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Testis-specific transcript 10 (Tex10) is highly expressed in the testis, embryonic stem cells (ESCs), and primordial germ cells (PGCs). We previously generated a Tex10 knockout mouse model demonstrating its critical roles in ESC pluripotency and preimplantation development. Here, using conditional knockout mice and dTAG-degron ESCs, we show Tex10 is required for spermatogenesis and ESC-to-PGCLC differentiation. Specifically, Tex10-null spermatocytes arrest at metaphase I, compromising round spermatid formation. Tex10 depletion and overexpression compromise and enhance ESC-to-PGCLC differentiation, respectively. Mechanistically, bulk and single-cell RNA sequencing reveals that Tex10 depletion downregulates genes involved in pluripotency, PGC development, and spermatogenesis while upregulating genes promoting somatic programs. Chromatin occupancy study reveals that Tex10 binds to H3K4me3-marked promoters of Psmd3 and Psmd7, negative regulators of Wnt signaling, and activates their expression, thereby restraining Wnt signaling. Our study identifies Tex10 as a previously unappreciated factor in spermatogenesis and PGC development, offering potential therapeutic insights for treating male infertility. Here they identify Tex10 as a critical regulator of male fertility and germ cell development. By fine-tuning Wnt signaling, Tex10 promotes spermatogenesis and PGC differentiation, offering potential therapeutic insights for treating male infertility. [ABSTRACT FROM AUTHOR]

Most pancreatic cancer patients are diagnosed at advanced stages, with poor survival rates and drug resistance making pancreatic cancer one of the highest causes of cancer death in the UK. Understanding the underlying mechanism behind its carcinogenesis, metastasis and drug resistance has become an essential task for researchers. We have discovered that a well-established tumour suppressor, EPLIN, has an oncogenic rather than suppressive role in pancreatic cancer. Notably, upregulation of EPLIN was observed in pancreatic cancer samples compared to normal samples at RNA and protein levels. Moreover, the presence of EPLIN resulted in poor clinical outcomes in patients. We also report that inhibition of EPLIN led to reduced cellular growth and migration in pancreatic cancer cells. EPLIN regulates expression and phosphorylation levels of several key players in MAPK and PIK3CA-AKT signalling pathways, as well as key contributors of EMT. Furthermore, EPLIN mediates the inhibitory ability PIK3 kinases, MEK and ERK inhibitors have on cell migration. EPLIN was also found to have an impact on pancreatic cancer cells response to chemotherapeutic and EGFR/HER2 targeted therapeutic agents, namely gemcitabine, fluorouracil (5FU) and neratinib (Nerlynx). [ABSTRACT FROM AUTHOR]

White lupin (Lupinus albus L.) is a high-protein grain legume alternative to soybean in Central Europe, but its cultivation is risky due to the fungal disease anthracnose that can cause severe yield damage. In addition, management of seed alkaloids is critical for human nutrition and animal feed. We report on a white lupin collection of genebank accessions, advanced breeding lines and cultivars that was genotyped and phenotypically characterized for anthracnose resistance and seed alkaloids and protein levels. Using genotyping by sequencing (GBS), SeqSNP-targeted GBS, BiomarkX genotyping and Sanger sequencing, a genetic resource of genome-wide SNPs for white lupin was established. We determined anthracnose resistance in two years field trials at four locations with infection rows and measured seed alkaloids and protein levels by near-infrared spectroscopy (NIRS). Few white lupin breeding lines showed anthracnose resistance comparable or better than Celina and Frieda, currently the best commercial cultivars in Germany. NIRS estimates for seed alkaloids and protein levels revealed variation in the white lupin collection. Using genome-wide association studies (GWAS), we identified SNPs significantly associated with anthracnose resistance in the field representing known and new genomic regions. We confirmed the pauper locus and detected new SNP markers significantly associated with seed alkaloids. For the first time, we present loci associated with total grain protein content. Finally, we tested the potential of genomic prediction (GP) in predicting the phenotype of these three quantitative traits. Application of results and resources are discussed in the context of fostering breeding programs for white lupin. [ABSTRACT FROM AUTHOR]

The pathological advancement of osteoporosis is caused by the uneven development of bone marrow-derived mesenchymal stem cells (BMSCs) in terms of osteogenesis and adipogenesis. While the role of EEF1B2 in intellectual disability and tumorigenesis is well established, its function in the bone-fat switch of BMSCs is still largely unexplored. During the process of osteogenic differentiation, we observed an increase in the expression of EEF1B2, while a decrease in its expression was noted during adipogenesis. Suppression of EEF1B2 hindered the process of osteogenic differentiation and mineralization while promoting adipogenic differentiation. On the contrary, overexpression of EEF1B2 enhanced osteogenesis and strongly inhibited adipogenesis. Furthermore, the excessive expression of EEF1B2 in the tibias has the potential to mitigate bone loss and decrease marrow adiposity in mice with osteoporosis. In terms of mechanism, the suppression of β-catenin activity occurred when EEF1B2 function was suppressed during osteogenesis. Our collective findings indicate that EEF1B2 functions as a regulator, influencing the differentiation of BMSCs and maintaining a balance between bone and fat. Our finding highlights its potential as a therapeutic target for diseases related to bone metabolism. [ABSTRACT FROM AUTHOR]

To take better advantage of buckwheat polyphenols, processings including extrusion, steam explosion, microwave, roasting, superheated steam, ultrasound and enzymolysis treatment were applied to buckwheat bran to release more bioactive polyphenols. Polyphenols were extracted and characterized, and rutin was identified as the predominant compound. To further improve the properties of buckwheat polyphenols, rutin was selected as the target polyphenol and a formation of its ionic cross-linking complex was proposed. Rutin was loaded on chitooligosaccharide as Rutin-COS with tripolyphosphate (TPP) as crosslinking agent, whose molecular structure and properties were investigated. Results showed that all processing significantly increased (p < 0.05) the content of buckwheat polyphenols, up to 1.83-fold increase. The composition of polyphenols was altered, and their antioxidant (up to 15% increase) and antibacterial activities were significantly enhanced (p < 0.05). Among all the processings, extrusion and superheated steam showed the best effect. For Rutin-COS complex, the encapsulation efficiency was as high as 74.77% with the mass ratio of rutin and COS at 1:8. The structure of Rutin-COS was stabilized by hydrogen bonding between aromatic rings of rutin and amino and hydroxy groups of COS in the network formed by COS and TPP. Compared to free rutin, Rutin-COS presented better thermal stability and water solubility. The antioxidant and antibacterial activities of Rutin-COS were also significantly improved (p < 0.05) due to the molecular interaction between rutin and COS. The combination of processing and complexation strategy for buckwheat polyphenols in this work provided new approaches to take better advantages of polyphenols of cereal foods. [ABSTRACT FROM AUTHOR]

