[Vibration as a risk of mastitis during milking]

INTRODUCTION

Mastitis is one of the most important factor diseases in dairy cattle worldwide. Milking technique represents one of the factors involved in the development of mastitis. The purpose of this study was to investigate the influence of vibrations during milking on the rate of clinical and subclinical mastitis. For this purpose, milking measurements, tank milk analyses and survey forms (general farm data, assessment of milking work and milking hygiene, teat condition, feeding, farm problems, animal behavior) were assessed in 8 Swiss dairy farms. The results show a correlation between present vibrations at the output of the milk meter and increasing bulk milk somatic cell count. Further, a tendency was shown for vibrations at the input of the milk meter to influence bulk milk somatic cell count. Also, a tendency regarding vibrations at the outlet of the milk meter and acute phase protein milk amyloid A was evident. In conclusion, the results suggest that vibration during milking might have a negative effect on udder health. However, further research with a larger number of dairies is needed to make a more generally valid statement.

On the force between "rafts"

"Rafts" in the plasma membrane are nanoscopic domains rich in sphingolipids and cholesterol. Groups of them are thought to provide stable platforms for various proteins. How several rafts can form a larger stable platform has yet to be made clear. Here, we show that in the microemulsion theory of rafts, in which they, and the sea in which they float, are characterized by a naturally occurring length, rafts separated by a sea larger than this length will attract one another, thus making the sea smaller. Similarly, if rafts are separated by a sea that is smaller than the characteristic size, they will repel one another thus allowing the sea to increase in size. Such an elastic force can clearly stabilize a platform of many rafts.

Lipid redistribution in the highly curved footprint of Piezo1

We investigate the effects on the distribution of lipids in the plasma membrane that are caused by the insertion of a protein, Piezo1, that significantly distorts the membrane toward the cytosol. From coarse-grained molecular dynamics simulations, we find that the major effects occur in the outer, extracellular, leaflet. The mol fraction of cholesterol increases significantly in the curved region of the membrane close to Piezo1, while those of phosphatidylcholine and of sphingomyelin decrease. In the inner leaflet, mol fractions of cholesterol and of phosphatidylethanolamine decrease slightly as the protein is approached, while that of phosphatidylserine increases slightly. The mol fraction of phosphatidylcholine decreases markedly as the protein is approached. Most of these results are understood in the context of a theoretical model that utilizes two elements; (i) a coupling between the leaflets' actual curvatures and their compositionally-dependent spontaneous curvatures and, (ii) the dependence of the spontaneous curvatures not only on the mol fractions of the phospholipids, but also on the effect that cholesterol has on the spontaneous curvatures of the phospholipids.

“A sorrow shared …”: a qualitative content analysis of what couples with recurrent miscarriages expect from one another and their families and friends

STUDY QUESTION

When couples have to face recurrent pregnancy loss (RPL), what are the partners’ wishes and needs and what is their perception of helpful and unhelpful factors with regard to their own, their partners’ and their families’ and friends’ ways of dealing with the problem?

SUMMARY ANSWER

Women and men with repeated miscarriages want open communication about their losses, but expect a sensitive and empathetic attitude from others, not pity or trivialization.

WHAT IS KNOWN ALREADY

RPL not only causes the women affected and their partners considerable emotional distress; it also has an impact on the couples’ relationships and the way they relate to their families and friends. Studies suggest that women have a greater need than their male partners to talk about their losses and that these differences may lead to dissatisfaction and cause relational tension. In addition, men often assume a ‘mainstay’ role, supporting their partners and displaying fortitude in the face of distress. As yet, however, little research has been conducted so far on the question of what the members of couples with RPL expect from one another and from their families and friends.

STUDY DESIGN, SIZE, DURATION

The study sample consisted of 147 couples and 17 women with at least 2 miscarriages attending the special unit for RPL at the University Women’s Hospital in Heidelberg (Germany) for the first time between September 2018 and October 2020 (response rate: 82.7%). The patients were asked to participate in this combined qualitative and questionnaire study.

PARTICIPANTS/MATERIALS, SETTING, METHODS

In order to explore the wishes and needs of those affected in more detail, the free text responses obtained were examined in this study by using qualitative content analysis. Categories and subcategories were created inductively to summarize and systematize content.

MAIN RESULTS AND THE ROLE OF CHANCE

Patients affected by RPL want their partners and their families and friends to deal with the topic openly and empathically. In the partnership itself, acceptance of individual grieving modes and sharing a common goal are important factors. Men, in particular, want their partners to be optimistic in facing up to the situation. Regarding communication with family and friends, it transpired that ‘good advice’, playing the matter down, inquiries about family planning, pity and special treatment are explicitly not appreciated.

LIMITATIONS, REASONS FOR CAUTION

The sample was a convenience sample, so self-selection effects cannot be excluded. In addition, the level of education in the sample was above average. Accordingly, the sample cannot be regarded as representative. The results of the content analysis are based on the respondents’ written answers to open-ended questions in the questionnaire. Unlike qualitative interview studies, further questioning was not possible in the case of ambiguities or to request more details.

WIDER IMPLICATIONS OF THE FINDINGS

Frank and sincere communication about miscarriages and about one’s own emotions and needs should be promoted both in the partnership and among family members and friends in order to strengthen the potential of social support as a resource. Open communication about the different needs of both partners is necessary to create mutual understanding. The results show the importance not only of empathy and consideration for the couples concerned but also their desire not to be pitied. Striking a fine balance between fellow-feeling and pity may also lead to tension, and this potential dilemma should be addressed in psychosocial counselling. Overall, the study contributes to a better understanding of what couples want from their families and friends when they are attempting to come to terms with RPL and highlights potential challenges in the interaction between affected couples and their families and friends.

STUDY FUNDING/COMPETING INTEREST(S)

No funding was received for this study. None of the authors declared any conflicts of interest.

TRIAL REGISTRATION NUMBER

DRKS00014965.

