How do Children with Intellectual Disabilities Empathize in Comparison to Typically Developing Children?

OBJECTIVES

Two studies were conducted to better understand how children with intellectual disabilities (ID) empathize with the feelings of others during social interactions. The first study tested hypotheses of developmental delay or difference regarding empathy in 79 children with ID by comparing them with typically developing (TD) children, matched for developmental age or chronological age. The second study examined specific aspects of empathy in 23 children with Down syndrome (DS), compared with 23 nonspecific ID children, matched for developmental age, and TD children, matched for developmental age or chronological age.

METHOD

An empathy task was administered to the children while their parents completed the French versions of the Empathy Questionnaire and the Griffith Empathy Measure.

RESULTS

The first study showed that ID children showed delayed empathy development but were perceived by their parents as deficient in cognitive empathy. The second study showed that DS children were perceived as being more attentive to the feelings of others than TD children and non-specific ID children, matched for developmental age, and as having affective empathy that was similar to that of TD children matched for chronological age.

CONCLUSION

These studies have drawn attention to delays or differences in different dimensions of empathy in children with ID and DS, which need to be taken into account in interventions.

[Big data and artificial intelligence in anesthesia : Reality or fiction?]

Big data and artificial intelligence are buzzwords that everyone is talking about and yet always provide a touch of science fiction to the scenery. What is the status of these topics in anesthesia? Are the first robots already rolling through the corridors while doctors are getting bored as all the work has been done? Spoiler alert! We are still far away from achieving this. Initially, paper charts and analogue notes stand in the way of comprehensive digitization. Source systems need to be merged and data standardized, harmonized and validated. Therefore, the friendly android that is rolling towards us, waving and holding a freshly brewed cup of coffee in our thoughts will have to wait; however, a glimpse of the future is already evident in some clinics and the first promising developments are already showing what could be the standard tomorrow. Learning algorithms calculate the length of stay individually for each patient in the intensive care unit (ICU), reducing negative consequences such as readmission and mortality. The field of ultrasound technology for regional anesthesia and closed-loop anesthesia systems is also demonstrating the benefits of artificial intelligence (AI)-assisted technologies in practice. The efforts are diverse and ambitious but they repeatedly collide with privacy challenges and significant capital expenditure, which weigh heavily on an already financially strained healthcare system; however, anyone who listens carefully to the medical staff knows that robots are not what they would expect and the buzzwords big data and artificial intelligence might be less science fiction than initially assumed.

Psychometric Properties of the Theory of Mind Task Battery (French Version) in Neurotypical Children and Intellectually Disabled Children

These studies tested the psychometric properties of the French version of the Theory of Mind (ToM) Task Battery (vf) in typically developing (TD) children and intellectually disabled (ID) children. The Battery was administered to 649 TD children (2 ½ to 12 years old) in Study 1 and 155 ID (4 ½ to 14 ½ years old) in Study 2. Their mothers completed questionnaires: in both studies, the Theory of Mind Inventory (ToMI-1-vf); in Study 1, the Griffith Empathy Measure (GEM-vf) and the Emotion Regulation Checklist (ERC-vf); and in Study 2, the Social Competence and Behavior Evaluation (SCBE-vf). The Battery showed good internal consistency in both groups. Positive links with age and differences between age groups were identified in their performances. Convergent validity was confirmed by positive correlations between TD children's scores in the Battery and in ToMI1-vf, in empathy, in emotion regulation, and by a negative correlation with emotion dysregulation. In ID children, their scores in the Battery were positively linked with those in ToMI-1-vf, in some scales of SCEB-vf, and had a low level of internalizing problems. This Battery presents good psychometric qualities and could be useful for explicit assessment of ToM in TD and ID children in future research and intervention.

Empathy in Preschoolers: Exploring Profiles and Age- and Gender-Related Differences

Empathy is a key skill in the daily life of preschoolers, and it is important to understand how it evolves during this crucial period of development. This paper includes two studies. The first study, which had a cross-sectional design, examined affective, cognitive, and behavioral empathy in 354 children (aged from 3 to 6 years) through a performance-based measure and questionnaires completed by their mothers. Although girls tended to have better affective empathy than boys on the performance-based task, no difference was noted in the mothers' perceptions of their children's empathy. Empathy dimensions varied depending on the age of the children. The hierarchical cluster analyses of the cases identified differentiated subgroups of children, according to their empathic skills in the three dimensions. The second study, which was longitudinal, used the same measures and investigated the developmental trajectory of empathy in 69 preschoolers over one year. The results showed that each empathic dimension predicted itself one year later, but did not predict the two others. The implications for potential interventions are emphasized in this study.