Key message: We mapped Ryd4Hb in a 66.5 kbp interval in barley and dissociated it from a sublethality factor. These results will enable a targeted selection of the resistance in barley breeding. Virus diseases are causing high yield losses in crops worldwide. The Barley yellow dwarf virus (BYDV) complex is responsible for one of the most widespread and economically important viral diseases of cereals. While no gene conferring complete resistance (immunity) has been uncovered in the primary gene pool of barley, sources of resistance were searched and identified in the wild relative Hordeum bulbosum, representing the secondary gene pool of barley. One such locus, Ryd4Hb, has been previously introgressed into barley, and was allocated to chromosome 3H, but is tightly linked to a sublethality factor that prevents the incorporation and utilization of Ryd4Hb in barley varieties. To solve this problem, we fine-mapped Ryd4Hb and separated it from this negative factor. We narrowed the Ryd4Hb locus to a corresponding 66.5 kbp physical interval in the barley ‘Morex’ reference genome. The region comprises a gene from the nucleotide-binding and leucine-rich repeat immune receptor family, typical of dominant virus resistance genes. The closest homolog to this Ryd4Hb candidate gene is the wheat Sr35 stem rust resistance gene. In addition to the fine mapping, we reduced the interval bearing the sublethality factor to 600 kbp in barley. Aphid feeding experiments demonstrated that Ryd4Hb provides a resistance to BYDV rather than to its vector. The presented results, including the high-throughput molecular markers, will permit a more targeted selection of the resistance in breeding, enabling the use of Ryd4Hb in barley varieties. [ABSTRACT FROM AUTHOR]

Copyright of Innere Medizin (2731-7080) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accurate Magnetic Resonance Imaging (MRI) simulation is fundamental for high-precision stereotactic radiosurgery and fractionated stereotactic radiotherapy, collectively referred to as stereotactic radiotherapy (SRT), to deliver doses of high biological effectiveness to well-defined cranial targets. Multiple MRI hardware related factors as well as scanner configuration and sequence protocol parameters can affect the imaging accuracy and need to be optimized for the special purpose of radiotherapy treatment planning. MRI simulation for SRT is possible for different organizational environments including patient referral for imaging as well as dedicated MRI simulation in the radiotherapy department but require radiotherapy-optimized MRI protocols and defined quality standards to ensure geometrically accurate images that form an impeccable foundation for treatment planning. For this guideline, an interdisciplinary panel including experts from the working group for radiosurgery and stereotactic radiotherapy of the German Society for Radiation Oncology (DEGRO), the working group for physics and technology in stereotactic radiotherapy of the German Society for Medical Physics (DGMP), the German Society of Neurosurgery (DGNC), the German Society of Neuroradiology (DGNR) and the German Chapter of the International Society for Magnetic Resonance in Medicine (DS-ISMRM) have defined minimum MRI quality requirements as well as advanced MRI simulation options for cranial SRT. [ABSTRACT FROM AUTHOR]

Background: The expression level of the programmed cell death ligand 1 (PD-L1) appears to be a predictor for response to immunotherapy using checkpoint inhibitors in patients with non-small cell lung cancer (NSCLC). As differences in terms of PD-L1 expression levels in the extracranial primary tumor and the brain metastases may occur, a reliable method for the non-invasive assessment of the intracranial PD-L1 expression is, therefore of clinical value. Here, we evaluated the potential of radiomics for a non-invasive prediction of PD-L1 expression in patients with brain metastases secondary to NSCLC. Patients and methods: Fifty-three NSCLC patients with brain metastases from two academic neuro-oncological centers (group 1, n = 36 patients; group 2, n = 17 patients) underwent tumor resection with a subsequent immunohistochemical evaluation of the PD-L1 expression. Brain metastases were manually segmented on preoperative T1-weighted contrast-enhanced MRI. Group 1 was used for model training and validation, group 2 for model testing. After image pre-processing and radiomics feature extraction, a test-retest analysis was performed to identify robust features prior to feature selection. The radiomics model was trained and validated using random stratified cross-validation. Finally, the best-performing radiomics model was applied to the test data. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analyses. Results: An intracranial PD-L1 expression (i.e., staining of at least 1% or more of tumor cells) was present in 18 of 36 patients (50%) in group 1, and 7 of 17 patients (41%) in group 2. Univariate analysis identified the contrast-enhancing tumor volume as a significant predictor for PD-L1 expression (area under the ROC curve (AUC), 0.77). A random forest classifier using a four-parameter radiomics signature, including tumor volume, yielded an AUC of 0.83 ± 0.18 in the training data (group 1), and an AUC of 0.84 in the external test data (group 2). Conclusion: The developed radiomics classifiers allows for a non-invasive assessment of the intracranial PD-L1 expression in patients with brain metastases secondary to NSCLC with high accuracy. [ABSTRACT FROM AUTHOR]

Building ventilation is essential to discharge indoor pollutants and improve indoor air quality for occupant health. Tracer gas method is an efficient way in the field of building ventilation to measure ventilation rate and to evaluate the ventilation performance. Literature shows notable deviation of measured ventilation rate using different tracer gases. In the present study, CFD simulations are carried out to analyze He-, CO2- and SF6- based tracer gas methods. The effects of tracer gas density and release rate on the concentration distribution and ventilation effectiveness are studied. Various application scenarios of different ventilation rates and airflow distribution forms are compared. The results show that the deviation of ventilation effectiveness evaluated by different tracer gases can be above 2–4 times, and the error is introduced by non-passive dispersion. Whether tracer gas dispersion is passive or not depends on the relative importance of density difference driven mass transfer to forced convection mass transfer, which is due to the combined effects of density difference, release rate, and indoor airflow velocity, and can be judged by a dimensionless number θ. Under the geometry and ventilation settings in the present study, the critical value of θ is 1.0 for the error range of 5%, and 2.0 for the error range of 10%. When θ is below the critical value, the gas transport is passive and dominated by the indoor ventilation airflow. A release of tracer gas with smaller release rate and smaller density difference into a stronger indoor airflow behaves more passive. Heavier tracer gas tends to significantly overestimate the performance of upper supply and lower exhaust ventilation, and lighter tracer gas aggravates the overestimation of the performance for lower supply and upper exhaust ventilation. In mechanical ventilation rooms with air change rate of 3.0–6.0 h−1, a continuous release of tracer gas SF6, CO2 or He with release rate above 8 mg/s or source concentration above 8–75 ppm should not be considered as passive. This work clarified the passive and non-passive transport characteristics and mechanisms of various tracer gases, which is helpful for the engineering applications of tracer gas method in building ventilation studies. [ABSTRACT FROM AUTHOR]

