Improved accuracy and robustness of electron density profiles from JET's X-mode frequency-modulated continuous-wave reflectometers

JET's frequency-modulated continuous wave (FMCW) reflectometers have been operating well with the current design since 2005, and density profiles have been automatically calculated intershot since then. However, the calculated profiles had long suffered from several shortcomings: poor agreement with other diagnostics, sometimes inappropriately moving radially by several centimeters, elevated levels of radial jitter, and persistent wriggles (strong unphysical oscillations). In this research, several techniques are applied to the reflectometry data analysis, and the shortcomings are significantly improved. Starting with improving the equilibrium reconstruction that estimates the background magnetic field, adding a ripple correction in the reconstructed magnetic field profile, and adding new inner-wall reflection positions estimated through ray-tracing, these changes not only improve the agreement of reconstructed profiles to other diagnostics but also solve density profile wriggles that were present during band transitions. Other smaller but also persistent wriggles were also suppressed by applying a localized correction to the measured beat frequency where persistent oscillations are present. Finally, the burst analysis method, as introduced by Varela et al. [Nucl. Fusion 46 S693 (2006)], has been implemented to extract the beat frequency from stacked spectrograms. Due to the strong suppression of spurious reflections, the radial jitter that sometimes would span several centimeters has been strongly reduced. The stacking of spectrograms has also been shown to be very useful for stacking recurring events, like small gas puff modulations, and extracting transport coefficients that would otherwise be below the noise level.

Adipokine secretion and lipolysis following gender-affirming treatment in transgender individuals

BACKGROUND

The organ-specific effects of gender-affirming sex hormone treatment (GAHT) in transgender women (TW) and transgender men (TM) are insufficiently explored. This study investigated the effects of GAHT on adipose tissue function.

METHODS

In a single-center interventional prospective study, 32 adults undergoing GAHT, 15 TW and 17 TM, were examined with anthropometry and abdominal subcutaneous adipose tissue biopsies obtained before initiation of treatment, 1 month after endogenous sex hormone inhibition and three and 11 months after initiated GAHT. Fat cell size, basal/stimulated lipolysis and cytokine secretion in adipose tissue were analyzed.

RESULTS

TW displayed an increase in complement component 3a and retinol-binding protein 4 (RBP4) secretion after sex hormone inhibition, which returned to baseline following estradiol treatment. No changes in lipolysis were seen in TW. TM showed downregulation of RBP4 after treatment, but no changes in basal lipolysis. In TM, the estrogen suppression led to higher noradrenaline stimulated (NA) lipolysis that was normalized following testosterone treatment. At 11 months, the ratio of NA/basal lipolysis was lower compared to baseline. There were no significant changes in fat cell size in either TW or TM.

CONCLUSION

In TW, gonadal hormone suppression results in transient changes in cytokines and in TM there are some changes in NA-stimulated lipolysis following testosterone treatment. However, despite the known metabolic effects of sex hormones, the overall effects of GAHT on adipose tissue function are small and likely have limited clinical relevance, but larger studies with longer follow-up are needed to confirm these findings.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02518009, Retrospectively registered 7 August 2015.

Weight loss outcomes are generally worse for dogs and cats with class II obesity, defined as > 40% overweight

In pet dogs and cats, adiposity is most-often estimated clinically using a 9-category body condition score (BCS), with BCS 9 equating to ~ 40% overweight. Animals that are more overweight (> 40%) are seen in clinical practice but are not appropriately depicted by descriptions in the existing categories. To determine whether being > 40% overweight has clinical relevance, this study aimed to compare the outcomes of weight management in animals that were > 40% overweight with those < 40% overweight. Records of dogs and cats attending a specialist obesity care clinic, where adiposity is determined using dual-energy X-ray absorptiometry (DXA), were reviewed. Animals were assigned to two classes (class I ≤ 40% overweight: 118/398 [40%] dogs and 68/116 [59%] cats; class II, > 40% overweight: 180/398 [60%] dogs and 48/116 [41%] cats) based on DXA results, and weight loss outcomes were compared. Fewer class II dogs obesity completed weight management than class I dogs (P < 0.001), rate of weight loss was also slower (P = 0.012) and lean tissue loss greater (P < 0.001). Compared with class I, cats with class II obesity lost more weight (P = 0.048) albeit over a longer period (P = 0.043) leading to greater lean tissue loss (P = 0.004). Approximately half the pets presenting to a specialist clinic were have class II obesity (> 40% overweight), and some weight loss outcomes are worse for these animals.

