Deciphering the Molecular Mechanisms behind Drug Resistance in Ovarian Cancer to Unlock Efficient Treatment Options

Ovarian cancer is a highly lethal form of gynecological cancer. This disease often goes undetected until advanced stages, resulting in high morbidity and mortality rates. Unfortunately, many patients experience relapse and succumb to the disease due to the emergence of drug resistance that significantly limits the effectiveness of currently available oncological treatments. Here, we discuss the molecular mechanisms responsible for resistance to carboplatin, paclitaxel, polyadenosine diphosphate ribose polymerase inhibitors, and bevacizumab in ovarian cancer. We present a detailed analysis of the most extensively investigated resistance mechanisms, including drug inactivation, drug target alterations, enhanced drug efflux pumps, increased DNA damage repair capacity, and reduced drug absorption/accumulation. The in-depth understanding of the molecular mechanisms associated with drug resistance is crucial to unveil new biomarkers capable of predicting and monitoring the kinetics during disease progression and discovering new therapeutic targets.

The influence of carvedilol posology timing on clinically significant portal hypertension: insights from elastography measurements

BACKGROUND AND AIMS

Carvedilol has emerged as the preferred β-blocker for treating portal hypertension. However, there is still a debate in dosing regimen, with a potential lower bioavailability in once-daily regimens. The aim of this study is to assess the acute effects of carvedilol posology in patients with clinically significant portal hypertension (CSPH), as a surrogate marker of bioavailability.

METHODS

In this experimental study, 34 patients with CSPH receiving carvedilol twice daily were asked to suppress the night dose of carvedilol, creating a standardized 24-hour dose interval. Spleen stiffness measurement (SSM) and liver stiffness measurement (LSM) by transient elastography (TE) were performed, with the exact interval between the last carvedilol administration and TE measurements consistently maintained at 24 hours and compared with values prior and under treatment.

RESULTS

Thirty-four patients were included, predominantly male (82.9%). SSM after suspending carvedilol for 24 hours [mean, 73.9kPa (SD, 17.0)] was significantly higher ( P < 0.001) than under treatment [mean, 56.3kPa (SD, 13.2)] and was not significantly different ( P = 0.908) from SSM prior to introduction of carvedilol [mean, 74.5kPa (SD, 12.4)]. Differences were also found in stratified analysis for carvedilol dosage, D'Amico classification stages, MELDNa scores, MELD3.0 scores, Child-Pugh class A and CSPH due to alcoholic cirrhosis. LSM after suspension was not significantly different from both under treatment and prior to treatment.

CONCLUSION

The differences in SSM after skipping one dose of carvedilol show both the importance of strict adherence to the prescribed dosing regimen to achieve the expected therapeutic benefits and the impact of twice daily prescription in bioavailability throughout the day.

A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept

(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.

A role for total alloplastic temporomandibular joint replacement in Gardner syndrome

Gardner syndrome (GS) is a rare autosomal dominant disorder that can present with craniomaxillofacial abnormalities. The identification of osteomas or craniomaxillofacial abnormalities can therefore serve as a marker of this condition, facilitating early referral and diagnosis. A 17-year-old female with GS was referred for the management of severe limited mouth opening, causing a major problem for routine endoscopy to monitor the gastrointestinal alterations of GS. Clinical and radiological evaluations showed multiple osteomas in the mandibular angle, condylar and coronoid regions bilaterally and maximum mouth opening of 8 mm. The patient underwent surgery for osteoma removal and bilateral customized alloplastic total temporomandibular joint replacement (TMJ-TJR). At the 2-year follow-up, the patient showed improvements in quality of life, with a maximum mouth opening of 34 mm, allowing routine upper endoscopy to be performed. This is the first report of GS, a rare and challenging craniomaxillofacial abnormality, treated with TMJ-TJR. A comprehensive overview of the patient's clinical presentation, diagnostic assessment, treatment planning, and outcomes is provided.

Cdc42 activation is necessary for heterosynaptic cooperation and competition

Synapses change their weights in response to neuronal activity and in turn, neuronal networks alter their response properties and ultimately allow the brain to store information as memories. As for memories, not all events are maintained over time. Maintenance of synaptic plasticity depends on the interplay between functional changes at synapses and the synthesis of plasticity-related proteins that are involved in stabilizing the initial functional changes. Different forms of synaptic plasticity coexist in time and across the neuronal dendritic area. Thus, homosynaptic plasticity refers to activity-dependent synaptic modifications that are input-specific, whereas heterosynaptic plasticity relates to changes in non-activated synapses. Heterosynaptic forms of plasticity, such as synaptic cooperation and competition allow neurons to integrate events that occur separated by relatively large time windows, up to one hour. Here, we show that activation of Cdc42, a Rho GTPase that regulates actin cytoskeleton dynamics, is necessary for the maintenance of long-term potentiation (LTP) in a time-dependent manner. Inhibiting Cdc42 activation does not alter the time-course of LTP induction and its initial expression but blocks its late maintenance. We show that Cdc42 activation is involved in the phosphorylation of cofilin, a protein involved in modulating actin filaments and that weak and strong synaptic activation leads to similar levels on cofilin phosphorylation, despite different levels of LTP expression. We show that Cdc42 activation is required for synapses to interact by cooperation or competition, supporting the hypothesis that modulation of the actin cytoskeleton provides an activity-dependent and time-restricted permissive state of synapses allowing synaptic plasticity to occur. We found that under competition, the sequence in which synapses are activated determines the degree of LTP destabilization, demonstrating that competition is an active destabilization process. Taken together, we show that modulation of actin cytoskeleton by Cdc42 activation is necessary for the expression of homosynaptic and heterosynaptic forms of plasticity. Determining the temporal and spatial rules that determine whether synapses cooperate or compete will allow us to understand how memories are associated.

