Chemical elements in Elaeis guineensis materials and derived oil

The production of oil palm (Elaeis guineensis) in Southeast Asia is vital to the economies of Indonesia and Malaysia. Both fertilisers and pesticides used in palm production can contain elevated concentrations of Trace Elements (TEs) which may accumulate in soils and leaf tissues of plants. We hypothesised that leaves from oil palms may be deficient in essential elements, while containing elevated concentrations of non-essential TEs commonly found in agrichemicals. Samples of plant materials (leaves and fruitlets) were collected from active and former plantations in Sumatra, Indonesia, and analysed for essential and non-essential elements. Indonesian palm oil samples were sourced in New Zealand and their elemental concentrations determined. Leaf materials from both active and abandoned production sites were deficient in N, K, S and Mo, while leaf materials from abandoned sites were deficient in P. These deficiencies may have been a contributing factor to the abandonment of production at these sites. Concentrations of non-essential elements were below or comparable to average plant concentrations and no evidence of contamination was found in plant tissues. Palm oil contained low concentrations of TEs, which did not pose any toxicity risks. However, Na and Al were present in concentrations of 1198 and 159 mg kg-1 respectively, which were higher than have been previously reported. Tropical oil palm production could benefit from the determination of bioaccumulation factors for fertiliser contaminants in E. guineensis, to limit the transfer of contaminants to plants and products if increased fertiliser applications were used to correct nutrient deficiencies.

The Uptake of Rare Trace Elements by Perennial Ryegrass (Lolium perenne L.)

Technological development has increased the use of chemical elements that have hitherto received scant scientific attention as environmental contaminants. Successful management of these rare trace elements (RTEs) requires elucidation of their mobility in the soil-plant system. We aimed to determine the capacity of Lolium perenne (a common pasture species) to tolerate and accumulate the RTEs Be, Ga, In, La, Ce, Nd, and Gd in a fluvial recent soil. Cadmium was used as a reference as a well-studied contaminant that is relatively mobile in the soil-plant system. Soil was spiked with 2.5-283 mg kg-1 of RTE or Cd salts, representing five, 10, 20, and 40 times their background concentrations in soil. For Be, Ce, In, and La, there was no growth reduction, even at the highest soil concentrations (76, 1132, 10.2, and 874 mg kg-1, respectively), which resulted in foliar concentrations of 7.1, 12, 0.11, and 50 mg kg-1, respectively. The maximum no-biomass reduction foliar concentrations for Cd, Gd, Nd, and Ga were 0.061, 0.1, 7.1, and 11 mg kg-1, respectively. Bioaccumulation coefficients ranged from 0.0030-0.95, and increased Ce < In < Nd ≅ Gd < La ≅ Be ≅ Ga < Cd. Beryllium and La were the RTEs most at risk of entering the food chain via L. perenne, as their toxicity thresholds were not reached in the ranges tested, and the bioaccumulation coefficient (plant/soil concentration quotient) trends indicated that uptake would continue to increase at higher soil concentrations. In contrast, In and Ce were the elements least likely to enter the food chain. Further research should repeat the experiments in different soil types or with different plant species to test the robustness of the findings.

The Potential of Myrtaceae Species for the Phytomanagement of Treated Municipal Wastewater

The use of native plants in land application systems for treated municipal wastewater (TMW) can contribute to ecological restoration. However, research on the potential of native species to manage the nutrients and contaminants contained in TMW is scarce. At a 10-hectare field site irrigated with TMW at >4000 mm yr-1, we investigated the distribution of nutrients and trace elements in the soil-plant system, comparing the New Zealand native Myrtaceae species Leptosperum scoparium and Kunzea robusta with pasture. The results showed that plant growth did not correlate with TMW irrigation rates. L. scoparium and K. robusta had higher foliar trace element concentrations than pasture, but these were not correlated with TMW irrigation rates. The pasture accumulated more N and P (68 kg of N ha-1 yr-1 and 11 kg of P ha-1 yr-1) than the Myrtaceae species (0.6-17 kg of N ha-1 yr-1 and 0.06-1.8 kg of P ha-1 yr-1). Regular harvesting of the pasture would likely remove more N and P from the site than the Myrtaceae species. The results highlight the importance of adjusting TMW application rates to the soil-plant capacity, in which case, native plants could provide ecological or economic value to TMW-irrigated land.

