trios consisting of a stallion, mare, and offspring were genotyped using a panel of 17 neutral microsatellite markers recommended by the International Society for Animal Genetics for paternity tests and individual identification. The number of alleles available for each marker ranges from 13 to 18, been 268 the total number of alleles investigated. The TRDscan v.2.0 software was used with the biallelic procedure to identify regions with distorted segregation ratios. After completing the analysis, a total of 12 alleles (out of 11 microsatellites) were identified with decisive evidence for genotypic TRD; 3 and 9 with additive and heterosis patterns, respectively. In addition, 19 alleles (out of 10 microsatellites) were identified displaying allelic TRD. Among them, 14 and 5 were parent-unspecific and stallion-mare-specific TRD. Out of the TRD regions, 24 genes were identified and annotated, predominantly associated with cholesterol metabolism and homeostasis. These genes are often linked to non-specific symptoms like impaired fertility, stunted growth, and compromised overall health. The results suggest a significant impact on the inheritance of certain genetic traits in horses. Further analysis and validation are needed to better understand the TRD impact before the potential implementation in the horse breeding programme strategies.

Randomized Trial of Five or Two MRI-guided Adaptive Radiotherapy Treatments for Prostate Cancer (FORT)

PURPOSE/OBJECTIVE(S)

The objective of this randomized clinical trial is to demonstrate that 2 treatments of real-time MRI-guided radiotherapy (RT) does not significantly increase patient-reported GI and GU symptoms compared to 5 treatments of RT 2 years after treatment completion (24 months).

MATERIALS/METHODS

Key Eligibility Criteria: Inclusion Criteria 1. Men aged > 18 with histologically confirmed low or intermediate risk prostate cancer per NCCN guidelines. 2. ECOG 0 - 1 3. IPSS < 18 4. Ability to receive MRI-guided radiotherapy. 5. Ability to complete the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Exclusion Criteria 1. Prior history of receiving pelvic RT. 2. Patient with history of IBD. 3. Hip replacements. 4. History of bladder neck or urethral stricture. 5. TURP < 8 weeks prior to RT 6. Metastatic (pelvic nodal or distant) disease on CT, Bone, and/or PSMA PET scan. Study Design/Endpoints: This is a randomized phase II non-inferiority trial comparing 2 fractions of ultrahypofractionated RT (25 Gy total with optional PSMA/MRI boost to 28 Gy) versus 5 fractions of ultra-hypofractionated RT (37.5 Gy total with optional PSMA/MRI boost to 45 Gy) in the definitive setting for prostate cancer. Subjects will be stratified based on pre-specified stratification factors and randomized 1:1 to receive 2 or 5 fractions using permuted block randomization. The primary endpoint is the change in patient-reported GI and GU symptoms as measured by EPIC at 2 years from end of treatment. Secondary endpoints will include both the safety endpoints including change in GI and GU symptoms at 3, 6, 12 and 60 months from end of treatment, and multiple efficacy endpoints including time to progression, prostate cancer specific survival and overall survival.

SAMPLE SIZE

The sample size is calculated based on a non-inferiority design. The non-inferiority margins are set to be a change score of 6 points for the GI symptoms and 5 points for the GU symptoms. The standard deviations of the change scores are assumed to be 13.2 for the GI symptoms and 10.5 for the GU symptoms based on estimates generated in RTOG 0415 trial. This level of change in scores are deemed as clinically meaningful. For example, 6 points of change score for GI symptoms corresponds to two symptoms worsening by 1 level (i.e., loose stools and frequency of bowel movements change from "no problem" to "very small problem") or one of the symptoms worsening by 2 levels (i.e., loose stool change from "no problem" to "small problem"). A sample size of 122 with 61 in each arm will ensure 80% power for GI endpoint and 83% power for GU endpoint to detect non-inferiority using a one-sided two-sample t-test at the significance level of 0.05. Adjusting for a projected 10% EPIC/non-compliance rate, 136 patients (68 per arm) will be randomized. Stratification Factors: Patients will be stratified according to baseline EPIC bowel and urinary domain scores and country of treatment. Enrollment: Twenty patients.

RESULTS

To be determined.

CONCLUSION

To be determined.

Survival analysis of productive life in Florida dairy goats using a Cox proportional hazards model

Longevity is an economically important trait, since extending the functional life of a doe would allow us to keep the most productive females in the herd as long as possible, and this could result in the increased profitability of dairy farms. Thus, the objectives of this study were to determine the most important factors that influence the length of productive life (LPL) of female Florida goats and to estimate its genetic additive variance using a Cox proportional hazards model. The data consisted of 70,695 productive life records from 25,722 Florida females kidding between 2006 and 2020. A total of 19,495 does had completed their productive life while 6227 (24.2%) does had censored information. The pedigree contained information on 56,901 animals. The average censoring age and average failure age after first kidding for LPL were 36 and 47 months respectively. The model included, as time-independent effects, the age at first kidding and the interaction between herd, year and season of birth of the doe, and as time-dependent effects, the age at kidding, the interaction between herd, year and season of kidding, the within-herd class of milk production deviation, and the interaction between the lactation number and the stage of lactation. All fixed effects had a significant effect on LPL (p < 0.05). Does with older ages at the first kidding and an earlier age at kidding were at higher risk of being culled. A large difference among herds was observed in terms of culling risk, which highlighted the importance of adequate management practices. Also, high-producing does were less likely to be culled. The estimate of the additive genetic variance was 1.844 (in genetic standard deviation), with a heritability estimate of 0.58 ± 0.012. The results of this study are expected to contribute to the development of a genetic model for genetic evaluation of the length of the productive life of Spanish dairy goat breeds.