Allopurinol-Induced Toxic Epidermal Necrolysis

Toxic epidermal necrolysis (TEN) is a rare and life-threatening cutaneous disease, frequently triggered by drugs. Allopurinol is one of the most frequent drugs associated with TEN, which implies detachment of a significant amount of the body surface area (BSA) and has a high morbidity and mortality associated with it. We present the case of a 68-year-old female with a recent diagnosis of hyperuricemia who started treatment with allopurinol. A week later, she presented to the emergency department with an extensive maculopapular exanthema with blisters and skin detachment. After the exclusion of other etiologies, the diagnosis of allopurinol-induced TEN was made, with 35% of BSA involvement. Due to the severity of the clinical condition, she was admitted to intensive care and treated with corticoids that had no response. So, she was started on immunoglobulins and transferred to a burn unit. She developed sepsis with multiorgan failure and required supportive treatment. She was discharged after a month, and physical rehabilitation was needed. This clinical case highlights the severity of allopurinol hypersensitivity that may happen and the importance of an accurate diagnosis and treatment for this rare disease.

Multi-analytical characterisation of blotting sands on documents from religious orders in Portugal (16th-19th centuries)

Too little is known about areia de escrever, i.e., blotting sands, the intriguing particles sprinkled on freshly written scripts to accelerate the drying time of the ink. Blotting sands constitute a valuable but underestimated historical source. This work investigated the blotting sands used on the account books of the religious houses scattered across continental Portugal and Madeira Island (16th-19th centuries). The sands were mainly composed of different minerals, predominately black sands, but in a few cases, minerals were found mixed with gums, paper cocoons or bone shavings. The combined use of SEM-EDS, µ-Raman and FT-IR techniques uncovered the materials' chemical or mineralogical composition and morphology. This approach, allied with image analysis and statistics complemented with multivariate analysis, allowed us to look for trends between the samples and hypothesise about their provenance. Heavy minerals, such as ilmenite, hematite and almandine, were identified as major components, together with other silicates (e.g. quartz). Samples were dominated by medium-sized grains with shape features indicating texturally mature sediments resulting from a medium-to-long sedimentary transport. Due to shorter geological transport distances, Madeira Island was the exception, with more angular grains. This work allowed us to uncover blotting sands, value them as historical sources, and establish a roadmap for their use in Portugal, aiming to pave the way towards a more global context in Europe.

First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector

We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40}  cm^{2}/Ar, where statistical and systematic uncertainties are combined.

Wear of Bulk-fill Composite Resins After Thermo-mechanical Loading

STATEMENT OF PROBLEM

Wear of conventional composite resin presented many challenges when restoring posterior teeth and resulted in clinical complications. Bulk-fill composite resins have been proposed as a more suitable and wear-resistant alternative.

OBJECTIVE

To evaluate and compare the volumetric wear (mm3) of bulk-fill composite resins to a conventional composite resin and enamel after thermo-mechanical loading.

METHODS AND MATERIALS

Five composite resins (n=10) were evaluated: four bulk-fill composite resins (Filtek One Bulk Fill [3M Oral Care], Tetric EvoCeram Bulk Fill [Ivoclar Vivadent], Tetric PowerFill [Ivoclar Vivadent], SonicFill 3 [Kerr Corp]); and one conventional composite resin (Filtek Supreme Ultra [3M Oral Care]). Enamel from recently extracted human teeth was used as a control. Specimens were subjected to a 2-body volumetric wear evaluation using a chewing simulator (CS-4.8, Mechatronik). Disc-shaped specimens (10 mm in diameter × 3 mm in thickness) received 500,000 load cycles against steatite antagonists while simultaneously thermocycled (5000 cycles, 5-55°C). Volumetric wear (mm3) was measured using the Geomagic Control X software (3D Systems) based on digital scans of the specimens obtained before and after thermo-mechanical loading, with a Trios 3 (3Shape) digital scanner. Scanning electron microscopy analysis of wear facets and composite resin filler shape and size was performed. Volumetric wear was statistically analyzed using the one-way ANOVA and Tukey's post-hoc test (α=0.05).

RESULTS

All tested composite resins wore at rates significantly higher than enamel (p<0.05). The mean volumetric wear of the composite resins ranged from 1.01 mm3 to 1.48 mm3, while enamel had a mean volumetric wear of 0.25 mm3. Bulk-fill composite resins showed higher wear resistance than the conventional composite resin (p<0.05).

CONCLUSIONS

Bulk-fill composite resins showed higher wear resistance than the conventional composite resin, and both types of composite resin were not as wear-resistant as enamel.

First Constraints on Light Sterile Neutrino Oscillations from Combined Appearance and Disappearance Searches with the MicroBooNE Detector

We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses.

