Genomic analyses elucidate S-locus evolution in response to intra-specific losses of distyly in Primula vulgaris

Distyly, a floral dimorphism that promotes outcrossing, is controlled by a hemizygous genomic region known as the S-locus. Disruptions of genes within the S-locus are responsible for the loss of distyly and the emergence of homostyly, a floral monomorphism that favors selfing. Using whole-genome resequencing data of distylous and homostylous individuals from populations of Primula vulgaris and leveraging high-quality reference genomes of Primula we tested, for the first time, predictions about the evolutionary consequences of transitions to selfing on S-genes. Our results reveal a previously undetected structural rearrangement in CYPᵀ associated with the shift to homostyly and confirm previously reported, homostyle-specific, loss-of-function mutations in the exons of the S-gene CYPᵀ. We also discovered that the promoter and intronic regions of CYPᵀ in distylous and homostylous individuals are conserved, suggesting that down-regulation of CYPᵀ via mutations in its promoter and intronic regions is not a cause of the shift to homostyly. Furthermore, we found that hemizygosity is associated with reduced genetic diversity in S-genes compared with their paralogs outside the S-locus. Additionally, the shift to homostyly lowers genetic diversity in both the S-genes and their paralogs, as expected in primarily selfing plants. Finally, we tested, for the first time, long-standing theoretical models of changes in S-locus genotypes during early stages of the transition to homostyly, supporting the assumption that two copies of the S-locus might reduce homostyle fitness.

Skewed morph ratios lead to lower genetic diversity of the heterostylous Primula veris in fragmented grasslands

Populations of heterostylous plant species are ideally composed of equal frequencies of two (distylous) or three (tristylous) morphologically different floral morphs. Intra-morph incompatibility helps to avoid inbreeding and to maintain genetic diversity, supporting plant fitness and long-term viability. Habitat fragmentation can lead to skewed morph ratios and thereby reduce the abundance of compatible mates. This, in turn, can result in a loss of genetic diversity. We tested whether the genetic diversity of heterostylous plants is affected by morph ratio bias using populations of the distylous grassland plant Primula veris in recently fragmented grasslands. We recorded morph frequencies and population sizes in 30 study populations of P. veris on two Estonian islands characterised by different degrees of habitat fragmentation. Examining variation of thousands of single nucleotide polymorphisms (SNPs) and heterostyly-specific genetic markers, we quantified overall and morph-specific genetic diversity and differentiation in these populations. Morph frequencies deviated more in smaller populations. Skewed morph ratios had a negative effect on the genetic diversity of P. veris in more fragmented grasslands. In the populations of better-connected grassland system, genetic differentiation among S-morphs was higher than among L-morphs. Our study shows that deviations from morph balance are stronger in small populations and have a negative impact on the genetic diversity of the distylous plant P. veris. Together with the direct negative effects of habitat loss and decreased population size on the genetic diversity of plants, morph ratio bias may intensify the process of genetic erosion, thus exacerbating the local extinction of heterostylous species.

The potential for aflatoxin predictive risk modelling in sub-Saharan Africa: a review

This review presents the current state of aflatoxin risk prediction models and their potential for value actors throughout the food chain in sub-Saharan Africa, with a specific focus on improving smallholder farmer management practices. Several empirical and mechanistic models have been developed either in academic research or by private sector aggregators and processors in high-income countries including Australia, the USA, and Southern Europe, but these models have been only minimally applied in sub-Saharan Africa, where there is significant potential and increasing need due to climate variability. Predictions can be made based on historic occurrence data using either a mechanistic microbiological framework for aflatoxin accumulation or an empirical model based on statistical correlations with climate conditions and local agronomic factors. Model results can then be distributed to smallholders through private, public, or mobile extension services, used by policymakers for strategy or policy, or utilised by private sector institutions for management decisions. Specific agricultural advice can be given during the three most critical points in the phenological cycle: preseason insight including sowing timing and crop varieties, preharvest advice about management and harvest timing, and postharvest optimal practices including storage, drying, and market information. Model development for sub-Saharan Africa is limited by a dearth of georeferenced aflatoxin occurrence data and real-time high resolution climate data; the wide diversity of farm typologies each with significant information and technology gaps; a prevalence of informal market structures and lack of economic incentives systems; and general lack of awareness around aflatoxins and best management practices to mitigate risk. Given advancements towards solving these challenges, predictive aflatoxin models can be integrated into decision support platforms to focus on optimisation of value for smallholders by minimising yield and nutritional losses, which can propagate value throughout the production and postharvest phases.