OP0213-HPR RECOMMENDATIONS FOR NURSES IN THE MANAGEMENT OF RA PATIENTS ON TREATMENT WITH JAKINIBS

Background

The number of new treatments available in rheumatology continues to increase. Kinase inhibitors, or jakinibs, pose an added challenge due to their variety and because they are oral. The most important role of the rheumatology nurse is patient education, especially on how to take the medication. The better the nurse understands the drugs, the better their practical recommendations and decisions will be and the better they will be able to respond to the patient. Guidelines or recommendations for inflammatory diseases do not usually include key practical details for nurses. It is our understanding that these points that will subsequently determine adherence and safety should be specially addressed in a specific document for nurses.

Objectives

To establish practical, evidence-based nursing recommendations for the management of people with RA undergoing treatment with jakinibs.

Methods

To reach an evidence-based consensus we used systematic review and Delphi survey. A multidisciplinary panel of experts was formed with 6 rheumatology nurses, 2 rheumatologists, 1 psychologist, 1 dietician-nutritionist and 1 patient on treatment with jakinibs. This panel met on 2 occasions and was kept informed at all times of the progress of the project through the Miro platform. At the preparatory meeting the scope and users, structure and PICOt questions were established (these included efficacy and adverse effects, infections, cardiovascular risk, surgery, vaccination, pregnancy and breastfeeding, interactions and switches between jakinibs).

The steering group made recommendations based on the issues raised at the first meeting. Only those that achieved 65% in favour were included as items in a Delphi survey. The Delphi survey was sent to all members of the society nurses and rheumatologists (n=60). Voting ranged from 0 to 10 (strongly disagree to strongly agree). Items with more than 75% agreement in the first round did not proceed to a second round.

Results

The Table 1 shows the recommendations with their level of evidence and level of agreement after the Delphi (n=40; 67%). One item with only 50% agreement was rejected and did not proceed to a second round.

Table 1.RecommendationLevel of evidenceDegree of agreementBefore starting treatment with a jakinib, it should be confirmed that the patient has no contraindications.5100%The patient’s efficacy and outcome expectations for the drug should be explored and those that need to be adjusted.585%It should be indicated that a double dose should not be taken if one is missed.4100%As with other DMARDs, the patient should be instructed that close management will follow.599%The use of contraception and discontinuation of the drug is recommended in case of gestational desire or unplanned pregnancy.396%It is recommended to explain the warning signs of infection: fever, blisters, burning pain in the ribs, itching when urinating, productive cough, diarrhoea, pus-filled wounds, phlegmon.1a100%It is recommended to instruct the patient on preventive measures for infectious diseases (dental and hand hygiene, HPV, social distance, etc.).1a89%Vaccination against common germs in immunocompromised persons and shingles with the current vaccine is recommended.1a93%CV risk factors should be monitored, and the patient trained for signs of thrombosis, HF or ischaemic heart disease.1a89%Close monitoring of elderly patients (CV risk, infections) is recommended.2100%Emphasis on adherence is recommended for jakinibs to be effective.3100%Before surgery, discontinuation of jakinib should be scheduled depending on the type of surgery and comorbidities.389%

Conclusion

These recommendations will allow a practical approach to the management of jakinibs by nurses and enjoy an adequate consensus among potential users.

Disclosure of Interests

José Maria Martín Martín Speakers bureau: Lilly, Consultant of: Lilly, Grant/research support from: Galapagos, Silvia García-Díaz Grant/research support from: Galapagos, Amparo Molina Grant/research support from: Galapagos, Carmen Dominguez Grant/research support from: Galapagos, Loreto Carmona: None declared, Laura Cano Garcia Grant/research support from: Galapagos

