Low rCBV values in glioblastoma tumor progression under chemoradiotherapy

PURPOSE

After standard treatment for glioblastoma, perfusion MRI remains challenging for differentiating tumor progression from post-treatment changes. Our objectives were (1) to correlate rCBV values at diagnosis and at first tumor progression and (2) to analyze the relationship of rCBV values at tumor recurrence with enhancing volume, localization of tumor progression, and time elapsed since the end of radiotherapy in tumor recurrence.

METHODS

Inclusion criteria were (1) age > 18 years, (2) histologically confirmed glioblastoma treated with STUPP regimen, and (3) tumor progression according to RANO criteria > 12 weeks after radiotherapy. Co-registration of segmented enhancing tumor VOIs with dynamic susceptibility contrast perfusion MRI was performed using Olea Sphere software. For tumor recurrence, we correlated rCBV values with enhancing tumor volume, with recurrence localization, and with time elapsed from the end of radiotherapy to progression. Analyses were performed with SPSS software.

RESULTS

Sixty-four patients with glioblastoma were included in the study. Changes in rCBV values between diagnosis and first tumor progression were significant (p < 0.001), with a mean and median decreases of 32% and 46%, respectively. Mean rCBV values were also different (p < 0.01) when tumors progressed distally (radiation field rCBV values of 1.679 versus 3.409 distally). However, changes and, therefore, low rCBV values after radiotherapy in tumor recurrence were independent of time.

CONCLUSION

Chemoradiation alters tumor perfusion and rCBV values may be decreased in the setting of tumor progression. Changes in rCBV values with respect to diagnosis, with low rCBV in tumor progression, are independent of time but related to the site of recurrence.

Metaphyseal Fracture Displacement is Predictive of Intra-articular Diastasis in Adolescent Triplane Ankle Fractures

BACKGROUND

Triplane fractures are rare enough that large homogeneous series to support management decisions are lacking. During initial evaluation, the addition of computed tomography (CT) to conventional X-rays (XR) does not always alter the patient's clinical course. Therefore, routine use of CT is controversial. This study aims to: (1) clarify quantitative relationships between articular displacement measured on XR versus CT and (2) identify whether metaphyseal displacement on the lateral XR predicts clinically relevant articular displacement on a CT scan.

METHODS

A 10-year retrospective review of consecutive triplane fractures was performed at a level 1 pediatric trauma center. Maximum articular and metaphyseal displacement were recorded from XR and CT. Quantitative relationships between XR and CT measurements were compared among imaging modalities and radiographically operative versus nonoperative fractures.

RESULTS

Eighty-seven patients met the inclusion criteria. XR underestimated articular displacement by 229% in the sagittal plane (1 mm on XR vs 3.3 mm on CT; P < 0.05) and 17% in the coronal plane (2.3 mm on XR vs 2.7 mm on CT; P < 0.05). XR underestimated articular step-off by 184% in the coronal plane and 177% in the sagittal plane ( P < 0.05). CT measurements more often differentiated patients who did or did not undergo surgery at our institution. Metaphyseal displacement was significantly higher in patients with traditionally operative articular displacement (≥2.5 mm on CT) versus those with articular displacement below traditionally operative thresholds (2.4 vs 0.9 mm, P = 0.001). Sixty patients had metaphyseal displacement >1 mm on the lateral XR, of whom 56 had surgical-magnitude articular displacement (≥2.5 mm) on CT (positive predictive value = 94%).

CONCLUSIONS

Conventional radiographs underestimate the true articular displacement of triplane fractures. Surgical-magnitude articular step-off is rare, and the largest articular gap is usually visualized on the axial CT image. Metaphyseal displacement >1 mm, which is easily measured on a lateral XR, is strongly predictive of clinically relevant articular displacement on CT. This radiographic finding should prompt advanced imaging before proceeding with nonoperative management.

LEVEL OF EVIDENCE

Level III.

Informal sale of antibiotics in Guatemalan convenience stores before and after implementation of federal antibiotic dispensing legislation

BACKGROUND

Convenience stores in Guatemala provide essential consumer goods in communities, but many dispense antibiotics illegally. Federal legislation, passed in August of 2019, requires prescriptions for antibiotic purchase at pharmacies but it is unclear if this legislation is enforced or if it has any impact on unlawful sales of antibiotics.

METHODS

To determine if antibiotic availability changed in convenience stores, we carried out a repeated measures study collecting antibiotic availability data before and after implementation of the dispensing regulation.

RESULTS

There was no statistical difference in the proportion of convenience stores that sold antibiotics before and after antibiotic regulations [66.6% (295/443) and 66.7% (323/484), respectively, P>0.96], nor in the number of stores selling amoxicillin [55.5% (246/443) and 52.3% (253/484), respectively, P>0.96], but fewer stores (20%) sold tetracycline capsules after regulation was passed (P<0.05). For stores visited both before and after passage of legislation (n=157), 15% stopped selling antibiotics while 25% started selling antibiotics. Antibiotics from convenience stores were reportedly sold for use in people and animals.