Work-related injuries and attendance at a Canadian regional emergency department

BACKGROUND

Monitoring trends in the burden of illness and injury attributable to work is key in assessing occupational health hazards; however, New Brunswick does not participate in the Canadian National Ambulatory Care Reporting System which itself does not collect details of occupation and industry.

AIMS

We set out to determine the proportion of emergency department attendances that were attributable to a work-related cause. We also wanted to evaluate the recording of occupation in the electronic health record system, and to describe the characteristics of patients with a work-related presentation.

METHODS

A retrospective observational study over a 1-year period was conducted using an administrative database obtained from Canadian Emergency Department Information System. Descriptive statistics are used to present the analysis of categorical and continuous data.

RESULTS

A total of 49 365 patients were included for analysis. Two per cent of patients presented with a self-reported work-related condition. Health care and social assistance, construction, retail trade and manufacturing were the most common industries reported by patients.

CONCLUSIONS

This study found the rate of work-related medical conditions to be substantially less than expected, and that occupation was not captured for any patients presenting to the emergency department with a work-related condition, despite a field being available in the electronic health record registration system. We were able to analyse the industry sectors for work-related presentations. The recording and coding of occupation and industry would significantly benefit occupational epidemiology in emergency medicine as well as potentially improving patient outcomes and health system efficiencies.

Pediatric Cardiology Fellowship Standards for Training in Exercise Medicine and Curriculum Outline

Over the past 2 decades, fundamentals of exercise medicine, including clinical exercise testing, assessment and promotion of physical activity, exercise prescription, and supervised exercise training/rehabilitation programming have demonstrated considerable clinical value in the management of children and adolescents with congenital and acquired heart disease. Although the principles of exercise medicine have become an integral component in pediatric cardiology, there are no standardized training recommendations for exercise physiology during pediatric cardiology fellowship at this time. Thus, the Pediatric Cardiology Exercise Medicine Curriculum Committee (PCEMCC) was formed to establish core and advanced exercise physiology training recommendations for pediatric cardiology trainees. The PCEMCC includes a diverse group of pediatric cardiologists, exercise physiologists, and fellowship program directors. The expert consensus training recommendations are by no means a mandate and are summarized herein, including suggestions for achieving the minimum knowledge and training needed for general pediatric cardiology practice.

An Assessment of the Feasibility of Phytoextraction for the Stripping of Bioavailable Metals from Contaminated Soils

Phytoextraction has been proposed in many papers as a low-cost method for remediating contaminated soil. However, if national regulation is based on total metal(loid) concentrations in soil, phytoextraction is generally infeasible because of the long time required for remediation. Assessing phytoextraction requires determination of the dynamic rate of metal removal from soil. Phytoextraction may be feasible if the main goal is to reduce the soluble fraction of the metal(loid) with the goal of reducing bioavailability. However, it has been reported that there is a large mass balance mismatch between the reduction of the soluble metal fraction in contaminated soil and metal uptake by plants. Several studies report that the decrease of soluble fraction of metals in soil is higher than can be accounted for by plant uptake. In other words, studies generally overestimate the feasibility of bioavailable contaminant stripping. Therefore, a more rigorous approach is advisable to ensure that papers on bioavailable contaminant stripping include relevant information on mass balances. Furthermore, to implement the concept of bioavailable contaminant stripping, regulations must distinguish between the bioavailable fraction and the total metal concentration in soil. Environ Toxicol Chem 2023;42:558-565. © 2022 SETAC.

Grasses procure key soil nutrients for clovers

Rhizobial nitrogen fixation in legumes provides spillover benefits to neighbouring plants such as pasture grasses. Generally, it is understood to be unidirectional between plant functional groups, providing a benefit from legumes to grasses. We question whether bidirectional complementarity also exists in terms of exploiting the wider soil nutrient pool. We test this hypothesis using soil cores with their component vegetation assemblages sampled from a hill country pasture in South Island, New Zealand. The soil was deficient in key essential elements: P, S, B, Mo and Ni. Facilitation from grasses to clovers was evident; legume-grass mixtures procured more nutrients from the soil than when either species was growing alone. When grasses and clover grow together in unfertilized grassland, more nitrogen is procured by the plant community, and other limiting plant nutrients in the soil are better exploited. Coexistence with grasses is favourable to clovers in terms of soil biogeochemistry.