P-455 Laparoscopic robot-assisted autologous transplantation of cryopreserved ovarian tissue: report of an operative technique and reproductive outcomes in a case series

Study question

Is laparoscopic robot-assisted autologous transplantation of ovarian tissue feasible and is the reproductive outcome adequate in comparison with published data?

Summary answer

Laparoscopic robot-assisted autologous transplantation of ovarian tissue is feasible and safe. The reproductive outcome in our series is comparable with published data.

What is known already

Autologous cryopreserved ovarian tissue transplantation (ACOTT) is recognized as a valid fertility preservation technique among young patients facing iatrogenic premature ovarian failure (IOP). Orthotopic transplantation consists in the reimplantation of ovarian tissue back to the medulla of the ovary or into a specially created peritoneal pouch. It has been described by laparoscopy or mini laparotomy. It is the most efficient technique to restore endocrine function and fertility. Conception and live birth rates have been reported to be respectively 38% and 26%. The robot-assisted laparoscopic approach was recently described in a 7-case series.

Study design, size, duration

We prospectively registered all ACOTT procedures performed in our department between November 2004 and January 2022.

Participants/materials, setting, methods

We analyzed the data of 29 ACOTT procedures performed among 22 patients. The indication for ovarian cryopreservation, the time to restore and duration of endocrine function (regular menstrual cycles), time to first pregnancy and number of pregnancies/live births have been prospectively collected. The operative technique (laparoscopic/robot), duration of surgical procedure, hospital stay, intra and post-operative complications have been retrospectively extracted from the patients’ files.

Main results and the role of chance

We included 22 patients: 8 with a malignant hematologic disease, 7 with a breast cancer, 3 with a benign disease, 2 with a pelvic malignancy and 2 with a sarcoma. Their median age at ovarian tissue cryopreservation was 28.5 (11 – 35) years. Their median age at first ACOTT was 36.5 (23 – 42) years. The median time between cryopreservation and ACOTT was 6.75 (2 – 21) years. Seven out of 22 patients had a second ACOTT. Twenty-nine procedures of orthotopic reimplantation were performed. A concomitant heterotopic (sub cutaneous) transplantation was performed among six out of the 29 procedures, at the beginning of our experience. All 29 orthotopic reimplantation were performed laparoscopically, 19 out of them with robot assistance. The median operating time was 102 (43 – 149) minutes and was shorter for laparoscopy (62 minutes) than for robot assisted laparoscopy (106 minutes). We encountered no complication, and the median hospital stay was 1 (1 – 2) day. The median time to restore endocrine function was 4 (1 – 6) months. Eighteen transplanted patients wished to be pregnant among whom 12 (67%) had at least one pregnancy and 8 (44%) had at least one live birth.

Limitations, reasons for caution

This is a small sample within a single institution. The patients were referred from many centers for ovarian tissue cryopreservation and secondary ACOTT. They were followed until they became pregnant and then referred to their gynecologist. Finally, three patients who did not wish to conceive were lost of follow-up.

Wider implications of the findings

This case series confirms the feasibility and safety of robot assisted ACOTT. The procedure is longer when performed with the robot. The fertility outcome (pregnancy/livebirth rates) is comparable with the published data. The added value of the robot approach needs to be investigated in larger series with long term follow-up.

Trial registration number

P2004/122

Coherent and Incoherent Tunneling into Yu-Shiba-Rusinov States Revealed by Atomic Scale Shot-Noise Spectroscopy

The pair breaking potential of individual magnetic impurities in s-wave superconductors generates localized states inside the superconducting gap commonly referred to as Yu-Shiba-Rusinov (YSR) states whose isolated nature makes them promising building blocks for artificial structures that may host Majorana fermions. One of the challenges in this endeavor is to understand their intrinsic lifetime, ℏ/Λ, which is expected to be limited by the inelastic coupling with the continuum thus leading to decoherence. Here we use shot-noise scanning tunneling microscopy to reveal that electron tunneling into superconducting 2H-NbSe_{2} mediated by YSR states is not Poissonian, but ordered as a function of time, as evidenced by a reduction of the noise. Moreover, our data show the concomitant transfer of charges e and 2e, indicating that incoherent single particle and coherent Andreev processes operate simultaneously. From the quantitative agreement between experiment and theory we obtain Λ=1  μeV≪k_{B}T demonstrating that shot noise can probe energy scales and timescales inaccessible by conventional spectroscopy whose resolution is thermally limited.