Purpose: In glioma patients, tumor development and multimodality therapy are associated with changes in health-related quality of life (HRQoL). It is largely unknown how different types and locations of tumor- and treatment-related brain lesions, as well as their relationship to white matter tracts and functional brain networks, affect HRQoL. Methods: In 121 patients with pretreated gliomas of WHO CNS grades 3 or 4, structural MRI, O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET, resting-state functional MRI (rs-fMRI) and self-reported HRQoL questionnaires (EORTC QLQ-C30/BN20) were obtained. Resection cavities, T1-enhancing lesions, T2/FLAIR hyperintensities, and lesions with pathologically increased FET uptake were delineated. Effects of tumor lateralization, involvement of white matter tracts or resting-state network nodes by different types of lesions and within-network rs-fMRI connectivity were analyzed in terms of their interaction with HRQoL scores. Results: Right hemisphere gliomas were associated with significantly less favorable outcomes in physical, role, emotional and social functioning, compared with left-sided tumors. Most functional HRQoL scores correlated significantly with right-sided white-matter tracts involvement by T2/FLAIR hyperintensities and with loss of within-network functional connectivity of right-sided nodes. Tumors of the left hemisphere caused significantly more communication deficits. Conclusion: In pretreated high-grade gliomas, right hemisphere lesions are associated with reduced HRQoL scores in most functional domains except communication ability, compared to tumors of the left hemisphere. These relationships are mainly observed for T2/FLAIR lesions involving structural and functional networks in the right hemisphere. The data suggest that sparing the right hemisphere from treatment-related tissue damage may improve HRQoL in glioma patients. [ABSTRACT FROM AUTHOR]

Given the recent surge in transcatheter heart valve replacement (THVR), cardiac surgeons will surely face the challenge of eventual explantation. The aim of this study was to determine indications for reoperation, while exploring pertinent technical aspects and survival after THV explantation in a cohort originally deemed high risk or even inoperable. Between February 2008 and March 2019, 31 patients with failed transcatheter aortic valve replacement (TAVR) underwent surgical explantations at our facility. Data were prospectively collected for retrospective analysis of procedural indications, technical issues, and postoperative survival. The major reason for TAVR removal was bioprosthetic valve failure (BVF) due to infective endocarditis (IE: 16/31 [51.6%]), non-structural (NSVD: 14/31 [45.2%]) and structural (SVD: 1/31 [3.2%]) valve deterioration accounting for the rest. Mean age at THV explantation was 76.3 ± 8.3 years, and median time from TAVR to explantation was 153 days (0 days–56.6 months). Median ICU and hospital stay were 6 days (1–44 days) and 23 days (8–62 days), respectively. Thirty-day and 1-year survival rates were 74.2% and 67.2%, respectively. Median follow-up interval after explantation was 364 days (3 days–80 months). Mean cardiopulmonary bypass time was 124.6 ± 46.8 min, and mean aortic cross-clamp time was 84.3 ± 32.9 min. There was no need for unplanned aortic root repair owing to tissue damage during dissection of the TAVR from surrounding tissue. The most common reason for THV explantation was (a) BVF for IE and (b) BVF secondary to NSVD. Although 30-day and 1-year mortality rates in this multimorbid cohort were predictably high, no procedural mortalities occurred. [ABSTRACT FROM AUTHOR]

Both active response execution and passive listening to verbal codes (a form of instruction) in single prime trials lead to item-specific repetition priming effects when stimuli re-occur in single probe trials. This holds for task-specific classification (stimulus–classification, SC priming, e.g., apple–small) and action (stimulus–action, SA priming, e.g., apple–right key press). To address the influence of expectation on item-specific SC and SA associations, we tested if item-specific SC and SA priming effects were modulated by the instructed probability of re-encountering individual SC or SA mappings (25% vs. 75% instructed switch probability). Importantly, the experienced item-specific switch probability was always 50%. In Experiment 1 (N = 78), item-specific SA/SC switch expectations affected SA, but not SC priming effects exclusively following active response execution. Experiment 2 (N = 40) was designed to emphasize SA priming by only including item-specific SC repetitions. This yielded stronger SA priming for 25% vs. 75% expected switch probability, both following response execution as in Experiment 1 and also following verbally coded SA associations. Together, these results suggest that SA priming effects, that is, the encoding and retrieval of SA associations, is modulated by item-specific switch expectation. Importantly, this expectation effect cannot be explained by item-specific associative learning mechanisms, as stimuli were primed and probed only once and participants experienced item-specific repetitions/switches equally often across stimuli independent of instructed switch probabilities. This corroborates and extends previous results by showing that SA priming effects are modulated by expectation not only based on experienced item-specific switch probabilities, but also on mere instruction. [ABSTRACT FROM AUTHOR]

Purpose of Review: Sudden cardiac death (SCD) in a young athlete is an infrequent yet devastating event often associated with substantial media attention. Screening athletes for conditions associated with SCD is a controversial topic with debate surrounding virtually each component including the ideal subject, method, and performer/interpreter of such screens. In fact, major medical societies such as the American College of Cardiology/American Heart Association and the European Society of Cardiology have discrepant recommendations on the matter, and major sporting associations have enacted a wide range of screening policies, highlighting the confusion on this subject. This review seeks to summarize the literature in this area to address the complex and disputed subject of screening young athletes for SCD. Recent Findings: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause myocarditis, which is one acquired cardiac disease associated with SCD. The coronavirus 2019 (COVID-19) pandemic has therefore resulted in an increased incidence of an otherwise less common condition, providing an expanded dataset for further study of this condition. Recent findings indicate that cardiac complications of athletes with myocardial involvement of SARS-CoV-2 infection are rare. Other contemporary work in SCD screening has been focused on the implementation of various screening protocols and measuring their effectiveness. Summary: No universal consensus exists for athlete screening for conditions associated with SCD with varying guidelines and protocols across cardiology and sport-specific organizations. No screening program will prevent all SCD; however, small programs managed by physicians familiar with the examination of an athlete that carefully personalize screening to the individual may maximize detection of dangerous cardiac conditions while minimizing false positives. [ABSTRACT FROM AUTHOR]