The Antineoplastic Effect of Carboplatin Is Potentiated by Combination with Pitavastatin or Metformin in a Chemoresistant High-Grade Serous Carcinoma Cell Line

The combination of Carboplatin with Paclitaxel is the mainstay treatment for high-grade serous carcinoma; however, many patients with advanced disease undergo relapse due to chemoresistance. Drug repurposing coupled with a combination of two or more compounds with independent mechanisms of action has the potential to increase the success rate of the antineoplastic treatment. The purpose of this study was to explore whether the combination of Carboplatin with repurposed drugs led to a therapeutic benefit. Hence, we assessed the cytotoxic effects of Carboplatin alone and in combination with several repurposed drugs (Pitavastatin, Metformin, Ivermectin, Itraconazole and Alendronate) in two tumoral models, i.e., Carboplatin (OVCAR8) and Carboplatin-Paclitaxel (OVCAR8 PTX R P) chemoresistant cell lines and in a non-tumoral (HOSE6.3) cell line. Cellular viability was measured using the Presto Blue assay, and the synergistic interactions were evaluated using the Chou-Talalay, Bliss Independence and Highest Single Agent reference models. Combining Carboplatin with Pitavastatin or Metformin displayed the highest cytotoxic effect and the strongest synergism among all combinations for OVCAR8 PTX R P cells, resulting in a chemotherapeutic effect superior to Carboplatin as a single agent. Concerning HOSE6.3 cells, combining Carboplatin with almost all the repurposed drugs demonstrated a safe pharmacological profile. Overall, we propose that Pitavastatin or Metformin could act synergistically in combination with Carboplatin for the management of high-grade serous carcinoma patients with a Carboplatin plus Paclitaxel resistance profile.

Combination of Antimalarial and CNS Drugs with Antineoplastic Agents in MCF-7 Breast and HT-29 Colon Cancer Cells: Biosafety Evaluation and Mechanism of Action

Drug combination and drug repurposing are two strategies that allow to find novel oncological therapies, in a faster and more economical process. In our previous studies, we developed a novel model of drug combination using antineoplastic and different repurposed drugs. We demonstrated the combinations of doxorubicin (DOX) + artesunate, DOX + chloroquine, paclitaxel (PTX) + fluoxetine, PTX + fluphenazine, and PTX + benztropine induce significant cytotoxicity in Michigan Cancer Foundation-7 (MCF-7) breast cancer cells. Furthermore, it was found that 5-FU + thioridazine and 5-fluorouracil (5-FU) + sertraline can synergistically induce a reduction in the viability of human colorectal adenocarcinoma cell line (HT-29). In this study, we aim to (1) evaluate the biosafety profile of these drug combinations for non-tumoral cells and (2) determine their mechanism of action in cancer cells. To do so, human fetal lung fibroblast cells (MRC-5) fibroblast cells were incubated for 48 h with all drugs, alone and in combination in concentrations of 0.25, 0.5, 1, 2, and 4 times their half-maximal inhibitory concentration (IC₅₀). Cell morphology and viability were evaluated. Next, we designed and constructed a cell microarray to perform immunohistochemistry studies for the evaluation of palmitoyl-protein thioesterase 1 (PPT1), Ki67, cleaved-poly (ADP-ribose) polymerase (cleaved-PARP), multidrug resistance-associated protein 2 (MRP2), P-glycoprotein (P-gp), and nuclear factor-kappa-B (NF-kB) p65 expression. We demonstrate that these combinations are cytotoxic for cancer cells and safe for non-tumoral cells at lower concentrations. Furthermore, it is also demonstrated that PPT1 may have an important role in the mechanism of action of these combinations, as demonstrated by their ability to decrease PPT1 expression. These results support the use of antimalarial and central nervous system (CNS) drugs in combination regimens with chemotherapeutic agents; nevertheless, additional studies are recommended to further explore their complete mechanisms of action.

Search for an Excess of Electron Neutrino Interactions in MicroBooNE Using Multiple Final-State Topologies

We present a measurement of ν_{e} interactions from the Fermilab Booster Neutrino Beam using the MicroBooNE liquid argon time projection chamber to address the nature of the excess of low energy interactions observed by the MiniBooNE Collaboration. Three independent ν_{e} searches are performed across multiple single electron final states, including an exclusive search for two-body scattering events with a single proton, a semi-inclusive search for pionless events, and a fully inclusive search for events containing all hadronic final states. With differing signal topologies, statistics, backgrounds, reconstruction algorithms, and analysis approaches, the results are found to be either consistent with or modestly lower than the nominal ν_{e} rate expectations from the Booster Neutrino Beam and no excess of ν_{e} events is observed.

First Measurement of Energy-Dependent Inclusive Muon Neutrino Charged-Current Cross Sections on Argon with the MicroBooNE Detector

We report a measurement of the energy-dependent total charged-current cross section σ(E_{ν}) for inclusive muon neutrinos scattering on argon, as well as measurements of flux-averaged differential cross sections as a function of muon energy and hadronic energy transfer (ν). Data corresponding to 5.3×10^{19} protons on target of exposure were collected using the MicroBooNE liquid argon time projection chamber located in the Fermilab booster neutrino beam with a mean neutrino energy of approximately 0.8 GeV. The mapping between the true neutrino energy E_{ν} and reconstructed neutrino energy E_{ν}^{rec} and between the energy transfer ν and reconstructed hadronic energy E_{had}^{rec} are validated by comparing the data and Monte Carlo (MC) predictions. In particular, the modeling of the missing hadronic energy and its associated uncertainties are verified by a new method that compares the E_{had}^{rec} distributions between data and a MC prediction after constraining the reconstructed muon kinematic distributions, energy, and polar angle to those of data. The success of this validation gives confidence that the missing energy in the MicroBooNE detector is well modeled and underpins first-time measurements of both the total cross section σ(E_{ν}) and the differential cross section dσ/dν on argon.