A genome-wide association study of mare fertility in the Pura Raza Español horse

Despite the economic importance of fertility for the horse industry, few efforts have been made to achieve a better understanding of the genetic mechanisms underlying its control. This is probably due to the difficulty of obtaining reliable phenotypes and the complexity of modelling the environmental and management factors. This work is novel in that we propose to use reproductive efficiency (RE) as an indicator of mare fertility. To achieve this, we performed a genome-wide association study in the Pura Raza Español horse aimed at identifying genomic variants, regions, and candidate genes associated with fertility in mares. The dataset included 819 animals genotyped with the Affymetrix Axiom™ Equine 670 K single-nucleotide polymorphisms (SNPs) Genotyping Array and the deregressed breeding values for RE trait, obtained using a ssBLUP model, employed as pseudo-phenotypic data. Our results showed 28 SNPs potentially associated with RE, which explained 87.19% of the genetic variance and 6.61% of the phenotypic variance. Those results were further validated in BayesB, showing a correlation between observed and predicted RE of 0.57. In addition, 15 candidate genes (HTRA3, SPIRE1, APOE, ERCC1, FOXA3, NECTIN-2, KLC3, RSPH6A, PDPK1, MEIOB, PAQR4, NM3, PKD1, PRSS21, IFT140) previously related to fertility in mammals were associated with the markers and genomic regions significantly associated with RE. To our knowledge, this is the first genome-wide association study performed on mare fertility.

The effect of the Robertsonian translocation 1/29 on the fertility of beef cattle reared under extensive conditions: a 30 years retrospective study

The Robertsonian translocation 1/29 (rob(1;29)) is the most worldwide widespread chromosomal abnormality in domestic animals. Previous studies have demonstrated its negative effect on fertility in dairy herds, but not in beef cattle extensively bred. In this study, we analyzed the effect of rob(1;29) in a Retinta cattle breed dataset gathered during the last 30 years. The data presented herein includes rob(1;29) analysis of 11,505 cows from 251 herds, pedigree information of 24,790 animals, and 67,457 calving records. Fertility was evaluated using estimated breeding values for the reproductive efficiency (Re), calculated as the percentage ratio between the number of calvings of an individual with the number expected in an optimal situation. Our results showed that cows carrying the heterozygote genotype showed a significant decrease in their Re (-5.10%, p<0.001). No decrease was detected in free rob(1;29) animals and homozygous carriers. In addition, the incidence of rob(1;29) in the breed fertility was decreased to very low values after 30 years of avoiding selection bulls carrier as stallions. The effect of rob(1;29) in cattle fertility is only significant when the prevalence of carrier individuals is high. Selecting against the disease only by the paternal side reduced the incidence to negligible values.

Screening and detection of chromosomal copy number alterations in the domestic horse using SNP-array genotyping data

Chromosomal abnormalities are a common cause of infertility in horses. However, they are difficult to detect using automated methods. Here, we propose a simple methodology based on single nucleotide polymorphism (SNP)-array data that allows us to detect the main chromosomal abnormalities in horses in a single procedure. As proof of concept, we were able to detect chromosomal abnormalities in 33 out of 268 individuals, including monosomies, chimerisms, and male and female sex-reversions, by analyzing the raw signal intensity produced by an SNP array-based genotyping platform. We also demonstrated that the procedure is not affected by the SNP density of the array employed or by the inbreeding level of the individuals. Finally, the methodology proposed in this study could be performed in an open bioinformatic environment, thus permitting its integration as a flexible screening tool in diagnostic laboratories and genomic breeding programs.

[Vocal cord dysfunction in athletes: Interest of rehabilitation to effort]

INTRODUCTION

Vocal Cord Dysfunction (VCD) is a syndrome characterized by paradoxical adduction of the vocal folds during breathing. Its non-specific clinical manifestations frequently lead to misdiagnosis and delay in its treatment. The treatment of VCD is not pharmacological but rehabilitative and remains poorly appreciated.

OBSERVATION

In this clinical case we describe a 16-year-old female judoka who presented with effort intolerance associated with occasional dyspnea, which had suddenly worsened over the preceding few months so that in now produced sudden respiratory difficulty, mainly during intense and sudden efforts. After a period where her symptoms were confused with asthma, she was diagnosed with exercise-induced VCD. Her treatment was aimed to: (a) rehabilitate respiratory mechanics in order to eliminate abdominal-thoracic asynchrony, (b) rehabilitate naso-nasal breathing, (c) train her to control abdominal-diaphragmatic breathing at rest and then during effort, (d) train her to use ventilatory control as soon as prodromal symptoms appear in order to prevent the development of stridor or complete closure of the vocal folds (at rest and then progressively during exercise).

CONCLUSION

Following the implementation of these rehabilitation strategies to correct her ventilatory and dyskinetic issues, the patient no longer develops respiratory discomfort during exercise, including during judo competitions.

