Abstract P6-09-02: Associations between hereditary cancer panel predisposition genes and breast cancer histological subtypes

Background: Clinical panel testing has become routine practice for patients that are diagnosed with breast cancer at a young age and/or have a personal or family history of cancer. Associations with known breast cancer genes and breast cancer subtypes have been previously identified, such as BRCA1 associations with estrogen receptor negative (ER-) and triple negative (ER-/PR-/HER2-) breast cancers. However, the cancer predisposition genes associated with each of the four clinical subtypes of breast cancer have not been fully defined. We evaluated 24,901 Caucasian female breast cancer cases receiving clinical panel testing for 23 cancer predisposition genes and assessed associations between mutations in each gene and breast cancer subtypes.

Methods: Germline hereditary cancer multigene panel testing results for cancer predisposition genes were obtained for 24,901 Caucasian female breast cancer cases evaluated by a clinical testing laboratory. Information on tumor histology, personal and family history of cancer, age at diagnosis, and previous genetic testing was provided by clinical care providers of patients receiving clinical cancer genetic testing. Breast cancer cases were classified into clinical breast cancer subtypes based on estrogen/progesterone hormone receptor status (HR) and HER2 status: Luminal A (HR+/HER2-), Luminal B (HR+/HER2-), HER2 subtype (HR-/HER2+), and Triple Negative (HR-/HER2-). The frequency of pathogenic or likely pathogenic mutations observed in each subtype was compared against the Exome Aggregation Consortium (ExAC) non-TCGA non-Finnish European population to estimate risks.

Results: ATM was associated with moderate risks (odds ratio (OR)>2.0) of Luminal A, Luminal B, and HER2 subtypes of breast cancer, but was not associated with the Triple Negative subtype. PALB2 was associated with moderate risk for Luminal B subtype, but high risk (OR>5.0) for Luminal A, HER2, and triple negative subtypes. TP53 was associated with high risks for Luminal B and HER2 tumors. NBN, MRE11A, and RAD50 were not associated with any subtype of breast cancer.

Conclusions: Identifying associations between inherited mutations (odds ratio (OR)>2.0) and breast cancer subtypes can inform clinical risk management, treatment options, and therapeutic development efforts.

Citation Format: Lilyquist J, Laduca H, Hu C, Na J, Polley EC, Hart SN, Pesaran T, Tippin-Davis B, Goldgar DE, Dolinsky JS, Couch FJ. Associations between hereditary cancer panel predisposition genes and breast cancer histological subtypes [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-02.

Abstract PD1-01: Triple negative breast cancer predisposition genes

Background: Germline cancer testing panels provide an effective method for identifying individuals at increased risk for breast cancer. However, estimates of risk for triple negative breast cancer (TNBC) (estrogen receptor-negative, progesterone receptor-negative, HER2-negative) associated with pathogenic mutations in panel genes have not been established. We sought to define the genes that contribute to TNBC.

Methods:Germline hereditary cancer multigene panel testing results were obtained for 8,753 TNBCs evaluated by a clinical testing laboratory. Associations between pathogenic mutations in individual genes and TNBC were assessed by comparing mutation frequencies in TNBCs and in the Exome Aggregation Consortium, non-Finn European, non-Cancer Genome Atlas reference controls.

Results: Inactivating mutations in 21 known cancer predisposition genes were identified in 14.6% of TNBCs. BRCA1, BRCA2, PALB2, BARD1, and RAD51D alterations were associated with high risks (odds ratio(OR)>5.0) of TNBC and variants in BRIP1, RAD51C, MSH6, and TP53 were associated with moderate risks (OR>2). In contrast, ATM, CHEK2, NBN, and RAD50 yielded no clinically relevant risks of TNBC. Pathogenic mutations in these established non-BRCA1/2 TNBC susceptibility genes were detected in 6.3% of TNBCs. Similar trends were observed among African American TNBCs. Overall, 5.5% of TNBCs with pathogenic mutations did not meet NCCN clinical testing criteria for BRCA1/2 due to a lack of significant family history and diagnosis over the age of 60.

Conclusions: The identification of genes associated with elevated risk of TNBC will improve understanding of the etiology of this aggressive form of breast cancer and inform risk management of individuals receiving panel testing. The high frequency of pathogenic variants suggests that all patients with TNBC, regardless of age of diagnosis or family history of cancer, should be considered for multigene panel testing.

Citation Format: Couch FJ, Shimelis H, LaDuca H, Hu C, Hart SN, Polley EC, Pesaran T, Tippin-Davis B, Goldgar DE, Dolinsky JS. Triple negative breast cancer predisposition genes [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-01.

Reflectance difference microscopy for nanometre thickness microstructure measurements

The discontinuity of medium at the boundary produces optically anisotropic response which makes reflectance difference microscopy (RDM) a potential method for nanometre-thickness microstructure measurements. Here, we present the methodology of RDM for the edge measurement of ultrathin microstructure. The RD signal of microstructure's boundary is mathematically deduced according to boundary condition and polarization optics theory. A normal-incidence RDM setup was built simply with one linear polarizer, one liquid crystal variable retarder and one 5 × objective. Then, the performance of the developed setup was identified using homogenous reflection mirror and high quality linear polarizer. For demonstration, microstructures array with 100 nm step height was measured. The results show that the RD signal is sensitive to the edge and its sign reflects the change direction of the edge. Furthermore, a height sensitivity of better than 10 nm and a spatial resolution of ∼3 μm offer this technique a good candidate for characterizing ultrathin microstructures.

wblA, a pleiotropic regulatory gene modulating morphogenesis and daptomycin production in Streptomyces roseosporus

AIMS

The wblA gene, encoding a homologue of the WhiB family protein, was identified in the sequenced genome of daptomycin producer Streptomyces roseosporus. To explore the function of wblA, we construct wblA disruption strains, complemented strains and overexpression strains to test whether it can affect the production of secondary metabolites and morphogenesis.