Search for Neutrino-Induced Neutral-Current Δ Radiative Decay in MicroBooNE and a First Test of the MiniBooNE Low Energy Excess under a Single-Photon Hypothesis

We report results from a search for neutrino-induced neutral current (NC) resonant Δ(1232) baryon production followed by Δ radiative decay, with a ⟨0.8⟩  GeV neutrino beam. Data corresponding to MicroBooNE's first three years of operations (6.80×10^{20} protons on target) are used to select single-photon events with one or zero protons and without charged leptons in the final state (1γ1p and 1γ0p, respectively). The background is constrained via an in situ high-purity measurement of NC π^{0} events, made possible via dedicated 2γ1p and 2γ0p selections. A total of 16 and 153 events are observed for the 1γ1p and 1γ0p selections, respectively, compared to a constrained background prediction of 20.5±3.65(syst) and 145.1±13.8(syst) events. The data lead to a bound on an anomalous enhancement of the normalization of NC Δ radiative decay of less than 2.3 times the predicted nominal rate for this process at the 90% confidence level (C.L.). The measurement disfavors a candidate photon interpretation of the MiniBooNE low-energy excess as a factor of 3.18 times the nominal NC Δ radiative decay rate at the 94.8% C.L., in favor of the nominal prediction, and represents a greater than 50-fold improvement over the world's best limit on single-photon production in NC interactions in the sub-GeV neutrino energy range.

InfectionCMA: A Cell MicroArray Approach for Efficient Biomarker Screening in In Vitro Infection Assays

The recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has forced the scientific community to acquire knowledge in real-time, when total lockdowns and the interruption of flights severely limited access to reagents as the global pandemic became established. This unique reality made researchers aware of the importance of designing efficient in vitro set-ups to evaluate infectious kinetics. Here, we propose a histology-based method to evaluate infection kinetics grounded in cell microarray (CMA) construction, immunocytochemistry and in situ hybridization techniques. We demonstrate that the chip-like organization of the InfectionCMA has several advantages, allowing side-by-side comparisons between diverse cell lines, infection time points, and biomarker expression and cytolocalization evaluation in the same slide. In addition, this methodology has the potential to be easily adapted for drug screening.

Generation of Two Paclitaxel-Resistant High-Grade Serous Carcinoma Cell Lines With Increased Expression of P-Glycoprotein

Debulking surgery followed by chemotherapy are the standard of care for high-grade serous carcinoma. After an initial good response to treatment, the majority of patients relapse with a chemoresistant profile, leading to a poor overall survival. Chemotherapy regimens used in high-grade serous carcinomas are based in a combination of classical chemotherapeutic drugs, namely, Carboplatin and Paclitaxel. The mechanisms underlying drug resistance and new drug discovery are crucial to improve patients’ survival. To uncover the molecular mechanisms of chemoresistance and test drugs capable of overcoming this resistant profile, it is fundamental to use good cellular models capable of mimicking the chemoresistant disease. Herein, we established two high-grade serous carcinoma cell lines with intrinsic resistance to Carboplatin and induced Paclitaxel resistance (OVCAR8 PTX R C and OVCAR8 PTX R P) derived from the OVCAR8 cell line. These two chemoresistant cell line variants acquired an enhanced resistance to Paclitaxel-induced cell death by increasing the drug efflux capacity, and this resistance was stable in long-term culture and following freeze/thaw cycles. The mechanism underlying Paclitaxel resistance resides in a significant increase in P-glycoprotein expression and, when this drug efflux pump was blocked with Verapamil, cells re-acquired Paclitaxel sensitivity. We generated two high-grade serous carcinoma cell lines, with a double-chemoresistant (Carboplatin and Paclitaxel) phenotype that mimics the majority of tumor recurrences in ovarian cancer context. This robust tool is suitable for preliminary drug testing towards the development of therapeutic strategies to overcome chemoresistance.

Search for a Higgs Portal Scalar Decaying to Electron-Positron Pairs in the MicroBooNE Detector

We present a search for the decays of a neutral scalar boson produced by kaons decaying at rest, in the context of the Higgs portal model, using the MicroBooNE detector. We analyze data triggered in time with the Fermilab NuMI neutrino beam spill, with an exposure of 1.93×10^{20} protons on target. We look for monoenergetic scalars that come from the direction of the NuMI hadron absorber, at a distance of 100 m from the detector, and decay to electron-positron pairs. We observe one candidate event, with a standard model background prediction of 1.9±0.8. We set an upper limit on the scalar-Higgs mixing angle of θ<(3.3-4.6)×10^{-4} at the 95% confidence level for scalar boson masses in the range (100-200)  MeV/c^{2}. We exclude, at the 95% confidence level, the remaining model parameters required to explain the central value of a possible excess of K_{L}^{0}→π^{0}νν[over ¯] decays reported by the KOTO collaboration. We also provide a model-independent limit on a new boson X produced in K→πX decays and decaying to e^{+}e^{-}.