The effect of obesity and subsequent weight reduction on cardiac structure and function in dogs

Background

In people, the cardiovascular effects of obesity include systemic hypertension, cardiac remodelling and both systolic and diastolic dysfunction, whilst weight reduction can reverse myocardial remodelling and reduce risk of subsequent cardiovascular disease. To date, variable results are reported in studies of the effect of obesity and controlled weight reduction on cardiovascular morphology and function in dogs. This prospective study aimed to assess cardiac function, heart rate variability, cardiac biomarkers and body composition before and after weight reduction in pet dogs with obesity. Twenty-four client-owned dogs referred for weight management due to obesity were recruited. To assess the cardiac effects of obesity, body composition analysis (by dual energy X-ray absorptiometry, DEXA) and cardiovascular assessment (echocardiography, Doppler blood pressure, electrocardiography, cardiac biomarkers) were performed prior to weight management. Twelve dogs completed the study and reached target weight, receiving a further cardiovascular assessment and DEXA. A Wilcoxon-signed rank test was used to compare each variable pre- and post- weight reduction.

Results

Median (interquartile range) duration of weight loss was 224 days (124–245 days), percentage weight loss was 23% (18–31%) of starting weight. Median change in body fat mass was -50% (-44% to -55%; P = 0.004), whilst median change in lean mass was -7% (+ 1% to -18%, P = 0.083).

Before weight reduction, diastolic dysfunction (evidence of impaired relaxation in all dogs), increased left ventricular wall thickness and mildly elevated systolic blood pressure (14/24 ≥ 160 mmHg, median 165 mmHg (140–183)) were common features in dogs with obesity. However, systolic left ventricular wall dimensions were the only variables that changed after weight reduction, with a decrease in both the systolic interventricular septum (P = 0.029) and systolic left ventricular free wall (P = 0.017). There was no evidence of decreased heart rate variability in dogs with obesity (P = 0.367), and no change in cardiac biomarker concentrations with weight reduction (N-terminal proBNP, P = 0.262; cardiac troponin I P = 0.657).

Conclusions

Canine obesity results in diastolic dysfunction and left ventricular hypertrophy, the latter of which improves with significant weight and fat mass reduction. Further studies are required to clarify the clinical consequences of these findings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-022-03449-4.

P-526 Targeting histone modifications: H3K27 acetylation regulates the expression of genes involved in key processes of uterine leiomyoma pathogenesis

Study question

Does histone mark H3K27ac regulate the expression of genes involved in uterine leiomyoma (UL) pathogenesis, and can histone deacetylation inhibition be a new therapeutic approach?

Summary answer

H3K27ac regulates genes implicated in UL pathogenesis through angiogenesis and extracellular matrix (ECM), and histone deacetylation reversion could offer a therapeutic approach to treat UL.

What is known already

UL is a benign tumor arising from myometrium (MM). Women present symptoms such as pelvic pain and infertility. There is no fully effective treatment with minimal side effects. Available medical options focus on the relief of symptoms and not in mechanisms implicated in UL development. Histone modifications are altered in tumors, particularly via histone acetylation which is correlated with gene activation. Herein, we aimed to identify if the modification H3K27ac is involved in UL pathogenesis, determining the relationship between H3K27ac and gene expression in UL versus MM and if its reversion may be a therapeutic option to treat UL.

Study design, size, duration

Prospective study comparing transcriptome (GEO:GSE192354 and GSE142332) by RNA sequencing (RNA-seq) (n = 48) and H3K27ac profile (GEO:GSE142332) by Chromatin Immunoprecipitation Sequencing (CHIP-seq) (n = 19) in UL versus adjacent MM tissue. Human uterine leiomyoma primary (HULP) cells obtained from individual patients (n = 10) were treated with 0.01% DMSO (control) and 10 µM SAHA, a histone deacetylases inhibitor, for 48 hours.