POS1158 CHARACTERIZATION OF GOUT IN US PATIENTS UNDERGOING HEMODIALYSIS (HD) AND PERITONEAL DIALYSIS (PD)

Background

Gout is the most common inflammatory arthritis and occurs frequently in patients with renal disease often leading to a significant burden on quality of life and functional status.1,2 Despite the established connection of renal disease with gout, little has been reported on the prevalence, patient characteristics, and associations of gout with other outcomes in the US hemodialysis (HD) and peritoneal dialysis (PD) population.

Objectives

This project used a large end-stage renal disease (ESRD) focused-database, Dialysis Outcomes and Practice Patterns Study (DOPPS), to examine gout in dialysis-dependent patients.

Methods

Gout patients were identified by active prescription (Rx) of (1) colchicine, (2) febuxostat, or (3) allopurinol; or by (4) prior diagnosis of gout from US cohorts of 70,297 HD (DOPPS, 2012-2020) patients and 5117 PD (Peritoneal DOPPS, 2014-2020) patients. Outcomes of HD and PD patients with and without a history of gout were compared with propensity score matching. Outcomes included erythropoietin resistance index (ERI = ESA dose/(hemoglobin*weight), cardiovascular death, all-cause mortality/hospitalization, and baseline patient-reported outcomes (PROs).

Results

Gout prevalence was 13% in HD and 21% in PD and was highest among incident dialysis patients. Of the gout patients identified, the most-commonly used gout-related medications were allopurinol (9-12%), followed by colchicine (2-3%), and then febuxostat (1%, Figure 1). Both HD and PD patients with gout (vs. no gout) were older and more likely male. Gout HD and PD patients had higher BMI and higher prevalence of cardiovascular comorbidities than HD and PD patients without gout. After propensity score matching, mean ERI was 4% higher for gout vs. non-gout patients, while there was minimal evidence of association with clinical outcomes (mortality and hospitalization) or PROs.

Figure 1.

Gout prevalence by dialysis duration in patients undergoing HD and PD. Criteria for gout included gout diagnosis and use of a urate-lowering therapy.

HD, hemodialysis; PD, peritoneal dialysis; mo, months; Rx, prescription; yrs, years. Some patients were included in multiple gout categories.

Conclusion

Gout was common in US HD and PD patients, with a large proportion of these patients treated with drugs indicated for hyperuricemia (allopurinol and febuxostat) and gout flares (colchicine). The true prevalence of gout was likely higher than observed when considering potential under-ascertainment of gout diagnosis history in nephrology/dialysis-focused clinical settings.3 This report provides a snapshot of gout in the US dialysis population and offers opportunities to expand on research to improve awareness and care for patients with gout and ESRD.

References

[1]Singh JA, Strand V. Ann Rheum Dis. 2008;67:1310–6.

[2]Singh JA, Cleveland JD. BMC Neph 2019;20:93.

[3]Roughley M, et al. Arthritis Res Ther. 2018;20(1):243.

Disclosure of Interests

Angelo Karaboyas Grant/research support from: Horizon Therapeutics, Junhui Zhao Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brad Marder Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Barry Gorlitsky Consultant of: AstraZenica, Davita, Horizon Therapeutics, Jensen Pharmaceuticals, KidneyAide LLC, vinicius domingues Consultant of: Abbvie, Aurinia Pharma, Exagen, Eli Lilly, Roberto Pecoits-Filho Grant/research support from: Horizon Therapeutics, Bruce Robinson Grant/research support from: Horizon Therapeutics

Plant Species Complementarity in Low-Fertility Degraded Soil

The aim of this study was to investigate the compatibility of plants with contrasting root systems, in terms of procurement of limiting soil nutrients. Paired combinations of species of proteas and grasses were grown in a pot experiment using soil from a site with impoverished vegetation and degraded soil. The soil contained sufficient N but was low to deficient in P, Mn, S, Fe, and B. The uptake of chemical elements into the foliage differed significantly according to whether the plants were growing as single or mixed species. When two species of Grevillea and grasses with evolutionary origins in low fertility soils were growing together, there was an enhanced uptake of P and Mn, in one or both species, in addition to other elements that were in low concentrations in the experimental soil. In contrast to this, Protea neriifolia that probably originated from a more fertile soil procured lesser amounts of the six elements from the soil when growing together with grasses. Two grasses tolerant of less fertile soils (Dactylis glomerata and Poa cita) obtained more nutrients when they grew together with proteas; this was a much stronger neighbour effect than was measured in Lolium perenne which is better adapted to high fertility soils. The findings illustrate both the functional compatibility and competition for plant nutrients in mixed-species rhizospheres. Species combinations substantially increased the acquisition of key elements from the soil nutrient pool.