Exact law for compressible pressure-anisotropic magnetohydrodynamic turbulence: Toward linking energy cascade and instabilities

We derive an exact law for compressible pressure-anisotropic magnetohydrodynamic turbulence. For a gyrotropic pressure tensor, we study the double-adiabatic case and show the presence of new flux and source terms in the exact law, reminiscent of the plasma instability conditions due to pressure anisotropy. The Hall term is shown to bring ion-scale corrections to the exact law without affecting explicitly the pressure terms. In the pressure isotropy limit we recover all known results obtained for isothermal and polytropic closures. The incompressible limit of the gyrotropic system leads to a generalization of the Politano and Pouquet's law where a new incompressible source term is revealed and reflects exchanges of the magnetic and kinetic energies with the no-longer-conserved internal energy. We highlight the possibilities offered by the new laws to investigate potential links between turbulence cascade and instabilities widely observed in laboratory and astrophysical plasmas.

Bonnes pratiques en matière de télémédecine

La télémédecine ou médecine à distance s’est imposée aux soignants à la faveur de la pandémie à SARS-Cov2. Elle doit être considérée comme un outil capable d’améliorer la pratique d’une médecine moderne. Ce texte en rappel les règles d’exercice et incite à en organiser l’enseignement.

Preschoolers' Empathy Profiles and Their Social Adjustment

Preschoolers face new challenges in their social life: the development of social and emotional abilities in order to have positive relationships with peers and adults. Empathy, the ability to share and understand the emotions of others, contributes to this socio-emotional adjustment. This exploratory study examines mothers and fathers' perceptions of their child's empathy and individual factors, such as age, gender, and personality, which are related to cognitive and affective empathy in 63 typically developing preschoolers. Links between children's individual characteristics (empathy and personality) and their social adjustment on the one hand and risk of developing internalized vs. externalized behaviors on the other were also investigated. Parents completed four questionnaires about their child's empathy, personality, and social (mal)adjustment. The results showed that mothers and fathers perceived their children's cognitive and affective empathy, attention to others' feelings, and social actions (such as helping), in the same way, except for emotion contagion. Gender differences appeared specifically for some components of empathy: girls were said to pay more attention to others' emotions while boys had better cognitive empathy. Moreover, children's empathy as perceived by mothers or fathers was positively linked with their age, and with personality factors (extraversion, emotional stability, agreeableness, and openness to experience). Cognitive empathy and personality were found to be partly related to higher social skills and lower externalized and internalized behaviors. The results nuanced specific links between cognitive and affective empathy and social adjustment as well as behavior problems at preschool age. These results may have some implications for future research and prevention in childhood.

CNS-3 status remains an independent adverse prognosis factor in children with acute lymphoblastic leukemia (ALL) treated without cranial irradiation: Results of EORTC Children Leukemia Group study 58951

AIM

To evaluate the prognostic significance of initial central nervous system (CNS) involvement of children with acute lymphoblastic leukemia (ALL) enrolled in the EORTC 58951 trial.

PATIENTS AND METHODS

From 1998 to 2008, 1930 ALL patients were included in the randomized EORTC 58951 trial. Overall treatment intensity was adjusted according to known prognostic factors including the level of minimal residual disease after induction treatment. CNS-directed therapy comprised four to 11 courses of i.v. methotrexate (5g/m²), and 10 to 19 intrathecal chemotherapy injections, depending on risk group and CNS status. Cranial irradiation was omitted for all patients.

RESULTS

The overall 8-year event-free survival (EFS) and overall survival (OS) rates were 81.3% and 88.1%, respectively. In the CNS-1, TPL+, CNS-2, and CNS-3 groups, the 8-year EFS rates were 82.1%, 77.1%, 78.3%, and 57.4%, respectively. Multivariable analysis indicated that initial CNS-3 status, but not CNS-2 or TLP+, was an independent adverse predictor of outcome. The 8-year incidence of isolated CNS relapse was 1.7% and of isolated or combined CNS relapse it was 3.7%. NCI high-risk group, male sex, CNS-2 and CNS-3 status were independent predictors for a higher incidence of any CNS relapse.