METHODS AND RESULTS

We constructed disruption strains by homologous recombination in S. roseosporus. The disruption mutant of wblA could block aerial mycelium sporulation and enhance the production of daptomycin by 51%. In contrast, overexpression of wblA resulted in significantly decreased the yield of daptomycin. In agreement with it, the transcription of key daptomycin regulatory genes atrA, dptR2 and dptR3 and structural gene dptE remarkably increased in the wblA disruption mutant.

CONCLUSIONS

wblA plays a key role in control of daptomycin biosynthesis and is essential for sporulation. The disruption of wblA could accumulate the transcription level of some key genes involving in daptomycin biosynthesis.

SIGNIFICANCE AND IMPACT OF THE STUDY

Daptomycin is an important antibiotic with potent activity against a variety of Gram-positive pathogens. This study demonstrates that valuable improvement in the yield of daptomycin can be achieved through modulating the expression of wblA transcription regulator.

Comparative Study for the Association of Mitochondrial Haplogroup F+ and Metabolic Syndrome between Longevity and Control Population in Guangxi Zhuang Autonomous Region, China

BACKGROUND

Our previous study suggested that mitochondrial haplogroup F (mtDNA F) was a longevity-associated biomarker, but the effect of mitochondrial haplogroup F on longevity individuals with metabolic syndrome (MetS) was not clear. Thus we explored the association between mtDNA F and MetS among longevity and control population in Guangxi Zhuang Autonomous Region, China.

METHOD

A total of 793 individuals consisting of 307 long-lived participants and 486 local healthy controls were involved in this study. Genotypes of mtDNA F were amplified by polymerase chain reaction and Sanger sequenced. MetS was defined according to the revised National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATPIII ) criteria.

RESULTS

The prevalence of MetS in longevity group (28.0%) was higher than that (18.5%) in control group (P=0.002). Through the case-control stratify analysis, the prevalence of MetS in mtDNA F+ longevity individuals (29.8%) was 4.6 fold higher than that (5.3%) in local control group (P<0.001). However, after further longevity-only analysis, no association between MetS and mtDNA F+ in longevity group was observed (P=0.167). Following same analysis of two variables in control group, we found that the prevalence of MetS in mtDNA F- (95.8%) was higher than that in mtDNA F+ (5.3%); conversely, the prevalence of non-metabolic syndrome (NMetS) in mtDNA F+ (94.7%) was markedly higher than that in mtDNA F- (4.2%) (P<0.001).

CONCLUSION

We demonstrated that mtDNA F+ , as a molecuar biomarker, might not only confer beneficial effect to resistance against MetS but also function as a positive factor for long-life span among the population in Guangxi Zhuang Autonomous Region, China.

The efficacy and safety of anti-PD-1/PD-L1 antibody therapy versus docetaxel for pretreated advanced NSCLC: a meta-analysis

Antibodies against the immune checkpoint proteins PD-1 and PD-L1 are novel therapeutic drugs for the treatment of advanced non-small cell lung cancer (NSCLC). Many clinical trials involving these drugs achieved breakthroughs in patients previously treated for advanced NSCLC. However, the results of these clinical studies are not consistent. In this report, we performed a meta-analysis to assess the efficacy and safety of anti-PD-1/PD-L1 antibodies compared with docetaxel treatment for advanced NSCLC patients from 5 randomized clinical trials. We demonstrated that the patients in anti-PD-1/PD-L1 antibody therapy groups had significantly longer overall survival (OS) (HR = 0.69, 95% CI 0.63-0.75, P < 0.05) and progression-free survival (PFS) (HR = 0.76, 95% CI 0.63-0.92, P < 0.05) than those in chemotherapy groups, especially PD-L1 positive patients. Anti-PD-1/PD-L1 antibodies improved the objective response rate (ORR) compared with docetaxel (OR = 1.64, 95% CI 1.19-2.26, p < 0.05). In addition, the anti-PD-1/PD-L1 antibody therapy had fewer treatment-related adverse events (AEs) (OR = 0.33, 95% CI 0.28-0.39, P < 0.05) than docetaxel, especially the grade ≥3 AEs (OR = 0.18, 95% CI 0.12-0.28, P < 0.001). In conclusion, our study revealed that, compared with docetaxel, anti-PD-1/PD-L1 antibody therapy improved clinical efficacy and safety in previously treated advanced NSCLC patients. This therapy may be a promising treatment for advanced NSCLC patients.

Feasibility study of iterative model reconstruction combined with low tube voltage, low iodine load, and low iodine delivery rate in craniocervical CT angiography

AIM

To investigate the feasibility of iterative model reconstruction (IMR) combined with low tube voltage, low iodine load, and low iodine deliver rate in craniocervical computed tomography angiography (CTA).