Binary IV–VI chalcogenides MXs (SnS, SnSe, SnTe, GeS, GeSe, and GeTe), as a family two-dimensional (2D) semiconductor material, have a proper bandgap, high carrier mobility, stability in ambient conditions, and a pucker structure, hence they are potential channel materials for the next-generation electronic and optoelectronic devices. 2D MXs devices should directly contact the metal electrodes to inject suitable types of carriers, on account of the random dopant fluctuation. However, a Schottky contact is always formed at the interface, which degrades the performance of the MXs devices. Herein, we report the contact characteristics of the MXs field-effect transistors (FETs) with Graphene(Gr)/Ag/Au electrodes (two-interface model) by using quantum transport calculations and density functional theory. At the vertical interface, the MXs FETs form Van der Waals (vdW) contact type after being contacted with the Gr electrode, and an Ohmic contact is formed after being contacted with Ag and Au electrodes. At the lateral interface, the SnTe (armchair and zigzag), GeS (zigzag), and GeSe (zigzag) FETs with Gr electrode get a desired p-type Ohmic contact or quasi p-type Ohmic contact, suggestive of high device performance in such an MXs device. Our simulation provides a theoretical foundation for the choice of suitable electrodes in future ML MXs devices. [ABSTRACT FROM AUTHOR]

Central venous pressure (CVP) is one of only a handful of variables that can be used to assess a patient's volume status to attempt to optimize stroke volume. The gold standard method for assessing CVP is though pulmonary artery catheterization, which is invasive and risks severe complications such as pneumothorax and cardiac conduction abnormalities. Current noninvasive methods for estimating CVP such as jugular venous pressure assessment are imperfect with wide inter-examiner variability. The inferior vena cava (IVC) is a highly compliant vessel that uniquely does not constrict in response to hypovolemia, making it an ideal, noninvasive surrogate for the estimation of CVP. A range of IVC indices including minimum and maximum IVC diameter and fraction of IVC collapse with inspiration (known as collapsibility index) have been studied with highly variable results that range from excellent to poor correlation between these values and CVP. Despite this inconsistency in findings, multiple schemes have been proposed to attempt to estimate CVP from IVC measurements, but when prospectively tested, none has been shown to be accurate. Since the most recent 2015 American Society of Echocardiography guidelines, multiple studies have identified unique ways of improving the accuracy of IVC measurement, which could translate into better CVP estimation. The goal of this review is to summarize the many, often conflicting studies that exist in this area, and provide recommendations for future studies based on our findings. [ABSTRACT FROM AUTHOR]

Background: Acquired arteriovenous fistula are rare complications of a piercing injury, including a gunshot or knife injury, the rupture of a preexisting aneurysm into a neighboring vein, or a complication of arterial catheterization or abdominal surgical techniques, most often colonic resection. Our aim was to develop an online systematic review of the literature to determine all documented incidents of endovascular embolization of secondary mesenteric Arteriovenous Fistula, spanning key databases as well as pertinent publications, from 1982 to 2019. Our case was included as well. The primary objectives were technical success and death; the secondary outcomes were the frequency of complications and the advice of the operators. Main body: Forty articles, comprising 41 patients, including our own, were reviewed. The superior mesenteric vessels are the most commonly affected by fistulas. Endovascularembolization was used in 80% of the cases. 100% of the patients had technical success. The intraoperative death rate was 0%, with a 90-day mortality rate of 8%, half of which was unrelated to the original pathology. More than 60% of patients who underwent successful treatments had no severe problems. All others had uneventful recoveries, with only 12% experiencing mild problems that were managed conservatively. Conclusions: The majority of authors supported this therapeutic approach thereby making endovascular glue embolization the treatment of choice for superior mesenteric arteriovenous fistula and inferior mesenteric arteriovenous fistula in high risk patients and in patients with multiple co-morbidities. [ABSTRACT FROM AUTHOR]

A sensitive molecular imprinted (MIP) electrochemical sensor for the rapid detection of coumarin was successfully constructed by modifying gold nanoparticles (AuNPs) improved reduced graphene oxide (rGO) on glassy carbon electrode (GCE). The modification of AuNPs/rGO was achieved by introducing/eluting coumarin template molecules. Imprinting parameters (template molecule to functional monomer ratio, pH value of electro-polymerization solution, polymerization cycles and types of eluent) of the sensor were experimentally optimized. The prepared nano-materials were characterized by scanning electron microscope (SEM), energy dispersion spectrum (EDS) and transmission electron microscope (TEM). The optimized imprinted electrochemical sensor was characterized by (cyclic voltammetry) CV (electrochemical impedance spectroscopy) and EIS and validated by standard linearity of current–concentration relation. The linear range and the detection of limit (LOD) of the molecular imprinted AuNPs/rGO/GCE sensor for coumarin detection were obtained from 1.0 × 10–7 to 1.8 × 10–5 M and 1.15 × 10–8 M (S/N = 3), respectively. The developed sensor is expected to be widely used in real sample detection due to the desirable features of high sensitivity and stability, and rapid response. [ABSTRACT FROM AUTHOR]

Purpose: In stereotactic radiosurgery (SRS), prescription isodoses and resulting dose homogeneities vary widely across different platforms and clinical entities. Our goal was to investigate the physical limitations of generating dose distributions with an intended level of homogeneity in robotic SRS. Methods: Treatment plans for non-isocentric irradiation of 4 spherical phantom targets (volume 0.27–7.70 ml) and 4 clinical targets (volume 0.50–5.70 ml) were calculated using Sequential (phantom) or VOLOTM (clinical) optimizers (Accuray, Sunnyvale, CA, USA). Dose conformity, volume of 12 Gy isodose (V12Gy) as a measure for dose gradient, and treatment time were recorded for different prescribed isodose levels (PILs) and collimator settings. In addition, isocentric irradiation of phantom targets was examined, with dose homogeneity modified by using different collimator sizes. Results: Dose conformity was generally high (nCI ≤ 1.25) and varied little with PIL. For all targets and collimator sets, V12Gy was highest for PIL ≥ 80% and lowest for PIL ≤ 65%. The impact of PIL on V12Gy was highest for isocentric irradiation and lowest for clinical targets (VOLOTM optimization). The variability of V12Gy as a function of collimator selection was significantly higher than that of PIL. V12Gy and treatment time were negatively correlated. Plans utilizing a single collimator with a diameter in the range of 70–80% of the target diameter were fastest, but showed the strongest dependence on PIL. Conclusion: Inhomogeneous dose distributions with PIL ≤ 70% can be used to minimize dose to normal tissue. PIL ≥ 90% is associated with a marked and significant increase in off-target dose exposure. Careful selection of collimators during planning is even more important. [ABSTRACT FROM AUTHOR]