Participants/materials, setting, methods

Samples were collected from 48 women aged 31-54 years. Bioinformatics analysis were performed within the R/Bioconductor (4.1.1.). Differential expressed genes (DEGs) were analysed using three methods: DESeq2, edgeR and limma. Common DEGs (FDR&lt;0.01,log2FC&gt;1 or &lt;-1) were considered for further analysis. Differential H2K27ac peak enrichment analysis of selected genes was performed with limma and functional enrichment analysis (FDR&lt;0.05) with Shiny Go (version 0.741). SAHA effect on hypoacetylated/downregulated genes was assessed in HULP cells by qRT-PCR.

Main results and the role of chance

CHIP-seq analysis showed a lower amount of global H3K27ac peak enrichment level in UL versus MM (p-value&lt;2.2e-16). RNA-seq showed 922 common DEGs in UL versus MM, being 559 up-regulated and 363 down-regulated (FDR&lt;0.01, log2FC&gt;1 or &lt;-1). Integration of CHIP-seq and RNA-seq data showed that among 922 selected genes, 482 also presented the histone mark H3K27ac. Differential peak enrichment analysis demonstrated that 82 of them presented differential acetylation (FDR&lt;0.05) in UL versus MM, being 29 hyper-acetylated/up-regulated and 53 hypo-acetylated/down-regulated. Functional enrichment analysis of 82 DEGs regulated by H3K27ac showed biological processes deregulated in UL that were related to angiogenesis. Additionally, we found cellular components enriched in UL, which were related to an alteration of ECM, one of the key features of UL. We studied further these 82 genes controlled by H3K27ac and found hyperacetylation/upregulation of oncogenes (NDP, TFAP2C, HOXA13, COL24A1 and IGFL3) and hypoacetylation/downregulation of tumor suppressor genes (CD40, GIMAP8, IL15, GPX3 and DPT) in UL, which are related to immune system, angiogenesis, invasion, metabolism, ECM, TGFβ3 and Wnt/β-catenin pathway dysregulation. Finally, SAHA treatment in HULP cells significantly increased expression of the tumor suppressor genes that were hypoacetylated/downregulated in UL versus MM (CD40, GIMAP8, IL15, GPX3 and DPT) (p &lt; 0.05).

Limitations, reasons for caution

This is a preliminary study including only 19 participants in ChIP-seq analysis, thereby we should be cautious extrapolating our results to the general population. Further studies are necessary to determine the effectiveness of histone deacetylases inhibition, SAHA dose and adverse effects on UL in vivo.

Wider implications of the findings

H3K27 acetylation regulates the expression of oncogenes and tumor suppressor genes involved in key processes of UL pathogenesis, such as angiogenesis and ECM formation. Histone deacetylation reversion by SAHA upregulated the expression of tumor suppressor genes in HULP cells, suggesting histone deacetylation as a potential therapeutic approach for UL patients.

Trial registration number

Not applicable

P–105 Clinical validation of mojo AISA, an artificial intelligence robotic CASA system

Study question

Can a CASA system based on Artificial Intelligence perform as well as manual semen assessment, within the WHO error margins?

Summary answer

The AI-based CASA systems that mimic high quality assessments show great potential for reducing clinical workloads while increasing treatment efficacy.

What is known already

The field of male-factor fertility investigation is still lacking an automated semen analysis system that can be widely clinically adopted. By leveraging state-of-the-art robotics and Artificial Intelligence (AI), it was possible to build mojo AISA which is an AI and robotic platform designed according to WHO recommendation for semen analysis. This system is based on AI software with a unique convolutional neural network (CNN) that detects and measures sperm concentration and motility while ruling out unwanted cells and debris in raw samples.

Study design, size, duration

This study presents and validates the mojo AISA device. A total of 60 patient samples at ANOVA Karolinska University Hospital were collected and results from manual assessment were compared to mojo AISA for concentration and motility. Semen samples were assessed manually (WHO 2010) and concurrently with Mojo AISA. Manual measurements ranged from 1–206M/ml. This study lasted from May 2020 to December 2020 following informed consent and ethics committee practices of ANOVA.

Participants/materials, setting, methods

Sample preparation protocol for mojo AISA consisted of placing two 10ul drops and covering with two 22x22mm coverslip. Manual assessment followed ANOVA EQA procedures akin to the WHO. A CNN was trained using videos captured with mojo AISA as input data. Images were annotated to form a validation set by which the AI was trained. To account for sampling error, videos of Hamilton Thorne Accubeads+ were captured using mojo AISA and the mojo counting chambers.

