In constant light, whole apples (cv. Red Spy) that received alternating 6/25°C treatment accumulated more phenylalanine ammonia-lyase (PAL) and anthocyanin than those receiving constant 25° throughout the course of experiment. The stimulatory effect of low temperature (6°) on the activity of PAL and synthesis of anthocyanin was also observed in the alternating light and dark experiment when low temperature was applied in the dark period. In constant light, the activity of phenylalanine ammonia-lyase inactivating system (PAL-IS) was lower in the apples that had received alternating 6/25° treatment than that in apples that had received constant 25°. When the apples were incubated in constant darkness, no accumulation of PAL and anthocyanin occurred but the level of PAL-IS increased steadily throughout the course of incubation. Nitrogen and potassium deficiency increased PAL accumulation and decreased accumulation of PAL-IS in the leaves of greenhouse-grown apple trees. PAL activity was found to be negatively correlated with activity of PAL-IS. It is therefore concluded that low temperature reduces the level of PAL-IS and increases the accumulation of PAL which in turn increase anthocyanin accumulation in the skin of whole apples, and that nitrogen and potassium deficiencies reduce the level of PAL-IS and hence increase the accumulation of PAL in apple leaves.

A 3 4 7 -A 7 6 6 EQ-5D record. Mean utility score for patients in progression-free and progressive disease state is 0.76 (95% CI 0.75, 0.77) and 0.69 (95% CI 0.66, 0.71), respectively. Mean utility showed a decrease on disease progression of 0.07, which is considered as clinically meaningful. Patients were split into five groups based on their time to death after the EQ-5D questionnaire was taken -over 360 days, 180-360 days, 90-180 days, 30-90 days, and under 30 days, and mean utility in each timeto-death category is 0.81(95% CI 0.79, 0.83),0.73 (95% CI 0.71, 0.75),0.69(95% CI 0.66, 0.72),0.60 (95% CI 0.56, 0.64) and 0.40 (95% CI 0.31, 0.48).the results showed a large decrease in utility in the 30 days prior to death. ConClusions: The results showed that quality of life for pre-treated advanced NSCLC patients rapidly deteriorates during the end of life period. Considerable deterioration of utility in NSCLC patients is associated with disease progression and time to death. The utility values estimated from the study will inform economic evaluations of treatments in pre-treated advanced NSCLC. PCN200

the model is useful in planning for SDN reliability in the presence of DDoS attacks while managing the overall cost.

Introduction Laryngomalacia has been associated with gastroesophageal reflux (GOR), which may cause adenotonsillar hypertrophy leading to early onset obstructive sleep apnoea (OSA). We aim to assess this proposed relationship, with adenoidectomy <4 years as our primary endpoint. Method 78 children seen in the airway clinic at the Glasgow Royal Hospital for Sick Children during September 2009 to August 2010 with a diagnosis of infantile laryngomalacia and for whom four years of follow up data was available were included, and their medical notes analysed. Results We found a significantly increased incidence of OSA in our cohort of 11.5%, compared to a reported population incidence of 0.7–1.8% (p = < 0.0001). The rate of adenoidectomy <4 years in this sample was 12.8%. We found that children who undergo adenoidectomy are more than 4x likely to also undergo a supraglottoplasty procedure than those who do not, 70% vs. 16.2% (p = 0.0008). Significant increase in the presence of neurodisability in the group of children who underwent an adenoidectomy was also seen, 40% vs. 2.9% (p = < 0.002). Conclusion Outcomes following adenoidectomy +/- tonsillectomy are suggestive of adenotonsillar hypertrophy being the leading cause of OSA. Our results also support an emerging link between GORD and OSA, as although there are a number of causes of adenotonsillar hypertrophy there was little evidence to suggest that any of these patients could have developed hypertrophy due to alternative mechanisms. Children with more severe laryngomalacia appear to be at higher risk of developing sleep disordered breathing symptoms, and subsequently requiring adenoidectomy.

No abstract

The t r i a l was designed to study the effectiveness of folded, high density polyethylene bags and sealed, high density polyethylene bags for maintaining the freshness of broccoli in waxed cartons and extending shelf life for exports. Four broccoli cultivars (cvv. Green Belt, Marathon, Skiff, and Shogun) were stored at 1�C for 3 weeks in folded, high density polyethylene bags. After storage, they were still green, compact, and marketable. After exposure to 26�C for another 2 days, most of the heads turned yellow and were unmarketable. Colour score and market quality were poorer in cv. Skiff than in the other 3 cultivars. Storage of broccoli in sealed, high density polyethylene bags retarded the yellowing after exposure to 26�C for 2 days and, hence, improved the market quality.

Objectives: Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer, with no US FDA approved treatment until 2017. Avelumab, a PD-L1 antibody, became the first FDA approved treatment for metastatic MCC (mMCC) in March 2017. Treatment guidelines from the National Comprehensive Cancer Network (NCCN) recommend CPIs including avelumab, nivolumab and pembrolizumab as treatment options for mMCC. This study is to assess the real-world treatment patterns and outcomes of mMCC patients receiving CPIs and chemotherapies. Methods: An observational study was conducted from March 1, 2015-December 31, 2017 using the Premier Healthcare Database (PHD). mMCC patients age $ 12 were identified by ICD-9/10 codes and included if the initial treatment received during the study period was a CPI or chemotherapy per NCCN guidelines. The initial treatment date served as the index date. Results: Thirty-seven mMCC patients received CPIs and 38 chemotherapy, with 84% of patients receiving platinum based chemotherapy. Baseline characteristics were similar between the CPI and chemotherapy group for age, race and Charlson comorbidity index, while the CPI group trended towards having more males and more patients with commercial insurance. More CPI patients stayed on treatments than the chemotherapy group at day 30 (68% vs. 53%, p,0.001), 60 (54% vs. 42%, p,0.001) and 90 (46% vs. 26%, p,0.001). By day 90, 74% of patients who started on chemotherapy switched to a different treatment in comparison to 54% of CPI patients (p,0.001). A comprehensive list of 47 adverse events commonly associated with CPIs and chemotherapies were studied, and the average number of AEs was 1.261.5 for the CPI group and 1.661.7 for the chemotherapy group (p=0.35). Conclusions: The availability of CPIs for mMCC patients is practice changing. CPI patients treated in hospital-based settings had longer time-on-treatment, less treatment switching, and trended towards fewer adverse events vs. chemotherapy.

A 7 1 9 -A 8 1 3 A743 were based on the 2013 utilisation volume data. Other local specific considerations e.g. subsidized selling prices and co-payments were included in the analyses for an assumed size of eligible patients. Sensitivity analyses were conducted. Results: The adoption rates of BIAsp were assumed to increase from 23.6% in 2013 to 30% or 36.5% in 2018 for base case and upside scenario, respectively. In comparison to base case scenario, increases in adoption rate of BIAsp were associated with a cumulative increase up to slightly greater than S$ 2.02M in insulin acquisition cost but a potential cumulative net saving up to approximately S$0.92M in overall total costs over 5 years, attributing to subsidized selling price of BIAsp assuming it is included standard drug list and its significantly lower major hypoglycaemia risk, respectively. Cost savings were predicted for other complications. ConClusions: The wider adoption of BIAsp was predicted to result in net cost savings from patient perspective in Singapore. More cost saving would be estimated in analyses with reduced productivity loss from a societal perspective.