CONCLUSIONS

Antibiotics remain widely available in convenience stores consistent with no significant change in the informal sector after implementation of prescription requirements for pharmacies. Importantly, effects from regulatory change could have been masked by potential changes in antibiotic use during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic.

Advancing the assessment of pacifier effects with a novel computational method

BACKGROUND

Numerous studies have demonstrated a high likelihood of malocclusions resulting from non-nutritive sucking. Consequently, quantifying the impact of pacifiers can potentially aid in preventing the development or exacerbation of malocclusions and guide the design of improved performance pacifiers.

METHODS

This work proposes and assesses a computational methodology that can effectively gather crucial information and provide more precise data regarding the consequences of non-nutritive pacifier sucking. The computational framework utilized is based on solids4Foam [1, 2], a collection of numerical solvers developed within the OpenFOAM® computational library [3]. The computational model focuses on the palate of a six-month-old baby and incorporates various components such as palate tissues, pacifier and tongue, and considers the negative intraoral pressure generated and the tongue displacement. Different models were tested, each offering varying levels of detail in representing the palate structure. These models range from a simplified approach, with one tissue, to a more intricate representation, involving up to five different tissues, offering a more comprehensive palate model compared to existing literature.

RESULTS

The analysis of results involved examining the distribution of stress on the palate surface, as well as the displacement and forces exerted on the dental crowns. By comparing the obtained results, it was possible to evaluate the precision of the approaches previously described in the literature. The findings revealed that the predictions were less accurate when using the simplified model with a single tissue for the palate, which is the most common approach proposed in the literature. In contrast, the results demonstrated that the palate model with the most intricate structure, incorporating five different tissues, yielded distinct outcomes compared to all other combinations.

CONCLUSIONS

The computational methodology proposed, employing the most detailed palate model, has demonstrated its effectiveness and necessity in obtaining accurate data on the impact of non-nutritive sucking habits, which are recognized as a primary contributor to the development of dental malocclusions. In the future, this approach could be extended to conduct similar studies encompassing diverse pacifier designs, sizes, and age groups. This would foster the design of innovative pacifiers that mitigate the adverse effects of non-nutritive sucking on orofacial structures.

Nuclear Charge Radius of ^{26m}Al and Its Implication for V_{ud} in the Quark Mixing Matrix

Collinear laser spectroscopy was performed on the isomer of the aluminium isotope ^{26m}Al. The measured isotope shift to ^{27}Al in the 3s^{2}3p ^{2}P_{3/2}^{○}→3s^{2}4s ^{2}S_{1/2} atomic transition enabled the first experimental determination of the nuclear charge radius of ^{26m}Al, resulting in R_{c}=3.130(15)  fm. This differs by 4.5 standard deviations from the extrapolated value used to calculate the isospin-symmetry breaking corrections in the superallowed β decay of ^{26m}Al. Its corrected Ft value, important for the estimation of V_{ud} in the Cabibbo-Kobayashi-Maskawa matrix, is thus shifted by 1 standard deviation to 3071.4(1.0) s.

Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry

AIMS

The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation.

METHODS AND RESULTS

Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin.

CONCLUSION

The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.

Metaphyseal Fracture Displacement is Predictive of Intra-Articular Displacement in Adolescent Triplane Ankle Fractures

Category:

Trauma; Ankle

Introduction/Purpose:

Triplane ankle fractures are a commonly encountered pediatric injury with potential long-term sequelae if not appropriately managed. Computed tomography (CT) imaging is frequently obtained in the workup of a triplane fracture, however the radiation and cost associated with CT imaging is not benign. We aim to determine the utility of a novel and simple plain radiographic measurement as a predictor of intra-articular displacement in adolescent triplane ankle fractures.

Methods:

An IRB approved, retrospective review of all adolescent triplane ankle fractures from 2003-2013 was performed at a single level 1 pediatric trauma center. Plain radiographs (XR) and CT imaging obtained at initial presentation were independently reviewed by three orthopaedic surgeons. Maximum articular displacement and step off were measured using digital calipers on AP, mortise and lateral XRs as well as on axial, coronal, and sagittal CT imaging. In addition, maximal metaphyseal fracture displacement was recorded on lateral XR. Articular displacement and step off were compared between the two imaging modalities using student's t-test. Pearson and Spearman coefficients were used to identify correlations between XR and CT measurements.

Results:

87 triplane ankle fractures were identified to meet inclusion criteria with a mean age of 12.9 years old (10-16 years old). XR was found to underestimate fracture displacement by 233% in the sagittal plane (1mm vs.3.3mm on sagittal CT; p<0.05). XR underestimated displacement by 24% in the coronal plane (2.3mm on AP XR vs. 2.9mm on coronal CT; p<0.05), and articular step off by 184% in the coronal plane and 177% in the sagittal plane (p<0.05). Axial CT demonstrated a significantly greater amount of articular displacement (4.2mm, range 0-19mm) when compared to coronal (2.9mm, range 0-18.7mm) and sagittal (3.3mm, range 0- 11mm) cuts (p<0.05). 65 patients demonstrated metaphyseal fracture displacement >=1mm on lateral XR, of whom 61 demonstrated articular displacement of >2.5mm on CT (positive predictive value of 94%).