Main results and the role of chance

Comparing the concentration measured by mojo AISA with the known value for each microbead, results are in agreement of 86%, within the confidence interval of the microbeads. The mean relative error was 6.7% and maximum error was 11%. Therefore, Accubeads+ validation proved no observational error regarding the use of mojo AISA microscope. As for comparing mojo AISA to manual assessment for concentration, Pearson (Spearman) correlation was 0.95 (0.97). The mean relative error was 24.8% and maximum relative error was 71.1%, where 90% of samples were below 50% error. By looking at the concentration range between 10 and 20 M/ml, mojo AISA displayed a mean error of 18.5%. For motility, as comparing mojo AISA to manual assessment, a result of 35.4% mean relative error was obtained. To conclude, mojo’s robotic solution shows promise for clinical practice as the AI continues to improve. In 6 months, sperm concentration correlation improved by 3-fold. Next, the AI will be further clinically trained for low concentration.

Limitations, reasons for caution

mojo AISA requires further development, especially for very low concentration ranges, below 5M/ml, due to high sensibility to false positive detections. The same applies to post-vasectomy samples. Additionally, the necessity to compute the motility of each sperm scales poorly with high concentration generating a poor experience for high volume clinics.

Wider implications of the findings: Automation is crucial in several industries. It enables fertility clinics & andrologists to standardize male factor infertility measurements (if paired with widespread standardization of protocols for automation) while enabling them to put more focus on demanding activities of their profession and removes human biases of inter-laboratory performance.

Trial registration number

Not applicable

Heterobilharzia americana infection in a Grant's zebra (Equus burchelli boehmi)

Heterobilharzia americana is a trematode parasite (family: Schistosomatidae) of mammalian wildlife that occasionally infects domestic dogs and horses in the southeastern United States. This report presents the first case of H. americana infection in a Grant's zebra (Equus burchelli boehmi). The parasite was diagnosed post mortem as an incidental finding by histopathologic identification of H. americana eggs in the liver parenchyma after the zebra succumbed in an accidental traumatic death. Molecular analysis of a portion of the parasite small subunit ribosomal RNA gene demonstrated 100% identity with DNA sequences from parasites previously characterized in domestic horses. Equine infections with H. americana are considered uncommon, but are probably underdiagnosed.

Determination of the Efficacy of Preservation of Non-Eye Area Water-Miscible Cosmetic and Toiletry Formulations: Collaborative Study

A collaborative study was conducted to test a method developed to distinguish between adequately and inadequately preserved cosmetic formulations. Nineteen laboratories participated in the study. Samples tested included shampoos, hair conditioners, oil-in-water emulsions, and water-in-oil-emulsions. Triplicate samples of 4 adequately preserved and 4 inadequately preserved cosmetic products were tested by each collaborative laboratory. Results showed that all inadequately preserved shampoo and conditioner samples failed to meet the acceptance criteria for adequately preserved formulations. Of the 51 preserved samples, 49 shampoos and 48 conditioners met the criteria for adequate preservation. All samples of inadequately preserved water-in-oil emulsions and oil-in-water emulsions failed to meet the acceptance criteria, whereas all adequately preserved emulsion formulations met the acceptance criteria.

A Fraxinus excelsior L. seeds/fruits extract benefits glucose homeostasis and adiposity related markers in elderly overweight/obese subjects: a longitudinal, randomized, crossover, double-blind, placebo-controlled nutritional intervention study

PURPOSE

The aim of this study was to investigate the potential benefits of an extract obtained from seeds/fruits of an Oleaceae (Fraxinus excelsior L.) on glucose homeostasis and associated metabolic markers in non-diabetic overweight/obese subjects.

MATERIALS AND METHODS

This study was performed in 22 participants (50-80 years-old; BMI 31.0 kg/m(2)). The design was a longitudinal, randomized, crossover, double-blind, placebo-controlled 7-week nutritional intervention. The participants received daily 3 capsules each containing either 333 mg of an extract from Fraxinus excelsior L. seeds (Glucevia(®)) or placebo capsules (control) in a random order for 3 weeks with 1 week of washout between treatments. Moreover, they followed a balanced covert energy-restricted diet (-15% energy). All variables were measured at the beginning and at the end of each period.