100 The evolution and premature hyperactivation of kinetic sperm subpopulations are affected by inbreeding level in Retinta cattle

Computer-assisted sperm analysis (CASA) has become a powerful tool to study sperm heterogeneity because it allows to cluster individual sperm in subpopulations (Sp) according to their kinetic parameters, which are associated with fertility and sperm quality. In cattle, inbreeding (mating between close relatives) affects sperm quality. Inbreeding estimation has become more accurate with the increasing availability of genomic methodologies, such as the detection of runs of homozygosity (ROH). Additionally, genomic inbreeding values (FROH) allow us to determine which metabolic pathways are differentially affected by this genetic trait. The aim of this study was to assess the effect of inbreeding on evolution of sperm Sp over time in cattle. Sperm samples (n=100) from 50 Retinta bulls (two replicates) were analysed in a sperm longevity experiment at time 0 (T0, after thawing), 1 (T1) and 2 (T2) h. At each time point, eight parameters were measured using a CASA system (Sperm Class Analyzer 5.4), including curvilinear velocity (VCL, μm/s), straight-line velocity (VSL, μm/s); average path velocity (VAP, μm/s), percentage of linearity (LIN,%: VSL/VCL), percentage of straightness (STR,%: VSL/VAP), wobble coefficient (WOB,%: VAP/VCL), mean amplitude of lateral head displacement (ALH, μm) and beat-cross frequency (BCF, Hz). The presence of Sp was determined by a two-step multivariate analysis including non-hierarchical followed by hierarchical analysis in 80,154 motile sperm. Four sperm Sp were identified: Sp1 (rapid and highly progressive sperm); Sp2 (progressive sperm with intermediate speed); Sp3 (slow and non-progressive sperm); and Sp4 (fastest, hyperactive-like, non-progressive sperm). To determine the effect of inbreeding, individuals were clustered into lowly (FROH &lt; 0.125, n=27) and highly (FROH &gt; 0.125, n=23) inbred individuals. After thawing (T0), the percentage of sperm Sp4 was higher and showed premature hyperactivation in highly inbred animals, which was previously associated with reduced fertility (Table 1). However, highly inbred individuals showed an increased percentage of rapid (Sp1) and intermediate (Sp2) progressive sperm after T1 and T2 incubation, respectively, compared with lowly inbred bulls (P&lt;0.001). These results suggest that sperm velocity and progression persist for longer in highly inbred bulls, at least after a short incubation. In conclusion, our results demonstrate that inbreeding affects sperm motility pattern and premature hyperactivation in cattle. Table 1. Percentage of subpopulations (Sp) by inbreeding group and time Time Sp1 Sp2 Sp3 Sp4 Highly inbred Lowly inbred Highly inbred Lowly inbred Highly inbred Lowly inbred Highly inbred Lowly inbred 0 33.17a 34a 32.39a 32.56a 28.07a 27.93a 6.37b 5.51a 1 31.73b 26.13a 36.75a 41.65b 23.80a 24.37a 7.72a 7.85a 2 11.73b 7.67a 53.75b 48.78a 29.68a 39.27b 4.83a 4.28a a,bDifferent superscripts by subpopulation in the same row denote significant difference (P&lt;0.05).

17 Increased inbreeding levels negatively affect sperm kinetics and motility in Purebred Spanish horses

Reproductive performance is one of the key factors in livestock production. It is well known that reproductive traits are influenced by several genetic factors, such as the increase of individual inbreeding levels, which are associated with changes in sperm motility and shape in several species. In horses, the increase in inbreeding is a common problem because of the reduction in effective population size and the increase in selection intensity observed in several breeds. However, studies assessing the effect of high levels of inbreeding on the sperm quality of stallions are scarce. In the present study, we aimed to determine the effect of increased inbreeding levels and age on the sperm motility patterns of Purebred Spanish horses (PRE). We performed kinetic characterisation of 557 sperm samples of 82 PRE stallions aged between 3 and16 years, using computer-assisted sperm analysis (Androvision™, Minitube). We evaluated 5 parameters in 6 different fields per sample: curved line velocity (VCL, µm/s), velocity average path (VAP, µm/s), velocity straight line (VSL, µm/s), amplitude of lateral head displacement (ALH, µm), and beat-cross frequency (BCF, Hz). We determined the pedigree-based inbreeding coefficient (Fped) based on ∼300,000 PRE pedigree records to evaluate the inbreeding effect. Individuals were separated into 2 groups: highly inbred (n=339) and lowly inbred (n=218) according to an F value of 12.5%. Differences between groups were analysed using a generalized linear model. The analysis did not show significant differences (P&gt;0.05) in the variables analysed with respect to the age of stallions. However, VAP, VCL, and AHL were lower in highly inbred than in lowly inbred animals (P&lt;0.05), suggesting less velocity and amplitude of head displacement. In the case of BCF, no significant differences (P&gt;0.05) were observed between the two study groups. In conclusion, age did not affect sperm quality parameters in the age group of stallions analysed. In addition, we demonstrated that high inbreeding coefficient reduced the mean velocity and trajectory pattern of spermatozoa in PRE.