A Theoretical Basis for Nanodomains

We review the current theories of nanodomain, or "raft," formation. We emphasize that the idea that they are co-exisiting Lo and Ld phases is fraught with difficulties, as is the closely related idea that they are due to critical fluctuations. We then review an alternate theory that the plasma membrane is a two-dimensional microemulsion, and that the mechanism that drives to zero the line tension between Lo and Ld phases is the coupling of height and composition fluctuations. The theory yields rafts of SM and cholesterol in the outer leaf and POPS and POPC in the inner leaf. The "sea" between rafts consists of POPC in the outer leaf and POPE and cholesterol in the inner leaf. The characteristic size of the domain structures is tens of nanometers.

P-490 Recurrent pregnancy loss acts as a posttraumatic stress event in both women and men

Study question

What are the psychological impacts of recurrent pregnancy loss (RPL) on men and women and their interdependencies?

Summary answer

Women show higher psychological risks than men, except for lack of social support. Avoidance behaviour of men correlates with higher posttraumatic stress of their partner.

What is known already

About 1-3% of all couples trying to conceive are affected by RPL. The loss of the unborn child can be the most traumatic experience in a woman’s life and is associated with significant psychological distress besides the instant grief. RPL can also be stressful for the partner, even though being at a lower risk for psychiatric morbidities. The man’s gender role expects him to support and not to show weakness which may result in a suppression of his feelings and a disenfranchised grief.

Study design, size, duration

Cross-sectional study. All women and men referred to the special unit for RPL between March 2019 and October 2020 were asked to participate voluntarily with a total sample size of 105 couples and 17 women. Exclusion criteria were less than two pregnancy losses, inadequate knowledge of the German language and incomplete data.

Participants/materials, setting, methods

Couples were invited to fill out a questionnaire package estimating their psychological risks (e.g. posttraumatic stress disorder, anxiety, depression, perceived social support) and coping strategies with established instruments. Clinical history was obtained from medical records. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as the unit of analysis.

Main results and the role of chance

The response rate was 82.3%. The following psychological risks were measured among women versus men: posttraumatic stress disorder (PTSD): 13.7% versus 3.9% (p = 0.017); anxiety: 50.4% versus 17.3% (p < 0.001), depression: 48.1% versus 14.4% (p < 0.001), lack of social support: 32.5% versus 32.7% (N.S.). A risk in at least one category showed 68.9% of women versus 44.8% of men (p < 0.001), with those at higher risk indicating a lower satisfaction with their partnership (p < 0.001) and higher impairment of their sexual life (p < 0.001). Neither total number of pregnancy losses nor time gap since last pregnancy loss showed relevant correlations with psychological risks. For women, number of curettages, controlled for the number of pregnancy losses, correlates with the severity of posttraumatic stress (p < 0.05). Higher levels of anxiety, depression and a lack of social support in women correlated positively with posttraumatic stress in their partners. The coping strategy “trivialization and wishful thinking” as well as the subscale “avoidance” of the Impact-of-Event-Scale (self-report questionnaire measuring posttraumatic stress) of men was correlated with more severe posttraumatic stress in their female partners (both p < 0.05).

Limitations, reasons for caution

The data show only correlations between the measured variables, as cross-sectional studies are not suitable to analyse causal relationships. The sample was obtained in a special unit for RPL at a university hospital, so the findings may not be generalizable to all couples with RPL.

Wider implications of the findings

Screening psychological risks in couples with RPL may be reasonable considering the high risks in both sexes and the extent of PTSD diagnoses in women, their interdependencies and the potential risk of chronification. Professionals should encourage affected couples to support each other and provide targeted information on mental health services.

Trial registration number

DRKS 00014965

P–490 Recurrent pregnancy loss acts as a posttraumatic stress event in both women and men

Study question

What are the psychological impacts of recurrent pregnancy loss (RPL) on men and women and their interdependencies?

Summary answer

Women show higher psychological risks than men, except for lack of social support. Avoidance behaviour of men correlates with higher posttraumatic stress of their partner.

What is known already

About 1–3% of all couples trying to conceive are affected by RPL. The loss of the unborn child can be the most traumatic experience in a woman’s life and is associated with significant psychological distress besides the instant grief. RPL can also be stressful for the partner, even though being at a lower risk for psychiatric morbidities. The man’s gender role expects him to support and not to show weakness which may result in a suppression of his feelings and a disenfranchised grief.

Study design, size, duration

Cross-sectional study. All women and men referred to the special unit for RPL between March 2019 and October 2020 were asked to participate voluntarily with a total sample size of 105 couples and 17 women. Exclusion criteria were less than two pregnancy losses, inadequate knowledge of the German language and incomplete data.

Participants/materials, setting, methods

Couples were invited to fill out a questionnaire package estimating their psychological risks (e.g. posttraumatic stress disorder, anxiety, depression, perceived social support) and coping strategies with established instruments. Clinical history was obtained from medical records. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as the unit of analysis.

Main results and the role of chance

The response rate was 82.3%. The following psychological risks were measured among women versus men: posttraumatic stress disorder (PTSD): 13.7% versus 3.9% (p = 0.017); anxiety: 50.4% versus 17.3% (p < 0.001), depression: 48.1% versus 14.4% (p < 0.001), lack of social support: 32.5% versus 32.7% (N.S.). A risk in at least one category showed 68.9% of women versus 44.8% of men (p < 0.001), with those at higher risk indicating a lower satisfaction with their partnership (p < 0.001) and higher impairment of their sexual life (p < 0.001). Neither total number of pregnancy losses nor time gap since last pregnancy loss showed relevant correlations with psychological risks. For women, number of curettages, controlled for the number of pregnancy losses, correlates with the severity of posttraumatic stress (p < 0.05). Higher levels of anxiety, depression and a lack of social support in women correlated positively with posttraumatic stress in their partners. The coping strategy “trivialization and wishful thinking” as well as the subscale “avoidance” of the Impact-of-Event-Scale (self-report questionnaire measuring posttraumatic stress) of men was correlated with more severe posttraumatic stress in their female partners (both p < 0.05).