MATERIALS AND METHODS

Sixty patients were randomly divided into two groups (n=30 for each): group A: 120 kVp, 50 ml of iopromide at a flow rate of 5 ml/s; filtered back projection (FBP) reconstruction; group B: 80 kVp, 30 ml of iohexol at 4.5 ml/s; hybrid iterative reconstruction (HIR) for group B1 and IMR for group B2. CT attenuation values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), subjective image quality, effective dose (ED), iodine load, and iodine delivery rate (IDR) were compared.

RESULTS

CT attenuation values of the arteries were higher in groups B1 and B2 than group A. The SNR and CNR were higher, while image noise was lower, for group B2 compared with groups B1 and A. The best subjective image quality was obtained with group B2. ED, iodine load, and IDR reduction of 69.6%, 51.4%, 27%, respectively, was obtained in group B compared with group A.

CONCLUSION

IMR combined with 80 kVp and 30 ml of iohexol at a flow rate of 4.5 ml/s for craniocervical CTA can reduce ED, iodine load, and IDR, while improving image quality.

Association of adiposity indices with bone density and bone turnover in the Chinese population

Associations of adiposity indices with bone mineral density (BMD) and bone turnover markers were evaluated in Chinese participants. Body mass index, fat mass, and lean mass are positively related to BMD in both genders. Subcutaneous fat area was proved to be negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females.

INTRODUCTION

Obesity is highly associated with osteoporosis, but the effect of adipose tissue on bone is contradictory. Our study aimed to assess the associations of adiposity indices with bone mineral density (BMD) and bone turnover markers (BTMs) in the Chinese population.

METHODS

Our study recruited 5215 participants from the Shanghai area, evaluated related anthropometric and biochemical traits in all participants, tested serum BTMs, calculated fat distribution using magnetic resonance imaging (MRI) images and image analysis software, and tested BMD with dual-energy X-ray absorptiometry.

RESULTS

When controlled for age, all adiposity indices were positively correlated with BMD of all sites for both genders. As for the stepwise regression analysis, body mass index (BMI), fat mass, and lean mass were protective for BMD in both genders. However, subcutaneous fat area (SFA) was detrimental for BMD of the L1-4 and femoral neck (β ± SE -0.0742 ± 0.0174; p = 2.11E-05; β ± SE -0.0612 ± 0.0147; p = 3.07E-05). Adiposity indices showed a negative correlation with BTMs adjusting for age, especially with osteocalcin. In the stepwise regression analysis, fat mass was negatively correlated with osteocalcin (β ± SE -8.8712 ± 1.4902; p = 4.17E-09) and lean mass showed a negative correlation with N-terminal procollagen of type I collagen (PINP) for males (β ± SE -0.3169 ± 0.0917; p = 0.0006). In females, BMI and visceral fat area (VFA) were all negatively associated with osteocalcin (β ± SE -0.4423 ± 0.0663; p = 2.85E-11; β ± SE -7.1982 ± 1.1094; p = 9.95E-11), while SFA showed a positive correlation with osteocalcin (β ± SE: 5.5993 ± 1.1753; p = 1.98E-06).

CONCLUSION

BMI, fat mass, and lean mass are proved to be beneficial for BMD in both males and postmenopausal females. SFA is negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females.

Determination of the Spin and Parity of the Z_{c}(3900)

The spin and parity of the Z_{c}(3900)^{±} state are determined to be J^{P}=1^{+} with a statistical significance larger than 7σ over other quantum numbers in a partial wave analysis of the process e^{+}e^{-}→π^{+}π^{-}J/ψ. We use a data sample of 1.92  fb^{-1} accumulated at sqrt[s]=4.23 and 4.26 GeV with the BESIII experiment. When parametrizing the Z_{c}(3900)^{±} with a Flatté-like formula, we determine its pole mass M_{pole}=(3881.2±4.2_{stat}±52.7_{syst})  MeV/c^{2} and pole width Γ_{pole}=(51.8±4.6_{stat}±36.0_{syst})  MeV. We also measure cross sections for the process e^{+}e^{-}→Z_{c}(3900)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-} and determine an upper limit at the 90% confidence level for the process e^{+}e^{-}→Z_{c}(4020)^{+}π^{-}+c.c.→J/ψπ^{+}π^{-}.

Clinical significance of PSMA, TERT and PDEF in malignant tumors of the prostate

OBJECTIVE

To investigate the clinical significance of the expression of PSMA (prostate specific membrane antigen), TERT (telomerase reverse transcriptase), and PDEF (prostate derived Ets factor) in malignant tumors of the prostate.

PATIENTS AND METHODS

The study was conducted with paraffin slices from 33 specimens of malignant tumors of the prostate and 17 of normal tissue. We found high levels of PSMA, TERT, and PDEF protein by Western blot and immunofluorescence in the malignant tumor of the prostate. We also detected upregulation of PSMA, TERT, and PDEF mRNA in the malignant tumor of the prostate, suggesting complex regulation of these three genes in prostate cancer.

RESULTS

Variance analysis showed statistically significant differences comparing the expression of PSMA, TERT, and PDEF in the malignant tumor of the prostate and normal tissues. The high expression of PSMA, TERT, and PDEF in the malignant tumor of the prostate suggests the important roles of these three factors in the occurrence and development of the malignant tumors of the prostate.