This research proposed to analyze the dependence on the water retention properties in granular samples (Guamo sand) regarding different contents of fines (kaolin). The extended evaporation method (EEM) and dew point method (DPM) allowed the construction of the water retention curves (WRCs). These methods can determine the matric suction of the samples at volumetric water contents in the partially saturated state. The results revealed that the Guamo sand only showed significant suction values in the pendular state of the system. As the kaolin content in the samples increased, the desaturation process revealing high suction values, even when samples have up to 30% volumetric water content. The evaluation of the experimental methods was generated from a WRC setting using traditional constitutive models. The prediction capacity of each model is defined with the coefficient of determination, where the behavior of the data indicates more significant predictive potential in high suction ranges. [ABSTRACT FROM AUTHOR]

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The patients' burden of comorbidities is a cornerstone in risk assessment, clinical management and follow-up. The aim of this study was to evaluate if biomarkers associated with comorbidity burden can predict outcome in acute dyspnea patients. We included 774 patients with dyspnea admitted to an emergency department and measured 80 cardiovascular protein biomarkers in serum collected at admission. The number of comorbidities for each patient were added, and a multimorbidity score was created. Eleven of the 80 biomarkers were independently associated with the multimorbidity score and their standardized and weighted values were summed into a biomarker score of multimorbidities. The biomarker score and the multimorbidity score, expressed per standard deviation increment, respectively, were related to all-cause mortality using Cox Proportional Hazards Model. During long-term follow-up (2.4 ± 1.5 years) 45% of the patients died and during short-term follow-up (90 days) 12% died. Through long-term follow-up, in fully adjusted models, the HR (95% CI) for mortality concerning the biomarker score was 1.59 (95% CI 1348–1871) and 1.18 (95% CI 1035–1346) for the multimorbidity score. For short-term follow-up, in the fully adjusted model, the biomarker score was strongly related to 90-day mortality (HR 1.98, 95% CI 1428–2743), whereas the multimorbidity score was not significant. Our main findings suggest that the biomarker score is superior to the multimorbidity score in predicting long and short-term mortality. Measurement of the biomarker score may serve as a biological fingerprint of the multimorbidity score at the emergency department and, therefore, be helpful for risk prediction, treatment decisions and need of follow-up both in hospital and after discharge from the emergency department. [ABSTRACT FROM AUTHOR]

The detrimental effects of increased length of stay at the emergency department (ED-LOS) for patient outcome have been sparsely studied in the Swedish setting. Our aim was to further explore the association between ED-LOS and short-term mortality in patients admitted to the EDs of two large University hospitals in Sweden. All adult patients (> 18 years) visiting the ED at the Karolinska University Hospital, Sweden, from 1/1/2010 to 1/1/2015 (n = 639,385) were retrospectively included. Logistic regression analysis was used to determine association between ED-LOS and 7- and 30-day mortality rates. All patients were triaged according to the RETTS-A into different levels of medical urgency and subsequently separated into five quintiles of ED-LOS. Mortality rate was highest in highest triage priority level (7-day mortality 5.24%, and 30-day mortality 9.44%), and decreased by lower triage priority group. For patients with triage priority levels 2–4, prolonged ED-LOS was associated with increased mortality, especially for lowest priority level, OR for priority level 4 and highest quintile of ED-LOS 30-day mortality 1.49 (CI 95% 1.20–1.85). For patients with highest triage priority level the opposite was at hand, with decreasing mortality risk with increasing quintile of ED-LOS for 7-day mortality, and lower mortality for the two highest quintile of ED-LOS for 30-day mortality. In patients not admitted to in-hospital care higher ED-LOS was associated with higher mortality. Our data suggest that increased ED-LOS could be associated with slightly increased short-term mortality in patients with lower clinical urgency and dismissed from the ED. [ABSTRACT FROM AUTHOR]

Despite its relevance for health and education, the neurocognitive mechanism of real-life self-control is largely unknown. While recent research revealed a prominent role of the ventromedial prefrontal cortex in the computation of an integrative value signal, the contribution and relevance of other brain regions for real-life self-control remains unclear. To investigate neural correlates of decisions in line with long-term consequences and to assess the potential of brain decoding methods for the individual prediction of real-life self-control, we combined functional magnetic resonance imaging during preference decision making with ecological momentary assessment of daily self-control in a large community sample (N = 266). Decisions in line with long-term consequences were associated with increased activity in bilateral angular gyrus and precuneus, regions involved in different forms of perspective taking, such as imagining one's own future and the perspective of others. Applying multivariate pattern analysis to the same clusters revealed that individual patterns of activity predicted the probability of real-life self-control. Brain activations are discussed in relation to episodic future thinking and mentalizing as potential mechanisms mediating real-life self-control. [ABSTRACT FROM AUTHOR]

Purpose: The introduction of hypofractionated stereotactic radiosurgery (hSRS) extended the treatment modalities beyond the well-established single-fraction stereotactic radiosurgery and fractionated radiotherapy. Here, we report the efficacy and side effects of hSRS using Cyberknife® (CK-hSRS) for the treatment of patients with critical brain metastases (BM) and a very poor prognosis. We discuss our experience in light of current literature. Methods: All patients who underwent CK-hSRS over 3 years were retrospectively included. We applied a surface dose of 27 Gy in 3 fractions. Rates of local control (LC), systemic progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan–Meier method. Treatment-related complications were rated using the Common Terminology Criteria for Adverse Events (CTCAE). Results: We analyzed 34 patients with 75 BM. 53% of the patients had a large tumor, tumor location was eloquent in 32%, and deep seated in 15%. 36% of tumors were recurrent after previous irradiation. The median Karnofsky Performance Status was 65%. The actuarial rates of LC at 3, 6, and 12 months were 98%, 98%, and 78.6%, respectively. Three, 6, and 12 months PFS was 38%, 32%, and 15%, and OS was 65%, 47%, and 28%, respectively. Median OS was significantly associated with higher KPS, which was the only significant factor for survival. Complications CTCAE grade 1–3 were observed in 12%. Conclusion: Our radiation schedule showed a reasonable treatment effectiveness and tolerance. Representing an optimal salvage treatment for critical BM in patients with a very poor prognosis and clinical performance state, CK-hSRS may close the gap between surgery, stereotactic radiosurgery, conventional radiotherapy, and palliative care. [ABSTRACT FROM AUTHOR]

