Electron efficiency measurements with the ATLAS detector using 2012 LHC proton-proton collision data

This paper describes the algorithms for the reconstruction and identification of electrons in the central region of the ATLAS detector at the Large Hadron Collider (LHC). These algorithms were used for all ATLAS results with electrons in the final state that are based on the 2012 pp collision data produced by the LHC at [Formula: see text] = 8 [Formula: see text]. The efficiency of these algorithms, together with the charge misidentification rate, is measured in data and evaluated in simulated samples using electrons from [Formula: see text], [Formula: see text] and [Formula: see text] decays. For these efficiency measurements, the full recorded data set, corresponding to an integrated luminosity of 20.3 fb[Formula: see text], is used. Based on a new reconstruction algorithm used in 2012, the electron reconstruction efficiency is 97% for electrons with [Formula: see text] [Formula: see text] and 99% at [Formula: see text] [Formula: see text]. Combining this with the efficiency of additional selection criteria to reject electrons from background processes or misidentified hadrons, the efficiency to reconstruct and identify electrons at the ATLAS experiment varies from 65 to 95%, depending on the transverse momentum of the electron and background rejection.

Abstract PD8-02: Tumor subtype and survival differences between Hispanic and non-Hispanic white breast cancer patients in the California cancer registry

Background: Prior studies show that Hispanic breast cancer patients are more likely than non-Hispanic white (NHW) women to be diagnosed with triple negative tumors but data on other subtypes are limited. Published data on survival differences between Hispanics and NHW breast cancer patients are inconsistent and vary depending on the covariates included in the multivariate models. We assessed differences in the distribution of the major tumor subtypes of breast cancer, as well as subtype-specific survival, between Hispanic and NHW patients according to nativity, and age and stage at diagnosis.

Methods: We used data from the population-based California Cancer Registry to include female invasive breast cancer cases diagnosed between 2004 and 2013 with follow-up through December 31, 2013, resulting in 90,236 total cases (69,693 NHW and 20,543 Hispanics). Tumor subtypes were classified into four categories: hormone receptor positive and HER2 negative (HR+/HER-), HR+/HER2+, HR-/HER2+, and triple negative (HR-/HER2-). Logistic regression was used to estimate differences in distribution of subtype between Hispanic and NHW women. Cox proportional hazard models were used to estimate differences in survival for Hispanics and NHWs by subtype, adjusting for clinical and sociodemographic characteristics.

Results: Compared to NHW patients, Hispanic women were more likely to be diagnosed with tumors that were HR+/HER2+ (OR=1.22; 95% CI, 1.16-1.29), HR-/HER2+ (OR=1.37; 95% CI, 1.29-1.47), and triple negative (OR=1.27; 95% CI, 1.21-1.34) than HR+/HER2-. Foreign-born Hispanics had a higher odds of having HER2+ than HR+/HER2- tumors compared to NHW women (OR=1.29 for HR+/HER2+ and OR=1.50 for HR-/HER2+); these differences were less pronounced among U.S.-born Hispanics (OR=1.04 for HR+/HER2+ and OR=1.16; 95% CI, 1.06-1.26 for HR-/HER2+). In age-adjusted models, Hispanic women had higher breast cancer mortality than NHW women (HR=1.23; 95% CI, 1.17-1.30), which was consistent across all tumor subtypes. However, the mortality differences disappeared after adjustment for clinical, sociodemographic characteristics, and marital status.

Conclusions: Hispanic women were more likely than NHWs to be diagnosed with triple negative breast cancer as well as tumors overexpressing HER2 than HR+/HER2- tumors. This pattern held true when stratified by nativity, although higher ORs for HER2+ tumors among foreign-born than U.S.-born Hispanic women were observed. Within each subtype, Hispanics had 20%-30% higher mortality than NHW, which appeared to be explained by a combination of sociodemographic and clinical factors.