Zygomatic Implants Placed in Immediate Function through Extra-Maxillary Surgical Technique and 45 to 60 Degrees Angulated Abutments for Full-Arch Rehabilitation of Extremely Atrophic Maxillae: Short-Term Outcome of a Retrospective Cohort

The use of new devices for the rehabilitation of the severely atrophic maxillae needs validation. We aimed to report the short-term outcome of severely atrophic jaws rehabilitated with zygomatic implants with no implant head angulation placed extramaxillary in conjunction with standard implants. Forty-four patients were consecutively included with 77 zygomatic implants (31 abutments of 45 degrees and 46 abutments of 60 degrees) and 115 standard implants. Outcome measures were prosthetic survival, implant/abutment success, complications, modified plaque index (mPLI), modified bleeding index (mBI), mucosal seal efficacy evaluation (MSEE) >4 mm, and Zygomatic implants classification level (ZICL). Two patients (4.5%) were lost to follow-up. No prosthesis was lost; one patient lost one zygomatic implant; two angulated abutments of 60 degrees needed to be replaced in one patient due to an aesthetic complaint; rendering a cumulative success rate at 2-years of 95.3% and 95.9% using patient and implant/abutment as unit of analysis, respectively. Mechanical and biological complications occurred in 13 and six patients, respectively; all resolved. The median mPLI and mBI was 1; MSEE > 4 mm occurred in 17% and 21% of patients at 1- and 2-years, respectively; ZICL1 was registered in 80% of patients. The current protocol enabled good short-term outcomes.

A3 THE LOSS OF THE CIRCADIAN CLOCK GENE BMAL1 INCREASES TUMOUR INITIATION IN APCMIN MICE

Background

Circadian rhythms are autonomously running 24h cycles in bodily processes. In animals these rhythms are driven by a molecular time keeper known as the circadian clock. The clock is a transcription-translation feedback loop composed of the transcription factors Bmal1 and Clock as well as their repressors Per and Cry. The circadian clock regulates over 40% of the genome rhythmically. Chronic circadian disruption, in the case of shift work, can lead to pathologies including cancer. Colorectal cancer is most frequently initiated through a mutation in the Wnt pathway regulator, Apc. Several studies have attempted to provide a mechanistic link between cancer and circadian clock disruption but the use of mice on mixed genetic backgrounds and poor circadian models have made this link unclear.

Aims

We aim to determine if the circadian clock plays a role in intestinal tumourigenesis.

Methods

We crossed the Apcmin mouse strain, a common intestinal tumour model, with Bmal1 mutant mice, which lack a functioning circadian clock. After creating an isogenic strain, we examined the number of tumours in control (Bmal1+/+) and clock dead (Bmal1-/-) animals. We derived organoids, a 3D cell culture method, from Apc+/+; Bmal1+/+ (healthy, clock-live), Apc+/+, Bmal1-/-(healthy, clock-dead), Apcmin; Bmal1+/+(adenoma, clock-live), Apcmin; Bmal1-/- (adenoma, clock-live) mouse ileum and collected every 2h from 24-48h after synchronizing their circadian clock. Collected samples were sent for RNA sequencing and assessed for circadian regulated transcripts. This experiment was followed up by in vitro organoid assays.

Results

The circadian clock controls 41 genes in the intestinal epithelium, including genes like Tead4 which are known to be important in intestinal biology. There are twofold more tumours in Bmal1-/- mice than their Bmal1+/+ littermates, and Bmal1-/- tumours upregulate Tead4 and Hippo pathway targets and downregulate Wnt pathway targets. Bmal1-/- adenoma organoids show increased self-renewal when compared to Bmal1+/+ adenoma organoids. However, this increase in self-renewal is lost when organoids are treated with inhibitors of the hippo pathway.

Conclusions

The circadian clock is important in maintaining the health of an organism, and disruption of the clock can lead to many health consequences including cancer. We show for the first time that the circadian clock controls the hippo signaling mediator Tead4. Additionally, we show that the loss of the clock leads to an increase in the number of tumours present in the epithelium which are characterized by an increase in hippo signaling. This research shows the important of considering time of day when studying stem cells during homeostasis and in cancer.

Funding Agencies

CIHRNSERC

Suplementação de butirato de sódio e os efeitos nos níveis de glicose e no metabolismo lipídico de vacas leiteiras

O objetivo desse estudo foi avaliar os efeitos da suplementação com butirato de sódio nos níveis de glicose plasmática e no metabolismo lipídico de vacas no meio da lactação. Para isso, foram utilizadas 10 vacas (4 da raça Holandês e 6 da raça Jersey), multíparas, com 150 dias em lactação (DEL) e aleatoriamente divididas em 2 grupos: Grupo Controle (GC, n = %), que recebeu uma dieta padrão; Grupo Tratamento (GT, n = 5), que recebeu a dieta padrão mais 1,0g/kg de peso vivo por dia de butirato de sódio por um periodo de 8 dias. Amostras individuais de sangue foram coletadas diariamente durante o periodo experimental para análise de β-hidroxibutirato (BHB), ácidos graxos não esterificados (AGNE), triglicerídeos, colesterol e glicose. Pode ser observado que no GT os níveis de BHB plasmático foi maior (0,64 ± 0,03 mmol/l e 0,91 ± 0,03 mmol/l, para GC e GT, respectivamente, P = 0.001) e os níveis de glicose foram mais baixos que o GC (55,5 ± 0,84 mg/dL e 51,1 ± 0,75 mg/dL, para GT e GC, respectivamente, P < 0.0001). Esses resultados mostram que a suplementação de vacas com butirato de sódio pode regular a taxa de lipólise e as concentrações de AGNE, melhorando o estado de saúde do animal.