Conclusion:

Plain radiographs appear to underestimate the articular displacement of triplane fractures. Maximal metaphyseal fracture displacement is easily measured on XR and appears to correlate with articular displacement. Maximal metaphyseal fracture displacement >= 1mm is strongly predictive of articular displacement above the commonly accepted threshold for operative intervention. This finding should raise suspicion for significant articular displacement that may not be appreciated on XR and should prompt consideration of a CT before a decision is made on definitive treatment.

POS0707 POTENTIAL USE OF BELIMUMAB IN LUPUS PATIENTS FROM ARGENTINE COHORT ACCORDING DISEASE ACTIVITY STATE

Background

The goal of targeted treatment in patients with Systemic Lupus Erythematosus (SLE) is to achieve clinical remission or low disease activity, with the best quality of life, low damage rates and better survival 1-4. RELESSAR is a multicenter, cross-sectional study registry of ≥18 years SLE (ACR 97) patients 5.

Objectives

To describe demographic, clinical characteristics and treatments in SLE patients according to disease activity state. To evaluate the proportion of SLE and refractory SLE patients that are potentially candidates for Belimumab treatment (Active SLE despite standard treatment including increased acDNA autoantibodies and low complement).

Methods

We evaluated demographic and clinical data, treatments, score of damage (SLICC), activity (SLEDAI) and comorbidity (Charlson), hospital admissions and severe infections. The patients were compared according to disease activity: remission (SLEDAI = 0 and without corticosteroids), low disease activity (LDA, SLEDAI> 0 and ≤4 and without corticosteroids) and non-optimal control (SLEDAI> 4 and any dose of corticosteroids). Refractory SLE was defined according to Rituximab (RTX) use, non-response to cyclophosphamide or two or more immunosuppressant or splenectomized patients. Potential use of Belimumab according approved prescription in Argentina was analyzed.

Results

Overall, 1277 patients were analyzed: 299 (23.4%) were in remission, 162 (12.7%) in LDA and 816 (63.9%) with non-optimal control of the disease.

Patients in non-optimal control group were younger, less frequently female and they showed less time of disease and lower socioeconomic status (p < 0.001). They were also more prevalent mestizos (p= 0.004), had higher SLEDAI and SLICC indexes (p <0.001) and higher use of immunosuppressant therapy (p <0.001). There was no difference regarding biologic treatment (RTX p= 0.547 and Belimumab p= 0.08). This group had higher proportion of hospital admissions and severe infections (p<0.001, respectively).

Two hundred and one SLE patients fulfilled the use of Belimumab prescription criteria but only 45/201 patients (22,3%) received it in the last visit. Malar rash was the only clinical variable associated with the use of Belimumab (72.7% vs 29.8% p= 0.005).

Seventy-six patients classified as refractory SLE (15.7%) and 56/76 (75.7%) never received Belimumab. Patients on Belimumab therapy were associated to treatment with lower doses of corticoids (p= 0.018) and lower rate of hospital admission caused by SLE flare (p= 0.027).

Conclusion

A high percentage of patients had uncontrolled disease upon entry into the registry and were potential candidates for treatment with Belimumab. The patients who received biologic treatment showed the benefit of requiring fewer doses of corticosteroids and having a lower rate of hospitalizations.

References

[1]Mok CC. Treat-to-target in systemic lupus erythematosus: Are we there yet? Expert Rev Clin Pharmacol. 2016;9(5).

[2]Morand EF, Mosca M. Treat to target, remission and low disease activity in SLE. Vol. 31, Best Practice and Research: Clinical Rheumatology. 2017.

[3]Golder V, Tsang-A-Sjoe MWP. Treatment targets in SLE: Remission and low disease activity state. Rheumatol (United Kingdom). 2020;59.

[4]Ruiz-Irastorza G, Bertsias G. Treating systemic lupus erythematosus in the 21st century: new drugs and new perspectives on old drugs. Vol. 59, Rheumatology (United Kingdom). 2021.

[5]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum [Internet]. 1997;40(9):1725. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9324032