RESULTS

Compared to baseline, the administration of 1 g of Glucevia(®) for 3 weeks resulted in significantly lower incremental glucose area under the curve (-28.2%; p<0.01), and significantly lower 2 h blood glucose values (-14%; p<0.01) following an oral glucose tolerance test. No significant changes were found in the control group (-7.9% AUC, -1.6% 2h blood glucose). Furthermore, significant differences were found between responses in the control and Glucevia(®) groups with respect to serum fructosamine and plasma glucagon levels (p<0.01 and p<0.05, respectively). Interestingly, administration of Glucevia(®) significantly increased the adiponectin:leptin ratio (p<0.05) and decreased fat mass (p<0.01) compared to control (p<0.05).

CONCLUSION

The administration of an extract from Fraxinus excelsior L. seeds/fruits in combination with a moderate hypocaloric diet may be beneficial in metabolic disturbances linked to impaired glucose tolerance, obesity, insulin resistance and inflammatory status, specifically in older adults.

Clinical pregnancy following pre-implantation genetic diagnosis for cystic fibrosis

Pre-implantation genetic diagnosis (PGD) is an established alternative to prenatal testing for couples at risk of transmitting genetic disorders such as cystic fibrosis (CF).PGD screens pre-implantation embryos, allowing the safe transfer of those identified as unaffected. Awareness of CF carrier status in Ireland is increasing following the introduction of neonatal screening in 2011. PGD is the most acceptable reproductive strategy for many at risk Irish couples but until now the treatment necessitated travelling abroad. In 2012, the Irish Medicines Board licenced two Irish fertility clinics to carry out embryo biopsy for PGD. This is the first reported clinical pregnancy following PGD carried out in Ireland.

Note: statistical errors estimation for Thomson scattering diagnostics

A practical way of estimating statistical errors of a Thomson scattering diagnostic measuring plasma electron temperature and density is described. Analytically derived expressions are successfully tested with Monte Carlo simulations and implemented in an automatic data processing code of the JET LIDAR diagnostic.

Spatial resolution of the JET Thomson scattering system

The instrument function of the high resolution Thomson scattering (HRTS) diagnostic in the Joint European Torus (JET) has been calculated for use in improved pedestal profile analysis. The full width at half maximum (FWHM) of the spatial instrument response is (22 ± 1) mm for the original HRTS system configuration and depends on the particular magnetic topology of the JET plasmas. An improvement to the optical design of the laser input system is presented. The spatial smearing across magnetic flux surfaces is reduced in this design. The new input system has been implemented (from JPN 78742, July 2009) and the HRTS instrument function corresponding to the new configuration has been improved to approximately FWHM = (9.8 ± 0.8) mm. The reconstructed instrument kernels are used in combination with an ad hoc forward deconvolution procedure for pedestal analysis. This procedure produces good results for both the old and new setups, but the reliability of the deconvolved profiles is greatly reduced when the pedestal width is of the same order as, or less than the FWHM of the instrument kernel.

Sterilisation of hybrid Galapagos tortoises (Geochelone nigra) for island restoration. Part 1: endoscopic oophorectomy of females under ketamine-medetomidine anaesthesia

An endoscopic sterilisation technique for use in Galapagos tortoises (Geochelone nigra) was developed as part of a conservation and ecosystem restoration project. Fifteen female giant Galapagos tortoises were anaesthetised, intubated and positioned in dorsal recumbency. A bilateral prefemoral approach was made and the ovaries were identified using a 5 mm × 33 cm rigid telescope. In the case of endoscope-assisted oophorectomy, the ovaries were exteriorised through the same incision, the vasculature was ligated and the mesovarium was transected. Two tortoises had immature ovaries that could not be exteriorised. In these animals, endoscopic oophorectomy was performed using radiosurgery. Closure of the incisions was routine. All tortoises except one recovered well from surgery. There were no reported complications six weeks and six months postoperatively, and all were successfully released on to Pinta Island in May 2010.

Laser beam combiner for Thomson scattering core LIDAR

The light detection and ranging Thomson scattering (TS) diagnostic is advantageous since it only requires a single view port into the tokamak. This technique requires a short pulse laser at high energy, usually showing a limited repetition rate. Having multiple lasers will increase the repetition rate. This paper presents a scanning mirror as a laser beam combiner. Measurements of the position accuracy and jitter show that the pointing stability of the laser beam is within ±25 μrad for over tens of seconds. A control feedback loop is implemented to demonstrate the long term stability. Such a system could be applied for ITER and JET.