From laboratory to the field: biological control of Fusarium graminearum on infected maize crop residues

Aim

To evaluate biological control agents (BCAs) against Fusarium graminearum on infected maize stalks as a means to reduce Fusarium head blight (FHB) in subsequently grown wheat.

Methods and Results

In the laboratory, BCAs were applied against F. graminearum on maize stalk pieces. Clonostachys rosea inhibited the perithecia development and ascospore discharge when applied before, simultaneously with and after the pathogen. In the field, we simulated a system with high disease pressure, that is, a maize‐wheat rotation under no‐tillage, by preparing maize stalks inoculated with F. graminearum. The infected stalks were treated with formulations of C. rosea selected in vitro or the commercial BCA strain Trichoderma atrobrunneum ITEM908 and exposed to field conditions over winter and spring between winter wheat rows. Monitoring with spore traps and of FHB symptoms, as well as quantification of F. graminearum incidence and DNA in harvested grain revealed significant reductions by C. rosea by up to 85, 91, 69 and 95% compared with an inoculated but untreated positive control, respectively. Deoxynivalenol (DON) and zearalenone (ZEN) contents were reduced by up to 93 and 98%, respectively. Treatments with T. atrobrunneum were inconsistent, with significant reductions of DON and ZEN under warm and wet climatic conditions only.

Conclusions

The findings support the application of C. rosea against F. graminearum on residues of maize to suppress the primary inoculum of FHB.

Significance and Impact of the Study

As sustainable agriculture requires solutions to control FHB, hence, the application of C. rosea during the mulching of maize crop residues should be evaluated in on‐farm experiments.

Changes in Pulmonary Function in Patients With Advanced Heart Failure Listed for Heart Transplantation

BACKGROUND

Pulmonary function tests (PFTs) are often impaired in patients with advanced heart failure. There is limited data about their impact on survival after heart transplantation (HT). We sought to assess the prevalence and type of PFT abnormalities in patients on HT waiting list and their impact on outcomes.

METHODS

We performed a retrospective analysis of a prospective registry of consecutive patients undergoing HT between 2012 and 2018. Patients were classified into 4 groups according to pre-HT PFT results: 1. normal pattern: forced vital capacity (FVC) ≥ 80% and forced expiratory volume in 1 second (FEV₁) to FVC ratio (FEV₁/FVC) ≥ 0.7; 2. obstructive: FEV₁/FVC < 0.7; 3. nonobstructive: FEV₁/FVC ≥ 0.7 and FVC < 80% when total lung capacity value was not available; and 4. restrictive: FEV₁/FVC ≥ 0.7 and total lung capacity < 80%. The prevalence of impaired carbon monoxide diffusing capacity corrected for hemoglobin < 80% and FEV₁ < 70% was also analyzed. High-urgency HT patients and those referred from other centers without quantitative pulmonary evaluation were excluded.

RESULTS

Among 123 patients who underwent HT, 83 patients with complete PFT were included. Median follow-up was 2.7 ± 1.9 years. Of these, 29 (34.9%) had an obstructive pattern, 20 (24.1%) a nonobstructive, 18 (21.7%) a restrictive, and 16 (19.3%) a normal pattern. Fifty-one (61.4%) patients had FEV₁ < 70% and 58 (69.9%) a carbon monoxide diffusing capacity corrected for hemoglobin < 80%. There was a tendency to lower survival in all altered PFT groups compared with normal (P = .054) but not within the other groups. Patients with an impaired FEV₁ had significantly higher mortality than patients with normal values (P = .008). Area under receiver operating characteristic curve for FEV₁ was 0.73 (95% confidence interval [0.60-0.86]). A cutoff value of FEV₁ (60.5) predicts mortality with 66% sensitivity and 64% specificity.

CONCLUSIONS

PFT alterations have a very high prevalence on HT waiting list patients. Patients with impaired FEV₁ had worse outcomes after heart transplantation.