CONCLUSIONS

PSMA, TERT, and PDEF may serve as a reference for clinical diagnosis and as potential targets for the malignant tumor of the prostate therapeutics.

[Killing effect and its mechanism of low-temperature plasma on different human cancer cell lines]

Objective: To investigate the killing effect of low-temperature plasma (LTP) on HepG2, A549 and HeLa cell lines and explore its possible mechanism. Methods: The inhibitory effect of LTP on the proliferation of HepG2, A549 and HeLa cells was determined by MTT assay. Transmission electron microscopy was used to observe the ultrastructural changes of HepG2, A549 and HeLa cells treated with LTP. Cell apoptosis was detected by Muse cytometry. Western blot was used to detect the expression of apoptosis-related proteins. Results: The survival rates of LTP-irradiated HepG2 cells (irradiated for 107 s), HeLa cells (irradiated for 121 s) and A549 cells (irradiated for 127 s) were 50%. LTP destroyed the ultrastructure of HepG2, A549 and HeLa cells to different degrees, showing nuclear fragmentation and organelle damages. The apoptosis rates of the three cell lines were increased at 24 h after exposure to LTP for 1/6 IC₅₀ irradiation time. Furthermore, LTP irradiation also suppressed the protein expression of Bcl-2 and XRCC1 and increased that of Bax. Conclusions: LTP has an obvious killing effect on HepG2, A549 and HeLa cancer cell lines. This effect may be related to the induction of cell apoptosis and inhibition of DNA repair.

The effect of glucose-dependent insulinotropic polypeptide (GIP) variants on visceral fat accumulation in Han Chinese populations

Objectives:

We aim to validate the effects of glucose-dependent insulinotropic polypeptide (GIP) on fat distribution and glucose metabolism in Han Chinese populations.

Methods:

We genotyped six tag single-nucleotide polymorphisms (SNPs) of GIP and four tag SNPs of glucose-dependent insulinotropic polypeptide receptor (GIPR) among 2884 community-based individuals from Han Chinese populations. Linear analysis was applied to test the associations of these variants with visceral fat area (VFA) and subcutaneous fat area (SFA) quantified by magnetic resonance imaging as well as glucose-related traits.

Results:

We found that the C allele of rs4794008 of GIP tended to increase the VFA and the VFA/SFA ratio in all subjects (P=0.050 and P=0.054, respectively), and rs4794008 was associated with the VFA/SFA ratio in males (P=0.041) after adjusting for the BMI. The VFA-increasing allele of rs4794008 was not related to any glucose metabolism traits. However, rs9904288 of GIP was associated with the SFA in males as well as glucose-related traits in all subjects (P range, 0.004–0.049), and the GIPR variants displayed associations with both fat- and glucose-related traits.

Conclusions:

The results could provide the evidence that GIP might modulate visceral fat accumulation via incretin function or independent of incretin.

CONSORT: May stereotactic intracavity administration of antibiotics shorten the course of systemic antibiotic therapy for brain abscesses?

BACKGROUND

Despite advances in surgical techniques in the management of the brain abscess, continuous systemic long-term antibiotics are necessary and crucial. This study was designed to evaluate the effect of intracavity administration of high-dose antibiotics on the course of antibiotic therapy.

METHODS

Between 2003 and 2013, 55 patients with bacterial brain abscesses (83 abscesses) were treated with stereotactic aspiration and intracavity injection of high-dose antibiotics combined with a short course systemic antibiotic therapy. Antibiotics of one-eighth daily systemic dosage were injected into the abscess cavity after stereotactic aspiration and intravenous antibiotics were given in all patients for 3 to 4 weeks. The results of the group treated with stereotactic aspiration and intracavity injection of antibiotic solution were compared to the results of our previous patients treated by stereotactic aspiration only.

RESULTS

Thirty-nine males and 16 females (age ranging from 1.5 to 76 years; mean age 38.7 years) were included in this study. During the follow-up (mean 26.2 months, ranging from 6 to 72 months), all the abscesses subsided with no recurrence. No adverse effects related to topical use of antibiotics occurred. At the end of follow-up, 38 patients had good outcomes, 11 had mild neurological deficits, 3 had moderate deficits, 1 was in vegetative state, and 2 died of accidents not related to brain abscesses. Compared with conventional stereotactic aspiration and drainage, intracavity injection of antibiotics shorted the course of consecutive systemic intravenous antibiotics by average 10.8 days without an increase of the recurrence rate of abscesses.

CONCLUSIONS

Our results indicate that topical application of antibiotics into the brain abscess cavity helps to reduce the length of systemic antibiotic therapy, decreases the abscess recurrence rate, avoids the side effects of long-term high dose antibiotics, shortens the hospitalization and reduces treatment costs.

The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries

BACKGROUND

Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.

METHOD

We assessed CAs, PEs and DSM-IV mental disorders in 23 998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.

RESULTS

Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.9-2.6]. CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR 8.5, 95% CI 3.6-20.2), whereas Other CA types were associated with PE onset in adolescence. Associations of other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).

CONCLUSIONS

Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood-onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.

