Evidence for a Square-Square Vortex Lattice Transition in a High-T_{c} Cuprate Superconductor

Using sound velocity and attenuation measurements in high magnetic fields, we identify a new transition in the vortex lattice state of La_{2-x}Sr_{x}CuO_{4}. The transition, observed in magnetic fields exceeding 35 T and temperatures far below zero field T_{c}, is detected in the compression modulus of the vortex lattice, at a doping level of x=p=0.17. Our theoretical analysis based on Eilenberger's theory of the vortex lattice shows that the transition corresponds to the long-sought 45° rotation of the square vortex lattice, predicted to occur in d-wave superconductors near a van Hove singularity.

OP0141 TREAT TO TARGET IN SYSTEMIC LUPUS ERYTHEMATOSUS FROM THE PATIENTS’ PERSPECTIVE – RESULTS FROM AN INTERNATIONAL PATIENT SURVEY

Background

Treat-to-target (T2T) is a generally accepted treatment concept in rheumatology care. It is assumed that T2T could significantly improve systemic lupus erythematosus (SLE) care and the patients’ outcomes. However, T2T has not yet been studied systematically and clinical trials are currently in preparation [1]. Furthermore, the patients’ opinion on T2T has barely been taken into account.

Objectives

As the success of T2T is largely determined by the involvement of patients, it was our aim to investigate the attitude towards, need, and willingness of SLE patients to participate in a T2T study and to identify possible obstacles.

Methods

A questionnaire on T2T, its acceptance, the need and willingness to participate in a T2T trial and possible obstacles for T2T was designed by the authors in cooperation with patient research partner and performed in the Netherlands (NL), Austria (AU), Germany (GE) and Bulgaria (BG). The web-based survey consisted of 13 questions with single and multiple answers and/or free text. After back-and-forth translation from German to Dutch and Bulgarian, it was distributed among members of the patient organizations of NL, GE, AU, BG via newsletter (GE, AU, BG), personal invitation (NL) and a closed Facebook group (BG). Castor Electronic Data Capture (NL) and SoSci-Survey (GE, AU, BG) were used as platforms.

Results

A total of 863 patients (n=316 NL, n=271 GE, n=232 BG, n=44 AU) with self-declared diagnosis of SLE completed the questionnaire. 93.3% were female, 52.2% were 41-60 years old. The disease duration was longer than 10 years in 54.8%, 12.4% had a disease duration of 0-2 years. Regarding the satisfaction with the current health status, 56.2% were somewhat to all the way satisfied, 29.3% were not at all or hardly satisfied. 65.5% were satisfied with their current therapeutic treatment, 14.8% where not at all or hardly satisfied.

48.4% declared being currently in remission, 13% did not know if they were in remission. As most important treatment goal, normalization of quality of life was chosen most frequently (37.4%) followed by prevention of organ damage (24.6%) and the absence of disease activity (22.6 %).

Regarding shared decision making, the majority reported to be somewhat to all the way involved in treatment decisions (62.1%) while 20,7% where hardly or not at all involved.

As most difficult decisions in T2T and shared decision making, respondents named the start of new SLE medication (37.9%) and to change medication while feeling good (39.4%). An increase in the dose of glucocorticoids to reach remission was difficult for 22.7%.

The majority of patients considered research of T2T in SLE useful (55,4% all the way, 29.8% somewhat useful) and 67% would probably or definitely participate in such scientific research. The perceived advantages and disadvantages of T2T are depicted in Figure 1.

Figure 1.

Consequences of T2T rated as advantage or disadvantage by SLE patients. SLE systemic lupus erythematosus, T2T treat-to-target.

Conclusion

Despite many SLE patients being satisfied with their treatment and health status, T2T is considered an important subject to be studied in clinical trials. Advantages did overweigh possible disadvantages of T2T with the possibility of more doctors’ visits and the prescription of a new drug as biggest disadvantage. Quality of life named as most important treatment goal emphasizes its importance as outcome parameter. Most patients would be willing to participate in a trial about T2T.

References

[1]Mucke J, Kuss O, Brinks R, Schanze S, Schneider M. LUPUS-BEST-treat-to-target in systemic lupus erythematosus: study protocol for a three-armed cluster-randomised trial. Lupus Sci Med 2021; 8(1)