Limitations, reasons for caution

The data show only correlations between the measured variables, as cross-sectional studies are not suitable to analyse causal relationships. The sample was obtained in a special unit for RPL at a university hospital, so the findings may not be generalizable to all couples with RPL.

Wider implications of the findings: Screening psychological risks in couples with RPL may be reasonable considering the high risks in both sexes and the extent of PTSD diagnoses in women, their interdependencies and the potential risk of chronification. Professionals should encourage affected couples to support each other and provide targeted information on mental health services.

Trial registration number

DRKS 00014965

Blood-derived DNA methylation predictors of mortality discriminate tumor and healthy tissue in multiple organs

Evidence has shown that certain methylation markers derived from blood can mirror corresponding methylation signatures in internal tissues. In the current study, we aimed to investigate two strong epigenetic predictors for life span, derived from blood DNA methylation data, in tissue samples of solid cancer patients. Using data from the Cancer Genome Atlas (TCGA) and the German DACHS study, we compared a mortality risk score (MRscore) and DNAmPhenoAge in paired tumor and adjacent normal tissue samples of patients with lung (N = 69), colorectal (n = 299), breast (n = 90), head/neck (n = 50), prostate (n = 50), and liver (n = 50) cancer. To explore the concordance across tissue and blood, we additionally assessed the two markers in blood samples of colorectal cancer (CRC) cases and matched controls (n = 93) in the DACHS+ study. The MRscore was significantly elevated in tumor tissues compared to normal tissues of all cancers except prostate cancer, for which an opposite pattern was observed. DNAmPhenoAge was consistently higher in all tumor tissues. The MRscore discriminated lung, colorectal, and prostate tumor tissues from normal tissues with very high accuracy [AUCs of 0.87, 0.99 (TCGA) /0.94 (DACHS), and 0.92, respectively]. DNAmPhenoAge accurately discriminated five types of tumor tissues from normal tissues (except prostate cancer), with AUCs of 0.82–0.93. The MRscore was also significantly higher in blood samples of CRC cases than in controls, with areas under the curve (AUC) of 0.74, whereas DNAmPhenoAge did not distinguish cases from controls, with AUC of 0.54. This study provides compelling evidence that blood‐derived DNAm markers could reflect methylation changes in less accessible tissues. Further research should explore the potential use of these findings for cancer diagnosis and early detection.

Model Plasma Membrane Exhibits a Microemulsion in Both Leaves Providing a Foundation for "Rafts"

We consider a model lipid plasma membrane, one that describes the outer leaf as consisting of sphingomyelin, phosphatidylcholine, and cholesterol and the inner leaf of phosphatidylethanolamine, phosphatidylserine, phosphatidylcholine, and cholesterol. Their relative compositions are taken from experiment; the cholesterol freely interchanges between leaves. Fluctuations in local composition are coupled to fluctuations in the local membrane curvature, as in the Leibler-Andelman mechanism. Structure factors of components in both leaves display a peak at nonzero wavevector. This indicates that the disordered fluid membrane is characterized by structure of the corresponding wavelength. The scale is given by membrane properties: its bending modulus and its surface tension, which arises from the membrane's connections to the cytoskeleton. From measurements on the plasma membrane, this scale is on the order of 100 nm. We find that the membrane can be divided into two different kinds of domains that differ not only in their composition but also in their curvature. The first domain in the outer, exoplasmic leaf is rich in cholesterol and sphingomyelin, whereas the inner, cytoplasmic leaf is rich in phosphatidylserine and phosphatidylcholine. The second kind of domain is rich in phosphatidylcholine in the outer leaf and in cholesterol and phosphatidylethanolamine in the inner leaf. The theory provides a tenable basis for the origin of structure in the plasma membrane and an illuminating picture of the organization of lipids therein.

Mutational patterns and regulatory networks in epigenetic subgroups of meningioma

DNA methylation patterns delineate clinically relevant subgroups of meningioma. We previously established the six meningioma methylation classes (MC) benign 1-3, intermediate A and B, and malignant. Here, we set out to identify subgroup-specific mutational patterns and gene regulation. Whole genome sequencing was performed on 62 samples across all MCs and WHO grades from 62 patients with matched blood control, including 40 sporadic meningiomas and 22 meningiomas arising after radiation (Mrad). RNA sequencing was added for 18 of these cases and chromatin-immunoprecipitation for histone H3 lysine 27 acetylation (H3K27ac) followed by sequencing (ChIP-seq) for 16 samples. Besides the known mutations in meningioma, structural variants were found as the mechanism of NF2 inactivation in a small subset (5%) of sporadic meningiomas, similar to previous reports for Mrad. Aberrations of DMD were found to be enriched in MCs with NF2 mutations, and DMD was among the most differentially upregulated genes in NF2 mutant compared to NF2 wild-type cases. The mutational signature AC3, which has been associated with defects in homologous recombination repair (HRR), was detected in both sporadic meningioma and Mrad, but widely distributed across the genome in sporadic cases and enriched near genomic breakpoints in Mrad. Compared to the other MCs, the number of single nucleotide variants matching the AC3 pattern was significantly higher in the malignant MC, which also exhibited higher genomic instability, determined by the numbers of both large segments affected by copy number alterations and breakpoints between large segments. ChIP-seq analysis for H3K27ac revealed a specific activation of genes regulated by the transcription factor FOXM1 in the malignant MC. This analysis also revealed a super enhancer near the HOXD gene cluster in this MC, which, together with general upregulation of HOX genes in the malignant MC, indicates a role of HOX genes in meningioma aggressiveness. This data elucidates the biological mechanisms rendering different epigenetic subgroups of meningiomas, and suggests leveraging HRR as a novel therapeutic target.