CONCLUSIONS

CNS-3 status remains associated with poor prognosis and requires intensification of both systemic and CNS-directed therapy. This trial was registered at https://clinicaltrials.gov/under/NCT00003728.

Social Cognition in Children With Non-specific Intellectual Disabilities: An Exploratory Study

Social cognitive abilities - notably, Theory of Mind (ToM) and social information processing (SIP) - are key skills for the development of social competence and adjustment. By understanding affective and cognitive mental states and processing social information correctly, children will be able to enact prosocial behaviors, to interact with peers and adults adaptively, and to be socially included. As social adjustment and inclusion are major issues for children with intellectual disabilities (IDs), the present study aimed to explore their social cognitive profile by combining cluster analysis of both ToM and SIP competence, and to investigate the structure of relations between these skills in children with IDs. Seventy-eight elementary school children with non-specific IDs were recruited. They had a chronological age ranging from 4 years and 8 months to 12 years and 6 months and presented a preschool developmental age. Performance-based measures were administered to assess ToM and SIP abilities. Questionnaires were completed by the children's parents to evaluate the children's social competence and adjustment and their risk of developing externalizing or internalizing behaviors. Exploratory analysis highlighted strengths and weaknesses in the social cognitive profiles of these children with IDs. It also emphasized that the understanding of affective and cognitive mental states was used differently when facing appropriate vs. inappropriate social behaviors. The present study leads to a better understanding of the socio-emotional profile of children with IDs and offers some suggestions on how to implement effective interventions.

[Anti-infective treatment in obesity-"just double it?"]

Adaequate antibiotic therapy is crucial for successful anti-infective therapy. In addition to the choice of the right antibiotic and the duration of therapy, the dose also plays a decisive role. Obesity has an influence on the pharmacokinetics of antibiotics, which can lead to underdosing if previous weight-independent dosing regimes are used. It is therefore necessary to carry out systematic measurements of concentrations in obese patients. Since pharmacokinetic differences between plasma and the interstitial fluid of different target tissues have been observed for different antibiotics, the measurement is also necessary in the target tissue. The technique of microdialysis is best suited for this purpose as it allows concentrations to be measured continuously in the target tissue.

[Focus on the endocannabinoid system and the reprotoxicity of marijuana in female users]

Among recreative compounds, marijuana is the most used worldwide. Delta9THC binding on brain endocannabinoid receptors drives its psychotropic effects. The endocannabinoid system (ECS) is an endogenous neurohormonal system essential for homeostasis composed of ligands, metabolic enzymes and at least 2 receptors discovered to date. In female reproduction, the ECS regulates the hypothalamic-pituitary axis and many steps of the reproduction process, such as ovulation, tubal transportation and trophoblast implantation. Delta9THC can cross the placental barrier and bind to the fetal endocannabinoid system. In humans, fetal and obstetrical consequences of marijuana use during pregnancy are intrauterine growth restriction and preterm delivery. In the light of legalization projects currently reviewed in several western countries, further research should be conducted to improve knowledge on maternal, fetal and reprotoxic consequences of marijuana use during reproductive age and pregnancy.

Photoelectrocatalytic activity of In(iii)-modified TiO2 photoanodes in the visible spectrum region

Nanocrystalline film photoanodes of titanium dioxide modified with In(iii) ions in the concentration range from 1.0 to 10 mass% (0.23 to 2.52 at%) are manufactured using the sol–gel method.

Complex diffractive surface patterns on metals by UV-ps laser ablation

Diffractive surface patterns with complex textures are generated on metal surfaces by picosecond UV laser ablation using an interference setup. Two diffraction gratings with variable distance and rotation angle provide a huge variety of interference patterns and thus resulting surface topographies. This variety can be further enhanced by selecting or blocking particular beams. A correlation analysis of the complex diffraction patterns generated by reflection of visible laser light at these surface topographies demonstrates that patterns with slightly differing fabrication parameters (variation of 0.5 mm in distance or 1° in rotation) can be clearly distinguished.

[Special situations of preconditioning and prehabilitation in oncological visceral surgery]

BACKGROUND

Prehabilitation prior to complex visceral oncological surgery is playing an increasingly important role.

OBJECTIVE

The aim of this review article is to present special situations of preconditioning in visceral oncological patient cohorts. The following conditions were defined as special situations with subsequently increased risk profile: cardiopulmonary comorbidities, geriatric patients, neoadjuvant therapy and simultaneous fatigue.