Age-related characteristics of infective endocarditis: prospective data from the Euro-Endo registry

Introduction

The profile of infective endocarditis (IE) is continuously evolving over time, and this may probably be partly due to increasing age of the patients.

Methods

All data were collected from the EURO-ENDO registry, which is a one-year prospective international multicentre observational survey on patients with definite or possible IE included between 2016 and 2018. Subjects were stratified into 3 groups according to their age at index hospitalization.

Results

Among the 3113 patients included, 1670 patients (54%, Young group) were &lt;65, 1068 (34%, Medium group) between 65 and 80 and 375 (12%, Old group) ≥80 years old. The most striking age-related differences were (old group vs others) (table 1) 1) the higher comorbidity burden and Charlson index; 2) the lower rate of embolic events on admission and under therapy; 3) the higher rate of Enterocci and digestive streptococci; 4) the lower rate of surgery during acute IE despite a theoretical indication; 5) the higher in-hospital and 1-year mortality. With regards to surgery, young and medium age were predictive of more frequent performance of surgery as compared to old age (Young: OR 4.33, 95% CI [3.09–6.06], Medium: 3.62, [2.57–5.10], p&lt;0.001). In multivariable analysis, age per se was not predictive of in-hospital and 1yr FU mortality, but lack of surgical procedures when indicated (27% of the old group), was strongly predictive.

Conclusion

This is the largest contemporary registry showing the strong influence of age on the demographic, clinical, therapeutic, and prognostic profile of IE. Non-performance of surgical procedures when indicated is frequent in old patients and is a strong predictor of mortality while age per se is not. Endocarditis Teams should take these results into account when considering surgery in elderly patients.

Funding Acknowledgement

Type of funding source: Other. Main funding source(s): EORP grant

Recycling the Purpose of Old Drugs to Treat Ovarian Cancer

The main challenge in ovarian cancer treatment is the management of recurrences. Facing this scenario, therapy selection is based on multiple factors to define the best treatment sequence. Target therapies, such as bevacizumab and polymerase (PARP) inhibitors, improved patient survival. However, despite their achievements, ovarian cancer survival remains poor; these therapeutic options are highly costly and can be associated with potential side effects. Recently, it has been shown that the combination of repurposed, conventional, chemotherapeutic drugs could be an alternative, presenting good patient outcomes with few side effects and low costs for healthcare institutions. The main aim of this review is to strengthen the importance of repurposed drugs as therapeutic alternatives, and to propose an in vitro model to assess the therapeutic value. Herein, we compiled the current knowledge on the most promising non-oncological drugs for ovarian cancer treatment, focusing on statins, metformin, bisphosphonates, ivermectin, itraconazole, and ritonavir. We discuss the primary drug use, anticancer mechanisms, and applicability in ovarian cancer. Finally, we propose the use of these therapies to perform drug efficacy tests in ovarian cancer ex vivo cultures. This personalized testing approach could be crucial to validate the existing evidences supporting the use of repurposed drugs for ovarian cancer treatment.

Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review

BACKGROUND

Cervical cancer screening has been effective in reducing incidence and mortality of cervical cancer, leading European countries to implement screening programs. However, migrant women show lower screening participation compared to nationals. This scoping review aims to provide a synthesis of the growing evidence on factors associated with participation in cervical cancer screening among migrant women in Europe.

METHODS

Electronic peer-reviewed databases were searched in November 2019 for studies on factors related to the participation of migrants in cervical cancer screening conducted in EU/EFTA countries, using comprehensive search expressions. Retrieved articles were screened and those eligible were selected for data extraction. Quantitative and qualitative studies were included. Factors were classified in barriers and facilitators and were divided into further categories.

RESULTS

Twenty out of 96 articles were selected and analyzed. Factors associated with participation in cervical cancer screening were classified in categories related to sociodemographic, healthcare-system, psychological, migration, knowledge, language, and cultural factors. Lack of information, lack of female healthcare providers, poor language skills, and emotional responses to the test (especially fear, embarrassment and discomfort) were the most reported barriers to cervical cancer screening. Encouragement from healthcare providers and information available in migrants' languages were frequently stated as facilitators. Results on the role of sociodemographic factors, such as age, education, employment and marital status, are the most conflicting, highlighting the complexity of the issue and the possibility of interactions between factors, resulting in different effects on cervical cancer screening participation among migrant women. Several identified barriers to screening are like those to access to healthcare services in general.

CONCLUSIONS

Efforts to increase migrant women's participation in CCS must target barriers to access to healthcare services in general but also specific barriers, including cultural differences about sexuality and gender, past traumatic personal experiences, and the gender and competences of healthcare professionals performing CCS. Healthcare services should strengthen resources to meet migrants' needs, including having CCS information translated and culturally adapted, as well as healthcare providers with skills to deal with cultural background. These findings can contribute to improve CCS programs among migrant women, reducing health disparities and enhancing their overall health and well-being.