Disclosure of Interests

Rosana Quintana: None declared, Lucila Garcia: None declared, Paula Alba: None declared, Susana Roverano: None declared, Analia Alvarez: None declared, Cesar Graf: None declared, Cecilia Pisoni: None declared, Alberto Spindler: None declared, Catalina Gomez: None declared, Heber Matias Figueredo: None declared, Silvia Papasidero: None declared, Raul Horacio Paniego: None declared, Maria DeLaVega: None declared, Emma Estela Civit De Garignani: None declared, Luciana Gonzalez Lucero: None declared, Victoria Martire: None declared, Rodrigo Águila Maldonado: None declared, Sergio Gordon: None declared, Carla Gobbi: None declared, Romina Nieto: None declared, Gretel Rausch: None declared, Vanina Góngora: None declared, Maria Agustina D´Amico: None declared, Diana Dubinsky: None declared, Alberto Omar Orden: None declared, Johana Zacariaz: None declared, Julia Romero: None declared, Mariana Alejandra Pera: None declared, Oscar Rillo: None declared, Roberto Baez: None declared, Valeria Arturi: None declared, Andrea Gonzalez: None declared, Florencia Vivero: None declared, Marcela Schmid: None declared, Victor Caputo: None declared, Maria Silvia Larroude: None declared, Graciela Gomez: None declared, Graciela Rodriguez: None declared, Josefina Marin: None declared, Maria Victoria Collado: None declared, Marisa Jorfen: None declared, Zaida Bedran: None declared, Judith Sarano: None declared, David Zelaya: None declared, MONICA SACNUN: None declared, Pablo Finucci: None declared, Romina Rojas Tessel: None declared, Maria Emilia Sattler: None declared, MAXIMILIANO MACHADO ESCOBAR: None declared, Pablo Astesana: None declared, Ursula Vanesa Paris: None declared, Alberto Allievi: None declared, Juan Manuel Vandale: None declared, Bernardo Pons-Estel: None declared, Guillermo Pons-Estel: None declared, Mercedes García Grant/research support from: GSK grant

Impact of Nuclear Deformation and Pairing on the Charge Radii of Palladium Isotopes

The impact of nuclear deformation can been seen in the systematics of nuclear charge radii, with radii generally expanding with increasing deformation. In this Letter, we present a detailed analysis of the precise relationship between nuclear quadrupole deformation and the nuclear size. Our approach combines the first measurements of the changes in the mean-square charge radii of well-deformed palladium isotopes between A=98 and A=118 with nuclear density functional calculations using Fayans functionals, specifically Fy(std) and Fy(Δr,HFB), and the UNEDF2 functional. The changes in mean-square charge radii are extracted from collinear laser spectroscopy measurements on the 4d^{9}5s ^{3}D_{3}→4d^{9}5p ^{3}P_{2} atomic transition. The analysis of the Fayans functional calculations reveals a clear link between a good reproduction of the charge radii for the neutron-rich Pd isotopes and the overestimated odd-even staggering: Both aspects can be attributed to the strength of the pairing correlations in the particular functional which we employ.

Nanosecond-Scale Proton Emission from Strongly Oblate-Deformed ^{149}Lu

Using the fusion-evaporation reaction ^{96}Ru(^{58}Ni,p4n)^{149}Lu and the MARA vacuum-mode recoil separator, a new proton-emitting isotope ^{149}Lu has been identified. The measured decay Q value of 1920(20) keV is the highest measured for a ground-state proton decay, and it naturally leads to the shortest directly measured half-life of 450_{-100}^{+170}  ns for a ground-state proton emitter. The decay rate is consistent with l_{p}=5 emission, suggesting a dominant πh_{11/2} component for the wave function of the proton-emitting state. Through nonadiabatic quasiparticle calculations it was concluded that ^{149}Lu is the most oblate deformed proton emitter observed to date.

The integrated diagnostic suite of the C-2W experimental field-reversed configuration device and its applications

In the current experimental device of TAE Technologies, C-2W (also called "Norman"), record breaking advanced beam-driven field-reversed configuration (FRC) plasmas are produced and sustained in steady state utilizing variable energy neutral beams (15-40 keV, total power up to 20 MW), advanced divertors, bias electrodes, and an active plasma control system. This fully operational experiment is coupled with a fully operational suite of advanced diagnostic systems. The suite consists of 60+ individual systems spanning 20 categories, including magnetic sensors, Thomson scattering, interferometry/polarimetry, spectroscopy, fast imaging, bolometry, reflectometry, charged and neutral particle analysis, fusion product detection, and electric probes. Recently, measurements of main ion temperatures via a diagnostic neutral beam, axial profiles of energy flux from an array of bolometers, and divertor and edge plasma parameters via an extensive set of electric probes, interferometers, and spectrometers have all been made available. All the diagnostics work together to provide a complete picture of the FRC, fast-ion inventory, and edge plasma details enabling tomographic reconstruction of plasma parameter profiles and real-time plasma control.

Selective bond breaking of halothane induced by electron transfer in potassium collisions

We present novel experimental results of negative ion formation of halothane (C₂HBrClF₃) upon electron transfer from hyperthermal neutral potassium atoms (K°) in the collision energy range of 8-1000 eV. The experiments were performed in a crossed molecular beam setup allowing a comprehensive analysis of the time-of-flight (TOF) mass negative ions fragmentation pattern and a detailed knowledge of the collision dynamics in the energy range investigated. Such TOF mass spectra data show that the only negative ions formed are Br^-, Cl^- and F^-, with a strong energy dependence in the low-energy collision region, with the bromine anion being the most abundant and sole fragment at the lowest collision energy probed. In addition, potassium cation (K⁺) energy loss spectra in the forward scattering direction were obtained in a hemispherical energy analyser at different K° impact energies. In order to support our experimental findings, ab initio quantum chemical calculations have been performed to help interpret the role of the electronic structure of halothane. Potential energy curves were obtained along the C-X (X = Br, Cl) coordinate to lend support to the dissociation processes yielding anion formation.