Citation Format: Martinez ME, Cress R, Gomez S, Rodriguez D, Cook LS, Schwab R, Nodora JN, Porter P, Li C. Tumor subtype and survival differences between Hispanic and non-Hispanic white breast cancer patients in the California cancer registry [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD8-02.

Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Background

The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Methods

Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).

Results

Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.

Conclusion

Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Mammalian Target of Rapamycin Inhibitor Monotherapy: Efficacy in Renal Transplantation

BACKGROUND

Calcineurin inhibitors (CNI) have failed to improve long-term outcomes in renal transplantation. Anti-proliferative and anti-angiogenic effects of mammalian target of rapamycin inhibitors (m-TOR) without nephrotoxicity could improve long-term survival in selected transplant recipients.

METHODS

We examined the evolution of 98 low-immunological risk renal transplant recipients on m-TOR monotherapy: 7 patients had induction without CNI and 91 were switched to m-TOR at 12 (p25-p75: 4-36) months after transplant.

RESULTS

Median follow-up time was 46 (p25-p75: 28.5-72.0) months. Fifteen recipients dropped out of the study (15.3%): 8 patients (8.2%) had to change their immunosuppressive treatment because of complications and 7 (7.1%) lost their grafts as a result of chronic rejection (4 cases) or death with a functioning graft (3 cases). At the end of follow-up, 83 of 98 (84.6%) recipients remained on monotherapy. The rates of recipient and graft survivals were 100% and 98.8% at 2 years and 96.9% and 93.5% at 4 years; the percentages of patients on monotherapy after 2 and 4 years were 95.2% and 85.2%, respectively. Renal function improved significantly and proteinuria decreased but not significantly. Those patients switched to m-TOR significantly received more erythropoietin, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and hypotensive agents than before starting m-TOR, whereas there were no significant changes related to the use of statins, body weight, or percentage of diabetic patients. No case of non-compliance was reported.

CONCLUSIONS

This study supports the safety and efficacy of monotherapy with m-TOR in selected renal transplant recipients.

RELN and VLDLR mutations underlie two distinguishable clinico-radiological phenotypes

Pontocerebellar hypoplasias (PCH) are characterized by lack of development and/or early neurodegeneration of cerebellum and brainstem. We report five patients referred for PCH, showing atypical clinical and magnetic resonance imaging (MRI) features suggestive of defects in the Reelin pathway. We screened for mutations in RELN or VLDLR and compared the phenotype of these patients with that of previously reported patients. All patients had profound cerebellar hypoplasia on MRI with peculiar cerebellar morphology, associated with flattened pons and neocortical abnormalities. Patient 1 had profound motor and intellectual disability with moderate lissencephaly suggestive of RELN mutations and was shown to harbor a splicing homozygous RELN mutation. The four other patients had a milder phenotype consistent with CARMQ1 (cerebellar ataxia and mental retardation with or without quadrupedal locomotion). These patients showed mild simplification or thickening of cortical gyration and had VLDLR mutations. Reelin signaling regulates neuronal migration in the developing mammalian brain. VLDLR is a key component of the Reelin pathway. Our patients had a very small and dysplatic cerebellar vermis that should suggest the involvement of these genes. Moreover, differences in clinical severity, involvement of the cerebellar hemispheres, together with the severity of the neocortical defect, enables RELN-mutated patients to be distinguished from VLDLR-mutated patients.

Association Between Time to Reperfusion and Outcome Is Primarily Driven by the Time From Imaging to Reperfusion

Background and Purpose—

A progressive decline in the odds of favorable outcome as time to reperfusion increases is well known. However, the impact of specific workflow intervals is not clear.

Methods—

We studied the mechanical thrombectomy group (n=103) of the prospective, randomized REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset) trial. We defined 3 workflow metrics: time from symptom onset to reperfusion (OTR), time from symptom onset to computed tomography, and time from computed tomography (CT) to reperfusion. Clinical characteristics, core laboratory-evaluated Alberta Stroke Program Early CT Scores (ASPECTS) and 90-day outcome data were analyzed. The effect of time on favorable outcome (modified Rankin scale, 0–2) was described via adjusted odds ratios (ORs) for every 30-minute delay.