Regulation of invasion and peritoneal dissemination of ovarian cancer by mesothelin manipulation

Peritoneal dissemination is a particular form of metastasis typically observed in ovarian cancer and the major cause for poor patient’s outcome. Identification of the molecular players involved in ovarian cancer dissemination can offer an approach to develop treatment strategies to improve clinical prognosis. Here, we identified mesothelin (MSLN) as a crucial protein in the multistep process of peritoneal dissemination of ovarian cancer. We demonstrated that MSLN is overexpressed in primary and matched peritoneal metastasis of high-grade serous carcinomas (HGSC). Using several genetically engineered ovarian cancer cell lines, resulting in loss or gain of function, we found that MSLN increased cell survival in suspension and invasion of tumor cells through the mesothelial cell layer in vitro. Intraperitoneal xenografts established with MSLN^high ovarian cancer cell lines showed enhanced tumor burden and spread within the peritoneal cavity. These findings provide strong evidences that MSLN is a key player in ovarian cancer progression by triggering peritoneal dissemination and provide support for further clinical investigation of MSLN as a therapeutic target in HGSC.

P212 Computed tomography derived left ventricular outflow tract area downgrades severity of prosthesis-patient mismatch after transcatheter aortic valve replacement

Background

Prosthesis-patient mismatch (PPM) is associated with poor outcomes after surgical aortic valve replacement, but evidence in the era of transcatheter aortic valve replacement (TAVR) is small. Although PPM is conventionally defined by transthoracic echocardiogram (TTE) derived indexed effective orifice area (EOAi), TTE may underestimate left ventricular outflow tract (LVOT) area when compared with cardiac computed tomography angiography (CTA).

Purpose

To evaluate the inter-modality (TTE vs CTA) agreement and inter-valve (balloon-expanding valve (BEV) vs. self-expandable valve (SEV)) differences in EOAi and the severity of PPM after TAVR.

Methods

We analyzed all patients who underwent TAVR between 2015 to 2017and who had both of CTA and TTE at 30-days after TAVR. EOAi was calculated using the continuity equation and then indexed to body surface area as per guidelines using TTE derived LVOT diameter (EOAi-TTE) or post-procedure CTA derived LVOT area (EOAi-CTA). The external LVOT diameter was measured at inflow of TAVR bioprosthetic stent frame as per recommendations. The EOAi was used to define the grading severity of PPM: None (&gt; 0.85 cm²/m²); Moderate (0.65 to 0.85 cm²/m²); and Severe (&lt; 0.65 cm²/m²). Paired or Student t-test and Chi-square test were used to assess the inter-modality and inter-valve difference.

Results

A total of 280 patients were included (the mean age, 81.2 ± 8.1 years; 48%, female). BEV was used in 150 patients (54%). The mean EOAi-TTE vs. EOAi-CTA was 1.00 ± 0.32 and 1.41 ± 0.50 cm²/m², respectively, p &lt; 0.001. Prevalence of severe (TTE 9% versus CTA 4%, p &lt; 0.01) and moderate (TTE 28% versus CTA 7%, p &lt; 0.01) PPM was lower when adjudicated by CTA (Figure-Panel A). There was a trends towards smaller EOAi by either TTE (0.97 ± 0.31 vs. 1.04 ± 0.33, p = 0.07) or CTA (1.38 ± 0.45 vs. 1.46 ± 0.56, p = 0.21) for BEV vs. SEV (Figure-Panel B). There was no significant difference in the severity of PPM defined by either EOAi-TTE (Figure-Panel C) or EOAi-CTA (Figure-Panel D) between these patients.

Conclusion

EOAi-CTA was larger and downgraded the severity of PPM than the EOAi-TTE. There was no significant difference in the severity of PPM defined by post-procedure CT between patients treated with BEV and those with SEV.

Abstract P212 Figure.

P09.08 Increased incidence of intracranial meningiomas in patients with acromegaly

BACKGROUND

An increased incidence of various neoplasms has been described in patients with acromegaly and there is evidence to suggest that growth factors are risk factors for the development of meningiomas. We aimed to study if patients with acromegaly are more at risk for developing intracranial meningiomas

MATERIAL AND METHODS

We conducted an observational study on 221 consecutive acromegalic patients recruited between January 1, 2000 and December 31, 2015, and 357 consecutive patients with a non-somatotropic pituitary adenoma recruited between March 1, 2015 and December 31, 2016 in our institution. Patients underwent a gadolinium-enhanced 3D T1 brain MRI to look for meningiomas. The proportion of meningiomas was compared between the two groups and the standardized incidence ratio (SIR) was computed from the incidence rates of meningiomas observed in the population of acromegalic patients and compared to that of the general population given by the local registry of central nervous system tumors.

RESULTS

Patients with acromegaly had a significant risk for developing intracranial meningiomas as compared to patients without acromegaly (7.7% vs. 2.2%, p = .005, OR = 3.45 [1.46; 8.15]). There was a significant increased incidence of intracranial meningiomas in patients with acromegaly (SIR = 126 [25; 367]) as compared to the general population.

CONCLUSION

Our study provides the first evidence that patients with acromegaly are more at risk for developing intracranial meningiomas.