Positive effects of high salinity can buffer the negative effects of experimental warming on functional traits of the seagrass Halophila ovalis

Coastal ecosystems, and especially estuaries, are subject to environmental fluctuations that can be amplified by anthropogenic changes. Under a future scenario of global warming, temperature and salinity are likely to be altered and the persistence of macrophyte-dominated ecosystems can be compromised, particularly native or local seagrass communities. This study examined the response of the local seagrass Halophila ovalis to the joint effect of a short-term salinity increase and a transient temperature stress, through two mesocosm experiments. Warming caused a decline in F_v/F_m, TNC content in leaves and plant growth, and increased dark respiration, revealing clear detrimental symptoms of heat stress on plant metabolism and performance. Salinity increase in isolation favoured ramet survival. However, in combination with warming, salinity had a positive effect on Gross P_max. This suggests that increased salinities might dampen the negative effects of high temperatures, buffering, to some extent, the impact of global warming in temperate estuaries.

Plasma Aβ42/40 Ratio Detects Early Stages of Alzheimer's Disease and Correlates with CSF and Neuroimaging Biomarkers in the AB255 Study

BACKGROUND

Easily accessible biomarkers are needed for the early identification of individuals at risk of developing Alzheimer's disease (AD) in large population screening strategies.

OBJECTIVES

This study evaluated the potential of plasma β-amyloid (Aβ) biomarkers in identifying early stages of AD and predicting cognitive decline over the following two years.

DESIGN

Total plasma Aβ42/40 ratio (TP42/40) was determined in 83 cognitively normal individuals (CN) and 145 subjects with amnestic mild cognitive impairment (a-MCI) stratified by an FDG-PET AD-risk pattern.

RESULTS

Significant lower TP42/40 ratio was found in a-MCI patients compared to CN. Moreover, a-MCIs with a high-risk FDG-PET pattern for AD showed even lower plasma ratio levels. Low TP42/40 at baseline increased the risk of progression to dementia by 70%. Furthermore, TP42/40 was inversely associated with neocortical amyloid deposition (measured with PiB-PET) and was concordant with the AD biomarker profile in cerebrospinal fluid (CSF).

CONCLUSIONS

TP42/40 demonstrated value in the identification of individuals suffering a-MCI, in the prediction of progression to dementia, and in the detection of underlying AD pathology revealed by FDG-PET, Amyloid-PET and CSF biomarkers, being, thus, consistently associated with all the well-established indicators of AD.

Hiding Ignorance Using High Dimensions

The absence of information-entirely or partly-is called ignorance. Naturally, one might ask if some ignorance of a whole system will imply some ignorance of its parts. Our classical intuition tells us yes, however quantum theory tells us no: it is possible to encode information in a quantum system so that despite some ignorance of the whole, it is impossible to identify the unknown part [T. Vidick and S. Wehner, Phys. Rev. Lett. 107, 030402 (2011).PRLTAO0031-900710.1103/PhysRevLett.107.030402]. Experimentally verifying this counterintuitive fact requires controlling and measuring quantum systems of high dimension (d>9). We provide this experimental evidence using the transverse spatial modes of light, a powerful resource for testing high-dimensional quantum phenomena.

Plasticity to drought and ecotypic differentiation in populations of a crop wild relative

Populations of widely distributed species often exhibit geographic variation in functional traits in response to environmental heterogeneity. Such trait variation may be the result of different adaptive mechanisms, including genetically based differentiation, phenotypic plasticity or a combination of both. Disentangling the genetic and environmental components of trait variation may be particularly interesting in crop wild relatives, since they may provide unique reservoirs of genetic diversity for crop improvement. In this study, we assessed ecotypic differentiation and patterns of plasticity to drought in populations of Lupinus angustifolius, a Mediterranean crop wild relative, from two climatically distinct regions in the Iberian Peninsula. Using an outdoor common garden, we compared phenotypic responses of inbred maternal families to two ecologically meaningful water availability treatments (drought and high-moisture). We measured 18 different functional traits related to growth, morphology, phenology and reproduction. Plants in the drought treatment grew less, had lower leaf chlorophyll content and photochemical efficiency, but also reproduced faster, produced larger seeds and altered leaflet morphology through increased leaflet thickness, higher leaflet dry matter content and lower specific leaf area. We also found significant differences between regions that likely reflect adaptation to climatically distinct environments, with populations from the south showing a faster onset of reproduction, higher leaf thickness and higher seed size, consistent with the drier conditions experienced in southern sites. Plasticity to drought was in most cases in the same direction as quantitative genetic differentiation (i.e. cogradient variation), providing evidence of the adaptive value of the plastic change. Our results show that both genetic differentiation and plasticity can generate adaptive phenotypic variation in L. angustifolius, and help to identify potentially valuable genetic resources to incorporate into breeding programmes.