Fear and distress disorders as predictors of heart disease: A temporal perspective

OBJECTIVE

Few studies have been able to contrast associations of anxiety and depression with heart disease. These disorders can be grouped in fear and distress disorders. Aim of this study was to study the association between fear and distress disorders with subsequent heart disease, taking into account the temporal order of disorders.

METHODS

Twenty household surveys were conducted in 18 countries (n=53791; person years=2,212,430). The Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of disorders, and respondents were categorized into categories based on the presence and timing of fear and distress disorders. Heart disease was indicated by self-report of physician-diagnosed heart disease or self-report of heart attack, together with year of onset. Survival analyses estimated associations between disorder categories and heart disease.

RESULTS

Most respondents with fear or distress disorders had either pure distress or pure fear (8.5% and 7.7% of total sample), while fear preceded distress in the large majority of respondents with comorbid fear and distress (3.8% of total sample). Compared to the "no fear or distress disorder" category, respondents with pure fear disorder had the highest odds of subsequent heart disease (OR:1.8; 95%CI:1.5-2.2; p<0.001) and compared to respondents with pure distress disorder, these respondents were at a significantly increased risk of heart disease (OR:1.3; 95%CI:1.0-1.6; p=0.020).

CONCLUSION

This novel analytic approach indicates that the risk of subsequent self-reported heart disease associated with pure fear disorder is significantly larger than the risk associated with distress disorder. These results should be confirmed in prospective studies using objective measures of heart disease.

Observation of Λ_{c}^{+}→nK_{S}^{0}π^{+}

We report the first direct measurement of decays of the Λ_{c}^{+} baryon involving the neutron. The analysis is performed using 567  pb^{-1} of e^{+}e^{-} collision data collected at sqrt[s]=4.599  GeV with the BESIII detector at the BEPCII collider. We observe the decay Λ_{c}^{+}→nK_{S}^{0}π^{+} and measure the absolute branching fraction to be B(Λ_{c}^{+}→nK_{S}^{0}π^{+})=[1.82±0.23(stat)±0.11(syst)]%. A comparison to B[Λ_{c}^{+}→p(K[over ¯]π)^{0}] provides an important test of isospin symmetry and final state interactions.

More surprises in the global greenhouse: Human health impacts from recent toxic marine aerosol formations, due to centennial alterations of world-wide coastal food webs

Reductions of zooplankton biomasses and grazing pressures were observed during overfishing-induced trophic cascades and concurrent oil spills at global scales. Recent phytoplankton increments followed, once Fe-, P-, and N-nutrient limitations of commensal diazotrophs and dinoflagellates were also eliminated by respective human desertification, deforestation, and eutrophication during climate changes. Si-limitation of diatoms instead ensued during these last anthropogenic perturbations of agricultural effluents and sewage loadings. Consequently, ~15% of total world-wide annual asthma trigger responses, i.e. amounting to ~45 million adjacent humans during 2004, resulted from brevetoxin and palytoxin poisons in aerosol forms of western boundary current origins. They were denoted by greater global harmful algal bloom [HAB] abundances and breathing attacks among sea-side children during prior decadal surveys of asthma prevalence, compiled here in ten paired shelf ecosystems of western and eutrophied boundary currents. Since 1965, such inferred onshore fluxes of aerosolized DOC poisons of HABs may have served as additional wind-borne organic carriers of toxic marine MeHg, phthalate, and DDT/DDE vectors, traced by radio-iodine isotopes to potentially elicit carcinomas. During these exchanges, as much as 40% of mercury poisonings may instead have been effected by inhalation of collateral HAB-carried marine neurotoxic aerosols of MeHg, not just from eating marine fish. Health impacts in some areas were additional asthma and pneumonia episodes, as well as endocrine disruptions among the same adjacent humans, with known large local rates of thyroid cancers, physician-diagnosed pulmonary problems, and ubiquitous high indices of mercury in hair, pesticides in breast milk, and phthalates in urine.

Precise Measurement of the e^{+}e^{-}→π^{+}π^{-}J/ψ Cross Section at Center-of-Mass Energies from 3.77 to 4.60 GeV

The cross section for the process e^{+}e^{-}→π^{+}π^{-}J/ψ is measured precisely at center-of-mass energies from 3.77 to 4.60 GeV using 9  fb^{-1} of data collected with the BESIII detector operating at the BEPCII storage ring. Two resonant structures are observed in a fit to the cross section. The first resonance has a mass of (4222.0±3.1±1.4)  MeV/c^{2} and a width of (44.1±4.3±2.0)  MeV, while the second one has a mass of (4320.0±10.4±7.0)  MeV/c^{2} and a width of (101.4_{-19.7}^{+25.3}±10.2)  MeV, where the first errors are statistical and second ones are systematic. The first resonance agrees with the Y(4260) resonance reported by previous experiments. The precision of its resonant parameters is improved significantly. The second resonance is observed in e^{+}e^{-}→π^{+}π^{-}J/ψ for the first time. The statistical significance of this resonance is estimated to be larger than 7.6σ. The mass and width of the second resonance agree with the Y(4360) resonance reported by the BABAR and Belle experiments within errors. Finally, the Y(4008) resonance previously observed by the Belle experiment is not confirmed in the description of the BESIII data.