Disclosure of Interests

Johanna Mucke Speakers bureau: AbbVie Deutschland GmbH & Co. KG, Bristol Myers Squibb, Celgene GmbH, Chugai Pharma Germany GmbH, Gilead Sciences Inc., GSK, Janssen-Cilag GmbH, Lilly Deutschlang GmbH, Novartis Pharma GmbH, Consultant of: AbbVie Deutschland GmbH & Co. KG, Amgen, Astra Zeneca, BMS, Celgene GmbH, Gilead Sciences Inc., GlaxoSmithKline, Novartis Pharma GmbH, Lilly Deutschland GmbH, Medac GmbH, Mylan, Grant/research support from: Sanofi Aventis, Daliya Pencheva: None declared, Agner Parra Sanchez Grant/research support from: AstraZeneca, Kyra Kramer: None declared, Matthias Schneider Speakers bureau: MSD, Abbott, AbbVie, Pfizer, GlaxoSmithKline, UCB, Roche, AstraZeneca, Lilly, Janssen-Cilag, Sanofi-Aventis, Chugai, Celgene, Novartis, Boehringer Ingelheim and Bristol-Myers Squibb, Consultant of: MSD, Abbott, AbbVie, Pfizer, GlaxoSmithKline, UCB, Roche, AstraZeneca, Lilly, Janssen-Cilag, Sanofi-Aventis, Chugai, Celgene, Novartis, Boehringer Ingelheim and Bristol-Myers Squibb, Grant/research support from: GSK, UCB, Irene Bultink Speakers bureau: Speaker fees from Eli Lilly, MSD, Amgen, UCB, GSK, Roche, Sanofi Genzyme (outside the submitted work), Consultant of: Consultancy fees from Sanofi Genzyme and AstraZeneca (outside the submitted work)

Dental defects in the primary dentition associated with hypophosphatasia from biallelic ALPL mutations

ALPL encodes tissue-nonspecific alkaline phosphatase (TNAP), an enzyme expressed in bone, teeth, liver, and kidney. ALPL loss-of-function mutations cause hypophosphatasia (HPP), an inborn error-of-metabolism that produces skeletal and dental mineralization defects. Case reports describe widely varying dental phenotypes, making it unclear how HPP comparatively affects the three unique dental mineralized tissues: enamel, dentin, and cementum. We hypothesized that HPP affected all dental mineralized tissues and aimed to establish quantitative measurements of dental tissues in a subject with HPP. The female proband was diagnosed with HPP during childhood based on reduced alkaline phosphatase activity (ALP), mild rachitic skeletal effects, and premature primary tooth loss. The diagnosis was subsequently confirmed genetically by the presence of compound heterozygous ALPL mutations (exon 5: c.346G>A, p.A116T; exon 10: c.1077C>G, p.I359M). Dental defects in 8 prematurely exfoliated primary teeth were analyzed by high resolution micro-computed tomography (micro-CT) and histology. Similarities to the Alpl^-/- mouse model of HPP were identified by additional analyses of murine dentoalveolar tissues. Primary teeth from the proband exhibited substantial remaining root structure compared to healthy control teeth. Enamel and dentin densities were not adversely affected in HPP vs. control teeth. However, analysis of discrete dentin regions revealed an approximate 10% reduction in the density of outer mantle dentin of HPP vs. control teeth. All 4 incisors and the molar lacked acellular cementum by micro-CT and histology, but surprisingly, 2 of 3 prematurely exfoliated canines exhibited apparently normal acellular cementum. Based on dentin findings in the proband's teeth, we examined dentoalveolar tissues in a mouse model of HPP, revealing that the delayed initiation of mineralization in the incisor mantle dentin was associated with a broader lack of circumpulpal dentin mineralization. This study describes a quantitative approach to measure effects of HPP on dental tissues. This approach has uncovered a previously unrecognized novel mantle dentin defect in HPP, as well as a surprising and variable cementum phenotype within the teeth from the same HPP subject.

Health workers on the move: the need for global policy

Issue

WHO's Global Code of Practice on the International Recruitment of Health Personnel was adopted in 2010 by WHO Member States to 1: monitor and address unethical international recruitment practices; 2: to strengthen national health workforces. Unethical recruitment and lack of investments in resilient health workforces was leading to increased health inequalities worldwide. The WHO Code provided non-binding behavioral principles to address these.

Description

The WHO Code came with a monitoring and review mechanism. Member States were to report on Code implementation every three years and every five years the Code's relevance and effectiveness is reviewed. In the 2018/19 reporting round, non-state actors, too, submitted reports to WHO. Wemos carried out a qualitative analysis of these (14) reports and presented the findings to the Expert Advisory Group (EAG) tasked to review the Code in 2019/20.

Results

Non-state actor reports provide important additional information to Member States' reports on Code implementation. The 14 submissions included cases of unfair treatment of migrant health workers and indicated some improvement in health workforce planning and forecasting. Moreover, they pointed to a lack of efforts (or results thereof) by governments to invest in more resilient health workforces, fueling health worker mobility globally.

Lessons

These findings are consistent with observations from civil society, trade unions, health professional associations and employers' organizations, as evidenced during the roundtable discussions with the EAG in June 2019. They noted that increased global mobility, not just by health workers, is a given and actually further accelerated by a growing number of inter-country migration agreements, undermining equitable access to a health worker across the globe. They urged for supra-national policies and practices in order to achieve Universal Health Coverage for all by 2030.