The Mars Environmental Dynamics Analyzer, MEDA. A Suite of Environmental Sensors for the Mars 2020 Mission

NASA's Mars 2020 (M2020) rover mission includes a suite of sensors to monitor current environmental conditions near the surface of Mars and to constrain bulk aerosol properties from changes in atmospheric radiation at the surface. The Mars Environmental Dynamics Analyzer (MEDA) consists of a set of meteorological sensors including wind sensor, a barometer, a relative humidity sensor, a set of 5 thermocouples to measure atmospheric temperature at ∼1.5 m and ∼0.5 m above the surface, a set of thermopiles to characterize the thermal IR brightness temperatures of the surface and the lower atmosphere. MEDA adds a radiation and dust sensor to monitor the optical atmospheric properties that can be used to infer bulk aerosol physical properties such as particle size distribution, non-sphericity, and concentration. The MEDA package and its scientific purpose are described in this document as well as how it responded to the calibration tests and how it helps prepare for the human exploration of Mars. A comparison is also presented to previous environmental monitoring payloads landed on Mars on the Viking, Pathfinder, Phoenix, MSL, and InSight spacecraft.

Meteorological Predictions for Mars 2020 Perseverance Rover Landing Site at Jezero Crater

The Mars Regional Atmospheric Modeling System (MRAMS) and a nested simulation of the Mars Weather Research and Forecasting model (MarsWRF) are used to predict the local meteorological conditions at the Mars 2020 Perseverance rover landing site inside Jezero crater (Mars). These predictions are complemented with the COmplutense and MIchigan MArs Radiative Transfer model (COMIMART) and with the local Single Column Model (SCM) to further refine predictions of radiative forcing and the water cycle respectively. The primary objective is to facilitate interpretation of the meteorological measurements to be obtained by the Mars Environmental Dynamics Analyzer (MEDA) aboard the rover, but also to provide predictions of the meteorological phenomena and seasonal changes that might impact operations, from both a risk perspective and from the perspective of being better prepared to make certain measurements. A full diurnal cycle at four different seasons (L_s 0°, 90°, 180°, and 270°) is investigated. Air and ground temperatures, pressure, wind speed and direction, surface radiative fluxes and moisture data are modeled. The good agreement between observations and modeling in prior works [Pla-Garcia et al. in Icarus 280:103-113, 2016; Newman et al. in Icarus 291:203-231, 2017; Vicente-Retortillo et al. in Sci. Rep. 8(1):1-8, 2018; Savijarvi et al. in Icarus, 2020] provides confidence in utilizing these models results to predict the meteorological environment at Mars 2020 Perseverance rover landing site inside Jezero crater. The data returned by MEDA will determine the extent to which this confidence was justified.

FRI0528 INDICATORS OF EFFECTIVENESS AFTER 6 YEARS OF FOLLOW-UP OF PATIENTS IN THE FLS DR. NEGRIN

Background:

Data on the effectiveness of FLS in the medium and long term in Spain are needed

Objectives:

To analyze the indicators of long-term persistence to treatment, refracture and mortality in our Fracture Liaison Service (FLS)

Methods:

Throughout 2019, the medical records of patients with an indication of treatment to prevent new fractures whose baseline visit took place between 2012 and 2014 were reviewed. The data included those of the baseline visit (age, sex, type of index fracture, FRAX scale and DXA results) and for the follow-up (death and date, refracture including revision of spine x-rays - it was considered only the first refracture and, in the case of several fractures the most serious was chosen-, prescribed treatment, persistence of treatment trough electronic prescription on the date of review or death, and MPR or proportion of days covered by treatment).

Results:

399 patients were included, 335 of them women (84%), mean age 73.8 years (range 51-93) and average follow-up of 6 years (range 5.5-7 years).

Baseline visit.- The average FRAX was 15 and 7 for major fracture and femoral fracture respectively. DXA was normal in 22 patients (5.5%), osteopenia in 143 (35.8%) and osteoporosis in 234 (58.6%). 78 patients (19.5%) had a previous fragility fracture.

Type of fracture index: femur 126 (31.5%), forearm 119 (29.8%), humerus 76 (19%), vertebra 24 (6%), others 54 (13.5%). 80 patients (20%) had received prior treatment for osteoporosis.

Follow-up.- The persistence of treatment was assessed in 394 patients; 245 patients (62%) were prescribed a treatment on the most recent date, 200 (51%) with MPR≥80%. When analyzing patients with prescribed treatment, in 176 cases (72%) it was a bisphosphonate in a sustained manner, in 23 cases (9%) a bisphosphonate was prescribed and subsequently changed to denosumab, while in 45 cases (18%) it was initiated and maintained denosumab.

71 of 397 patients presented a new fracture (17.8%). The type of incident fracture was as follows: femur in 24 patients (34%), vertebra in 20 patients (28%), forearm in 9 patients (12%) and other fractures in 18 patients (25%). Refracture occurred in 9 patients in the first year, 16 in 2nd, 12 in the 3rd, 9 in 4th, 14 in 5th, 6 in 6th and 3 in 7th year. The persistence of treatment with MPR≥80% was similar in patients with and without refracture (52 vs 51%). The average baseline age and FRAX for major fracture in the fractured and non-fractured were 75 vs. 73 years (p = 0.10) and 17 vs. 14 respectively (p <0.01).

92 patients (23%) died, 25% of them in the two years that followed the baseline visit and 61% in the following 4 years. The persistence of treatment was 37% in those who died and 69% in those who remained alive (p <0.01).