Brain metastases treated with radiosurgery or hypofractionated stereotactic radiotherapy: outcomes and predictors of survival

INTRODUCTION

To assess treatment outcome and prognostic factors associated with prolonged survival in patients with brain metastases (BM) treated with stereotactic radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (HFSRT).

METHODS/PATIENTS

This study retrospectively reviewed 200 patients with 324 BM treated with one fraction (15-21 Gy) or 5-10 fractions (25-40 Gy) between January 2010 and August 2016. 26.5% of patients received whole brain radiotherapy (WBRT) and 25% initial surgery. Demographics, prognostic scales, systemic and local controls, patterns of relapse and rescue, toxicity, and cause of death were analyzed. A stratified analysis by primary tumor was done.

RESULTS

Median overall survival (OS) was 8 months from SRS/HFSRT. Breast cancer patients had a median OS of 17 months, followed by renal (11 months), lung (8 months), colorectal (5 months), and melanoma (4 months). The univariate analysis showed improved OS in females (p 0.004), RPA I-II (p < 0.001) initial surgery (p < 0.001), absence of extracranial disease (p 0.023), and good disease control (p 0.002). There were no differences in OS or local control between SRS and HFSRT or in patients receiving WBRT. Among 44% of brain recurrences, 11% were in field. 174 patients died, 10% from confirmed intracranial progression.

CONCLUSIONS

SRS and HSFRT are equally effective and safe for the treatment of BM, with no exceptions among different primary tumors. Disease control, surgery, age, and prognostic scales correlated with OS. However, the lack of survival benefit regarding WBRT might become logical evidence for its omission in a subset of patients.

Computing the relevant colors that describe the color palette of paintings

In this paper, we introduce an innovative parameter that allows us to evaluate the so-called "relevant colors" in a painting; in other words, the number of colors that would stand out for an observer when just glancing at a painting. These relevant colors allow us to characterize the color palette of a scene and, on this basis, those discernible colors that are colorimetrically different within the scene. We tried to carry out this characterization of the chromatic range of paints according to authors and styles. We used a collection of 4,266 paintings by 91 painters, from which we extracted various parameters that are exclusively colorimetric to characterize the range of colors. After this refinement of the set of selected colors, our algorithm obtained an average number of 18 relevant colors, which partially agreed with the total 11-15 basic color names usually found in other categorical color studies.

RID: Evaluation of the Possible Inhibiting Effect of the Proinflammatory Signaling Induced by TNF-α through NF-κβ and AP-1 in Two Cell Lines of Breast Cancer

Receptor internalization and degradation (RID), is a transmembrane protein coded within the E3 region expression cassette of adenoviruses. RID downregulates the cell surface expression of epidermal growth factor receptor (EGFR), tumor necrosis factor receptor (TNFR), and apoptosis antigen 1 (FAS), causing a reduction of the effects of their respective ligands. In addition, RID inhibits apoptosis by decreasing the secretion of TNF-related apoptosis-inducing ligand (TRAIL) by normal tissue cells. In this article, we report that RID inhibited chemokine expression in human breast cancer cell line MDA-MB-231 but showed no effect in cell line MCF7. These dissimilar results may be due to the different molecular and functional properties of both cell lines. Therefore, it is necessary to replicate this study in other breast cancer cell models.

Performance of butanol separation from ABE mixtures by pervaporation using silicone-coated ionic liquid gel membranes

This work aims at the separation of n-butanol from aqueous solutions by means of pervaporation using membranes based on gelled ionic liquids (IL).

Correlations between plasma and PET beta-amyloid levels in individuals with subjective cognitive decline: the Fundació ACE Healthy Brain Initiative (FACEHBI)

BACKGROUND

Peripheral biomarkers that identify individuals at risk of developing Alzheimer's disease (AD) or predicting high amyloid beta (Aβ) brain burden would be highly valuable. To facilitate clinical trials of disease-modifying therapies, plasma concentrations of Aβ species are good candidates for peripheral AD biomarkers, but studies to date have generated conflicting results.

METHODS

The Fundació ACE Healthy Brain Initiative (FACEHBI) study uses a convenience sample of 200 individuals diagnosed with subjective cognitive decline (SCD) at the Fundació ACE (Barcelona, Spain) who underwent amyloid florbetaben(18F) (FBB) positron emission tomography (PET) brain imaging. Baseline plasma samples from FACEHBI subjects (aged 65.9 ± 7.2 years) were analyzed using the ABtest (Araclon Biotech). This test directly determines the free plasma (FP) and total plasma (TP) levels of Aβ40 and Aβ42 peptides. The association between Aβ40 and Aβ42 plasma levels and FBB-PET global standardized uptake value ratio (SUVR) was determined using correlations and linear regression-based methods. The effect of the APOE genotype on plasma Aβ levels and FBB-PET was also assessed. Finally, various models including different combinations of demographics, genetics, and Aβ plasma levels were constructed using logistic regression and area under the receiver operating characteristic curve (AUROC) analyses to evaluate their ability for discriminating which subjects presented brain amyloidosis.