Key messages

With increased global mobility of individuals, an equitable distribution of health workers worldwide surpasses the policy scope of national governments and requires supra-national measures. The involvement of civil society in the monitoring of mobility trends and equity effects of health workforce policies is essential for shared prosperity as envisioned in the SDG Agenda.

How healthy is a ‘healthy economy’? Incompatibility between current pathways towards SDG3 and SDG8

Background

The link between health and the economy is well known. However, economic growth as measured in SDG8, continues to leave people behind and the funding gap for realizing SDG3 for good health and well-being remains vast. International financial institutions, i.e. the IMF, influence national policies in ways that may undermine the SDGs. We examine incoherencies between economic growth and health goals in Malawi, Uganda, and Tanzania.

Methods

We conducted qualitative research based on policy analysis. To analyse IMF policy advice in the three countries we reviewed relevant program documents, article IV consultation reports (2016-18) and literature on structural adjustment. We accessed health information from WHO and World Bank databases, and national policies.

Results

In all three countries, some indicators, e.g. infant and child mortality, improved, but others lag behind. Underfunding is a major cause for poor health and inequities. GDP increases (as a measure of economic growth) do not automatically translate to increases in health spending. Health expenditure from domestic public resources remains much lower than international thresholds. To achieve this level of spending domestically, GDP in these countries would require an unrealistic manifold increase. IMF policy advice and loan conditionality that focus on GDP growth and tight monetary and fiscal targets impair social spending, while suggested taxation measures are generally regressive.

Conclusions

The GDP-focused SDG8 can delay efforts towards the SDG3 if governments opt to focus on GDP growth without measures to equally distribute wealth and invest in social sectors, often under IMF's influence. Although the IMF has acknowledged the importance of social development, its policy advice still adheres to austerity, harming population health. To realize the SDGs everywhere, governments should abandon GDP growth as a policy objective, strive for equitable economic development and emphasise global co-operation.

Key messages

GDP increases do not automatically translate to an increase of health spending, partly a result of IMF structural adjustment programs and policy advice. To realize the SDGs everywhere, governments should abandon GDP growth as a policy objective and place more emphasis on SDG17 on global co-operation.

Health workforce financing in Uganda: challenges and opportunities

Background

For health systems to operate well and improve people's health by leaving no one behind, they need a fit-for-purpose health workforce. Shortage of health workers leads to reduced access to healthcare, health inequities, and adverse outcomes in the population's health. A key challenge in many low-income countries is mobilising the needed investment for health workforce development. This study evaluated the policy environment of the health workforce in Uganda, analysed its current status, and identified financing mechanisms and management practices that affect the country's health resource envelope.

Methods

The study was conducted in 2018/19. It entailed literature review, key informant interviews and stakeholder consultations for validation of the findings.

Results

The shortage of health workers is persevering, despite efforts of the Ugandan Government and development partners. The health workforce is not keeping up with the population growth, nor the epidemiologic changes and demographic trends. Paradoxically, there is a large pool of qualified and licensed health professionals, who remain unabsorbed. Notably, even if all of them were absorbed, Uganda would be still far from the international requirements for universal health coverage. The issues are recognized at the policy level, but insufficient funding and poor management are impeding the recruitment and retention of health workers. Domestic resources are insufficient to fund a health system which can offer a minimum healthcare package and most donors are reluctant to contribute to health workers' salaries. Besides, Uganda is lacking a national health insurance scheme, which keeps out-of-pocket spending on health at very high rates. Moreover, increases in external financing have been accompanied by decreases in domestic government financing, despite economic growth.

Conclusions

The health sector financing is influenced by a complex political economy, which impedes investments in the health workforce.

Key messages

The problems and gaps of the Ugandan human resources for health are persisting due to the insufficient financial allocation and the poor management of the health workforce and existing funds. The shortage of health workers is a global health issue that goes beyond national borders and the health sector. It is an essential requirement for exercising the universal right to health.

Abstract P4-06-20: Delivering tumour antigens survivin and mucin-1 on virus-like particles for breast cancer immunotherapy