MATERIAL AND METHODS

A selective literature review based on a search in the electronic databases MEDLINE, PubMed, Cochrane Library and the International Standard Randomization Controlled Trial Number (ISRCTN) was performed.

RESULTS

The identification of high-risk patients is an essential part of the preoperative evaluation conducted by the anesthesiologist prior to surgery. The cardiovascular and the pulmonary risk profile are determined by means of prediction indices evaluating patient-specific and surgery-related risk factors. The increased use of new oral anticoagulants and dual platelet aggregation inhibition requires individualized treatment strategies. Numerous studies have shown clinically relevant effects of exercise therapy interventions throughout all phases of oncological treatment. In addition to positive effects on therapy-associated side effects, sport can also counteract the effects of sedentary behavior in cancer patients and improve the health-related quality of life. The effectiveness of sport and exercise therapies as well as psychological interventions in oncological patients with fatigue (CRF) is broad, with important components being motivation and compliance.

DISCUSSION

In high-risk patients an interdisciplinary approach to planning and conduction of prehabilitation is essential for the early detection and optimization of perioperative risk factors and potential complications. The aim is faster recovery, reduced morbidity and mortality and the possibility to improve long-term survival and quality of life.

Measurement of soft tissue drug concentrations in morbidly obese and non-obese patients - A prospective, parallel group, open-labeled, controlled, phase IV, single center clinical trial

Background

Pharmacokinetic (PK) and pharmacodynamic (PD) data on perioperative antibiotic prophylaxis or antibiotic therapy are rare in patients suffering from morbid obesity. Furthermore, dosing regimens should be based on PK/PD models that ensure effective antibiotic exposure not in plasma, but primarily at the site of infection, mostly in the interstitial fluid (ISF). The aim of this trial is to investigate whether current dosing regimens of various antibiotics lead to effective concentrations in the ISF of morbidly obese patients.

Methods

We designed a prospective, parallel group, open-labeled, controlled single center trial to investigate the plasma and tissue pharmacokinetics of the antibiotics linezolid, meropenem, tigecycline, piperacillin/tazobactam, fosfomcyine, cefazolin, metronidazole and as secondary aim the analgesics metamizole and acetaminophen. Inclusion criteria comprise body mass index ≥35 kg/m² for obese or between 18.5 and 30 kg/m² for non-obese patients scheduled for elective abdominal surgery. For PK analysis, blood and microdialysate samples of subcutaneous tissue were collected 0–8 h after study drug administration. The primary endpoint is to investigate a possible dependency of the area-under-the-curve (AUC_0-8) in the interstitial fluid on body weight and obesity with population based pharmacokinetic analysis.

Discussion

Inadequate dosing regimes of antibiotics may be a relevant factor for morbidity and mortality of patients, as well as for the development of bacterial antibiotic resistance. The measurement of plasma and tissue concentrations will provide information necessary for PK/PD-modelling. These data about antibiotic PK/PDcharacteristics in soft tissue and their dependence on weight should help to develop weight-dependent models for calculation of patient's individual doses of different antibiotics.

Trial registration

EU clinical trials register (EudraCT-No. 2012-004383-22) and German Clinical trials Register (DRKS00004776);

Individualized positive end-expiratory pressure in obese patients during general anaesthesia: a randomized controlled clinical trial using electrical impedance tomography

Background

General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects.

Methods

Patients with a BMI ≥35 kg m -2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg -1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEP IND ) or (ii) no RM and PEEP of 5 cm H 2 O (PEEP 5 ). Gas exchange, regional ventilation distribution, and EELV (multiple breath nitrogen washout method) were determined before, during, and after anaesthesia. The primary end point was the ratio of arterial partial pressure of oxygen to inspiratory oxygen fraction ( P aO 2 / F iO 2 ).

Results

For PEEP IND ( n =25) and PEEP 5 ( n =25) arms together, P aO 2 / F iO 2 and EELV decreased by 15 kPa [95% confidence interval (CI) 11-20 kPa, P <0.001] and 1.2 litres (95% CI 0.9-1.6 litres, P <0.001), respectively, after intubation. Mean ( sd ) PEEP IND was 18.5 (5.6) cm H 2 O. In the PEEP IND arm, P aO 2 / F iO 2 before extubation was 23 kPa higher (95% CI 16-29 kPa; P <0.001), EELV was 1.8 litres larger (95% CI 1.5-2.2 litres; P <0.001), driving pressure was 6.7 cm H 2 O lower (95% CI 5.4-7.9 cm H 2 O; P <0.001), and regional ventilation was more equally distributed than for PEEP 5 . After extubation, however, these differences between the arms vanished.