Results—

Median admission National Institutes of Health Stroke Scale was 17.0 (14.0–20.0), reperfusion rate was 66%, and rate of favorable outcome was 43.7%. Mean (SD) workflow times were as follows: OTR: 342 (107) minute, onset to CT: 204 (93) minute, and CT to reperfusion: 138 (56) minute. Longer OTR time was associated with a reduced likelihood of good outcome (OR for 30-minute delay, 0.74; 95% confidence interval [CI], 0.59–0.93). The onset to CT time did not show a significant association with clinical outcome (OR, 0.87; 95% CI, 0.67–1.12), whereas the CT to reperfusion interval showed a negative association with favorable outcome (OR, 0.72; 95% CI, 0.54–0.95). A similar subgroup analysis according to admission ASPECTS showed this relationship for OTR time in ASPECTS<8 patients (OR, 0.56; 95% CI, 0.35–0.9) but not in ASPECTS≥8 (OR, 0.99; 95% CI, 0.68–1.44).

Conclusions—

Time to reperfusion is negatively associated with favorable outcome, being CT to reperfusion, as opposed to onset to CT, the main determinant of this association. In addition, OTR was strongly associated to outcome in patients with low ASPECTS scores but not in patients with high ASPECTS scores.

Clinical Trial Registration—

URL: http://www.clinicaltrials.gov . Unique identifier: NCT01692379.

Abstract P2-13-02: Radiation and depression associated with complications of tissue expander reconstruction

Background: Rates of implant failure, wound healing delay, and infection are higher in patients having RT after tissue expander (TE) and permanent implant reconstruction. Some have suggested greater complications with increased body mass index (BMI) and with diabetes.

Patients and Methods: 127 patients had bilateral TE reconstruction and radiation from 2003 to 2013 at two centers. In 95% (121/127) of cases RT was performed while the TE was in place with the permanent implant inserted after RT. 3D-CRT technique included 50 Gy with daily or every other day bolus and forward planned segments. The supraclavicular and/or internal mammary lymph node bearing regions were treated in 82.7% (105/127) cases. The non-irradiated breast provided an internal control. Chi-squared testing of pretreatment factors included radiation, chemotherapy, and medical history of hypertension, diabetes, cardiovascular, and pulmonary disease. BMI, tobacco and alcohol use, use of antiestrogen, statin, antidepressant, antihypertensive, anxiolytics, and antidiabetic medications were also studied. Comparison of differences in means for continuous variables used analysis of variance, then multiple pairwise comparisons with Bonferroni correction of p-value.

Results: Mean age was 53 ± 10.1 years with just 14.6% African- American. Twelve (9.4%) were BRCA positive (9 BRCA1, 4 BRCA2, 1 Both). Nearly all complications were in the radiated breast. Complications were: Grade 0 (no complication; 43.9%), Grade 1 (tightness and/or drifting of implant or Baker grade II capsular contracture; 30.9 %), Grade 2 (infection, hypertrophic scarring, or incisional necrosis; 9.8%), Grade 3 (Baker grade III capsular contracture, wound dehiscence, or impending exposure of implant; 5.7%), Grade 4 (implant failure, exchange of implant, or Baker grade IV capsular contracture; 9.8%). 15.3 percent (19 cases) experienced grade 3 or 4 complication and 9.8% (12 cases) had grade 4 complication. Considering non-irradiated breasts, there were two (1.6%) Grade 3-4 complications. For BMI, there was no significant difference by category as defined by the CDC (p=0.91). Patients history of HRT tended to be more likely to have Grade 3 or 4 complications (31.8% vs 12.4% respectively; p=0.08). Patients with depression were more likely to experience a Grade 3 or 4 complication (29.4% vs 13.2%; p=0.01). Multiple logistic regression was used to predict the probability of a Grade 3 or 4 complication with HR use and depression as independent variables. Patients with depression were 4.2 times more likely to have a Grade 3 or 4 complication (OR=4.2, p=0.03) and patients with a history of HRT use were 3.4 times more likely to experience a Grade 3 or 4 complication (OR = 3.4, p=0.04). Only clinical diagnosis of depression was considered as 12/31 (38.7%) with antidepressants used only venlafaxine. Neither BRCA status (p=0.72) nor chemotherapy factors (p=0.42) were associated with complication rates.