Breast cancer is the most frequently diagnosed cancer in women worldwide. Although there are a variety of treatment options available, breast cancer is a difficult disease to treat and many patients experience recurrence following treatment. We have previously shown that tumour antigens delivered on virus-like particles (VLP) induce a targeted anti-cancer immune response. In this study we investigated whether combining the two tumour antigens survivin and mucin 1 as vaccine targets can induce a superior anti-cancer immune response for breast cancer immunotherapy. VLP were designed to recombinantly express the murine survivin epitope. Following expression of Survivin-VLP, aberrantly glycosylated mucin 1 (MUC1) peptide was conjugated onto the Survivin-VLP using intracellular cleavable bis-arylhydrazone linking strategy. Western Blot analysis and electron microscopy confirmed Survivin-VLP expression and UV absorption confirmed conjugation of the MUC1 peptide to the Survivin-VLP. C57mg.MUC1 breast cancer cells were injected into the mammary fat pad of C57Bl/6 and MUC1 transgenic mice. Once tumours were palpable, mice were vaccinated with the Survivin-MUC1-VLP and controls of DPBS, VLP without antigen or VLP delivering either survivin or MUC1 antigen. Tumour growth and mouse survival were monitored for 80 days. Mice vaccinated with Survivin-MU1-VLP delivering both antigens showed enhanced survival (D78) compared to mice vaccinated with VLP delivering only one of the antigens (D66) and controls (D53). Delivery of two tumour antigens induced an enhanced anti-tumour immune response compared to delivery of single tumour antigens. The induction of multiple immune responses against different tumour antigens may apply additional evolutionary pressure upon tumours, prolonging the ability for tumours to develop resistance, or escape through the proliferation of a resistant subpopulation. The use of VLP for the delivery of multiple antigens and adjuvants represents a promising approach to improve cancer immunotherapy for breast cancer.

Citation Format: Kramer K, Braeden D, Young VL, Walker GF, Ward VK, Young SL. Delivering tumour antigens survivin and mucin-1 on virus-like particles for breast cancer immunotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-06-20.

Three-Dimensional Fermi Surface of Overdoped La-Based Cuprates

We present a soft x-ray angle-resolved photoemission spectroscopy study of overdoped high-temperature superconductors. In-plane and out-of-plane components of the Fermi surface are mapped by varying the photoemission angle and the incident photon energy. No k_{z} dispersion is observed along the nodal direction, whereas a significant antinodal k_{z} dispersion is identified for La-based cuprates. Based on a tight-binding parametrization, we discuss the implications for the density of states near the van Hove singularity. Our results suggest that the large electronic specific heat found in overdoped La_{2-x}Sr_{x}CuO_{4} cannot be assigned to the van Hove singularity alone. We therefore propose quantum criticality induced by a collapsing pseudogap phase as a plausible explanation for observed enhancement of electronic specific heat.

Abstract P4-09-01: Tumor suppressor control of the cancer stem cell angiogenic niche

Mammary stem cells (MSC) expansion is associated with aggressive human breast cancer. The nuclear receptor peroxisome proliferator activated receptor γ (PPARγ) is a breast cancer tumor suppressor, but the mechanisms of this suppression are not completely characterized. To determine if PPARγ regulates MSC expansion in mammary cancer, we deleted PPARγ expression in the mammary epithelium of an in vivo model of basal breast cancer. Loss of PPARγ expression reduced tumor latency, and expanded the CD24+/CD49fhi MSC population. PPARγ null mammary tumors exhibited increased angiogenesis which was detected in human breast cancer. In vivo inhibition of a PPARγ regulated miR-15a/angiopoietin-1 pathway blocked increased angiogenesis and MSC expansion. PPARγ bound and activated a canonical response element in the miR-15a gene. PPARγ null tumors were sensitive to the targeted anti-angiogenic drug sunitinib but resistant to cytotoxic chemotherapy. Normalization of tumor vasculature with sunitinib resulted in objective response to cytotoxic chemotherapy. Chemotherapy treated PPARγ null mammary tumors exhibited luminal phenotype and expansion of unipotent CD61+ luminal progenitor cells. Transplantation of chemotherapy treated luminal progenitor cells recapitulated the luminal phenotype. These results have important implications for anti-angiogenic therapy in breast cancer patients.

Citation Format: Crowe D, Kramer K, Wu J. Tumor suppressor control of the cancer stem cell angiogenic niche [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 P4-09-01.

Acclimatization of rats after ground transportation to a new animal facility

This study aimed to assess the time needed by rats, which had not been previously transported, to acclimatize to a new environment after 5 h of van transport, using physiological parameters as measures of acclimatization. Animal shipping boxes and transport van conditions were standardized to minimize stress factors that could be associated with transport. Heart rate (HR), body temperature and activity levels were measured in the rats before and after transport using previously implanted radio-telemetry transmitters. Body weight was also recorded. All parameters were changed significantly except for body temperature. Results suggest that rats take three days to acclimatize to a new environment, as measured by the physiological parameters of body weight, HR and activity.

Surgical procedure for implanting a radiotelemetry transmitter to monitor ECG, heart rate and body temperature in small Carassius auratus and Carassius auratus gibelio under laboratory conditions

Radiotelemetry provides an alternative means of obtaining physiological measurements from conscious and freely moving animals, without introducing stress artefacts. A surgical procedure is described for implanting radiotelemetry transmitters to monitor the electrocardiogram (ECG), heart rate (HR) and body temperature (BT) in small goldfish ( Carassius auratus; 50–100 g) and Prussian carp ( Carassius auratus gibelio; 100 g). This type of transmitter is commonly implanted in freely moving mice. After surgery and a recovery period of 24 h, the ECG, HR and BT were recorded in freely swimming fish within the limitations of the aquarium.