Presence of the metabolic syndrome is associated with shorter time to castration-resistant prostate cancer

BACKGROUND

Metabolic syndrome (MS) is a set of risk factors that includes obesity and insulin resistance and has been implicated in the development of prostate cancer. Its impact on androgen deprivation therapy (ADT) efficacy has not been studied.

PATIENTS AND METHODS

Retrospective study of prostate cancer patients seen from 1998 to 2005 in a medical oncology clinic. MS, as defined by modified Adult Treatment Panel III criteria, was assessed at the time of initiation of ADT. The study end points were time to prostate-specific antigen (PSA) progression and overall survival (OS) from time of starting ADT.

RESULTS

Eighty-two patients treated with ADT and data to assess for presence of MS were identified. Median age in men with and without MS was 70 years and 49% of the patients evaluated met criteria for MS. Median time to PSA progression for patients with MS was 16 versus 36 months without MS (P=0.003). The median OS for patients with MS was 36.5 months after commencing ADT compared with 46.7 months for those patients without MS (P=0.061).

CONCLUSIONS

This preliminary data suggest that MS is a risk factor for earlier development of castration-resistant prostate cancer and support the need for a prospective evaluation of this finding.

Monitoring medication adherence by unannounced pill counts conducted by telephone: reliability and criterion-related validity

BACKGROUND

Although demonstrated valid for monitoring medication adherence, unannounced pill counts conducted in patients' homes are costly and logistically challenging. Telephone-based unannounced pill counts offer a promising adaptation that resolves most of the limitations of home-based pill counting.

PURPOSE

We tested the reliability and criterion-related validity of a telephone-based unannounced pill count assessment of antiretroviral adherence.

METHOD

HIV-positive men and women (N = 89) in Atlanta, Georgia, completed a telephone-based unannounced pill count and provided contemporaneous blood specimens to obtain viral loads; 68 participants also received an immediate second pill count conducted during an unannounced home visit.

RESULTS

A high degree of concordance was observed between the number of pills counted on the telephone and in the home (intraclass correlation [ICC] = .981, p < .001) and percent of pills taken (ICC = .987, p < .001). Adherence obtained by the telephone count and home count reached 92% agreement (Kappa coefficient = .94). Adherence determined by telephone-based pill counts also corresponded with patient viral load, providing evidence for criterion-related validity.

CONCLUSION

Unannounced telephone-based pill counts offer a feasible objective method for monitoring medication adherence.

Association between health literacy and HIV treatment adherence: further evidence from objectively measured medication adherence

BACKGROUND

People with lower-health literacy are vulnerable to health problems. Studies that have examined the association between literacy and medication adherence have relied on self-reported adherence, which is subject to memory errors, perhaps even more so in people with poor literacy.

PURPOSE

To examine the association between health literacy and objectively assessed HIV treatment adherence.

METHODS

Men and women (N = 145) receiving antiretroviral therapy completed a test of health literacy and measures of common adherence markers. Medication adherence was monitored by unannounced pill counts.

RESULTS

Median adherence was 71%; participants with lower-health literacy also demonstrated poorer adherence compared to participants with higher literacy. Hierarchical regression showed literacy predicted adherence over and above all other factors. Sensitivity tests showed the same results for 80% and 90% adherence.

CONCLUSIONS

The association between literacy and adherence appears robust and was confirmed using an objective measure of medication adherence.

Adherence to antiretroviral therapy assessed by unannounced pill counts conducted by telephone

BACKGROUND

Unannounced pill counts conducted in patients' homes is a valid objective method for monitoring medication adherence that is unfortunately costly and often impractical. Conducting unannounced pill counts by telephone may be a viable alternative for objectively assessing medication adherence.

PURPOSE

To test an unannounced pill count assessment of adherence conducted by telephone.

METHODS

HIV-positive men and women (N = 77) in Atlanta GA completed an unannounced telephone-based pill count immediately followed by a pill count conducted in an unannounced home visit.