Understand the Potential Role of Aureobasidium pullulans, a Resident Microorganism From Grapevine, to Prevent the Infection Caused by Diplodia seriata

Grapevine trunk diseases (GTDs) are one of the major concern amongst grapevine diseases, responsible for the decline of vineyards and for several economical losses. Since grapevine is naturally colonized by resident microorganisms such as Aureobasidium pullulans, the present challenge is to understand their biocontrol potential and how such microorganisms can be successfully integrated in the control of GTDs. In this context, the first priority consists to exploit the plant-beneficial-phytopathogen interactions in plant model systems, to identify the most prevalent equilibrium limiting expression of GTDs. In the current study, we deep characterized the interaction of a resident and abundant microorganism from grapevine - Aureobasidium pullulans strain Fito_F278 - against D. seriata F98.1, a Botryosphaeria dieback agent, and with plant (cv Chardonnay). Results revealed that A. pullulans strain Fito_F278 was able to reduce significantly the mycelium growth of D. seriata F98.1 at 33.41 ± 0.55%, under in vitro conditions, though this reduction is possibly dependent on a direct interaction between strain Fito_F278 and pathogen. Furthermore, strain Fito_F278 was able to promote an induction of some plant defense responses in cutting plants, 1 week after the D. seriata F98.1 infection. Results evidenced that strain Fito_F278 colonized efficiently grapevine at both epiphyte and endophyte level, could persist on plant roots for long-periods (up to 2 months after its inoculation) and grow at different pH and high salinity conditions. Moreover, a significant decrease of the microbial load from soil and rhizosphere was observed in plants treated with the strain Fito_F278, suggesting its competitivity potential in a microbial ecosystem. Altogether, the present study gives the first insights about the interaction of A. pullulans strain Fito_F278, a resident microorganism, with grapevine, its potential role against a Botryosphaeria dieback agent, and highlights its importance to toward more resilient grapevine.

Lasiodiplodia theobromae as a Producer of Biotechnologically Relevant Enzymes

Phytopathogenic fungi are known to produce several types of enzymes usually involved in plant cell wall degradation and pathogenesis. The increasing of global temperature may induce fungi, such as Lasiodiplodia theobromae (L. theobromae), to alter its behavior. Nonetheless, there is only limited information regarding the effect of temperature on L. theobromae production of enzymes. The need for new, thermostable enzymes, that are biotechnologically relevant, led us to investigate the effect of temperature on the production of several extracellular enzymatic activities by different L. theobromae strains. Fungi were grown at 25 °C, 30 °C and 37 °C and the enzymatic activities were detected by plate assays, quantified by spectrophotometric methods and characterized by zymography. The thermostability (25–80 °C) of the enzymes produced was also tested. Strains CAA019, CBS339.90, LA-SOL3, LA-SV1 and LA-MA-1 produced amylases, gelatinases, caseinases, cellulases, lipases, laccases, xylanases, pectinases and pectin liases. Temperature modulated the expression of the enzymes, and this effect was more visible when fungi were grown at 37 °C than at lower temperatures. Contrary to proteolytic and endoglucanolytic activities, whose highest activities were detected when fungi were grown at 30 °C, lipolytic activity was not detected at this growth temperature. Profiles of proteases and endoglucanases of fungi grown at different temperatures were characterized by zymography. Enzymes were shown to be more thermostable when fungi were grown at 30 °C. Proteases were active up to 50 °C and endoglucanases up to 70 °C. Lipases were the least stable, with activities detected up to 45 °C. The enzymatic profiles detected for L. theobromae strains tested showed to be temperature and strain-dependent, making this species a good target for biotechnological applications.

Seven mm long dental implants in posterior jaws: 3-year report of an ongoing prospective single cohort study

PURPOSE

To report on the outcome of 7 mm long implants in the rehabilitation of posterior areas of atrophic jaws 3 years after loading.

MATERIALS AND METHODS

This prospective study included 127 patients treated with 217 implants supporting 165 fixed prostheses. Final abutments were delivered at surgery stage and in the large majority of patients (n = 116) the implants (n = 199) were loaded after 4 months. Primary outcome measures were implant success and prosthetic success calculated at patient level; secondary outcome measures were complications, and marginal bone level changes calculated at patient level.

RESULTS

Thirteen patients with 21 implants dropped out of the study after 3 years. Implant losses occurred in 10 of the 127 patients and 14 of the 217 implants placed failed, giving a cumulative success rate of 93.7% at 3 years, using the patient as unit of analysis. Eight prosthetic failures occurred in six patients, rendering a prosthetic success rate 95.3% at patient level. The average (standard deviation) marginal bone resorption after 3 years of follow-up was 1.46 mm (0.78 mm). Complications occurred in 13 patients (10.2%) and 15 implants (6.9%).

CONCLUSIONS

Within the limitations of this study, 7 mm long implants in posterior atrophic jaws can be a viable treatment option given the good prosthetic and implant success rates, low marginal bone loss and low incidence of complications. Nevertheless, longer follow-ups are needed to validate the long-term outcome. Conflict-of-interest statement: This study was funded by grant no. 2015-1378 from Nobel Biocare Services. Paulo Maló is currently a consultant for Nobel Biocare. The remaining authors declare no conflicts of interest.

Optimization of dengue virus genome assembling using GSFLX 454 pyrosequencing data: evaluation of assembling strategies

Currently assembling genomes without reference is one of the most important challenges for bioinformaticists all over the world in an attempt to characterize new organisms. The current study has used two dengue virus type 4 (DENV-4) strains recently isolated in Brazil, which have its genomes sequenced using the GSFLX 454 sequencer (Roche, Life Science) by the pyrosequencing method. The GSFLX 454 data were used for testing different genome assembling strategies. We described a pipeline that was able to recover more than 96% of the sequenced genome in a single run and could be helpful for further assembly attempts of other DENV genomes, as well as other RNA virus-like genomes.