Abstract P5-10-03: XRAYS (eXamining Relevance of Articles to Young Survivors) program survey of information needs and media use by young breast cancer survivors and young women at high risk for breast cancer

Women age 45 or under with breast cancer, or who are at high risk for breast cancer, have distinct health risks and needs when compared to their older counterparts. Young women with breast cancer or at high risk for breast cancer need evidence-based, high-quality information to help them make informed decisions about their specific health needs. Interpreting media reports on research findings, including determining the study implications for younger women is often challenging. To help women better understand media coverage of new research, Facing Our Risk of Cancer Empowered (FORCE) developed the CDC-funded XRAYS (eXamining Relevance of Articles to Young Survivors) program. To assure that the XRAYS program is responsive to the community's needs, FORCE launched a survey to assess where young women turn for information about breast cancer and to identify their information needs. The survey examines: how frequently women visit various media sources and health- or cancer-related websites for information on breast cancer screening, treatment, surgery, prevention, genetics, or survivorship; how much the women trust these information sources; whether they have ever tried to share media articles with their health care team and how the team received the information; and at what point(s) during the process of screening, diagnosis, treatment, survivorship and/or risk management respondents actively seek out information from the media. FORCE launched the survey nationally through its network of 50 outreach groups, partner organizations that serve young breast cancer survivors, and via a social media campaign targeting women age 45 and under with, or at high risk for breast cancer. The survey was open March 15 - June 30, 2015. We will report results from over 800 women, age 45 or younger, including those with breast cancer, who have previously had breast cancer, or who are at high risk for breast cancer. Analysis will determine response frequencies and whether information needs and utilization correlate with key demographic variables such as race/ethnicity, education, and income level. We will use correlation and multiple regression analysis to assess patterns in the types of information needed and channels where information is sought. These results will ensure XRAYS materials and dissemination efforts are efficient and responsive to the young breast cancer population's needs, and will inform the broader medical, media and patient advocacy communities about the distinct information needs of this group.

Citation Format: Rezende LF, Huynh J, Kramer K, Cranmer M, Schlager L, Pugh-Yi R, Friedman S. XRAYS (eXamining Relevance of Articles to Young Survivors) program survey of information needs and media use by young breast cancer survivors and young women at high risk for breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-10-03.

Abstract P6-07-06: Clinicopathologic characterization and comprehensive genomic profiling (CGP) of advanced breast cancer patients with fibroblast growth factor receptor (FGFR) alterations

BACKGROUND: FGFR family members are infrequently mutated but are frequently overexpressed in breast cancer and often accompanied by increased, or altered, expression of FGF ligands. In this retrospective study, we reviewed a large series of FGFR altered breast cancer cases that received comprehensive genomic profiling (CGP) in the course of clinical care.

MATERIAL AND METHODS: CGP was performed on hybridization-captures, adaptor ligation-based libraries using DNA extracted from 40 μm formalin-fixed paraffin-embedded (FFPE) section cut at 10 μm performed in a CLIA-certified lab (Foundation Medicine, Inc.). The pathologic diagnosis of each case was confirmed on routine hematoxylin and eosin-stained slides, and all samples forwarded for DNA extraction contained a minimum of 20% of DNA derived from tumor cells. The FoundationOne test sequences the full coding regions of up to 315 cancer-related genes, and up to 28 genes that are frequently altered in cancer to detect all classes of genomic alterations including base substitutions, indels, copy-number alterations (CNA), and fusions/rearrangements. The average depth of coverage is greater than 600X. The genomic profiles of 2,617 patients with diverse advanced malignancies who were evaluated at Cancer Treatment Centers of America between 12/24/12 and 03/11/15 were reviewed. 176 FGFR alterations (7.8%) were detected, of which 76 (43.5%) were found in breast cancer cases out of 434 (16.5%). The study was carried out in accordance with WIRB Institutional Review Board.