Cholesterol-Dependent Bending Energy Is Important in Cholesterol Distribution of the Plasma Membrane

We consider the plasma membrane that contains a cholesterol molar fraction of 0.4 and ask how that cholesterol is distributed between the two leaves. Because of the rapid flip-flop of cholesterol between leaves, we assume that its distribution is determined by the equality of its chemical potentials in the two leaves. When we consider only the contributions of entropy and interactions to the cholesterol chemical potential in our model system, we find, not surprisingly, that the cholesterol is mostly in the outer leaf because of the strong attraction between cholesterol and sphingomyelin (SM), which is predominantly in that leaf. We find 72% there. We then include the contribution from the bending energy in each leaf that must be overcome to join the leaves in a flat bilayer. The product of bending modulus and spontaneous curvature is obtained from simulation. We find that the addition of cholesterol to the outer leaf reduces the spontaneous curvature, which is initially positive, until it passes through zero when the molar fraction of cholesterol in the outer leaf is 0.28. Additional cholesterol is driven toward the inner leaf by the sphingomyelin phosphatidylcholine mixture. This is resisted by the bending energy contribution to the inner leaf. We find, again by simulation, that the addition of cholesterol monotonically increases the magnitude of the spontaneous curvature of the inner leaf, which is negative. This increases its bending energy. We conclude that, as a result of these competing effects, the percentage of cholesterol in the outer leaf is reduced to ∼63 ± 6%.

Effect of milking stall dimensions on upper limb and shoulder muscle activity in milkers

Increasing societal awareness for animal welfare can promote changes in legislation. Some of these changes may also affect the person that interacts with the animal in a shared workspace, such as in milking stalls. Swiss milking stalls were designed many years ago, when cows were smaller than they are today. A recent animal-based study indicated that welfare decreased in cows exposed to restricted space allowance in milking stalls, which had resulted from increasing body size without adjustment of milking stall dimensions. However, changing the milking stall dimensions without considering the milker may be detrimental. For many years, health issues, particularly of the upper limb and shoulders, have affected milking personnel. The current study investigated the effect of large and standard milking stall dimensions on muscle activity in milkers (as a measure of workload) during milking. This assessment is fundamental to ensure that legislation improving animal welfare does not jeopardize human health. The study took place in an experimental milking parlor that allowed for size adjustment of the individual milking stall. Nine milkers performed 2 shifts of milking in a herringbone and 2 shifts in a side-by-side milking parlor. The milking stall dimensions were large on one side and standard on the other side of the parlor; the 2 sides were switched between milking shifts. We used surface electromyography to monitor bilateral muscle activity of forearm (flexor carpi ulnaris), arm (biceps brachii), and shoulder (deltoideus anterior; upper trapezius) muscles. Statistical analysis was performed separately for the herringbone and the side-by-side parlor for each muscle using mean and maximum muscle activity as the target variables in a linear mixed-effects model. The analysis showed that the different milking stall dimensions did not consistently affect activity of the measured muscles. Our results suggest that milking stall dimensions are not a primary risk factor for poor ergonomics in parlor workers.

Long intergenic noncoding RNA 299 methylation in peripheral blood is a biomarker for triple-negative breast cancer

Aim: To identify DNA methylation biomarkers in peripheral blood samples from triple-negative breast cancer (TNBC) patients. Materials & methods: We conducted an epigenome-wide association study (EWAS): the most promising markers were identified in 233 TNBC case–control pairs (discovery set) and subsequently validated in an independent validation set (57 TNBC patients and 124 controls). Results: cg06588802 (LINC00299/ID2) showed a higher methylation in TNBC patients compared with controls (discovery set: 3% increase, p-value = 0.0009; validation set: 2% increase, p-value = 0.01). Consistent results at four neighboring methylation probes and the strong negative correlation (rho = -0.93) with LINC00299 expression add plausibility to this result. Conclusion: Hypermethylation of LINC00299 in peripheral blood may constitute a useful circulating biomarker for TNBC.

MEST mediates the impact of prenatal bisphenol A exposure on long-term body weight development

Background

Exposure to endocrine-disrupting chemicals can alter normal physiology and increase susceptibility to non-communicable diseases like obesity. Especially the prenatal and early postnatal period is highly vulnerable to adverse effects by environmental exposure, promoting developmental reprogramming by epigenetic alterations. To obtain a deeper insight into the role of prenatal bisphenol A (BPA) exposure in children's overweight development, we combine epidemiological data with experimental models and BPA-dependent DNA methylation changes.

Methods

BPA concentrations were measured in maternal urine samples of the LINA mother-child-study obtained during pregnancy (n = 552), and BPA-associated changes in cord blood DNA methylation were analyzed by Illumina Infinium HumanMethylation450 BeadChip arrays (n = 472). Methylation changes were verified by targeted MassARRAY analyses, assessed for their functional translation by qPCR and correlated with children's body mass index (BMI) z scores at the age of 1 and 6 years. Further, female BALB/c mice were exposed to BPA from 1 week before mating until delivery, and weight development of their pups was monitored (n ≥ 8/group). Additionally, human adipose-derived mesenchymal stem cells were treated with BPA during the adipocyte differentiation period and assessed for exposure-related epigenetic, transcriptional and morphological changes (n = 4).

Results

In prenatally BPA-exposed children two CpG sites with deviating cord blood DNA-methylation profiles were identified, among them a hypo-methylated CpG in the promoter of the obesity-associated mesoderm-specific transcript (MEST). A mediator analysis suggested that prenatal BPA exposure was connected to cord blood MEST promoter methylation and MEST expression as well as BMI z scores in early infancy. This effect could be confirmed in mice in which prenatal BPA exposure altered Mest promoter methylation and transcription with a concomitant increase in the body weight of the juvenile offspring. An experimental model of in vitro differentiated human mesenchymal stem cells also revealed an epigenetically induced MEST expression and enhanced adipogenesis following BPA exposure.