Evidence of Two Resonant Structures in e^{+}e^{-}→π^{+}π^{-}h_{c}

The cross sections of e^{+}e^{-}→π^{+}π^{-}h_{c} at center-of-mass energies from 3.896 to 4.600 GeV are measured using data samples collected with the BESIII detector operating at the Beijing Electron Positron Collider. The cross sections are found to be of the same order of magnitude as those of e^{+}e^{-}→π^{+}π^{-}J/ψ and e^{+}e^{-}→π^{+}π^{-}ψ(2S), but the line shape is inconsistent with the Y states observed in the latter two modes. Two structures are observed in the e^{+}e^{-}→π^{+}π^{-}h_{c} cross sections around 4.22 and 4.39  GeV/c^{2}, which we call Y(4220) and Y(4390), respectively. A fit with a coherent sum of two Breit-Wigner functions results in a mass of (4218.4_{-4.5}^{+5.5}±0.9)  MeV/c^{2} and a width of (66.0_{-8.3}^{+12.3}±0.4)  MeV for the Y(4220), and a mass of (4391.5_{-6.8}^{+6.3}±1.0)  MeV/c^{2} and a width of (139.5_{-20.6}^{+16.2}±0.6)  MeV for the Y(4390), where the first uncertainties are statistical and the second ones systematic. The statistical significance of Y(4220) and Y(4390) is 10σ over one structure assumption.

Abstract S2-01: Breast cancer risks associated with mutations in cancer predisposition genes identified by clinical genetic testing of 60,000 breast cancer patients

Clinical genetic testing panels are broadly used to gather information about cancer predisposition in individuals with personal and/or family history of breast cancer. However, the involvement of several of the genes on clinical testing panels in predisposition to breast cancer, such as MRE11A and RAD50, has recently come into question. In addition, accurate risk estimates for breast and other cancer are not well defined for the majority of genes on testing panels. We studied 60,000 women diagnosed with breast cancer who were tested for germline cancer predisposing mutations using hereditary cancer gene panels. Information on personal and family cancer history, age of diagnosis, and ethnicity of patients was obtained from test requisition forms. Greater than 90% met National Comprehensive Cancer Network HBOC testing criteria. To estimate gene-specific risks for breast cancer, case-control analyses were performed comparing the frequencies of pathogenic mutations from Caucasian cancer cases with frequencies from Caucasian, non-Finnish, non-TCGA controls from the Exome Aggregation Consortium (ExAC) database. Mutations were detected in 9% of breast cancer patients. Twelve genes displayed a significant association (p&lt;0.05) with breast cancer. Nine of these genes, including ATM, RAD51D, NF1, and MSH6, were associated with moderate risk (RR&gt;2.0) of breast cancer and three genes (BRCA1, BRCA2, PALB2) were associated with high risk (RR&gt;5.0) of breast cancer. Cumulative age-dependent risk models were developed for each gene. This large clinical testing dataset of 60,000 women with breast cancer provides useful data for many predisposition genes previously lacking risk estimates, and should prove useful for clinical risk management of patients with inherited mutations in these genes.

Citation Format: Couch FJ, Hu C, Lilyquist J, Shimelis H, Akinhanmi M, Na J, Polley EC, Hart SN, McFarland R, LaDuca H, Huether R, Goldgar DE, Dolinsky JS. Breast cancer risks associated with mutations in cancer predisposition genes identified by clinical genetic testing of 60,000 breast cancer patients [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 S2-01.

Abstract P5-09-03: Associations between breast cancer subtypes and mutations in cancer predisposition genes identified by clinical genetic testing of breast cancer patients

Clinical genetic testing of individuals with a personal or family history of breast and ovarian cancer using panels for BRCA1/2 and other candidate cancer predisposition genes has become routine clinical practice. Several of the genes on hereditary cancer testing panels have been strongly associated with specific subtypes of breast cancer. In particular, individuals with germline mutations in BRCA1 predominantly develop estrogen receptor (ER)-negative and triple negative (TN) (estrogen receptor negative, progesterone receptor negative, HER2 negative) breast tumors. In contrast, CHEK2 and ATM mutations have been associated with ER-positive breast cancer. In this study, associations between mutations in panel genes and breast cancer subtypes were evaluated. A cohort of 60,000 breast cancer patients tested for germline cancer predisposing mutations using hereditary cancer gene panels was utilized. Information on personal and family cancer history, age of diagnosis, tumor pathology, and ethnicity of patients was obtained from test requisition forms or by follow up with ordering health care providers. Mutations in each gene were combined into four histological subtypes (triple negative; HER2 positive; ER-positive,HER2-positive; and ER-positive,HER2 negative). Associations for each subtype were estimated by case-control analyses comparing the frequencies of pathogenic mutations in each subtype with frequencies from non-TCGA controls from the Exome Aggregation Consortium (ExAC) database. In addition, case-case analyses were conducted to assess enrichment of gene mutations in specific breast cancer subtypes. Among the observed associations between genes and breast cancer subtypes, mutations in CHEK2 and ATM were highly enriched in luminal breast cancers and BARD1 was specifically associated with TN breast cancer. Refining the spectrum of pathological correlates with mutations in hereditary breast cancer genes will aid gene specific cancer risk management, and may accelerate the development of novel gene-specific therapeutic interventions.

Citation Format: Couch FJ, Lilyquist J, Na J, Hu C, Polley EC, Shimelis H, Akinhanmi M, McFarland R, LaDuca H, Goldgar DE, Dolinsky JS. Associations between breast cancer subtypes and mutations in cancer predisposition genes identified by clinical genetic testing of breast cancer patients [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 P5-09-03.