From mine to mind and mobiles - Lithium contamination and its risk management

With the ever-increasing demand for lithium (Li) for portable energy storage devices, there is a global concern associated with environmental contamination of Li, via the production, use, and disposal of Li-containing products, including mobile phones and mood-stabilizing drugs. While geogenic Li is sparingly soluble, Li added to soil is one of the most mobile cations in soil, which can leach to groundwater and reach surface water through runoff. Lithium is readily taken up by plants and has relatively high plant accumulation coefficient, albeit the underlying mechanisms have not been well described. Therefore, soil contamination with Li could reach the food chain due to its mobility in surface- and ground-waters and uptake into plants. High environmental Li levels adversely affect the health of humans, animals, and plants. Lithium toxicity can be considerably managed through various remediation approaches such as immobilization using clay-like amendments and/or chelate-enhanced phytoremediation. This review integrates fundamental aspects of Li distribution and behaviour in terrestrial and aquatic environments in an effort to efficiently remediate Li-contaminated ecosystems. As research to date has not provided a clear picture of how the increased production and disposal of Li-based products adversely impact human and ecosystem health, there is an urgent need for further studies on this field.

Phytomanagement of a metal(loid)-contaminated agricultural site using aromatic and medicinal plants to produce essential oils: analysis of the metal(loid) fate in the value chain

Phytomanagement uses plants and soil conditioners to create value on contaminated land while minimizing environmental risk. This work was carried out on a metal(loid)-contaminated site and aimed at assessing the suitability of Salvia sclarea L. (sage) and Coriandrum sativum L. (coriander) combined with an arbuscular mycorrhizal fungus (AMF) inoculant to immobilize metal(loid)s and produce essential oils (EO). The effect of the inoculant on the transfer of metal(loid)s (ML, i.e., Cd, Cu, Pb, Zn, As, Ni, and Sb) to plants and the ML soil mobility were investigated. The ML concentrations in EO from both plant species and the valorization options for the distillation residues (soil conditioner, animal fodder, and anaerobic digestion) were studied. Sage was a suitable candidate for this value chain because it presents an excluder phenotype and the residues of oil extraction could be used as a soil conditioner. The metal concentrations in the sage EO were similar to those obtained from plants cultivated on an uncontaminated soil. These results indicate the suitability of sage harvested on the contaminated soil according to the ML fate in the whole value chain. Like the EO of sage, ML concentrations in the coriander EO did not differ from those in the commercial EO that were obtained from plants grown on uncontaminated soil. However, the use of distillation residues of coriander was limited by their relatively elevated Cd concentrations. The use of a mycorrhizal inoculum did not decrease the Cd mobility in soil for the coriander.

Utilization of Short Tandem Repeat Analysis to Resolve Specimen Mislabeling in the Anatomic Pathology Laboratory

Introduction/Objective

A mislabeled specimen is an example of preanalytical error that can have significant consequences on patient care. These errors can be difficult to detect and resolve. One method to confirm genetic identity is short tandem repeat (STR) analysis, which is utilized in forensic investigations, paternity studies, and post- hematopoietic stem cell transplantation monitoring. Herein we present application of STR analysis to resolve a suspected specimen mislabeling prior to receipt in our anatomic pathology laboratory.

Methods/Case Report

DNA was extracted from paraffin embedded tissues. Chimerism testing was performed by STR analysis using the Globalfiler (ThermoFisher Scientific) and analyzed by Chimermarker (Softgenetics) automated chimerism software.

Results (if a Case Study enter NA)

Colon biopsies were received for a single patient (#1) with two requisition forms. Each specimen (A-F) was labeled with the patient’s name, with specimens A-D noted on first page of requisition and specimens E-F on the second requisition page. After the case was signed out, the lab was contacted looking for biopsy results on another patient (#2) who was seen on the same day as patient #1. Review of all the patients seen in the endoscopy suite on the given date raised suspicion that specimens E-F from the second page of the requisition actually pertained to patient #2. STR analysis performed on specimens confirmed that specimens E-F were genetically distinct from those labelled A-D. Tissue from a subsequent biopsy on patient #2 was analyzed by STR testing, which was identical to STR results performed on specimens E-F.