Conclusions

Our study provides evidence that MEST mediates the impact of prenatal BPA exposure on long-term body weight development in offspring by triggering adipocyte differentiation.

DNA methylation-based classification of central nervous system tumours

Accurate pathological diagnosis is crucial for optimal management of patients with cancer. For the approximately 100 known tumour types of the central nervous system, standardization of the diagnostic process has been shown to be particularly challenging-with substantial inter-observer variability in the histopathological diagnosis of many tumour types. Here we present a comprehensive approach for the DNA methylation-based classification of central nervous system tumours across all entities and age groups, and demonstrate its application in a routine diagnostic setting. We show that the availability of this method may have a substantial impact on diagnostic precision compared to standard methods, resulting in a change of diagnosis in up to 12% of prospective cases. For broader accessibility, we have designed a free online classifier tool, the use of which does not require any additional onsite data processing. Our results provide a blueprint for the generation of machine-learning-based tumour classifiers across other cancer entities, with the potential to fundamentally transform tumour pathology.

The Effect of Solutes on the Temperature of Miscibility Transitions in Multicomponent Membranes

We address questions posed by experiments that show small-chain alcohols reduce the miscibility transition temperature when added to giant plasma membrane vesicles (GPMVs), but increase that temperature when added to giant unilamellar vesicles. In giant unilamellar vesicles the change in temperature displays a definite minimum, between decanol and tetradecanol, as a function of alcohol chain length; in GPMVs there is no such minimum. To emphasize the competition between internal entropies of the components and the interactions between them, we model the system as consisting of three different linear polymers. Two of them are the constituents of a liquid, one that can undergo a miscibility transition. To this liquid is added the third polymer component, which represents the short-chain alcohol. We show that, within Flory-Huggins theory, the addition of alcohol causes an increase or decrease of the miscibility transition temperature depending upon the competition of two effects. The first is the dilution of the interactions between the two components of the liquid caused by the introduction of the alcohol. This tends to lower the transition temperature. The second effect is the preferential partitioning of the alcohol into one phase of the liquid or the other. This tends to raise the transition temperature irrespective of which phase the alcohol prefers. This second effect is the smallest, and the decrease in transition temperature the largest, when the alcohol partitions equally between the two phases. Such equal partitioning occurs when the effect of the entropic excluded volume interactions (which cause the alcohol to prefer one phase) just balances the effect of the direct interactions, which cause it to prefer the other. These results allow us to make several predictions, and to propose an explanation for the different behavior of the transition temperature in GPMVs and giant unilamellar vesicles that results from the addition of alcohols.

Clinical impact of KMT2C and SPRY4 expression levels in intensively treated younger adult acute myeloid leukemia patients

OBJECTIVE

To evaluate the prognostic impact of gene expression levels (ELs) of two tumor suppressor genes, sprouty 4 (SPRY4, located on 5q) and lysine methyltransferase 2C (KMT2C, located on 7q) in correlation with clinical characteristics and genetic abnormalities assessed at initial diagnosis in acute myeloid leukemia (AML).

METHOD

Gene expression levels were measured on cDNA by RT-qPCR from diagnostic bone marrow samples of 275 intensively treated adult AML patients (median age, 48 years).

RESULTS

KMT2C ELs were significantly lower in abn7q/-7 (P = .001), whereas SPRY4 ELs were not associated with abn5q/-5. Higher KMT2C and SPRY4 ELs were significantly associated with lower genetic risk groups as defined by the European LeukemiaNet classification. Additionally, KMT2C ELs were lower in cytogenetically normal patients with DNMT3A (P = .01) or FLT3-ITD mutations (P = .05). KMT2C ELs were not associated with prognosis, whereas higher SPRY4 ELs showed a favorable impact on event-free (EFS, P = .01), relapse-free (RFS, P = .01) and in-trend on overall survival (P = .06) for cytogenetically abnormal patients, which was confirmed in multivariable analysis for EFS (HR, 0.84; 95%-CI, 0.73-0.97; P = .02) and RFS (HR, 0.85; 95%-CI, 0.73-0.98; P = .02).

CONCLUSION

Our data indicate that KMT2C ELs are associated with specific genetic features and that SPRY4 ELs may add prognostic information.

Evaluation of the RumiWatchSystem for measuring grazing behaviour of cows

Feeding behaviour is an important parameter of animal performance, health and welfare, as well as reflecting levels and quality of feed available. Previously, sensors were only used for measuring animal feeding behaviour in indoor housing systems. However, sensors such as the RumiWatchSystem can also monitor such behaviour continuously in pasture-based environments. Therefore, the aim of this study was to validate the RumiWatchSystem to record cow activity and feeding behaviour in a pasture-based system. The RumiWatchSystem was evaluated against visual observation across two different experiments. The time duration per hour at grazing, rumination, walking, standing and lying recorded by the RumiWatchSystem was compared to the visual observation data in Experiment 1. Concordance Correlation Coefficient (CCC) values of CCC=0.96 for grazing, CCC=0.99 for rumination, CCC=1.00 for standing and lying and CCC=0.92 for walking were obtained. The number of grazing and rumination bouts within one hour were also analysed resulting in Cohen's Kappa (κ)=0.62 and κ=0.86 for grazing and rumination bouts, respectively. Experiment 2 focused on the validation of grazing bites and rumination chews. The accordance between visual observation and automated measurement by the RumiWatchSystem was high with CCC=0.78 and CCC=0.94 for grazing bites and rumination chews, respectively. These results indicate that the RumiWatchSystem is a reliable sensor technology for observing cow activity and feeding behaviour in a pasture based milk production system, and may be used for research purposes in a grazing environment.