P5407Body-composition analysis of patients with acute heart failure - preliminary results from the SCALE HF trial

Background

Guidance for intensified diuretic therapy in acute heart failure (AHF) is mainly based on body weight measurement, frequently leading to a short episode of dehydration with kidney failure after recompensation. In addition, patients often present immobilized due to severe health issues making weight measurement stressful.

Purpose

Bioelectrical impedance analysis (BIA) may be a more direct approach to guide intensified diuretic therapy analysing patient's body composition. We hypothesized that patient's weight loss during therapy correlates with loss of body water measured by BIA. Therefore, we tested if this method could be an alternative to daily weight measurement.

Methods

We conducted an observational, single-centre study to evaluate and monitor body composition of patients hospitalised with AHF, adjudicated according to current ESC/HFA guidelines by a cardiologist. We used an eight-electrode, segmental, multi-frequency body composition analyser, previously validated against air displacement plethysmography, whole body MRI, deuterium and sodium bromide dilution. We investigated patients until hospital discharge or latest one day after ending intensified diuretic therapy. Disease specific properties, BIA and weight measurement were assessed daily. Furthermore, we investigated BIA raw data.

Results

390 BIA were applied on 76 patients (47 men; 29 women; mean age 76±11 years; mean weight 75.6±15.7 kg). 34 patients presented with global, 27 with left-heart, 8 with right-heart and 7 with not specified AHF. 44 patients presented with pleural effusion. Pearson correlations showed that total body water (r=0.737, p≤0.001) and extracellular water (r=0.69, p≤0.001) correlated each with total body weight. Changes in total body water accurately (within a range of ± 1kg) reflected changes in total body weight in 40.28% of the patients and changes in extracellular water showed a similarly accurate reflection of total body weight change in 68.06% of the patients. BIA raw-data analysis showed significant changes using Wilcoxon test between measurements at the beginning of intensified diuretic therapy and at its end. We found a significant increase of resistance (mean from 334.6±67.5 to 362.8±69.5 Ohm/m; p=0.021) and reactance (mean from 21.3±7.1 to 24.1±6.2 Ohm/m; p=0.009) standardized to patients height and a non-significant increase of phase angle (mean from 3.6±0.9 to 3.8±0.8 °; p=0.149) during hospitalisation.

Conclusion

BIA is able to estimate changes in total body weight by analysing changes in extracellular body water in patients under intensified diuretic therapy and raw data analysis seems even more accurate and promising. This data derive from a heterogeneous AHF patient group, needing further investigation. Once validated, wearable BIA connected to an automated device monitoring system would enable an easy to use diuretic therapy monitoring for impaired patients or outpatients and could help reducing care efforts.

Convergent evolution of a metabolic switch between aphid and caterpillar resistance in cereals

Tailoring defense responses to different attackers is important for plant performance. Plants can use secondary metabolites with dual functions in resistance and defense signaling to mount herbivore-specific responses. To date, the specificity and evolution of this mechanism are unclear. Here, we studied the functional architecture, specificity, and genetic basis of defense regulation by benzoxazinoids in cereals. We document that DIMBOA-Glc induces callose as an aphid resistance factor in wheat. O-methylation of DIMBOA-Glc to HDMBOA-Glc increases plant resistance to caterpillars but reduces callose inducibility and resistance to aphids. DIMBOA-Glc induces callose in wheat and maize, but not in Arabidopsis, while the glucosinolate 4MO-I3M does the opposite. We identify a wheat O-methyltransferase (TaBX10) that is induced by caterpillar feeding and converts DIMBOA-Glc to HDMBOA-Glc in vitro. While the core pathway of benzoxazinoid biosynthesis is conserved between wheat and maize, the wheat genome does not contain close homologs of the maize DIMBOA-Glc O-methyltransferase genes, and TaBx10 is only distantly related. Thus, the functional architecture of herbivore-specific defense regulation is similar in maize and wheat, but the regulating biosynthetic genes likely evolved separately. This study shows how two different cereal species independently achieved herbivore-specific defense activation by regulating secondary metabolite production.