Conclusions

In obese patients, an RM and higher PEEP IND restored EELV, regional ventilation distribution, and oxygenation during anaesthesia, but these differences did not persist after extubation. Therefore, lung protection strategies should include the postoperative period.

Clinical trial registration

German clinical trials register DRKS00004199, www.who.int/ictrp/network/drks2/en/ .

Abstract PD5-06: The immunomodulatory potential of denosumab in breast cancer: results from D-BEYOND, a window of opportunity trial evaluating a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer

Background

Breast cancer (BC) in young women has unique biology and poor prognosis. Previous reports suggest that they often express RANKL, which was also shown to play a role in mammary tumorigenesis and various immune processes. Here, we present the primary results of D-BEYOND, a window study investigating the biological activity of the RANKL inhibitor; denosumab in pre-menopausal BC patients.

Methods

D-BEYOND is a prospective, phase Iia, single-arm, multicenter study assessing the effect of denosumab on BC biology in premenopausal women with early BC (NCT01864798). Patients received two subcutaneous injections of denosumab (120mg), one week apart, followed by breast surgery. The primary endpoint was geometric mean change in tumor Ki67 assessed by immunohistochemistry (IHC). Blood, tumor and normal adjacent breast tissue were collected pre- and post-treatment. Serum levels of RANKL, OPG and CTX were assessed by ELISA. RNA was extracted from fresh-frozen tissue and RNAseq was performed. DESeq2 was used for differential expression analysis, GAGE was used for pathway analysis and CIBERSORT was used to infer immune cell subsets between pre- and post-treatment. Ki67, CD4/Foxp3 and CD4/CD8 IHC were performed on FFPE tissue to further assess the immune microenvironment. The percentage of TILs was independently evaluated by two pathologists on H&E slides. Pre- and post-treatment values were compared using a paired t-test.

Results

A total of 27 patients were enrolled in the study between October 2013 and July 2016. The median age was 45 years (range 35-51 years). Tumors of 21 patients were hormone receptor positive (77.8%), 4 were HER2 positive (14.8%) and 2 were triple negative (7.4%). No serious adverse events were reported, the most frequent non-serious adverse event being arthralgia (14.8%). After treatment, serum levels of CTX and RANKL decreased in all patients (P &lt; 0.001) whereas OPG increased in 76.9% of patients (P = 0.009, 95% CI 0.56-0.91). There was no significant reduction of Ki67 values from baseline (geometric mean [GM] change after treatment; 0.98, 95% CI 0.76-1.26; P = 0.90). Twenty-four pre- and post-treatment tumor pairs were available for RNAseq, IHC and TILs evaluation. There was a significant increase in the percentage of stromal TILs after treatment (GM change of 1.75, 95% CI 1.28–2.39; P = 0.001). 1084 differentially expressed genes were identified and pathway analysis revealed enrichment of several immune processes. CIBERSORT revealed an enrichment of CD8+ T cells (GM change 1.72, 95% CI 1.19–2.48; P = 0.006) and a decrease of Treg cells (0.71, 95% CI 0.52–0.98, P = 0.040). These results were confirmed by IHC of CD8+ and CD4+/Foxp3+ cells (GM change 1.59, 95% CI 1.14–2.21; P = 0.008 and 0.63, 95% CI 0.49–0.83, P = 0.001, respectively).

Conclusion

Short course of denosumab did not reduce tumor proliferation rate. However, it induced a significant increase in TILs and CD8 cytotoxic T cells, while Treg infiltration decreased. These findings suggest an immunomodulatory role for denosumab in young breast cancer and that its use in combination could boost immunotherapy efficacy.

Citation Format: Nguyen B, Marion M, Salgado R, Venet D, Vuylsteke P, Polastro L, Wieldiers H, Simon P, Lindeman G, Larsimont D, Van den Eynden G, Velghe C, Rothe F, Garaud S, Michiels S, Willard-Gallo K, Azim Jr HA, Loi S, Piccart M, Sotiriou C. The immunomodulatory potential of denosumab in breast cancer: results from D-BEYOND, a window of opportunity trial evaluating a RANK-ligand (RANKL) inhibitor and its biological effects in young pre-menopausal women diagnosed with early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-06.