Amplitude Analysis of the Decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0}

Based on a sample of 1.31×10^{9}  J/ψ events collected with the BESIII detector, an amplitude analysis of the isospin-violating decays η^{'}→π^{+}π^{-}π^{0} and η^{'}→π^{0}π^{0}π^{0} is performed. A significant P-wave contribution from η^{'}→ρ^{±}π^{∓} is observed for the first time in η^{'}→π^{+}π^{-}π^{0}. The branching fraction is determined to be B(η^{'}→ρ^{±}π^{∓})=(7.44±0.60±1.26±1.84)×10^{-4}, where the first uncertainty is statistical, the second systematic, and the third model dependent. In addition to the nonresonant S-wave component, there is a significant σ meson component. The branching fractions of the combined S-wave components are determined to be B(η^{'}→π^{+}π^{-}π^{0})_{S}=(37.63±0.77±2.22±4.48)×10^{-4} and B(η^{'}→π^{0}π^{0}π^{0})=(35.22±0.82±2.54)×10^{-4}, respectively. The latter one is consistent with previous BESIII measurements.

Joint Association of Obesity and Hypertension with Disability in the Elderly-- A Community-Based Study of Residents in Shanghai, China

BACKGROUND

Although both obesity and hypertension are known risk factors for disability, the joint association of obesity and hypertension with risk of disability is unknown. This paper is aim to examine the joint association of obesity and hypertension with risk of disability.

METHODS

Cross-sectional study with 8060 elderly community-dwelling individuals participating in the survey initiated by Shanghai Health and Family Planning Commission from March to September 2013. Obesity was measured using the body mass index (BMI) in World Health Organization (WHO) Asia criteria. Hypertension, based on the doctor's diagnosis, was obtained through face-to-face interview. Disability was measured using the self-reported physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scale developed by Lawton and Brody.

RESULTS

A total of 8.97% of participants reported ADL disability, and 15.18% for IADL disability. After adjusting social demographics and chronic conditions, the risk of ADL disability was progressively greater in obese persons with hypertension (OR=1.40, 95% CI=1.05-1.89), underweight persons without hypertension (OR=2.05, 95% CI=1.29-3.25), and underweight persons with hypertension (OR=2.14, 95% CI=1.36-3.36). For IADL disability, only underweight persons with hypertension were significantly associated (OR=1.65, 95% CI=1.23-2.21).

CONCLUSIONS

Low or extremely high BMI, independent of its metabolic consequences, is a risk factor for disability among the elderly. Simple hypertension wasn't significantly associated with disability. In addition, having hypertension significantly increased the risk of ADL disability in obese individuals and IADL disability in underweight individuals.

Sargassum fusiforme Polysaccharide Rejuvenat es the Small Intestine in Mice Through Altering its Physiol ogy and Gut Microbiota Composition

BACKGROUND AND OBJECTIVE

Aging can result in a progressive decline in cellular protection and physiological function. The physiological status and microbiota of the intestine are intensively linked to the aging process. Numerous studies have suggested that Sargassum fusiforme polysaccharides possess antioxidant and antiaging activities. However, it remains unclear as to whether S. fusiforme polysaccharides can prevent the insult of oxidant and aging through modulating the physiological status and microbiota of the intestine.

METHODS

To assess the cytoprotective effect of S. fusiforme polysaccharides (SFPS) in the small intestine of mice embarking on the aging process, we compared the expressions of Nrf2 and several representative markers (SOD-2, CAT, NQO1 and HO-1) of the Nrf2/ARE signaling pathway in the small intestine of male ICR mice fed with a control diet with those of mice fed with a SFPS-containing diet. In addition, the overall compositional changes in the small intestine microbiota were determined by 16s rDNA sequencing followed by alpha and beta diversity analyses.

RESULTS

The results showed that dietary intake of SFPS could ameliorate the declined cytoprotective capacity of the small intestine by upregulating the Nrf2/ARE signaling pathway. Moreover, SFPS could partially rejuvenate the overall status of the small intestine microbiota.

CONCLUSION

The results suggested that dietary SFPS may promote the health condition of the small intestine, consequently leading to a healthy aging.

Analysis of outcomes of fertility restoration surgery in women with infertility secondary to tubal pregnancy: a series of 77 cases

PURPOSE

To assess pregnancy outcomes after minimally-invasive fertility restoration surgery in women with infertility secondary to tubal pregnancy treated with salpingectomy.

MATERIALS AND METHODS

The study included 77 women diagnosed with infertility after salpingectomy for tubal pregnancy between December 2008 and October 2010 for intraoperative assessment and treatment of tubal and pelvic adhesions. The mean age of the patients was 31.12 ± 3.58 years and their duration of infertility was 3.91 ± 2.80 years. Chi-square test, Student's t-test, rank-sum test, and Kaplan-Meier test was used. A p-value < 0.05 was considered significant.

RESULTS

Tubal function was restored in 68.8% of women, 33.77% experienced intrauterine conception, 32.47% had a live birth, 5.19% had an ectopic pregnancy, and 1.30% had a spontaneous abortion within the three-year follow up period.