THUR 174 The magnify-ms study: mavenclad® tablets in active rms

Authors Disclaimer: http://medpub-poster.merckgroup.com/ABN2018DISC_MAGNIFY.pdf

Background

Cladribine tablets (CT) improve clinical and MRI outcomes in patients with active RMS, with significant differences versus placebo after 24 weeks.

Objective

Describe the design of a study to assess the onset of CT’s clinical and MRI effects in patients with active RMS.

Methods

MAGNIFY-MS is a 2 year prospective Phase IV trial (including approximately 100 centres in Europe). Eligible patients will receive two years treatment with CT 3.5 mg/kg cumulative dose. Frequent MRI assessments (including lesion count, lesion volume, brain volume and MTR) will be performed at screening, baseline and 1, 2, 3, 6, 12, 15, 18 and 24 months. Various T- and B-cell subtype counts and functional profiling (eg cytokine production) will be assessed. Clinical outcomes will include changes in cognition (SDMT), disability (EDSS/KFS, 9HPT, T25FW), relapses, NEDA, NEDAP and safety at timepoints up to 24 months.

Results

Aim recruit 300 patients. Primary endpoint: change in the count of combined unique active lesions at end of 6 months versus baseline. Final outcomes expected in 2021.

Conclusions

MAGNIFY-MS will provide important information on the effects of CT, including early MRI changes, insights into effects on a range of disability and cognition markers, and detailed characterization of immune cell reconstitution.

Disclosure statement

This study was sponsored by EMD Serono, Inc., a business of Merck KGaA, Darmstadt, Germany (in the USA), and Merck Serono SA – Geneva, an affiliate of Merck KGaA Darmstadt, Germany (ROW).

THUR 172 Phase iv study of cladribine tablets and quality of life: clarify-ms

Authors Disclaimer: http://medpub-poster.merckgroup.com/ABN2018DISC_CLARIFY.pdf

Background

Relapsing multiple sclerosis (RMS) negatively affects health-related quality of life (HRQoL).

Objective

An open-label, single-arm, exploratory Phase IV study in centres in Europe and Australia will assess HRQoL in RMS patients receiving CT 3.5 mg/kg (CT3.5).

Methods

Eligible patients will receive CT 3.5 (cumulative) over 2 years. HRQoL (Multiple Sclerosis Quality of Life-54 [MSQoL-54]) and other patient-reported outcomes (Fatigue Severity Scale; Hospital Anxiety and Depression Scale; Treatment Satisfaction Questionnaire for Medication v1.4) will be assessed at baseline, and at 6, 12, 24 months.

Other outcomes include AEs, MRI measures (T1 Gd+ lesions, T2 lesions, brain atrophy), number of relapses, and disability/functioning measures (EDSS; 9-Hole Peg Test; Timed 25-Foot Walk and Brief International Cognitive Assessment for Multiple Sclerosis). The sample size estimation is based on the power to detect a mean difference of 5 points in MSQoL-54 composite score at 24 months vs baseline.

Results

The study aims to recruit 356 adults with RMS by 2019. Final data are anticipated in 2022.

Conclusions

This study will explore the effects of CT on HRQoL outcomes, and describe the effects of CT on treatment satisfaction and disability/functioning.

Disclosure statement

The trial is sponsored by Merck KGaA, Darmstadt, Germany.

„Mein Haus, mein Auto, mein Boot“. Zufriedenheit mit dem Lebensstandard als geschlechtsspezifischer Mortalitätsprädiktor

Hintergrund: Männer haben ein höheres Mortalitätsrisiko als Frauen und reagieren wesentlich sensibler auf statusbezogene Stressbelastungen. Mögliche Erklärungen für die stärker ausgeprägte männliche Empfindlichkeit liefert der über die HPA-Achse vermittelte Zusammenhang zwischen hierarchischem Rang und Gesundheit. Viel Aufmerksamkeit hat in diesem Zusammenhang das Konstrukt des Statusunbehagens erfahren, wonach soziale Vergleichsprozesse das generelle Wohlbefinden senken und als wesentliche Risikofaktoren für verschiedene Erkrankungen angesehen werden.