RESULTS

FBB-PET global SUVR correlated weakly but significantly with Aβ42/40 plasma ratios. For TP42/40, this observation persisted after controlling for age and APOE ε4 allele carrier status (R2 = 0.193, p = 1.01E-09). The ROC curve demonstrated that plasma Aβ measurements are not superior to APOE and age in combination in predicting brain amyloidosis. It is noteworthy that using a simple preselection tool (the TP42/40 ratio with an empirical cut-off value of 0.08) optimizes the sensitivity and reduces the number of individuals subjected to Aβ FBB-PET scanners to 52.8%. No significant dependency was observed between APOE genotype and plasma Aβ measurements (p value for interaction = 0.105).

CONCLUSION

Brain and plasma Aβ levels are partially correlated in individuals diagnosed with SCD. Aβ plasma measurements, particularly the TP42/40 ratio, could generate a new recruitment strategy independent of the APOE genotype that would improve identification of SCD subjects with brain amyloidosis and reduce the rate of screening failures in preclinical AD studies. Independent replication of these findings is warranted.

Carbon economy of Mediterranean seagrasses in response to thermal stress

Increased plant mortality in temperate seagrass populations has been recently observed after summer heatwaves, although the underlying causes of plant death are yet unknown. The potential energetic constrains resulting from anomalous thermal events could be the reason that triggered seagrass mortality, as demonstrated for benthic invertebrates. To test this hypothesis, the carbon balance of Posidonia oceanica and Cymodocea nodosa plants from contrasting thermal environments was investigated during a simulated heatwave, by analyzing their photosynthetic performance, carbon balance (ratio photosynthesis:respiration), carbohydrates content, growth and mortality. Both species were able to overcome and recover from the thermal stress produced by the six-week exposure to temperatures 4 °C above mean summer levels, albeit plants from cold waters were more sensitive to warming than plants from warm waters as reflected by their inability to maintain their P:R ratio unaltered. The strategies through which plants tend to preserve their energetic status varied depending on the biology of the species and the thermal origin of plants. These included respiratory homeostasis (P. oceanica warm-plants), carbon diversion from growth to respiration (C. nodosa cold-plants) or storage (P. oceanica warm-plants) and changes in biomass allocation (C. nodosa warm-plants). Findings suggest an important geographic heterogeneity in the overall response of Mediterranean seagrasses to warming with potential negative impacts on the functions and services offered by seagrass meadows including among others their capacity for carbon sequestration and carbon export to adjacent ecosystems.

Experimental evidence of warming-induced flowering in the Mediterranean seagrass Posidonia oceanica

Sexual reproduction in predominantly clonal marine plants increases recombination favoring adaptation and enhancing species resilience to environmental change. Recent studies of the seagrass Posidonia oceanica suggest that flowering intensity and frequency are correlated with warming events associated with global climate change, but these studies have been observational without direct experimental support. We used controlled experiments to test if warming can effectively trigger flowering in P. oceanica. A six-week heat wave was simulated under laboratory mesocosm conditions. Heating negatively impacted leaf growth rates, but by the end of the experiment most of the heated plants flowered, while controls plants did not. Heated and control plants were not genetically distinct and flowering intensity was significantly correlated with allelic richness and heterozygosity. This is an unprecedented finding, showing that the response of seagrasses to warming will be more plastic, more complex and potentially more resilient than previously imagined.

Indefinite Causal Order in a Quantum Switch

Quantum mechanics allows events to happen with no definite causal order: this can be verified by measuring a causal witness, in the same way that an entanglement witness verifies entanglement. Here, we realize a photonic quantum switch, where two operations A[over ^] and B[over ^] act in a quantum superposition of their two possible orders. The operations are on the transverse spatial mode of the photons; polarization coherently controls their order. Our implementation ensures that the operations cannot be distinguished by spatial or temporal position-further it allows qudit encoding in the target. We confirm our quantum switch has no definite causal order by constructing a causal witness and measuring its value to be 18 standard deviations beyond the definite-order bound.

Prognostic Factors and Results of Radiation Therapy in Optic Pathway Tumors

Aims and Background

The role of radiotherapy in the management of patients with optic pathway tumors remains controversial. This study analyzes the outcome of patients treated with radiotherapy and attempts to identify the groups of patients that may require early therapy.

Methods

We retrospectively reviewed 36 patients with optic pathway tumors treated with radiotherapy alone (26 patients) or with postoperative radiotherapy (10 patients). Seven patients had optic nerve tumors and 29 patients had chiasmal tumors. The actuarial progression free survival and observed survival probabilities were calculated using the Kaplan-Meier method and differences between curves were evaluated by the Mantel-Cox test. The obtained significant variables in the univariate analysis were analyzed using the Cox proportional hazards model.