RESULTS: A total of 76 female breast cancer patients, having a median age 50 (range, 28-69), with FGFR alterations were reviewed. All patients had metastatic/relapsed advanced breast cancer. 54 patients were Estrogen Receptor-positive (70%), and 15 were HER2+ (20%). 6 patients had gBRCA deleterious mutations. 84% of the samples (n=67) tissue block were analyzed, and the anatomic sites represented by the samples were 24 breast primary tumor (31%), 15 liver (19%), 10 lymph nodes (13%), and other sites (37%). The median number of chemotherapies cycles was 4 (range, 1-12), and the median time to metastasis was 31 months (range, 0-175). At the time of this report, 31 patients (40%) were deceased. 79 FGFR gene alterations were identified in 76 patients, including FGFR1 (65), FGFR2 (6), FGFR3 (2), and FGFR4 (4), with all but 7 of these being amplifications. The most co-existent altered gene was TP53 (66%), and other altered genes included PIK3CA (37%), MYC (28%), FGF3/4/19 (17%), CCND1 (17%), and CCNE1 (16%). The subset of co-amplified FGF3/4/19 and FGFR amplified patients were all (7) ER+ except for 1 patient.

CONCLUSIONS: FGFR genomic alterations in breast cancer patients are predominantly amplifications and are most commonly observed in ER+ patients. Further review of treatment history will be performed to evaluate the hypothesis that alterations of FGFR is a modifier of response to endocrine therapy, and co-amplified FGF3/4/19 and FGFR breast cancer cases may be a distinct clinic-pathologic entity. Any patients in this series initiated on anti-FGFR targeted therapy will also be reported.

Citation Format: Alvarez RH, Thomas JW, Kramer K, Niu J, Ahn E, McKnight JE, Dhillon N, Pabbathi H, Johnson AT, Wang K, Ross JS, Miller VA, Stephens PJ, Daneker GW, Ali S, Markman M. Clinicopathologic characterization and comprehensive genomic profiling (CGP) of advanced breast cancer patients with fibroblast growth factor receptor (FGFR) alterations. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-07-06.

Frequence, spectrum and prognostic impact of additional malignancies in patients with gastrointestinal stromal tumors

Currently available data on prognostic implication of additional neoplasms in GIST miss comprehensive information on patient outcome with regard to overall or disease specific and disease free survival. Registry data of GIST patients with and without additional neoplasm were compared in retrospective case series. We investigated a total of 836 patients from the multi-center Ulmer GIST registry. Additionally, a second cohort encompassing 143 consecutively recruited patients of a single oncology center were analyzed. The frequency of additional malignant neoplasms in GIST patients was 31.9% and 42.0% in both cohorts with a mean follow-up time of 54 and 65 months (median 48 and 60 months), respectively. The spectrum of additional neoplasms in both cohorts encompasses gastrointestinal tumors (43.5%), uro-genital and breast cancers (34.1%), hematological malignancies (7.3%), skin cancer (7.3%) and others. Additional neoplasms have had a significant impact on patient outcome. The five year overall survival in GIST with additional malignant neoplasms (n = 267) was 62.8% compared to 83.4% in patients without other tumors (n = 569) (P < .001, HR=0.397, 95% CI: 0.298-0.530). Five-year disease specific survival was not different between both groups (90.8% versus 90.9%). 34.2% of all deaths (n = 66 of n = 193) were GIST-related. The presented data suggest a close association between the duration of follow-up and the rate of additional malignancies in GIST patients. Moreover the data indicate a strong impact of additional malignant neoplasms in GIST on patient outcome. A comprehensive follow-up strategy of GIST patients appears to be warranted.

Untersuchungen zum Problem des An- und Abklingens der Lumineszenz organischer Molekülkristalle

The theoretical background of the time behaviour of the luminescence of organic molecular crystals is shortly discussed and a measuring equipment is described to measure the rise and the decay of luminescence intensities over four decades. Results on single crystals of anthracene, pyrene, 2,3-dimethylnaphthalene and mixed crystals at 77°K and 300°K are reported and conclusions are drawn regarding the luminescence mechanism in mixed crystals. In an appendix, some methods of measuring luminescence decay times are compared.

Fluoreszenzabklingdauer von einigen aromatischen Kohlenwasserstoffen bei α-Strahlanregung

Aus dem FOURIER-Spektrum von Szintillationslichtblitzen in α-bestrahlten kristallinen Pulvern aromatischer Kohlenwasserstoffe werden Aussagen über die Abklingzeiten (zum Teil auch über Anklingzeiten) gewonnen. Die reinen Kristallpulver zeigen alle ein nicht einfach exponentielles Abklingen der Lumineszenzblitze. Dagegen findet man für die Lumineszenz der Fremdmoleküle, die in die gleichen Wirtsgitter eingebaut wurden, ein fast einfach exponentielles Abklingen. Die gemessenen Werte für die Abklingzeiten sind in zwei Tabellen zusammengestellt. Konsequenzen, die sich daraus für den Anregungsmechanismus ergeben, werden kurz diskutiert.