CONCLUSIONS

Minimally-invasive fertility restoration surgery after tubal pregnancy treated with salpingectomy restored tubal function in the contralateral fallopian tube in the majority of women.

The alienation of affection toward parents and influential factors in Chinese left-behind children

OBJECTIVE

Although alienation toward parents is important for children (for current mental health status or later interpersonal relationships in adulthood), it is undervalued and even lacks a standardized tool of assessment. Moreover, the large number of left-behind children in China is a cause of public concern. However, their experienced alienation toward their parents remains unclear, which may be important for early detection or intervention for behavioral problems in this population. Hence, the current study aimed to develop an alienation inventory for children and then use it to investigate the experienced alienation toward parents in Chinese left-behind children.

METHODS

Two studies were carried out. Study 1 was designed to develop a standard inventory of alienation toward parents (IAP). In study 2, 8361 children and adolescents (6704 of them were left-behind status) of the Chongqing area, aged between 8 and 19 years old, were recruited for investigation. All participants were surveyed with a standard sociodemographic questionnaire, children's cognitive style questionnaire, children's depression inventory, adolescent self-rating life events checklist, and newly built IAP in study 1.

RESULTS

In study 1, we developed a two-component (communication and emotional distance) and 18-item (9 items for maternal or paternal form, respectively) IAP questionnaire. In study 2, exploratory factor analysis indicated an expected two-factor structure of IAP, which was confirmed by confirmatory factor analysis. The Cronbach's alpha coefficients showed a good reliability (0.887 and 0.821 for maternal and paternal form, respectively). Children with absent mother experienced the highest alienation toward parents. Boys as well as children aged 8-10 years old experienced higher alienation toward parents. Poor communication with parents (sparse or no connection), level of left-behind condition (parents divorced, been far away from parents), and psychosocial vulnerability (stressful life events, negative cognitive style) were risk factors of alienation toward parents.

CONCLUSIONS

The current study develops a two-factor (communication and emotional distance) IAP, which offers a reliable tool to assess experienced alienation of affection toward parents in children aged between 8 and 19 years old. Our result is the first investigation of experienced alienation and potential influential factors in Chinese left-behind children. The findings that children with absent mother experience higher alienation toward parents, as well as three recognized risk factors for alienation of affection toward parents (poor communication with absent parents, worse left-behind condition, and psychosocial vulnerability), give valuable guidance for parents who intend to leave or who are already leaving as well as for government policymaking.

Measurement of Singly Cabibbo Suppressed Decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}

Using 567  pb^{-1} of data collected with the BESIII detector at a center-of-mass energy of sqrt[s]=4.599  GeV, near the Λ_{c}^{+}Λ[over ¯]_{c}^{-} threshold, we study the singly Cabibbo-suppressed decays Λ_{c}^{+}→pπ^{+}π^{-} and Λ_{c}^{+}→pK^{+}K^{-}. By normalizing with respect to the Cabibbo-favored decay Λ_{c}^{+}→pK^{-}π^{+}, we obtain ratios of branching fractions: [B(Λ_{c}^{+}→pπ^{+}π^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(6.70±0.48±0.25)%, [B(Λ_{c}^{+}→pϕ)/B(Λ_{c}^{+}→pK^{-}π^{+})]=(1.81±0.33±0.13)%, and [B(Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-})/B(Λ_{c}^{+}→pK^{-}π^{+})]=(9.36±2.22±0.71)×10^{-3}, where the uncertainties are statistical and systematic, respectively. The absolute branching fractions are also presented. Among these measurements, the decay Λ_{c}^{+}→pπ^{+}π^{-} is observed for the first time, and the precision of the branching fraction for Λ_{c}^{+}→pK^{+}K_{non-ϕ}^{-} and Λ_{c}^{+}→pϕ is significantly improved.

Ten-year follow-up analysis of chronic hepatitis C patients after getting sustained virological response to pegylated interferon-α and ribavirin therapy

There is little data on the long-term follow-up outcomes of chronic hepatitis C patients achieving sustained virological response (SVR) after treatment with peglylated interferon-α plus ribavirin. We prospectively investigated the overall clinical, biochemical, virological and histological outcomes in a ten-year cohort study of 325 patients with chronic hepatitis C achieving SVR to pegylated interferon-α and ribavirin therapy. Patients underwent consistent clinical, biochemical and virological evaluation every six months, and patients with pretherapy Ishak fibrosis score ≥2 were invited to accept a second liver biopsy at the last follow-up. Liver biopsy specimens were evaluated using Ishak's scoring system. At the end of follow-up, five patients developed decompensated liver cirrhosis. One patient (0.3%) with pretherapy cirrhosis was diagnosed with hepatocellular carcinoma (HCC). A total of 305 patients (94%) had normal serum ALT and AST levels during the entire period of follow-up. Twenty-seven patients (8%) had conclusive evidence of virological relapse. Among the 117 patients with paired pretherapy and long-term follow-up biopsies, 96 (82%) had a decreased fibrosis score. Ninety-nine (79%) had a decrease in combined inflammation score. Thirty-seven (32%) had normal or nearly normal livers on long-term follow-up biopsy. SVR achieved with PEG-IFN-α and RBV combination therapy is durable, while late virological relapse may still occur in some patients. Clinical outcomes for patients who obtain SVR are excellent, although the patients with cirrhosis are still at a low risk of hepatocellular carcinoma.