Methodik: Mittels Sekundärdatenanalyse des sozio-ökonomischen Panels (SOEP) soll analysiert werden, inwiefern die subjektive Unzufriedenheit mit dem eigenen Lebensstandard mit einem erhöhten geschlechtsabhängigen Mortalitätsrisiko assoziiert werden kann. Zur statistischen Modellierung der Fragestellung werden geschlechtsdifferenzierte Cox-Regressionsmodelle berechnet. Die unbalancierte Teilstichprobe umfasst 6 963 Männer (764 Todesfälle) und 7 461 Frauen (663 Todesfälle).

Ergebnisse: Unzufriedenheit mit dem eigenen Lebensstandard hat einen signifikanten Einfluss auf das Mortalitätsrisiko von Männern nicht jedoch von Frauen. Unzufriedene Männer weisen ein nahezu doppelt so hohes Mortalitätsrisiko auf als die Referenzgruppe (HR=1,95, 95% KI 1,48–2,58), Männer mit mittlerer Zufriedenheit ein um 25% höheres Mortalitätsrisiko (HR=1,26, 95% KI 1,08–1,49). Außerdem zeigt der subjektive Statusindikator stärkere Dosis-Wirkungs-Beziehungen als die klassischen objektiven Statusparameter.

Schlussfolgerung: Unzufriedenheit mit dem eigenen Lebensstandard kann mit einem erhöhten geschlechtsabhängigen Mortalitätsrisiko in Verbindung gebracht werden und erweist sich als klarer Prädiktor insbesondere für die männliche Mortalität. Eine zentrale Ursache können über die HPA-Achse vermittelte Stressreaktionen aufgrund von herabsetzenden sozialen Vergleichsprozessen zu sein. Die Ergebnisse sprechen für eine standardisierte Einbeziehung subjektiver Statusindikatoren; der ausgeprägte Geschlechterunterschied legt darüber hinaus eine geschlechtergerechte epidemiologische Datenanalyse nahe.

Promotion of alternative-sized personal protective equipment

INTRODUCTION

With more diversity in the workforce, companies are producing PPE such as hard hats, safety glasses, coveralls, foot protection, and safety harnesses for a larger range of body shapes and sizes. However, gray literature reports suggest that barriers exist to getting alternate sized PPE from the manufacturer to the workers who need it. The purpose of this study is to determine the extent to which alternative-sized PPE is marketed.

METHOD

A web-based review of seven major manufacturers of PPE was conducted to determine: (a) whether or not they offer alternative-sized products, (b) if these products are clearly labeled, and (c) if images used to display PPE are representative of a diverse workforce.

RESULTS

Of the seven PPE manufacturers investigated, six had at least one product that was marketed as gender and/or size alternatives however, alternative sizes were more common for larger body types. Alternative-sized products rarely included size charts, and the models used to display PPE were overwhelmingly white males of average size.

CONCLUSIONS

Despite the growing availability of alternative-sized PPE, it can be difficult to find these products, which suggests that they are rarely promoted or labeled as alternative-sized. Our study indicates that companies should expand their product lines and more aggressively market and promote these items. Guidance on how to properly fit their products would also be extremely helpful to the end-user.

PRACTICAL APPLICATIONS

Manufacturers could improve the availability of alternative-sized PPE and increase their promotion of these products on their websites and in their catalogs. Individual companies and safety professionals may assist in this process by demonstrating demand for alternative-sized PPE.

Neural correlates of proactive and reactive motor response inhibition of gambling stimuli in frequent gamblers

We used functional magnetic resonance imaging to examine whether motivational-salient cues could exert a differential impact on proactive (the restrain of actions in preparation for stopping) and reactive (outright stopping) inhibition. Fourteen high-frequency poker players, and 14 matched non-gambler controls, performed a modified version of the stop-signal paradigm, which required participants to inhibit categorization of poker or neutral pictures. The probability that a stop-signal occurs (0%, 17%, 25%, 33%) was manipulated across blocks of trials, as indicated by the color of the computer screen. Behavioral analyses revealed that poker players were faster than controls in categorizing pictures across all levels of proactive motor response inhibition (go trials). Brain imaging analyses highlighted higher dorsal anterior cingulate cortex activation in poker players, as compared to controls, during reactive inhibition. These findings suggest that, due to their faster rates of stimulus discrimination, poker players might have recruited more cognitive resources than controls when required to stop their response (reactive inhibition). Nevertheless, no main effect of stimulus type was found, on either proactive or reactive inhibition. Additional studies are, therefore, needed in order to confirm that investigating the dynamics between reactive and proactive inhibition offers a discriminative analysis of inhibitory control toward motivational-salient cues.