Results

The 10-year actuarial progression-free survival (10-y PFS) rate was 86% for patients with optic nerve gliomas and 47% for patients with chiasmal tumors. The 10-year actuarial observed survival (10-y OS) rate was 75% for patients with optic nerve gliomas and 53% for patients with chiasmal gliomas. In the group of patients with chiasmal tumors, progression-free survival and observed survival rates were significantly lower in infants (10-y PFS: 30%; 10-y OS: 37%), in patients with neurological deficits (10-y PFS and 10-y OS: 23%), in patients with signs of elevated intracranial pressure (10-y PFS and 10-y OS: 9%), with hydrocephalus (10-y PFS and 10-y OS: 0%), or with impairment of consciousness (10-y PFS and 10-y OS: 17%). Evaluation by computed tomography scanning was associated with a significantly higher probability of PFS. Radiation doses lower than 50 Gy were associated with significantly lower PFS and OS rates. In the Cox multivariate analysis, presence of neurological deficits and radiation dose significantly influenced observed survival. Presence of hydrocephalus significantly influenced progression-free survival.

Conclusions

The prognosis of patients with chiasmal gliomas presenting with neurologic deficits is poor and should be treated at diagnosis. A minimum tumor dose of 50 Gy is recommended.

ROC Analysis of Diagnostic Performance Utilizing Serum Antiproteases in Cancer Patients

Assessment of the accuracy of diagnostic procedures is made independent of diagnostic criteria by means of a receiver-operating-characteristics (ROC) curve. We performed ROC analysis for the major serum antiproteases: alpha-1-antitrypsin (A1AT) and alpha-2-macroglobulin (A2M), in 99 cancer patients compared with 71 normal individuals. A1AT and A2M were significantly higher in cancer patients (p < 0.0005). By comparing true positive and false positive rates for different serum levels, ROC analysis showed that serum A1AT quantification seems more useful in clinical practice than serum A2M.

Assessing body image in anorexia nervosa using biometric self-avatars in virtual reality: Attitudinal components rather than visual body size estimation are distorted

BACKGROUND

Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN.

METHODS

We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants' weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity.

RESULTS

Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1.

CONCLUSIONS

Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.

Detection of latent infections caused by Colletotrichum sp. in olive fruit

AIMS

To set up a practical method to detect latent infections of Colletotrichum sp., the causal agent of olive anthracnose, on olives before the onset of disease symptoms.

METHODS AND RESULTS

Freezing, sodium hydroxide (NaOH), ethanol and ethylene treatments were evaluated to detect latent infections on inoculated and naturally infected olive fruit by Colletotrichum sp. as non-hazardous alternatives to paraquat. Treatments were conducted using fruit of cultivars Arbequina and Hojiblanca. The disease incidence and T₅₀ were calculated. Dipping in NaOH 0·05% solution and the paraquat method were the most effective treatments on both inoculated and naturally infected fruit, although the value of T₅₀ was lower for the NaOH method than for the paraquat method in one of the experiments. Subsequently, the dipping time in NaOH 0·05% was evaluated. Longer dipping times in NaOH 0·05% were better than shorter ones in cultivar Arbequina, with 72 h being the most effective in cultivar Hojiblanca.

CONCLUSIONS

NaOH solution is a practical method to detect latent infections of Colletotrichum sp. on immature olive fruit.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study is relevant because we set up a viable, non-hazardous alternative to paraquat to detect latent infections of Colletotrichum sp. using NaOH. The use of NaOH is a simple and eco-friendly tool that allows the determination of the level of latent infections by Colletotrichum in olives. Therefore, our method will be useful in decision-making processes for disease management before the appearance of the first visible symptoms.

Enhanced magnetic field probe array for improved excluded flux calculations on the C-2U advanced beam-driven field-reversed configuration plasma experiment

External flux conserving coils were installed onto the exterior of the C-2U [M. W. Binderbauer et al., Phys. Plasmas 22, 056110 (2015)] confinement vessel to increase the flux confinement time of the system. The 0.5 in. stainless steel vessel wall has a skin time of ∼5 ms. The addition of the external copper coils effectively increases this time to ∼7 ms. This led to better-confined/longer-lived field-reversed configuration (FRC) plasmas. The fringing fields generated by the external coils have the side effect of rendering external field measurements invalid. Such measurements were key to the previous method of excluded flux calculation [M. C. Thompson et al., Rev. Sci. Instrum. 83, 10D709 (2012)]. A new array of B-dot probes and Rogowski coils were installed to better determine the amount of flux leaked out of the system and ultimately provide a more robust measurement of plasma parameters related to pressure balance including the excluded flux radius. The B-dot probes are surface mountable chip inductors with inductance of 33 μH capable of measuring the DC magnetic field and transient field, due to resistive current decay in the wall/coils, when coupled with active integrators. The Rogowski coils measure the total change in current in each external coil (150 A/2 ms). Currents were also actively driven in the external coils. This renders the assumption of total flux conservation invalid which further complicates the analysis process. The ultimate solution to these issues and the record breaking resultant FRC lifetimes will be presented.