Comparison of pollen gene flow among four European beech (Fagus sylvatica L.) populations characterized by different management regimes

The study of the dispersal capability of a species can provide essential information for the management and conservation of its genetic variability. Comparison of gene flow rates among populations characterized by different management and evolutionary histories allows one to decipher the role of factors such as isolation and tree density on gene movements. We used two paternity analysis approaches and different strategies to handle the possible presence of genotyping errors to obtain robust estimates of pollen flow in four European beech (Fagus sylvatica L.) populations from Austria and France. In each country one of the two plots is located in an unmanaged forest; the other plots are managed with a shelterwood system and inside a colonization area (in Austria and France, respectively). The two paternity analysis approaches provided almost identical estimates of gene flow. In general, we found high pollen immigration (~75% of pollen from outside), with the exception of the plot from a highly isolated forest remnant (~50%). In the two unmanaged plots, the average within-population pollen dispersal distances (from 80 to 184 m) were higher than previously estimated for beech. From the comparison between the Austrian managed and unmanaged plots, that are only 500 m apart, we found no evidence that either gene flow or reproductive success distributions were significantly altered by forest management. The investigated phenotypic traits (crown area, height, diameter and flowering phenology) were not significantly related with male reproductive success. Shelterwood seems to have an effect on the distribution of within-population pollen dispersal distances. In the managed plot, pollen dispersal distances were shorter, possibly because adult tree density is three-fold (163 versus 57 trees per hectare) with respect to the unmanaged one.

[Incidence of, risk factors for, and prevention of intestinal leakage]

BACKGROUND

Intestinal anastomotic leakage represents a major complication in visceral surgery with relevant morbidity and mortality.

MATERIAL AND METHODS

Based on a literature -search in Medline / PubMed the available data are presented, critically reviewed and summarised.

RESULTS AND CONCLUSION

Beside optimisation of surgical technique, patient-dependent risk factors - such as relevant comorbidity, certain medications or previous radiochemotherapy - play a major role in the development of anastomotic leak-age. The effort for optimisation of these patient-dependent risk factors is not incorporated within the compensation scheme in German hospitals.

Identification of equine cutaneous lymphangioma by application of a lymphatic endothelial cell marker

An adult horse was presented with a mass located within the dermis and subcutis of the right forelimb. At post-mortem examination there was a marked increase in thickness of the subcutis of the right forelimb extending from the fetlock to the pectoral muscles. Microscopically, the dermis and subcutis were diffusely infiltrated by endothelial-like cells forming irregular channels and cavernous spaces. Immunohistochemical examination revealed the endothelial-like cells to express vimentin, factor VIII-related antigen and PROX-1, confirming the identity of the tumour as a lymphangioma. Ultrastructural analysis showed that the cavernous spaces were lined by a discontinuous endothelium lacking any basement membrane.

Value of MDCT in preoperative local staging of rectal cancer for predicting the necessity for neoadjuvant radiochemotherapy

PURPOSE

Neoadjuvant therapy may reduce local rectal cancer recurrence after total mesorectum extirpation. This study was performed to assess whether multi-detector row CT (MDCT) is capable of reliably differentiating UICC I (surgery) from UICC II-IV (neoadjuvant therapy).

MATERIALS AND METHODS

29 patients underwent preoperative MDCT of the abdomen in a portal venous phase. Two blinded readers independently evaluated the datasets on a dedicated workstation using axial and coronal reformations. Local tumor extension (T), nodal status (N) and distant metastases (M) were evaluated and the UICC stage was determined. Findings were correlated with postoperative histology.

RESULTS

Histologically, 9 patients were UICC I; 20 UICC > I (II: 7; III: 11; IV: 2). Reader 1 correctly identified 3 / 9 as UICC I, overstaged 6 / 9, and correctly staged 20 / 20 as UICC > I. Reader 2 correctly identified 4 / 9 as UICC I, overstaged 5 / 9, understaged 4 / 20 and correctly staged 16 / 20 as UICC > I (PPV UICC I 100 % [50 %] reader 1 [reader 2], NPV 77 % [76 %], accuracy 79 % [69 %]). Reasons for overstaging by reader 1 (reader 2) included false-positive lymph nodes (LN) in 5 (5), overgrading T 1 tumors as T 3 in 1(0), and T overgrading in 4 / 5 (2 / 5) patients with false-positive LN.

CONCLUSION

MDCT failed to reliably identify UICC I in rectal cancer patients. Therefore, a strategy based solely on MDCT to identify patients who would benefit from neoadjuvant therapy does not seem appropriate.

Science-policy interfacing in support of the Water Framework Directive implementation

Many current water-related RTD projects have established operational links with practitioners, which allow the needs of policy makers to be taken into account. However, RTD results are not easily available to water policy implementers and research scientists may lack insight in the needs of policy makers and implementers (i.e. the European Commission and water managers). The SPI-Water project worked out a number of concrete actions to bridge these gaps in communication by developing and implementing a 'science-policy interface', enhancing the use of RTD results in the Water Framework Directive (WFD) implementation. This project is part of a wider EC perspective aiming to bridge the gap between science and policy, specifically with respect to the WFD implementation. As a first action, existing science-policy links are investigated. RTD and LIFE projects that are of direct relevance for the implementation of the WFD are identified and analysed. Secondly, an information system (Harmoni-CA's WISE RTD Web Portal) has been further developed to cater for an efficient and easy to use tool for dissemination as well as retrieval of RTD results. As third action, this science-policy interfacing of WFD related topics are extended to non-EU countries taking into account their specific needs.