Clay soil is typically an electrically charged porous tissue whose behaviour is dependent on possible variations in the composition and concentration of the interstitial water. Various complex mechanical impacts can be generated from the physicochemical reactions produced within the compact sets of elongated sheets, often called tactoids. If the chemistry of the used fluids varies appreciably, the natural response to cation exchange is affected, which results in intense physicochemical effects in the soil. In this article, five synthetic agents (Al2O3, Fe2O3, NaCl, CaCO3, and C2H5OH) were included in the kaolin, in different proportions, to explain the influence of the chemistry of these fluids on the chemical-mechanical behaviour of the clay soils. The artificial inclusion of these agents indicated specific changes in the material structure and the known paths of the fundamental Atterberg constants, ranging from the substantial reduction in plasticity according to the oxidizing agents to the considerable increase of this property monohydric solution. [ABSTRACT FROM AUTHOR]

In certain modeling approaches, activation analyses of task-based fMRI data can involve a relatively large number of predictors. For example, in the encoding model approach, complex stimuli are represented in a high-dimensional feature space, resulting in design matrices with many predictors. Similarly, single-trial models and finite impulse response models may also encompass a large number of predictors. In settings where only few of those predictors are expected to be informative, a sparse model fit can be obtained via L1-regularization. However, estimating L1-regularized models requires an iterative fitting procedure, which considerably increases computation time compared to estimating unregularized or L2-regularized models, and complicates the application of L1-regularization on whole-brain data and large sample sizes. Here we provide several functions for estimating L1-regularized models that are optimized for the mass-univariate analysis approach. The package includes a parallel implementation of the coordinate descent algorithm for CPU-only systems and two implementations of the alternating direction method of multipliers algorithm requiring a GPU device. While the core algorithms are implemented in C++/CUDA, data input/output and parameter settings can be conveniently handled via Matlab. The CPU-based implementation is highly memory-efficient and provides considerable speed-up compared to the standard implementation not optimized for the mass-univariate approach. Further acceleration can be achieved on systems equipped with a CUDA-enabled GPU. Using the fastest GPU-based implementation, computation time for whole-brain estimates can be reduced from 9 h to 5 min in an exemplary data setting. Overall, the provided package facilitates the use of L1-regularization for fMRI activation analyses and enables an efficient employment of L1-regularization on whole-brain data and large sample sizes. [ABSTRACT FROM AUTHOR]

Key message: We mapped the Rym14Hb resistance locus to barley yellow mosaic disease in a 2Mbp interval. The co-segregating markers will be instrumental for marker-assisted selection in barley breeding. Barley yellow mosaic disease is caused by Barley yellow mosaic virus and Barley mild mosaic virus and leads to severe yield losses in barley (Hordeum vulgare) in Central Europe and East-Asia. Several resistance loci are used in barley breeding. However, cases of resistance-breaking viral strains are known, raising concerns about the durability of those genes. Rym14Hb is a dominant major resistance gene on chromosome 6HS, originating from barley's secondary genepool wild relative Hordeum bulbosum. As such, the resistance mechanism may represent a case of non-host resistance, which could enhance its durability. A susceptible barley variety and a resistant H. bulbosum introgression line were crossed to produce a large F2 mapping population (n = 7500), to compensate for a ten-fold reduction in recombination rate compared to intraspecific barley crosses. After high-throughput genotyping, the Rym14Hb locus was assigned to a 2Mbp telomeric interval on chromosome 6HS. The co-segregating markers developed in this study can be used for marker-assisted introgression of this locus into barley elite germplasm with a minimum of linkage drag. [ABSTRACT FROM AUTHOR]

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Background: Circulating levels of TNF alpha receptor 1 (TNFR1) and 2 (TNFR2) are associated with increased long-term mortality and impaired kidney function. Aim: To study association between circulating levels of TNFR1 and TNFR2 and short-term mortality in patients with diabetes and dyspnea. Population and methods: Patients aged ≥ 18 years seeking at emergency department (ED) during daytime on weekdays between December 2013 and July 2018, with diabetes and acute dyspnea, identified at the triage process, were included. Participants (n = 291) were triaged according to Medical Emergency Triage and Treatment System-Adult score, and blood samples were collected. Association between TNFR1 and TNFR2, respectively, and 90-day mortality were estimated by Cox regression models adjusted for age, sex, BMI, creatinine and CRP. Results: Univariate models showed significant associations between TNFR1 and TNFR2, respectively, and CRP, age and creatinine. TNFR1 and TNFR2 tended to be elevated in patients with the highest triage level, compared to patients with lower triage levels (ns). In longitudinal analyses, TNFR1 but not TNFR2 was associated with increased short-term mortality, HR adjusted for age, BMI and creatinine 1.43 (95% CI 1.07–1.91), but not in the model also adjusted for CRP, HR 1.29 (95% CI 0.94–1.77). In secondary analysis for quartile 4 versus quartiles 1–3 of TNFR1, corresponding HRs were 2.46 (95% CI 1.27–5.15) and 2.21 (95% CI 1.07–2.56). Conclusions: We found a trend for the association between circulating TNFR1 levels and short-term mortality in patients with diabetes and acute dyspnea at the ED, possibly suggesting an inflammatory pathway for the association. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) and amino acid positron-emission tomography (PET) of the brain contain a vast amount of structural and functional information that can be analyzed by machine learning algorithms and radiomics for the use of radiotherapy in patients with malignant brain tumors. Methods: This study is based on comprehensive literature research on machine learning and radiomics analyses in neuroimaging and their potential application for radiotherapy in patients with malignant glioma or brain metastases. Results: Feature-based radiomics and deep learning-based machine learning methods can be used to improve brain tumor diagnostics and automate various steps of radiotherapy planning. In glioma patients, important applications are the determination of WHO grade and molecular markers for integrated diagnosis in patients not eligible for biopsy or resection, automatic image segmentation for target volume planning, prediction of the location of tumor recurrence, and differentiation of pseudoprogression from actual tumor progression. In patients with brain metastases, radiomics is applied for additional detection of smaller brain metastases, accurate segmentation of multiple larger metastases, prediction of local response after radiosurgery, and differentiation of radiation injury from local brain metastasis relapse. Importantly, high diagnostic accuracies of 80–90% can be achieved by most approaches, despite a large variety in terms of applied imaging techniques and computational methods. Conclusion: Clinical application of automated image analyses based on radiomics and artificial intelligence has a great potential for improving radiotherapy in patients with malignant brain tumors. However, a common problem associated with these techniques is the large variability and the lack of standardization of the methods applied. [ABSTRACT FROM AUTHOR]