Leukocyte Telomere Length and All-Cause, Cardiovascular Disease, and Cancer Mortality: Results From Individual-Participant-Data Meta-Analysis of 2 Large Prospective Cohort Studies

We studied the associations of leukocyte telomere length (LTL) with all-cause, cardiovascular disease, and cancer mortality in 12,199 adults participating in 2 population-based prospective cohort studies from Europe (ESTHER) and the United States (Nurses' Health Study). Blood samples were collected in 1989-1990 (Nurses' Health Study) and 2000-2002 (ESTHER). LTL was measured by quantitative polymerase chain reaction. We calculated z scores for LTL to standardize LTL measurements across the cohorts. Cox proportional hazards regression models were used to calculate relative mortality according to continuous levels and quintiles of LTL z scores. The hazard ratios obtained from each cohort were subsequently pooled by meta-analysis. Overall, 2,882 deaths were recorded during follow-up (Nurses' Health Study, 1989-2010; ESTHER, 2000-2015). LTL was inversely associated with age in both cohorts. After adjustment for age, a significant inverse trend of LTL with all-cause mortality was observed in both cohorts. In random-effects meta-analysis, age-adjusted hazard ratios for the shortest LTL quintile compared with the longest were 1.23 (95% confidence interval (CI): 1.04, 1.46) for all-cause mortality, 1.29 (95% CI: 0.83, 2.00) for cardiovascular mortality, and 1.10 (95% CI: 0.88, 1.37) for cancer mortality. In this study population with an age range of 43-75 years, we corroborated previous evidence suggesting that LTL predicts all-cause mortality beyond its association with age.

DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis

BACKGROUND

The WHO classification of brain tumours describes 15 subtypes of meningioma. Nine of these subtypes are allotted to WHO grade I, and three each to grade II and grade III. Grading is based solely on histology, with an absence of molecular markers. Although the existing classification and grading approach is of prognostic value, it harbours shortcomings such as ill-defined parameters for subtypes and grading criteria prone to arbitrary judgment. In this study, we aimed for a comprehensive characterisation of the entire molecular genetic landscape of meningioma to identify biologically and clinically relevant subgroups.

METHODS

In this multicentre, retrospective analysis, we investigated genome-wide DNA methylation patterns of meningiomas from ten European academic neuro-oncology centres to identify distinct methylation classes of meningiomas. The methylation classes were further characterised by DNA copy number analysis, mutational profiling, and RNA sequencing. Methylation classes were analysed for progression-free survival outcomes by the Kaplan-Meier method. The DNA methylation-based and WHO classification schema were compared using the Brier prediction score, analysed in an independent cohort with WHO grading, progression-free survival, and disease-specific survival data available, collected at the Medical University Vienna (Vienna, Austria), assessing methylation patterns with an alternative methylation chip.

FINDINGS

We retrospectively collected 497 meningiomas along with 309 samples of other extra-axial skull tumours that might histologically mimic meningioma variants. Unsupervised clustering of DNA methylation data clearly segregated all meningiomas from other skull tumours. We generated genome-wide DNA methylation profiles from all 497 meningioma samples. DNA methylation profiling distinguished six distinct clinically relevant methylation classes associated with typical mutational, cytogenetic, and gene expression patterns. Compared with WHO grading, classification by individual and combined methylation classes more accurately identifies patients at high risk of disease progression in tumours with WHO grade I histology, and patients at lower risk of recurrence among WHO grade II tumours (p=0·0096) from the Brier prediction test). We validated this finding in our independent cohort of 140 patients with meningioma.

INTERPRETATION

DNA methylation-based meningioma classification captures clinically more homogenous groups and has a higher power for predicting tumour recurrence and prognosis than the WHO classification. The approach presented here is potentially very useful for stratifying meningioma patients to observation-only or adjuvant treatment groups. We consider methylation-based tumour classification highly relevant for the future diagnosis and treatment of meningioma.

FUNDING

German Cancer Aid, Else Kröner-Fresenius Foundation, and DKFZ/Heidelberg Institute of Personalized Oncology/Precision Oncology Program.

Shift in membrane miscibility transition temperature upon addition of short-chain alcohols

I consider the effect of a small concentration of a molecule, such as a short-chain alcohol, on the miscibility transition temperature of a giant plasma membrane vesicle. For concentrations sufficiently small such that the system can be treated as a dilute solution, the change in transition temperature is known to depend upon the extent of the molecule's partition into the coexisting liquid-disordered and liquid-ordered phases. Preferential partitioning into the former decreases the miscibility temperature, while preferential partitioning into the latter causes an increase. The analysis, combined with calculated values of the partition coefficient of saturated chains, illuminates the results of recent experiments on the change in miscibility transition temperatures with changing alcohol chain length, and makes several testable predictions.

Next-generation personalised medicine for high-risk paediatric cancer patients - The INFORM pilot study

The 'Individualized Therapy for Relapsed Malignancies in Childhood' (INFORM) precision medicine study is a nationwide German program for children with high-risk relapsed/refractory malignancies, which aims to identify therapeutic targets on an individualised basis. In a pilot phase, reported here, we developed the logistical and analytical pipelines necessary for rapid and comprehensive molecular profiling in a clinical setting. Fifty-seven patients from 20 centers were prospectively recruited. Malignancies investigated included sarcomas (n = 25), brain tumours (n = 23), and others (n = 9). Whole-exome, low-coverage whole-genome, and RNA sequencing were complemented with methylation and expression microarray analyses. Alterations were assessed for potential targetability according to a customised prioritisation algorithm and subsequently discussed in an interdisciplinary molecular tumour board. Next-generation sequencing data were generated for 52 patients, with the full analysis possible in 46 of 52. Turnaround time from sample receipt until first report averaged 28 d. Twenty-six patients (50%) harbored a potentially druggable alteration with a prioritisation score of 'intermediate' or higher (level 4 of 7). Common targets included receptor tyrosine kinases, phosphoinositide 3-kinase-mammalian target of rapamycin pathway, mitogen-activated protein kinase pathway, and cell cycle control. Ten patients received a targeted therapy based on these findings, with responses observed in some previously treatment-refractory tumours. Comparative primary relapse analysis revealed substantial tumour evolution as well as one case of unsuspected secondary malignancy, highlighting the importance of re-biopsy at relapse. This study demonstrates the feasibility of comprehensive, real-time molecular profiling for high-risk paediatric cancer patients. This extended proof-of-concept, with examples of treatment consequences, expands upon previous personalised oncology endeavors, and presents a model with considerable interest and practical relevance in the burgeoning era of personalised medicine.