Conclusions: Higher rates of TE reconstruction complications may be expected in patients receiving radiotherapy. Patients reporting medical history of depression or HRT use showed statistically significant increase in complication rates. This effect might be attributed to a drug effect or to patient factors such as body image.

Citation Format: Wagner RM, Spzunar SM, Stefani WA, Falk JS, Williams JL, Edhayan E, Dul CL, Rodriguez D, Busuito MJ, Browne CH, Aref A, Rabbani AN, Chuba PJ. Radiation and depression associated with complications of tissue expander reconstruction. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-13-02.

Neuropsychological evaluation and parental assessment of behavioral and motor difficulties in children with neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem disorder, with large inter and intrafamilial clinical variability and uncertain prognosis. In children with NF1 cognitive disorders, learning difficulties and behavioral problems are common. The present study aims to establish the neuropsychological and behavioral profiles of 78 patients with NF1, aged between 5 and 18 years, and to examine the relationship between these profiles and the transmission of NF1 (sporadic vs. familial), clinical manifestations, and environmental factors. We used several questionnaires completed by parents and neuropsychological tests. The results confirmed specific neuropsychological disabilities in children with NF1, especially involving visuospatial and fine motor skills, learning difficulties and behavioral problems. Cognitive difficulties were significantly more frequent in patients with familial than in those with sporadic NF1. All parental questionnaires were correlated with each other, but parental reports were not associated with FSIQ, SES, school status, and clinical manifestations of the disease. Neuropsychological tests were poorly related to parental reports of cognitive and behavioral difficulties.

Molecular and antigenic characterization of bovine Coronavirus circulating in Argentinean cattle during 1994-2010

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Detection rate of BCoV was statistically higher in dairy than in beef calves.

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Argentinean strains are distant from the Mebus strain included in local vaccines.

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In vitro cross-protection between Arg95 field strain and Mebus reference strain.

Bovine coronavirus (BCoV) is an important viral pathogen associated with neonatal calf diarrhea. Our aim was to investigate the incidence of BCoV in diarrhea outbreaks in beef and dairy herds from Argentina during 1994–2010. A total of 5.365 fecal samples from diarrheic calves were screened for BCoV diagnosis by ELISA. The virus was detected in 1.71% (92/5365) of the samples corresponding to 5.95% (63/1058) of the diarrhea cases in 239 beef and 324 dairy farms. The detection rate of BCoV was significantly higher in dairy than in beef herds: 12.13% (29/239) vs. 4.32% (14/324) respectively. Phylogenetic analysis of the hypervariable S1 region of seven representative samples (from different husbandry systems, farm locations and years of sampling) indicated that BCoV strains circulating in Argentinean beef and dairy herds formed a cluster distinct from other geographical regions. Interestingly, Argentinean strains are distantly related (at both the nucleotide and amino acid levels) with the Mebus historic reference BCoV strain included in the vaccines currently available in Argentina. However, Mebus-induced antibodies were capable of neutralizing the BCoV Arg95, a field strain adapted to grow in vitro, and vice versa, indicating that both strains belong to the same CoV serotype reported in cattle. This work represents the first large survey describing BCoV circulation in Argentinean cattle.

Magnetic resonance diffusion metrics indexing high focal cellularity and sharp transition at the tumour boundary predict poor outcome in glioblastoma multiforme

AIM

To investigate the prognostic power of intra-tumoural and gradient magnetic resonance imaging (MRI) diffusion metrics in patients with glioblastoma multiforme (GBM).