Conclusion:

After an average of 6 years after the assessment in an FLS, the persistence of treatment was 62% (MPR≥80% in 51%), the mortality was 23% and the percentage of refractured patients was 17%.

Disclosure of Interests:

Antonio Naranjo Grant/research support from: amgen, Consultant of: UCB, Speakers bureau: AMGEN, Amparo Molina Speakers bureau: AMGEN, STADA, Cristina Sepúlveda: None declared, Francisco Rubiño: None declared, Soledad Ojeda Speakers bureau: AMGEN, LILLY, GEBRO

AB1180 THE EVOLUTION OF AN FLS IN SEARCH OF EXCELLENCE: THE EXPERIENCE OF GRAN CANARIA

Background:

The implementation of an FLS in the Spanish public health system is not an easy task since there are no official plans for the incorporation of personnel dedicated to the unit

Objectives:

To expose the consolidation and improvement of an FLS after its implementation as well as the problems that have arisen over time.

Methods:

The health program for secondary fracture prevention was implemented in 2012. Initially worked with the same staff assigned to the Rheumatology service, since 2016 we have a part-time support nurse. Patients are identified from the emergency registry and, more recently, from patients admitted for hip fracture and treated in a monographic osteoporosis clinic. The baseline visit consists of consultation with the nurse, DXA and bone metabolism analytics. Falling patients are referred to a fall prevention school. Most patients are referred to their primary care physician to start a treatment.

Results:

Of the 2,416 patients attended the baseline visit, 30% were forearm fractures, 27% hip, 20% humerus, 10% spine and 11% other fractures. In comparison to 2012, in 2019 the monthly average of patients has doubled, increased the number of hip and spine fractures, and increased the percentage of captured patients (Table). In spite of consolidating the unit, getting a support nurse for the admitted patients and establishing a solid alliance with primary care, it is pending the involvement of Primary Care Nurses and start first prescription at the hospital.

Table.

Comparison of the first year with the last year of implementation of our FLS.

20122019Mean monthly number of fractures, N2242Type of fracture: forearm/hip/spine, %37/20/628/40/11Captured patients of elegible, %5777Delay in weeks until first visit to FLS, median1412Patient origin: emergency list/inpatient/outpatient, %100/0/059/31/9DXA performed, %10061Referral to fall prevention school, %026Criteria to start a treatment, %6790*Referral to the osteoporosis clinic, %377

*We apply the 2019 recommendations of the Spanish Society of Rheumatology

Conclusion:

We present the achievements made by our FLS along 8 years and the difficulties within the Spanish public health system.

Disclosure of Interests:

Antonio Naranjo Grant/research support from: amgen, Consultant of: UCB, Speakers bureau: AMGEN, Amparo Molina Speakers bureau: AMGEN, STADA, Cristina Sepúlveda: None declared, Candelaria Torres: None declared, Fabiola Santana: None declared, Francisco Rubiño: None declared, Rubén López: None declared, Soledad Ojeda Speakers bureau: AMGEN, LILLY, GEBRO

Short communication: Red deer (Cervus elaphus) colostrum during its transition to milk

We studied changes in chemical composition, somatic cell count, and immunoglobulin G (IgG) and M (IgM) content in red deer (Cervus elaphus) colostrum during the transition to milk at different times after parturition (<5 h, 24 h, 48 h, 2 wk, and 4 wk). The production level was higher at 2 and 4 wk of lactation than during the first day after parturition, with intermediate values at 48 h postpartum. Fat content did not vary during the study period. However, total protein and casein contents were particularly high in the initial 5 h after parturition, decreasing to approximately 50% after 24 h postpartum. Conversely, lactose concentration was low in the beginning (<5 h), increasing gradually throughout the study. Similarly, dry matter dropped during the first 24 h and then remained constant throughout the study. Urea content decreased during the study, showing a slight recovery at 4 wk. Somatic cell count was higher during the first hours after parturition and gradually decreased throughout the study period. The IgG content was higher before 5 h postpartum than at 24 h postpartum. After 5 h, the level of IgG decreased progressively until it reached 0.18 mg/mL at 4 wk of lactation. We observed a similar pattern for IgM content, but it decreased more quickly than IgG and was not detected after 2 wk. In the case of deer, milk should be considered transitional from 24 to 48 h after parturition, and samples collected after 2 wk can be considered mature milk.

General Explicit Mathematical Solution for the Voltammetry of Nonunity Stoichiometry Electrode Reactions: Diagnosis Criteria in Cyclic Voltammetry

Electrochemical reactions can effectively follow nonunity stoichiometries as can be found in the electrochemistry of halides, hydrogen, and metal complexes. The voltammetric response of these systems shows peculiar deviations with respect to the well-described features of the 1:1 stoichiometry. With the aim of specifying such differences, a rigorous and manageable analytical theory is deduced for the complete characterization of reversible electrode processes with complex stoichiometry in cyclic voltammetry (CV) at macroelectrodes. Particularly, the main features of the CV of 2:1, 1:2, 3:1, and 1:3 processes (that is, the peak currents and potentials and the influence of the scan rate and of the species concentration and diffusion coefficients) are given and compared with the 1:1 case in order to propose unambiguous diagnostic criteria of the stoichiometry of the electrode reaction. Also, expressions for the concentration profiles and surface concentrations of the redox species are given.