Conclusion

Here we utilized STR testing to resolve a suspected mislabeled specimen, allowing the appropriate diagnosis to be attributed to the correct patient. This is a unique application of a common method, which could be implemented in anatomic pathology laboratories to resolve cases of specimen mix-ups.

Arsenic redox transformations and cycling in the rhizosphere of Pteris vittata and Pteris quadriaurita

Pteris vittata (PV) and Pteris quadriaurita (PQ) are reported to hyperaccumulate arsenic (As) when grown in Asrich soil. Yet, little is known about the impact of their unique As accumulation mechanisms on As transformations and cycling at the soil-root interface. Using a combined approach of two-dimensional (2D), sub-mm scale solute imaging of arsenite (As^III), arsenate (As^V), phosphorus (P), manganese (Mn), iron (Fe) and oxygen (O₂), we found localized patterns of As^III/As^V redox transformations in the PV rhizosphere (As^III/As^V ratio of 0.57) compared to bulk soil (As^III/As^V ratio of ≤0.04). Our data indicate that the high As root uptake, translocation and accumulation from the As-rich experimental soil (2080 mg kg^-1) to PV fronds (6986 mg kg^-1) induced As detoxification via As^V reduction and As^III root efflux, leading to As^III accumulation and re-oxidation to As^V in the rhizosphere porewater. This As cycling mechanism is linked to the reduction of O2 and Mn^III/IV (oxyhydr)oxides resulting in decreased O2 levels and increased Mn solubilization along roots. Compared to PV, we found 4-fold lower As translocation to PQ fronds (1611 mg kg^-1), 2-fold lower As^V depletion in the PQ rhizosphere, and no As^III efflux from PQ roots, suggesting that PQ efficiently controls As uptake to avoid toxic As levels in roots. Analysis of root exudates obtained from soil-grown PV showed that As acquisition by PV roots was not associated with phytic acid release. Our study demonstrates that two closely-related As-accumulating ferns have distinct mechanisms for As uptake modulating As cycling in As-rich environments.

Pesticides in aquatic environments and their removal by adsorption methods

Although pesticides are widely used in agriculture, industry and households, they pose a risk to human health and ecosystems. Based on target organisms, the main types of pesticides are herbicides, insecticides and fungicides, of which herbicides accounted for 46% of the total pesticide usage worldwide. The movement of pesticides into water bodies occurs through run-off, spray drift, leaching, and sub-surface drainage, all of which have negative impacts on aquatic environments and humans. We sought to define the critical factors affecting the fluxes of contaminants into receiving waters. We also aimed to specify the feasibility of using sorbents to remove pesticides from waterways. In Karun River in Iran (1.21 × 10⁵ ng/L), pesticide concentrations are above regulatory limits. The concentration of pesticides in fish can reach 26.1 × 10³ μg/kg, specifically methoxychlor herbicide in Perca fluviatilis in Lithuania. During the last years, research has focused on elimination of organic pollutants, such as pesticides, from aqueous solution. Pesticide adsorption onto low-cost materials can effectively remediate contaminated waters. In particular, nanoparticle adsorbents and carbon-based adsorbents exhibit high performance (nearly 100%) in removing pesticides from water bodies.

Investigating arsenic impact of ACC treated timbers in compost production (A case study in Christchurch, New Zealand)

The arsenic concentration is an important issue in compost production. The main inputs of a compost factory, including kerbsides, green wastes, food industry wastes, and river weeds are investigated in this study. Also, this study investigated how treated timbers, ashes, and other contamination can impact arsenic concentration in compost production. The results showed that most treated timbers and all ashes of treated and untreated timbers contained significant amounts of arsenic. These results revealed that the presence of a small amount of treated timber ashes can significantly increase the arsenic concentration in composts. The results of the study show the arsenic concentration in compost increase during cold months, and it dropped during summer, which would be mostly because of high arsenic concentration in ashes of log burners. This study shows ashes of burning timbers can impact arsenic contamination mostly because of using Copper-Chrome-Arsenic wood preservatives (CCA). Also, the lab results show the arsenic level even in ashes of untreated timber is around 96 ppm. The ashes of H3, H4, and H5 treated timbers contain approximately 133,000, 155,000, and 179,000 ppm of arsenic, which one kg of them can increase arsenic concentration around 10 ppm in 13.3, 15.5 and 17.9 tons of dry compost products. The main problem is many people look at ashes and treated timber as organic materials; however, ashes of treated and untreated timbers contained high concentrations of arsenic. Therefore, it was necessary to warn people about the dangers of putting any ashes in organic waste bins.