Effect of mobile ions on the electric field needed to orient charged diblock copolymer thin films

We examine the behavior of lamellar phases of charged/neutral diblock copolymer thin films containing mobile ions in the presence of an external electric field. We employ self-consistent field theory and focus on the aligning effect of the electric field on the lamellae. Of particular interest are the effects of the mobile ions on the critical field, the value required to reorient the lamellae from the parallel configuration favored by the surface interaction to the perpendicular orientation favored by the field. We find that the critical field depends strongly on whether the neutral or charged species is favored by the substrates. In the case in which the neutral species is favored, the addition of charges decreases the critical electric field significantly. The effect is greater when the mobile ions are confined to the charged lamellae. In contrast, when the charged species is favored by the substrate, the addition of mobile ions stabilizes the parallel configuration and thus results in an increase in the critical electric field. The presence of ions in the system introduces a new mixed phase in addition to those reported previously.

Smoking habits and leukocyte telomere length dynamics among older adults: Results from the ESTHER cohort

BACKGROUND & AIMS

Leukocyte telomere length (LTL) shortens with age and short LTL has been associated with increased mortality and increased risk for some age-related outcomes. This study aims to analyse the associations of smoking habits with LTL and rate of LTL change per year in older adults.

METHODS

LTL was measured by quantitative PCR at baseline in 3600 older adults, who were enrolled in a population-based cohort study in Germany. For longitudinal analyses, measurements were repeated in blood samples obtained at 8-year follow-up from 1000 participants. Terminal Restriction Fragment analysis was additionally performed in a sub-sample to obtain absolute LTL in base pairs. Multivariate linear regression models were used to estimate associations of smoking habits with baseline LTL and changes in LTL over time.

RESULTS

LTL was inversely associated with age (r=-0.090, p<0.0001). Women had longer LTL than men (p<0.0001). Smoking was inversely associated with LTL. On average, current smokers had 73 base pairs (BP) shorter LTL compared to never smokers. Smoking intensity and pack-years of smoking were also inversely associated with LTL, and a positive association was observed with years since smoking cessation. Slower LTL attrition rates were observed in ever smokers over 8years of follow-up.

CONCLUSIONS

Our cross-sectional analysis supports suggestions that smoking might contribute to shortening of LTL but this relationship could not be shown longitudinally. The overall rather small effect sizes observed for smoking-related variables suggest that LTL reflects smoking-related health hazards only to a very limited extent.

Abstract LB-114: The INFORM personalized medicine study for high-risk pediatric cancer patients

Background: Despite substantial progress in treating primary childhood malignancies, relapses from high-risk entities remain a major clinical challenge. The German INFORM study (INdividualized therapy FOr Relapsed Malignancies) is attempting to address this problem using an integrated next-generation sequencing analysis to rapidly generate personalized tumor profiles and identify therapeutic targets.

Methods: The INFORM pilot phase assessed the feasibility of integrating rapid molecular profiling into the clinical management of progressive or relapsed high-risk pediatric cancer patients. Whole-exome and low-coverage whole-genome sequencing of tumor and normal DNA was complemented with tumor RNA sequencing (Illumina HiSeq2500, ‘rapid’ mode). This allowed reliable detection of copy-number changes, point mutations, InDels, fusion genes and deregulated gene expression. Identified alterations were prioritized according to tumor biological relevance and potential as an actionable drug target, with results discussed in a weekly molecular tumor board.

Results: From Oct 2013 to Jan 2015, 57 patients (average age 13 years) were enrolled from 20 centers throughout Germany. Entities included: high-grade glioma (n = 12), Ewing's sarcoma (n = 11), rhabdomyosarcoma/DSRCT (n = 7), medulloblastoma (n = 5), ependymoma (n = 5), osteosarcoma (n = 4), neuroblastoma (n = 4), and others (n = 9). Tumor tissue was sufficient for analysis of 52 cases. Average turnaround time from tissue arrival to molecular results was 25 days. Actionable targets with at least ‘borderline’ evidence (according to a prioritization score harmonized with other pediatric precision oncology programs across Europe) were identified in 28 patients (49%). The most commonly affected targets included: tyrosine kinases (ALK, n = 5; FGFR, n = 4; MET, n = 4; others, n = 4), the PI3K/mTOR-pathway (PIK3CA, n = 4; PIK3R1, n = 1; TSC2, n = 1), the MAPK pathway (BRAF, n = 1; KRAS, n = 1), the SHH-pathway (PTCH1, n = 3) and cell-cycle control (CCND1/2, n = 4; CDK4, n = 4; CDKN2A/B, n = 3).

Based on these findings, targeted therapeutics were incorporated into the therapy regime of several patients (as single experimental treatments or in clinical trials), with anecdotal reports of marked responses. For example, one patient with a previously inoperable myofibroblastic sarcoma is now in complete remission more than 12 months after entering an ALK-inhibitor trial on the basis of our identification of an ALK fusion.

Conclusion: A nationwide individualized diagnostic and treatment approach for pediatric cancer patients based on rapid next-generation sequencing is feasible. Our pilot phase results show that actionable targets can be identified in roughly half of the patients. The INFORM registry study has now opened (www.dkfz.de/en/inform/), to collect molecular and clinical data and establish the infrastructure for prospective clinical trials on personalized pediatric oncology.