23 Sperm quality of Pure Spanish stallions is affected by inbreeding coefficient and age

Inbreeding depression, a genetic condition produced by the mating of close-related individuals, has been associated with a reduction of fertility in several species. However, a loss in sperm quality was also associated with age. In horses, the few existing reports have described a tendency of both parameters to produce a negative effect on sperm quality. However, those reports were performed using a subjective evaluation of sperm motility. In the present study, a total of 692 ejaculates from 86 Pure Spanish stallions (PRE), aged between 3 and 22 years, were evaluated using a computer-assisted methodology to determine the effect of inbreeding in four semen parameters: free-gel volume (V), sperm concentration (C, by haemocytometer), and total (TM) and progressive (PM) sperm motility (by Spermvision sperm class analyser; Minitube). The inbreeding coefficient (F) was estimated using 300 000 PRE pedigree records approximately (minimum pedigree depth, eight equivalent complete generations; range, between 1 and 30.1%). Stallion, age, ejaculate, and season of semen collection were the variables included in the statistical model (general linear model), with ejaculate and season being the variables with a major effect (by variance components analysis). Our results showed that sperm concentration (r=−0.18; P&lt;0.0001) and volume (to a lesser extent) were reduced with advancing age, both showing a major decline after 15 years of age. To the contrary, sperm motility was not affected by age of the stallion. We also found a negative correlation between the inbreeding coefficient and ejaculate volume (r=−0.14; P&lt;0.001), with a marked decrease seen when F was between 7 and 20%. Also, a negative correlation was observed in PM (r=−0.08; P&lt;0.05), although to a lower extent. Conversely, C and TM were not affected by inbreeding depression (P&gt;0.05). In conclusion, our results demonstrated that high levels of inbreeding can compromise severely the sperm quality of the PRE stallion, which, subsequently, may have a negative influence on fertility. Ongoing studies using genomic data will help to detect genetic variants associated with stallion semen quality and how it is influenced by inbreeding in specific genomic regions.

Guidelines for the Voltammetric Study of Electrode Reactions with Coupled Chemical Kinetics at an Arbitrary Electrode Geometry

A powerful, unified, and simplifying mathematical approach for the theoretical treatment of first-order chemical kinetics coupled to interfacial charge transfers at electrodes of arbitrary geometry and size, both uniformly accessible and nonuniformly accessible to the electroactive species, is presented. The general CEC mechanism at spherical and disc electrodes is considered to test the validity and benefits of such an approach, based on the application of the so-called kinetic steady state, that enables the reduction of the multivariable problem of kinetic-diffusive differential equations to a single variable problem of a diffusion-only differential equation. This is solved both analytically and numerically, showing how this approach leads to general, simple, and efficient solutions for the study of the influence of coupled chemical kinetics on the voltammetric response. The voltammetry of the CEC mechanism is analyzed as a function of the kinetics and thermodynamics of the preceding and subsequent chemical reactions and of the electrode size (from macroelectrodes to ultramicroelectrodes) and shape (spherical and disc). Comparison with the responses of the CE, EC, and E mechanisms is included, proposing diagnosis criteria and procedures for quantitative analysis of experimental data.

Quantitative Analysis of Cyclic Voltammetry of Redox Monolayers Adsorbed on Semiconductors: Isolating Electrode Kinetics, Lateral Interactions, and Diode Currents

The design of devices whose functions span from sensing their environments to converting light into electricity or guiding chemical reactivity at surfaces often hinges around a correct and complete understanding of the factors at play when charges are transferred across an electrified solid-liquid interface. For semiconductor electrodes in particular, published values for charge-transfer kinetic constants are scattered. Furthermore, received wisdom suggests slower charge-transfer kinetics for semiconductors than for metal electrodes. We have used cyclic voltammetry of ferrocene-modified silicon photoanodes and photocathodes as the experimental model system and described a systematic analysis to separate charge-transfer kinetics from diode effects and interactions between adsorbed species. Our results suggest that literature values of charge-transfer kinetic constants at semiconductor electrodes are likely to be underestimates of their actual values. This is revealed by experiments and analytical models showing that the description of the potential distribution across the semiconductor-monolayer-electrolyte interface has been largely oversimplified.

Relationship between patient-reported outcomes and clinical outcomes in metastatic castration-resistant prostate cancer: post hoc analysis of COU-AA-301 and COU-AA-302

Background

Patient-reported outcomes (PROs) are used to assess benefit-risk in drug development. The relationship between PROs and clinical outcomes is not well understood. We aim to elucidate the relationships between changes in PRO measures and clinical outcomes in metastatic castration-resistant prostate cancer (mCRPC).