RESULTS

A high degree of concordance was observed between phone and home-based number of pills counted (Intraclass correlation, ICC = .997, 95% CI .995-.998, P < .001) and percent of pills taken (ICC = .990, 95% CI .986-.992, P < .001). Concordance between adherence above/below 90% and phone/home counts was 95%, Kappa coefficient = .995. Concordance between pill counts was not influenced by participant education or health literacy and was maintained when the data were censored to remove higher levels of adherence. Analyses of discordant pill counts found the most common source of error resulted from overcounted doses in pillboxes on the telephone.

CONCLUSIONS

Unannounced phone-based pill counts offer an economically and logistically feasible objective method for monitoring medication adherence.

Evidence of the purely leptonic decay B- --> tau- nu(tau)

We present the first evidence of the decay B- --> tau- nu(tau), using 414 fb(-1) of data collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric-energy e+ e- collider. Events are tagged by fully reconstructing one of the B mesons in hadronic modes. We detect the signal with a significance of 3.5 standard deviations including systematics and measure the branching fraction to be B(B- --> tau- nu(tau)) = (1.79(-0.49) +0.56(stat)(-0.51) +0.46(syst)) x 10(-4). This implies that fB = 0.229(-0.031) +0.036(stat)(-0.037) +0.034(syst) GeV and is the first direct measurement of this quantity.

Observation of B0-->pi0pi0

We report the observation of the decay B0-->pi(0)pi(0), using a 253 fb(-1) data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB e(+)e(-) collider. The measured branching fraction is B(B0-->pi(0)pi(0))=(2.3(+0.4+0.2)(-0.5-0.3))x10(-6), with a significance of 5.8 standard deviations including systematic uncertainties. We also make a measurement of the direct CP violating asymmetry in this mode.

Evidence for direct CP violation in B0-->K+pi- decays

We report evidence for direct CP violation in the decay B0-->K+pi(-) with 253 fb(-1) of data collected with the Belle detector at the KEKB e(+)e(-) collider. Using 275x10(6) BB pairs we observe a B-->K+/-pi(-/+) signal with 2140+/-53 events. The measured CP violating asymmetry is A(CP)(K+pi(-))=-0.101+/-0.025(stat)+/-0.005(syst), corresponding to a significance of 3.9sigma including systematics. We also search for CP violation in the decays B+-->K+pi(0) and B+-->pi(+)pi(0). The measured CP violating asymmetries are A(CP)(K+pi(0))=0.04+/-0.05(stat)+/-0.02(syst) and A(CP)(pi(+)pi(0))=-0.02+/-0.10(stat)+/-0.01(syst), corresponding to the intervals -0.05<A(CP)(K+pi(0))<0.13 and -0.18<A(CP)(pi(+)pi(0))<0.14 at 90% confidence level.

Observation of large CP violation and evidence for direct CP violation in B0-->pi(+)pi(-) decays

We report the first observation of CP violation in B0-->pi(+)pi(-) decays based on 152x10(6) gamma (4S)-->BB decays collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. We reconstruct a B0-->pi(+)pi(-) CP eigenstate and identify the flavor of the accompanying B meson from its decay products. From the distribution of the time intervals between the two B meson decay points, we obtain A(pipi)=+0.58+/-0.15(stat)+/-0.07(syst) and S(pipi)=-1.00+/-0.21(stat)+/-0.07(syst). We rule out the CP-conserving case, A(pipi)=S(pipi)=0, at a level of 5.2 standard deviations. We also find evidence for direct CP violation with a significance at or greater than 3.2 standard deviations for any S(pipi) value.

Upper bound on the decay tau-->microgamma from the Belle detector

We have performed a search for the lepton-flavor-violating decay tau-->microgamma using a data sample of 86.3 fb(-1) accumulated by the Belle detector at KEK. No evidence for a signal is seen, and we set an upper limit for the branching fraction of B(tau-->microgamma)<3.1 x 10(-7) at the 90% confidence level.