Lake sediments, as an important emission source of nutrients and greenhouse gases, play a crucial role during the biogeochemical cycle processes. However, the impact mechanisms of different nutrient levels on greenhouse gas emission from lakes are still insufficient. In this study, the sediments from eight shallow lakes in the middle and lower reaches of the Yangtze River were cultured to study the release characteristics of greenhouse gases more than one month. Results showed that the greenhouse gases during the mineralization processes of sediments were mainly released to the atmosphere instead of being dissolved in the overlying water. The released concentrations of CH4 and CO2 were as high as 1 × 103 μmol L−1 in the later stage of the experiment, while the concentration of N2O was relatively low with a maximal value of about 10 μmol L−1. In addition, all the lake sediments displayed a nutrient release to the overlying water, where the concentrations of TC, TOC, TN, NH4+-N and TP were up to 173.0, 102.7, 36.7, 30.8 and 6.34 mg L−1, respectively. The nutrient levels of different lake sediments are symmetrical to the released nutrients concentrations in the overlying water. The further statistical analysis illustrated a synchronous nutrient controlled-release of greenhouse gases, that is, the higher the levels of nutrients in the sediments, the higher the concentrations of greenhouse gases released. These findings provide a better understanding that the control of endogenous nutrient levels of sediments is extremely important for lacustrine management, which can play a positive role in mitigating the greenhouse gas emissions from lake sediments. [ABSTRACT FROM AUTHOR]

Stereotactic radiosurgery (SRS) has evolved as widely accepted treatment option for small-sized (Koos I up to II) vestibular schwannoma (VS). For larger tumors (prevalent Koos VI), microsurgery or combined treatment strategies are mostly recommended. However, in patients not suited for microsurgery, SRS might also be an alternative to balance tumor control, hearing preservation and adverse effects. The purpose of this analysis was to evaluate the efficacy and toxicity of SRS for VS with regard to different Koos grades. All patients with untreated VS who received SRS at our center were included. Outcome analysis included tumor control, preservation of serviceable hearing based on median pure tone averages (PTA), and procedure-related adverse events rated by the Common Terminology Criteria for Adverse Events (CTCAE; v4.03) classification. In total, 258 patients (median age 58 years, range 21–84) were identified with a mean follow-up of 52 months (range 3–228 months). Mean tumor volume was 1.8 ml (range 0.1–18.5). The mean marginal dose was 12.3 Gy ± 0.6 (range 11–13.5). The cohort was divided into two groups: A (Koos grades I and II, n = 186) and B (Koos grades III and IV, n = 72). The actuarial tumor control rate was 98% after 2 years and 90% after 5 and 10 years. Koos grading did not show a significant impact on tumor control (p = 0.632) or hearing preservation (p = 0.231). After SRS, 18 patients (7%) had new transient or permanent symptoms classified by the CTCAE. The actuarial rate of CTCAE-free survival was not related to Koos grading (p = 0.093). Based on this selected population of Koos grade III and IV VS without or with only mild symptoms from brainstem compression, SRS can be recommended as the primary therapy with the advantage of low morbidity and satisfactory tumor control. The overall hearing preservation rate and toxicity of SRS was influenced by age and cannot be predicted by tumor volume or Koos grading alone. [ABSTRACT FROM AUTHOR]

Purpose: To provide detailed long-term data after initial observation for patients after histological confirmation of low grade (WHO II) gliomas according to molecular stratification. Methods: A series of 110 patients with watchful waiting strategy after initial surgery for LGG and re-surgery at tumor progression were analyzed. Progression-free survival, time to malignant transformation, post-recurrence survival, and overall survival were estimated with the Kaplan–Meier method. Prognostic factors were identified by the Log Rank test and Cox multivariate proportional hazards model. Results: The cohort comprised 18 IDH wild type (IDHwt) and 53 IDH mutated (IDHmut) astrocytomas, and 39 IDH mutated and 1p 19q co-deleted (IDHmut/codel) patients. The median follow-up was 126 (95% CI 109–143) months. Surgery was gross total resection in 58, subtotal resection in 28, and biopsy in 24 patients. Progression-free survival rates at 5, 10 and 15 years was 38% 18% and 1%. The corresponding malignant transformation rates were 17%, 39% and 71%. The initial extent of resection influenced progression-free survival, time to malignant transformation and overall survival. Molecular subtype IDHmut/codel was the strongest prognostic factor for overall survival and for time to malignant transformation. Conclusion: The strongest determinant of the patients' course after initial watchful waiting was the molecular tumor status. Extensive resection may increase time to progression and malignant transformation. Observation may be justified in selected patients. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated the feasibility, safety, and diagnostic yield of frame-based stereotactic biopsies (SB) in lesions located in deep-seated and midline structures of the brain to analyze these parameters in comparison to other brain areas. Patients and methods: In a retrospective, tertiary care single-center analysis, we identified all patients who received SB for lesions localized in deep-seated and midline structures (corpus callosum, basal ganglia, pineal region, sella, thalamus, and brainstem) between January 1996 and June 2015. Study participants were between 1 and 82 years. We evaluated the feasibility, procedural complications (mortality, transient and permanent morbidity), and diagnostic yield. We further performed a risk analysis of factors influencing the latter parameters. Chi-square test, Student t test, and Mann-Whitney rank-sum test were used for statistical analysis. Results: Four hundred eighty-nine patients receiving 511 SB procedures (median age 48.5 years, range 1–82; median Karnofsky Performance Score 80%, range 50–100%, 43.8% female/56.2% male) were identified. Lesions were localized in the corpus callosum (29.5%), basal ganglia (17.0%), pineal region (11.5%), sella (7.8%), thalamus (4.3%), brainstem (28.8%), and others (1.1%). Procedure-related mortality was 0%, and permanent morbidity was 0.4%. Transient morbidity was 9.6%. Histological diagnosis was possible in 99.2% (low-grade gliomas 16.2%, high-grade gliomas 40.3%, other tumors in 27.8%, no neoplastic lesions 14.5%, no definitive histological diagnosis 0.8%). Only the pons location correlated significantly with transient morbidity (p < 0.001). Conclusion: In experienced centers, frame-based stereotactic biopsy is a safe diagnostic tool with a high diagnostic yield also for deep-seated and midline lesions. [ABSTRACT FROM AUTHOR]