Antioxidant Enzyme Activity and Lipid Peroxidation in Aporrectodea caliginosa Earthworms Exposed to Silver Nanoparticles and Silver Nitrate in Spiked Soil

Silver nanoparticles (AgNPs) from industrial use, discharged via the land application of sewage sludge, are interacting with soil biota, including earthworms. In affected organisms, excessive production of reactive oxygen species can result in lipid peroxidation, shifting the balance between oxidants and antioxidants to cause oxidative stress. We determined selected lower-tier biomarkers such as antioxidant responses and lipid peroxidation in Aporrectodea caliginosa earthworms exposed to soils spiked with AgNPs or silver nitrate (AgNO₃ ). Aporrectodea caliginosa were exposed to AgNPs at 0 (control), 0.3, 3, 30, and 300 mg/kg or Ag⁺ (as AgNO₃ ) at 0, 0.03, 0.3, 3, and 10 mg/kg in soil for 4 wk. At 1, 2, 3, and 4 wk, the activity of the antioxidant enzymes superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase, as well as lipid peroxidation (malondialdehyde content), increased as a function of concentration, with a much larger response for Ag⁺ than AgNPs. Given the likelihood of ever-increasing AgNP concentrations in soil, where AgNPs can transform to ionic Ag (Ag⁺ ), our findings of antioxidant response to oxidative stress in a common indicator organism even at an environmentally realistic exposure concentration of 0.03 mg/kg demonstrate that AgNPs may affect soil fertility and, thus, agricultural production. Evaluating selected lower-tier biomarkers offers a meaningful assessment of AgNPs and Ag⁺ effects on terrestrial earthworms. Environ Toxicol Chem 2020;39:1257-1266. © 2020 SETAC.

Environmental Parameters Affecting the Concentration of Iodine in New Zealand Pasture

Iodine (I) is an essential trace element commonly deficient in agricultural systems. Whereas there is much information on I in food crops, there is a lacuna of knowledge on the environmental factors that affect pasture I concentrations. We aimed to identify the most important environmental factors affecting the concentration of I in New Zealand pastures, and the consequences to agricultural systems. Soil and pastoral samples were collected throughout the country and analyzed for I and other elements. The soils contained 1.1 to 86 mg I kg, with 0.005 to 1.4 mg kg in the pasture. In 26% of pastures, I concentrations were insufficient for sheep nutrition, whereas 87% contained insufficient I for cattle nutrition. Pasture I concentrations were negatively correlated with the distance from the sea, and the concentration of oxalate-extractable amorphous Al, Fe, and Si oxides, which immobilize soil I. Soil organic C and clay increased I retention in soil but did not significantly affect pasture I concentrations. Future work should investigate how soil properties affect pasture I uptake in inland areas.

Unlocking PARP inhibitor efficacy for HRD-negative cancers using the alphalex tumor targeting platform inhibitor efficacy for HRD-negative cancers using the alphalex tumor targeting platform