MATERIALS AND METHODS

Forty-six consecutive patients with histologically confirmed GBM who had undergone preoperative diffusion tensor imaging at 3 T were included. Mean diffusivity (MD) and MD gradient maps were computed. Regions of interest were analysed to determine the minimum MD within the enhancing tumour (minMD). MD gradients were calculated along the enhancing tumour boundary and subjected to histogram analysis. Overall survival (OS) and time to progression (TTP) were derived and survival analysis was undertaken.

RESULTS

There were 31 deaths and 37 patients progressed during the study period. Multivariate survival analysis, controlling for treatment and gender, showed that minMD values<6.1×10(-4) mm(2)/s predicted shorter OS (hazard ratio [HR]=2.82, 1.25-6.34; p=0.012) and TTP (HR=5.43, 1.96-15.05; p=0.001). Higher MD gradient values of the tumour boundary predicted shorter survival: MD gradient values >4.7×10(-5) mm(2)/s (10(th) centile) had a significantly shorter OS with a HR of 0.43 (0.19-0.96; p=0.04). Similarly, a value above 1.4×10(-4) mm(2)/s (75(th) centile) was a significant predictor for shorter OS (HR=0.39, 0.17-0.89; p=0.03).

CONCLUSIONS

Lower minMD and higher MD gradient values for the 10(th) and 75(th) percentile of the tumour boundary demonstrated prognostic value in preoperative GBM. This suggests that MRI diffusion metrics indicative of higher focal cellularity and steeper transition from high cellular tumour edge to low cellular oedema define more aggressive glioblastoma subtypes with a poorer prognosis.

Advances in the metabolic profiling of acidic compounds in children's urines achieved by comprehensive two-dimensional gas chromatography

The main objective of this work was to evaluate a comprehensive two-dimensional gas chromatographic (GCxGC) coupled to quadrupole mass spectrometry (qMS) method in the field of biomarker candidates' discovery. To this purpose we developed a GCxGC-qMS method suitable for the separation of organic acids and other classes of compounds with silylable polar hydrogen such as sugars, amino-acids, and vitamins. As compared to those obtained by a widely used 1D-GC method, the urinary chromatographic profiles performed by the proposed 2D-GC method exhibit higher resolution and sensitivity, leading to the detection of up to 92 additional compounds in some urine samples including some well-known biomarkers. In order to validate the proposed method we focused on three metabolites of interest with various functional groups and polarities including CH3-malonic acid (MMA: biomarker of methylmalonic acidemia), 3-hydroxy-3-methyl-glutaric acid (3-OHMGA: biomarker of 3-hydroxy-3-methylglutaric acidemia), and phenylpiruvic acid (PhPA: marker of phenylketonuria). While these three metabolites can be considered as representative of organic acids classically determined by 1D-GC, they cannot be representative of new detected metabolites. Thus, we also focused on quinolic acid (QUIN), taken as an example of biomarker not detected at basal levels with the classical 1D GC-qMS method. In order to obtain sufficient recoveries for all tested compounds, we developed a sample preparation protocol including a step of urea removal followed by two extraction steps using two solvents of different polarity and selectivity. Recoveries with the proposed method reached more than 80% for all targeted compounds and the linearity was satisfactory up to 50μmol/L. The CVs of the within-run and within-laboratory precisions were less than 8% for all tested compounds. The limits of quantification (LOQs) were 0.6μmol/L for MMA, 0.4μmol/L for 3-OHMGA, 0.7μmol/L for PhPA, and 1μmol/L for QUIN. The LOQs of these metabolites obtained by a classical GC-MS method under the same chromatographic conditions were 5μmol/L for MMA, 4μmol/L for 3-OHMGA, 6μmol/L for PhPA while QUIN was below the limit of detection. As compared to 1D-GC, these results highlight the enhanced detectability of urine metabolites by the 2D-GC technique. Our results also show that for each new detected compound it is necessary to develop and validate an appropriate sample preparation procedure.