Patients and methods

We investigated relationships between changes in self-reported fatigue, pain, functional well-being (FWB), physical well-being (PWB) and prostate cancer-specific symptoms with overall survival (OS) and radiographic progression-free survival (rPFS) after 6 and 12 months of treatment in COU-AA-301 (N = 1195) or COU-AA-302 (N = 1088). Eligible COU-AA-301 patients had progressed after docetaxel and had Eastern Cooperative Oncology Group performance status (ECOG PS) ≤ 2. Eligible COU-AA-302 patients had no prior chemotherapy and ECOG PS 0 or 1. Patients were treated with abiraterone acetate (1000 mg/day) plus prednisone (10 mg/day) or prednisone alone daily. Association between self-reported fatigue, pain and functional status, and OS and/or rPFS, using pooled data regardless of treatment, was assessed. Cox proportional hazard regression modeled time to death or radiographic progression.

Results

In COU-AA-301 patients, PRO improvements were associated with longer OS and longer time to radiographic progression versus worsening or stable PROs (P < 0.0001). In multivariate models, all except pain intensity remained associated with OS. Pain intensity, PWB and FWB improvements remained associated with rPFS. In COU-AA-302 patients, worsening PROs were associated with higher likelihood of radiographic progression (P ≤ 0.025) compared with improved or stable PROs. In multivariate models, worsening PWB remained associated with worse rPFS. The 12-month analysis confirmed the 6-month results.

Conclusions

PROs are significantly associated with clinically relevant time-to-event efficacy outcomes in clinical trials and may complement and help predict traditional clinical practice methods for monitoring patients for disease progression.

[Assessment of muscular toxicity due to chemotherapy by cardio-pulmonary exercise testing]

INTRODUCTION

Cardio-pulmonary exercise testing (CPET) is frequently used to assess aerobic capacity, to evaluate respiratory tolerance and to provide prognostic information. Therefore, CPET is often incorporated in the preoperative assessment of cancer patients. This clinical case report presents the preoperative assessment of a patient before thoracic surgery, in whom an important decrease of aerobic capacity was noted, possibly because of muscular toxicity linked to chemotherapy.

CASE REPORT

This clinical case concerns a fit, 66-year-old man with a large cell carcinoma of the bronchus. He had received 2 cycles of adjuvant chemotherapy. Subsequently, a left pneumonectomy had been proposed and preoperative assessment performed. CPET showed no further increase in oxygen uptake after the first ventilatory threshold, in spite of increases in carbon dioxide output, minute ventilation and heart rate. Moreover, maximal oxygen uptake was low and there was a decrease of oxygen pulse at maximal effort.

CONCLUSION

We suggest that the limitation of effort was due to a limitation of muscular oxygen extraction, which could be explained by possible muscular toxicity due to chemotherapy.

Characteristics of ripened Tronchón cheese from raw goat milk containing legally admissible amounts of antibiotics

The aim of this study was to evaluate the transfer of the most widely used antibiotics in dairy goats from milk to cheese as well as their effect on the cheese-making process and cheese characteristics during ripening. Antibiotic-free milk was spiked individually with 7 veterinary drugs (amoxicillin, benzylpenicillin, cloxacillin, erythromycin, ciprofloxacin, enrofloxacin, and oxytetracycline) at an equivalent concentration of the European Union maximum residue limit. Spiked goat milk was used to make mature Tronchón cheeses, which were analyzed at 0, 30, and 60 d of maturation to determine pH, chemical composition, proteolytic and lipolytic activities, and color and textural properties. A sensory evaluation of 60-d ripened cheeses was carried out. Cheeses from raw antibiotic-free goat milk were made simultaneously to be used as reference. The cheese-making process was unaffected by the presence of most antibiotics evaluated. Only erythromycin and oxytetracycline significantly increased the time required for cheese production (122 ± 29 and 108 ± 25 min, respectively). However, variable amounts of antibiotics, ranging from 7.4 to 68%, were transferred from milk to cheese, with oxytetracycline and quinolones showing the highest retention rates. In general, antibiotic residues present in the cheeses at the beginning of maturation decrease significantly along time. Thus, β-lactams and erythromycin residues were not detectable after 30 d of ripening. However, relatively high concentrations of enrofloxacin (148 ± 12 µg/kg) and ciprofloxacin (253 ± 24 µg/kg) residues were found in the cheeses after 60 d of maturation. The quality characteristics of the Tronchón cheeses were only slightly affected by such substances, with few significant differences in the free fatty acid concentration and color and textural properties of the cheeses. Results herein indicate that the use of goat milk containing antibiotics, such as quinolones, at the European Union maximum residue limit for cheese production could adversely affect the safety of the final products because relatively high concentrations of these substances could be retained in soft and semi-mature cheeses, making it necessary to assess the risk for consumer health. Studies on the partition of the antibiotic substances during cheese-making, using specific technologies, would be convenient to guarantee the safety of cheese and related products.