Cyanobacteria facilitate parasite epidemics in Daphnia

The seasonal dominance of cyanobacteria in the phytoplankton community of lake ecosystems can have severe implications for higher trophic levels. For herbivorous zooplankton such as Daphnia, cyanobacteria have poor nutritional value and some species can produce toxins affecting zooplankton survival and reproduction. Here we present another, hitherto largely unexplored aspect of cyanobacteria, namely that they can increase Daphnia susceptibility to parasites. In a 12-yr monthly time-series analysis of the Daphnia community in Greifensee (Switzerland), we observed that cyanobacteria density correlated significantly with the epidemics of a common gut parasite of Daphnia, Caullerya mesnili, regardless of what cyanobacteria species was present or whether it was colonial or filamentous. The temperature from the previous month also affected the occurrence of Caullerya epidemics, either directly or indirectly by the promotion of cyanobacterial growth. A laboratory experiment confirmed that cyanobacteria increase the susceptibility of Daphnia to Caullerya, and suggested a possible involvement of cyanotoxins or other chemical traits of cyanobacteria in this process. These findings expand our understanding of the consequences of toxic cyanobacterial blooms for lake ecosystems and might be relevant for epidemics experienced by other aquatic species.

Identification and genetic mapping of PmAF7DS a powdery mildew resistance gene in bread wheat (Triticum aestivum L.)

Gene PmAF7DS confers resistance to wheat powdery mildew (isolate Bgt#211 ); it was mapped to a 14.6-cM interval ( Xgwm350 a- Xbarc184 ) on chromosome 7DS. The flanking markers could be applied in MAS breeding. Wheat powdery mildew (Pm) is caused by the biotrophic pathogen Blumeria graminis tritici (DC.) (Bgt). An ongoing threat of breakdown of race-specific resistance to Pm requires a continuous effort to discover new alleles in the wheat gene pool. Developing new cultivars with improved disease resistance is an economically and environmentally safe approach to reduce yield losses. To identify and characterize genes for resistance against Pm in bread wheat we used the (Arina × Forno) RILs population. Initially, the two parental lines were screened with a collection of 61 isolates of Bgt from Israel. Three Pm isolates Bgt#210 , Bgt#211 and Bgt#213 showed differential reactions in the parents: Arina was resistant (IT = 0), whereas Forno was moderately susceptible (IT = -3). Isolate Bgt#211 was then used to inoculate the RIL population. The segregation pattern of plant reactions among the RILs indicates that a single dominant gene controls the conferred resistance. A genetic map of the region containing this gene was assembled with DNA markers and assigned to the 7D physical bin map. The gene, temporarily designated PmAF7DS, was located in the distal region of chromosome arm 7DS. The RILs were also inoculated with Bgt#210 and Bgt#213. The plant reactions to these isolates showed high identity with the reaction to Bgt#211, indicating the involvement of the same gene or closely linked, but distinct single genes. The genomic location of PmAF7DS, in light of other Pm genes on 7DS is discussed.

Hippocampal cell fate regulation by chronic cocaine during periods of adolescent vulnerability: Consequences of cocaine exposure during adolescence on behavioral despair in adulthood

Given that adolescence represents a critical moment for shaping adult behavior and may predispose to disease vulnerability later in life, the aim of this study was to find a vulnerable period during adolescence in which hippocampal cell fate regulation was altered by cocaine exposure, and to evaluate the long-term consequences of a cocaine experience during adolescence in affecting hippocampal plasticity and behavioral despair in adulthood. Study I: Male rats were treated with cocaine (15mg/kg, i.p.) or saline for 7 consecutive days during adolescence (early post-natal day (PND) 33-39, mid PND 40-46, late PND 47-53). Hippocampal plasticity (i.e., cell fate regulation, cell genesis) was evaluated 24h after the last treatment dose during the course of adolescence (PND 40, PND 47, PND 54). Study II: The consequences of cocaine exposure during adolescence (PND 33-39 or PND 33-46; 7 or 14days) were measured in adulthood at the behavioral (i.e., forced swim test, PND 62-63) and molecular (hippocampal cell markers, PND 64) levels. Chronic cocaine during early adolescence dysregulated FADD forms only in the hippocampus (HC), as compared to other brain regions, and during mid adolescence, impaired cell proliferation (Ki-67) and increased PARP-1 cleavage (a cell death maker) in the HC. Interestingly, chronic cocaine exposure during adolescence did not alter the time adult rats spent immobile in the forced swim test. These results suggest that this paradigm of chronic cocaine administration during adolescence did not contribute to the later manifestation of behavioral despair (i.e., one pro-depressive symptom) as measured by the forced swim test in adulthood.