Radiotherapy Cancer Registry (Hospital Based)

Background and context: The cancer registry is the information system designed to collect, manage and analyze the data on persons with malignancy (cancer). The objective of the cancer registry is collecting, classifying, evaluation of data and analysis. The purpose of the cancer registry is to identify the incidence, have cancer awareness program and cancer control activities. Aim: To analyze the demography of cancer patients seen at the Department of Radiation Oncology, Christian Medical College (CMC), Vellore, India during the period 2014-2016 and to categorize the data based on age, sex, type of cancer and geographical distribution. Strategy/Tactics: The Department of Radiation Oncology, CMC, Vellore, used to see 3500 to 5000 new patients annually with various malignancies. To develop a cancer registry, a detailed pro forma having three sections of information about the patient was developed. The first section includes patient identification information such as name, hospital ID, RT number, Hospital Based Cancer Registry (HBCR) number, date of registration, and geographic details of patients. The second section has the demographic details of the patient and the third section has the investigation details, the diagnosis and the treatment. Program/Policy process: In this study, we have collected data for the years 2014, 2015 and 2016 and compiled relating to demographic data such age, sex, diagnosis site, and geographic information. For the past three years period i.e., from 2015 to 2017, there were 3691, 4177 and 5036 new patients annually seen in our outpatient section respectively. From the three years data, distribution of patients with respect to age, sex, diagnosis, state and country were analyzed. Outcomes: The maximum numbers of patient seen were head and neck followed by CNS and gynecologic malignancies. The analysis showed the total number of patients seen was increasing every year. The study when compared with respect to sex distribution, the male patients were more than the female patients. There were patients from various states of India and few patients from abroad. The details of the age group, sex, cancer types and geographical distribution will be presented. What was learned: In conclusion, we used to see patients from different parts of India and abroad annually and the number of cancer cases seen are increasing annually. While analyzing the distribution on the types of cancer, head and neck cancer were the maximum followed by CNS, breast, and gynecologic malignancies. Early detection and diagnosis of cancers, for example, head and neck, cervix, and educating the patients on breast cancer by screening methods and on self-examination methods will help to control prevalence of cancer.

Tunable quantum criticality and super-ballistic transport in a “charge” Kondo circuit

Quantum phase transitions (QPTs) are ubiquitous in strongly correlated materials. However, the microscopic complexity of these systems impedes the quantitative understanding of QPTs. We observed and thoroughly analyzed the rich strongly correlated physics in two profoundly dissimilar regimes of quantum criticality. With a circuit implementing a quantum simulator for the three-channel Kondo model, we reveal the universal scalings toward different low-temperature fixed points and along the multiple crossovers from quantum criticality. An unanticipated violation of the maximum conductance for ballistic free electrons is uncovered. The present charge pseudospin implementation of a Kondo impurity opens access to a broad variety of strongly correlated phenomena.

Does Immunodeficiency in Uremic Patients Promote Dialysis-Related Amyloidosis?

The present study was undertaken to evaluate the immune function of 5 hemodialysis patients with dialysis-related amyloidosis as compared to 6 without, both groups having a dialytic age from 7 to 21 years, and 5 healthy controls. We investigated serum levels of immunoglobulins (IgG, IgA, IgM), made skin tests and measured peripheral lymphocyte subsets using monoclonal antibodies.

1) The absolute numbers of T3, T4 and T8 cells were significantly lower in hemodialysis patients than controls and T3, T4 cells were lower in patients with amyloidosis than in those without: T3 (m ± SD/μl), 387 ± 253 vs 744 ± 207 (p = 0.03); T4, 262 ± 115 vs 589 ± 297 (p = 0.04).

2) Serum levels of IgG and IgM were significantly lower in patients with amyloidosis than in the others: IgG (m ± SD, g/l), 10.2 ± 1.4 vs 15.4 ± 3.2 (p < 0.001); IgM, 0.65 ± 0.28 vs 1.65 ± 0.37 (p < 0.001).

3) Delayed hypersensitivity studied by skin tests showed less than 3 positive antigens in 4/5 patients with amyloidosis against 1/6 patients without. These data suggest there is a marked defect of T-cell help in uremic patients with dialysis-related amyloidosis.

Erratum: Fluctuation-Dissipation Relations of a Tunnel Junction Driven by a Quantum Circuit [Phys. Rev. Lett. 114, 126801 (2015)]

This corrects the article DOI: 10.1103/PhysRevLett.114.126801.