Citation Format: Barbara C. Worst, Cornelis M. van Tilburg, Gnana P. Balasubramanian, Petra Fiesel, David Capper, Miream Boudalil, Stephan Wolf, Sabine Schmidt, Melanie Bewerunge-Hudler, Matthias Schick, Angelika Freitag, Ruth Witt, Lenka Taylor, Andreas von Deimling, Matthias Schlesner, Angelika Eggert, Peter Lichter, David TW Jones, Olaf Witt, Stefan M. Pfister. The INFORM personalized medicine study for high-risk pediatric cancer patients. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-114. doi:10.1158/1538-7445.AM2015-LB-114

How cholesterol could be drawn to the cytoplasmic leaf of the plasma membrane by phosphatidylethanolamine

In the mammalian plasma membrane, cholesterol can translocate rapidly between the exoplasmic and cytoplasmic leaves, so that its distribution between them should be given by the equality of its chemical potential in the leaves. Due to its favorable interaction with sphingomyelin, which is almost entirely in the outer leaf, one expects the great majority of cholesterol to be there also. Experimental results do not support this, implying that there is some mechanism attracting cholesterol to the inner leaf. We hypothesize that it is drawn there to reduce the bending free energy of the membrane caused by the presence of PE (phosphatidylethanolamine). It does this in two ways: first by simply diluting the amount of PE in the inner leaf, and second by ordering the tails of the PE to reduce its spontaneous curvature. Incorporating this mechanism into a model free energy for the bilayer, we find that between 50 and 60% of the total cholesterol should be in the inner leaf of human erythrocytes.

Improving ergonomics in milking parlors: empirical findings for optimal working heights in five milking parlor types

Milking postures have shifted from seated milking in tethered stalls to milking in a standing position in parlors. However, the musculoskeletal workload of dairy farmers remains high. Previous studies have shown that different working heights affect ergonomics, but they could not objectively evaluate and quantify the workload. The aim of the present study was to assess the effect of working height in different milking parlor types on the milker's workload during the task of attaching milking clusters. Computer-assisted recording and long-term analysis of movements were used to record positions of joints and body regions while performing certain tasks in terms of angular degrees of joints (ADJ) according to the neutral zero method. The 5th, 50th, and 95th percentiles described the distribution of angular degree values measured for each joint. The ADJ were evaluated according to international standards and other scientific literature on the issue to assess the muscular load. The workload was compared between 5 parlor types (auto tandem, herringbone 30°, herringbone 50°, parallel, and rotary) on 15 farms with 2 subjects per parlor and 1 milking period per subject. The working height was defined as a coefficient based on the milker's body height, the floor level, and the cow's udder height. The data recorded during the attachment task were analyzed using generalized linear mixed-effects models taking into account the hierarchical experimental design. The results indicated that the interaction of the cow's udder height, the milker's body height, and the parlor type had a larger effect on ergonomics than each parameter had independently. The interaction was significant in at least 1 of the 3 percentiles in 28 out of 31 ADJ. The postural differences between parlor types, however, were minor. A milking health formula was created to calculate the ideal depth of pit by considering the parlor type, the milker's height, and the mean herd udder height. This formula can be used to develop individual recommendations for future parlor construction.

Abstract 1889: Next-generation neuropathology - Improving diagnostic accuracy for brain tumors using DNA methylation array-based molecular profiling

Background

The current World Health Organisation (WHO) classification of central nervous system tumors comprises over 100 entities. Most of these are defined by purely histological criteria, with varying and often overlapping spectra. Histological diagnosis is often challenging, however, especially in cases with limited or non-representative biopsy material. Thus, molecular technologies that can complement standard pathology testing have the potential to greatly enhance diagnostic precision and improve clinical decision-making. DNA methylation profiling, acting as a ‘fingerprint’ of cellular origins and molecular alterations, is one such promising technology.

Methods

We have assembled a reference dataset of more than 2,000 methylation profiles using the Illumina HumanMethylation450 (450k) array, currently representing over 50 brain tumor entities or subgroups. The array platform is suitable for both frozen and paraffin-embedded material, with minimal DNA input required. This reference set is iteratively updated, and a ‘random forest’ algorithm used to produce a classification scheme. Each new diagnostic case receives an entity prediction with an associated probability score. Genome-wide copy number profiles and target gene methylation data (e.g. MGMT) generated from the array provide important additional information.

Results

In addition to the reference cohort, more than 300 diagnostic samples from Heidelberg University Hospital and external institutions have been processed. Many cases displayed a discrepancy between histological and molecular diagnoses. Careful re-examination of these often resulted in refinement of the original diagnosis, and improved patient care.

Furthermore, samples collected for the reference cohort have led to significant improvements in our understanding of the biology of several tumor types, including the identification of further subgroups for several entities and associations with recurrent copy number changes.

Conclusion

Our understanding of the molecular alterations underlying brain tumors has grown enormously in recent years, and it is crucial that this is translated into the clinic promptly. DNA methylation profiling is one tool with the potential to become an important part of the diagnostic armoury of neuropathologists. This relatively inexpensive and robust method is well suited to complement standard histopathologic techniques and improve diagnostic accuracy, thereby optimising patient management. It offers a diagnostic assessment completely independent of histopathological evaluation, and may thus be especially valuable in histologically uncertain cases. We are currently expanding our pipeline to include additional diagnostic sites, allowing for further refinement and validation as well as broader access across the globe.

Citation Format: David T. W. Jones, David Capper, Martin Sill, Volker Hovestadt, Leonille Schweizer, Roger Fischer, Matthias Schick, Melanie Bewerunge-Hudler, Axel Benner, David Zagzag, Peter Lichter, Matthias A. Karajannis, Kenneth D. Aldape, Andrey Korshunov, Andreas von Deimling, Stefan M. Pfister. Next-generation neuropathology - Improving diagnostic accuracy for brain tumors using DNA methylation array-based molecular profiling. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1889. doi:10.1158/1538-7445.AM2014-1889