Predictive factors for local control in primary and metastatic lung tumours after four to five fraction stereotactic ablative body radiotherapy: a single institution's comprehensive experience

AIMS

We report the outcomes of a large lung stereotactic ablative body radiotherapy (SABR) programme for primary non-small cell lung cancer (NSCLC) and pulmonary metastases. The primary study aim was to identify factors predictive for local control.

MATERIALS AND METHODS

In total, 311 pulmonary tumours in 254 patients were treated between 2008 and 2011 with SABR using 48-60 Gy in four to five fractions. Local, regional and distant failure data were collected prospectively, whereas other end points were collected retrospectively. Potential clinical and dosimetric predictors of local control were evaluated using univariate and multivariate analyses.

RESULTS

Of the 311 tumours, 240 were NSCLC and 71 were other histologies. The 2 year local control rate was 96% in stage I NSCLC, 76% in colorectal cancer (CRC) metastases and 91% in non-lung/non-CRC metastases. Predictors of better local control on multivariate analysis were non-CRC tumours and a larger proportion of the planning target volume (PTV) receiving ≥100% of the prescribed dose (higher PTV V100). Among the 45 CRC metastases, a higher PTV V100 and previous chemotherapy predicted for better local control.

CONCLUSIONS

Lung SABR of 48-60 Gy/four to five fractions resulted in high local control rates for all tumours except CRC metastases. Covering more of the PTV with the prescription dose (a higher PTV V100) also resulted in superior local control.

A usability study of a mobile monitoring system for congestive heart failure patients

Sensor-based monitoring of congestive heart-failure (CHF) patients living at home can improve quality of care, detect exacerbations of disease at an earlier stage and motivate the patient for better self care. This paper reports on a usability study of the ESUMS system that provides continuous measurements of heart rate, activity, upper body posture and skin temperature via a sensor belt and a smartphone as patient terminal. Five CHF patients were included in the trial, all recently discharged from hospital. The nurses experienced continuous heart rate, activity and posture monitoring as useful and objective tools that helped them in their daily assessment of patient health. They also saw the system as an important educational tool to help patients gain insight into their own condition. Three patients liked that they could have a view of their own physiological and activity data, however the smartphones used in the study turned out to be too complicated for the patients to operate. A smartphone is built to be a multi-purpose device, and this may (conceptually and practically) be incompatible with the patients' demands for ease of use.

Simulation of oxygen transfer in stented arteries and correlation with in-stent restenosis

Computational models are used to study the combined effect of biomechanical and biochemical factors on coronary in-stent restenosis, which is a postoperative remodeling and regrowth pathology of the stented arteries. More precisely, we address numerical simulations, on the basis of Navier-Stokes and mass transport equations, to study the role of perturbed wall shear stresses and reduced oxygen concentration in a geometrical model reconstructed from a real porcine artery treated with a stent. Joining in vivo and in silico tools of investigation has multiple benefits in this case. On one hand, the geometry of the arterial wall and of the stent closely correspond to a real implanted configuration. On the other hand, the inspection of histological tissue samples informs us on the location and intensity of in-stent restenosis. As a result, we are able to correlate geometrical factors, such as the axial variation of the artery diameter and its curvature; the numerical quantification of biochemical stimuli, such as wall shear stresses; and the availability of oxygen to the inner layers of the artery, with the appearance of in-stent restenosis. This study shows that the perturbation of the vessel curvature could induce hemodynamic conditions that stimulate undesired arterial remodeling.