e14664

Background: Poly(ADP-ribose)polymerase inhibitors (PARPi’s) are a promising new class of anti-cancer agents, but their clinical application has largely been limited to tumors with homologous recombination deficiency (HRD), such as those with BRCA1/2 mutations. One strategy to target HRD-negative tumors with PARPi’s is to combine them with chemotherapy, although clinical trials indicate that dose-limiting toxicities are a major barrier to achieving synergistic efficacy with these combinations. Methods: We sought to test the hypothesis that HRD-negative cancers can be effectively treated with tumor-targeted PARPi’s in combination with chemotherapy, using our recently developed alphalex platform. This platform allows small molecule anti-cancer agents to penetrate cell membranes only at the low pH associated with the tumor microenvironment and tumor cells, directly delivering drugs to tumors while sparing normal tissue. We tested whether alphalex PARPi-conjugates in combination with chemotherapy could selectively kill cancers independent of HRD status, using a range of in vitro and in vivo tumor models. Results: We conjugated a diverse range of structurally unique PARPi’s using the alphalex platform, and demonstrated that these molecules are delivered directly into tumor cells in a pH-dependent manner. We observed significant reductions in PARylation activity and exquisite synergy with DNA damaging agents in vitro. We then demonstrated that alphalex-PARPi conjugates in combination with both temozolomide (TMZ) and irinotecan induce significant tumor cell killing in HRD-negative tumors in vivo. Importantly, we found that our tumor-targeting approach significantly reduced normal tissue toxicity, with almost complete sparing of the bone marrow relative to TMZ alone. Conclusions: The alphalex platform enables PARPi combinations with clinically relevant chemotherapies, as a means to target HRD-negative cancers without significant bone marrow toxicity. Based on these successful proof-of-concept data, we are now performing IND-enabling studies for an alphalex PARPi conjugate (CBX-11), and we anticipate initiating a Phase I clinical trial in January 2020 in solid tumors independent of HRD status.

Cadmium Uptake by Ryegrass and Ryegrass-Clover Mixtures under Different Liming Rates

Cadmium accumulates in soils that receive repeated applications of Cd-rich superphosphate fertilizers. There is evidence that adding clovers to a crop solubilizes soil Cd, increasing the bioavailability of Cd. This can lead to high plant Cd concentrations. This research aimed to test whether liming-induced increases in pH in mixed crops of clovers and ryegrasses reduced forage Cd concentrations. A greenhouse pot trial applied lime at three rates (0, 1, and 2% of soil dry weight) to eight different plant treatments-four as monocultures (perennial ryegrass [ L.], Italian ryegrass [ Lam.], white clover [ L.], and red clover [ L.]) and four as ryegrass-clover mixtures (two plant types in each treatment)-in soil (initial soil pH = 5.1, initial soil Cd concentration = 1.31 mg kg) with added Cd (CdSO ∼ 1 mg kg). Adding lime increased soil pH in both mono- and mixed crops and, in most treatments, increased forage yields. However, the relationship between forage Cd and soil pH differed between plant treatments. In mono- and mixed crop treatments containing perennial ryegrass, adding lime increased the forage yield but did not increase the mass of Cd in the plants compared with the no-lime treatment. However, adding lime to treatments that included Italian ryegrass increased both the forage yield and the Cd compared with the no-lime treatment. The results show that a combination of certain plant species composition and lime rates can optimize forage yields without increasing forage Cd concentrations.

Adherence to Adjuvant Endocrine Therapy in Christchurch Women with Early Breast Cancer

AIMS

To assess adherence to adjuvant endocrine therapy by a real-world cohort of women in Christchurch and to determine any associated factors.

MATERIALS AND METHODS

Records were retrieved of all women newly diagnosed with early breast cancer and registered on the Christchurch Breast Cancer Patient Register over 4 years from June 2009. Demographic and pathological factors, dates of starting and stopping endocrine therapies and reported side-effects were collected. The proportion remaining on endocrine therapy was analysed by Kaplan-Meier curve; Cox regression analysis was used to identify independent factors influencing adherence.

RESULTS

Of 1213 women, 1018 (83.9%) had oestrogen receptor-positive tumours, of whom 674 (66.2%) started adjuvant endocrine therapy, including 62 (9.2%) neoadjuvantly. Uptake was 52.4% of those with T1 tumours, 89% with T2 tumours, 93% with T3/T4 tumours, 92.7% with node-positive tumours and 49.7% with node-negative tumours. The initial endocrine therapy was an aromatase inhibitor in 254 (38%) and tamoxifen for 412 (61%). At 1 year, 90% remained adherent, at 2 years 84%, at 3 years 81%, at 4 years 76%, at 4.5 years 71% and at 5 years 50%, with a median duration of 60 months (56-64 months, 95% confidence interval) and a median follow-up of 33 months. Overall, 135 (20%) women stopped treatment for adverse events or poor tolerability. A longer persistence with endocrine therapy was associated with node-positive tumours (hazard ratio 1.38, P = 0.003), but not first hormone used; aromatase inhibitor compared with tamoxifen, P = 0.76.

CONCLUSION

Adjuvant endocrine therapy use fell to 50% by 5 years, limiting possible survival benefits, providing support for efforts to increase compliance.