Measurement of time-dependent CP-violating asymmetries in B0-->phiK(0)S, K+K-K0(S), and eta'K0(S) decays

We present an improved measurement of CP-violation parameters in B0-->phiK(0)(S), K(+)K(-)K(0)(S), and eta(')K(0)(S) decays based on a 140 fb(-1) data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB energy-asymmetric e(+)e(-) collider. One neutral B meson is fully reconstructed in one of the specified decay channels, and the flavor of the accompanying B meson is identified from its decay products. CP-violation parameters for each of the three modes are obtained from the asymmetries in the distributions of the proper-time intervals between the two B decays. We find that the observed CP asymmetry in the B-->phiK(0)(S) decay differs from the standard model (SM) expectation by 3.5 standard deviations, while the other cases are consistent with the SM.

Evidence for B0-->pi0pi0

We report evidence for the decay B0-->pi(0)pi(0). The analysis is based on a data sample of 152x10(6) BBmacr; pairs collected at the Upsilon(4S) resonance with the Belle detector at the KEKB e(+)e(-) storage ring. We detect a signal for B0-->pi(0)pi(0) with a significance of 3.4 standard deviations, and measure the branching fraction to be [1.7+/-0.6(stat)+/-0.2(syst)]x10(-6).

Observation of the D(sJ)(2317) and D(sJ)(2457) in B decays

We report the first observation of the B-->Dmacr;D(sJ)(2317) and B-->Dmacr;D(sJ)(2457) decays based on 123.8x10(6) BBmacr; events collected with the Belle detector at KEKB. We observe the D(sJ)(2317) decay to D(s)pi(0) and the D(sJ)(2457) decay to the D(*)(s)pi(0) and D(s)gamma final states. We also set 90% C.L. upper limits for the decays D(sJ)(2317)-->D(*)(s)gamma, D(sJ)(2457)-->D(*)(s)gamma, D(sJ)(2457)-->D(s)pi(0), and D(sJ)(2457)-->D(s)pi(+)pi(-).

Observation of B-->K*l+l-

We report the observation of the flavor-changing neutral current decay B-->K(*)l(+)l(-) and an im-proved measurement of the decay B-->Kl(+)l(-), where l represents an electron or a muon, with a data sample of 140 fb(-1) accumulated at the Upsilon(4S) resonance with the Belle detector at KEKB. The results for the branching fractions are B(B-->K(*)l(+)l(-))=(11.5(+2.6)(-2.4)+/-0.8+/-0.2)x10(-7) and B(B-->Kl(+)l(-))=(4.8(+1.0)(-0.9)+/-0.3+/-0.1)x10(-7), where the first error is statistical, the second is systematic and the third is from model dependence.

Observation of a narrow charmoniumlike state in exclusive B+/--->K+/-pi+pi-J/psi decays

We report the observation of a narrow charmoniumlike state produced in the exclusive decay process B+/--->K+/-pi(+)pi(-)J/psi. This state, which decays into pi(+)pi(-)J/psi, has a mass of 3872.0+/-0.6(stat)+/-0.5(syst) MeV, a value that is very near the M(D0)+M(D(*0)) mass threshold. The results are based on an analysis of 152M B-Bmacr; events collected at the Upsilon(4S) resonance in the Belle detector at the KEKB collider. The signal has a statistical significance that is in excess of 10sigma.

Analysis of the candidate 8p21 tumour suppressor, BNIP3L, in breast and ovarian cancer

Loss of heterozygosity (LOH) on the short arm of chromosome 8, at 8p12-p23, is one of the most frequent genetic events in both breast and ovarian cancer, suggesting the location of a shared tumour suppressor gene. Microcell-mediated chromosome transfer of chromosome 8 suppresses tumorigenicity and growth of colorectal and prostate cancer cell lines, further supporting the presence of a tumour suppressor gene on 8p. We have taken a candidate gene approach to try to identify this tumour suppressor gene at 8p12-p23. BNIP3L, which has sequence homology to pro-apoptotic proteins and the ability to suppress colony formation in soft agar, is located at 8p21, within a region of ovarian cancer LOH, breast cancer LOH and prostate cancer metastasis suppression. BNIP3L expression was assessed by both RT-PCR and Northern blot analysis in breast and ovarian cancer cell lines and found to be expressed at similar levels relative to expression in their respective normal epithelial cell lines. Genetic analysis of BNIP3L in 40 primary ovarian and 25 primary breast tumours identified one somatic, intronic mutation in one ovarian tumour, as well as several polymorphisms, including one resulting in an amino-acid substitution. These data suggest that BNIP3L is unlikely to be the target of 8p LOH in ovarian or breast cancer.