Quark-hadron duality in neutron (3He) spin structure

We present experimental results of the first high-precision test of quark-hadron duality in the spin-structure function g_{1} of the neutron and 3He using a polarized 3He target in the four-momentum-transfer-squared range from 0.7 to 4.0 (GeV/c);{2}. Global duality is observed for the spin-structure function g_{1} down to at least Q;{2}=1.8 (GeV/c);{2} in both targets. We have also formed the photon-nucleon asymmetry A1 in the resonance region for 3He and found no strong Q2 dependence above 2.2 (GeV/c);{2}.

3He spin-dependent cross sections and sum rules

We present a measurement of the spin-dependent cross sections for the 3He over -->(e over -->,e')X reaction in the quasielastic and resonance regions at a four-momentum transfer 0.1< or =Q2< or =0.9 GeV2. The spin-structure functions have been extracted and used to evaluate the nuclear Burkhardt-Cottingham and extended Gerasimov-Drell-Hearn sum rules for the first time. The data are also compared to an impulse approximation calculation and an exact three-body Faddeev calculation in the quasielastic region.

Measurement of nuclear transparency for the A(e,e'pi+) reaction

We have measured the nuclear transparency of the A(e,e'pi+) process in 2H, 12C, 27Al, 63Cu, and 197Au targets. These measurements were performed at the Jefferson Laboratory over a four momentum transfer squared range Q2=1.1 to 4.7 (GeV/c)2. The nuclear transparency was extracted as the super-ratio of (sigmaA/sigmaH) from data to a model of pion-electroproduction from nuclei without pi-N final-state interactions. The Q2 and atomic number dependence of the nuclear transparency both show deviations from traditional nuclear physics expectations and are consistent with calculations that include the quantum chromodynamical phenomenon of color transparency.

Poisoning with 1-propanol and 2-propanol

1-Propanol and 2-propanol are isomers of an alcohol with three carbons. They are colorless liquids with a sweet odor. 1-Propanol is metabolized by alcohol dehydrogenase to propionic acid and presents with metabolic acidosis and elevated anion gap, whereas 2-propanol is metabolized by alcohol dehydrogenase to acetone and presents with rapidly developing (within 3-4 h after exposure) ketosis and ketonuria but without metabolic acidosis. We report a patient who simultaneously ingested a lethal dose of 1-propanol and 2-propanol as a hand disinfectant in hospital. The patient lost consciousness and stopped breathing within half an hour after ingestion. He was intubated and artificially ventilated. Initial laboratory results showed mixed acidosis with elevated anion gap, but ketonuria appeared only 12 h after admission and 6 h following the regaining of consciousness. Therefore, laboratory results in simultaneous poisoning with two isomers of alcohol are not just a sum of laboratory results obtained in isolated poisoning with each isomer because they influence each other's metabolism: 1-propanol retards the metabolism of 2-propanol to acetone. In conclusion, 1-propanol and 2-propanol poisoning presents early with mixed acidosis and elevated anion gap and only later with ketonuria.

A refined radio-telemetry technique to monitor right ventricle or pulmonary artery pressures in rats: a useful tool in pulmonary hypertension research

Implantable radio-telemetry methodology, allowing for continuous recording of pulmonary haemodynamics, has previously been used to assess effects of therapy on development and treatment of pulmonary hypertension. In the original procedure, rats were subjected to invasive thoracic surgery, which imposes significant stress that may disturb critical aspects of the cardiovascular system and delay recovery. In the present study, we describe and compare the original trans-thoracic approach with a new, simpler trans-diaphragm approach for catheter placement, which avoids the need for surgical invasion of the thorax. Satisfactory overall success rates up to 75% were achieved in both approaches, and right ventricular pressures and heart and respiratory rates normalised within 2 weeks. However, recovery was significantly faster in trans-diaphragm than in trans-thoracic operated animals (6.4 ± 0.5 vs 9.5 ± 1.1 days, respectively; p < 0.05). Stable right ventricular pressures were recorded for more than 4 months, and pressure changes, induced by monocrotaline or pulmonary embolisms, were readily detected. The data demonstrate that right ventricular telemetry is a practicable procedure and a useful tool in pulmonary hypertension research in rats, especially when used in combination with echocardiography. We conclude that the described trans-diaphragm approach should be considered as the method of choice, for it is less invasive and simpler to perform.