Phonon, electronic and thermoelectric transport properties of two-dimensional (2D) GaTe with hexagonal structure and monoclinic structure are investigated by using first-principles calculations. Stability of these structures are confirmed by phonon dispersion calculations. The hexagonal structure shows better thermoelectric properties because of its lower thermal conductivity, higher electrical conductivities and Seebeck coefficients. The maximum value of the figure of merit (ZT) for GaTe reaches 0.85 for hexagonal structure when T = 1100 K. This indicates that 2D GaTe will be useful in the field of thermoelectric applications. [ABSTRACT FROM AUTHOR]

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Rutin possesses a wide range of application prospects with various bioactivities. However, its bitter and water-insoluble properties restrict its application in the field of functional foods. A new complex of rutin and chitooligosaccharide (Rutin-COS) was prepared via spray-drying method (100 °C, 1 L/h) and freeze-drying method (-80 °C, 24 h), respectively. The water solubility, bitterness, antioxidant and antibacterial activities of Rutin-COS were evaluated, and the complexation of Rutin-COS was characterized by SEM, 1H-NMR and ROESY. Compared to freeze-drying method, spray-drying method was more effective for preparing stable Rutin-COS complex. The spray-dried Rutin-COS showed increased water solubility, weakened bitterness, enhanced antioxidant and antibacterial activity compared to rutin. The Rutin-COS complex was demonstrated to be formed through hydrogen bonds between the A, B rings of rutin and COS. [ABSTRACT FROM AUTHOR]

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Copyright of Wissen Kompakt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The compound, 5-aminolevulinic acid (5-ALA) is approved for fluorescence-guided resections of malignant gliomas in Europe and other countries for use in adults, but not for children. The application of 5-ALA in children remains an off-label use. Several case reports on fluorescence-guided surgery use in children have been published, yet no prospective study has been conducted. Here we systematically review the reported studies and discuss the usefulness, application, and safety of 5-ALA use in resection of pediatric brain tumors. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of postoperative fractionated local 3D-conformal radiotherapy (3DRT) of the resection cavity in brain metastases.Patients and Methods: Between 2011 and 2016, 57 patients underwent resection of a single, previously untreated (37/57, 65%) or recurrent (20/57, 35%) brain metastasis (median maximal diameter 3.5 cm [1.1-6.5 cm]) followed by 3DRT. For definition of the gross tumor volume (GTV), the resection cavity was used and for the clinical target volume (CTV), margins of 1.0-1.5 cm were added. Median dose was 48.0 Gy (30.0-50.4 Gy) in 25 (10-28) fractions; most patients had 36.0-42.0 Gy in 3.0 Gy fractions (n = 16, EQD210Gy 39.0-45.5 Gy) or 40.0-50.4 Gy in 1.8-2.0 Gy fractions (n = 37, EQD210Gy 39.3-50.0 Gy).Results: Median follow-up was 18 months. Local control rates were 83% at 1 year and 78% at 2 years and were significantly influenced by histology (breast cancer 100%, non-small lung cancer 87%, melanoma 80%, colorectal cancer 26% at 2 years, p = 0.006) and resection status (p < 0.0001), but not by EQD210Gy or size of the planning target volume (median 96.7 ml [16.7-282.8 ml]). At 1 and 2 years, 74% and 52% of the patients were free from distant brain metastases. Salvage procedures were applied in 25/27 (93%) of recurrent patients. Survival was 68% at 1 year and 41% at 2 years and was significantly improved in younger patients (p = 0.006) with higher Karnofsky performance score (p < 0.0001) and without prior radiotherapy (54% vs. 9% at 2 years, p = 0.006). No cases of radiographic or symptomatic radionecrosis were observed.Conclusion: Adjuvant fractionated local 3DRT is highly effective in radiosensitive, completely resected metastases and should be considered for treating large resection cavities as an alternative to postoperative stereotactic single dose or hypofractionated radiosurgery. [ABSTRACT FROM AUTHOR]

The implementation of self-reported outcome measurements into clinical routine was tested to help facilitate early access to palliative care (PC) for glioblastoma (GBM)-patients. Measures detail PC symptoms and concerns and caregiver burden. Between January 2014 and December 2016, a total of 337 GBM-patients were discussed during meetings of the neuro-oncology tumor board to examine further treatment options. Each patient, along with their caregivers, was requested to participate in self-assessment using the palliative outcome scale (POS) and the Zarit Burden Interview (ZBI). Analyses encompassed summary statistics, non-parametric tests, visual graphic analysis, content analysis and assessing the utilization of the specialized PC consulting service (SPCCS). Ninety-five (28%) GBM-patients and 71 (21%) caregivers completed the self-assessment. Of these, 20 patients and 12 caregivers repeated the assessment at least once more during follow-up. POS total scores were similar in the group of patients with initial diagnosis [10 (0-31)] and those with later disease stages like recurrent diagnosis [9 (0-25)], but ZBI total scores differed [14 (0-51) vs. 24 (2-62)]. Single item analysis demonstrated that anxiety and worries about the future predominated. Caregivers were torn between high engagement in caring and feeling overburdened. Still, requests for the SPCCS showed no increase. Actual implementation of measures like POS and ZBI for detecting PC concerns and caregiver burden with GBM-patients in the field remains challenging as indicated by the limited response rate and lack of increased requests for the SPCCS. Modified clinical routines including strengthening awareness of PC, and allowing proxy-assessment might help to overcome barriers. [ABSTRACT FROM AUTHOR]