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Introduction: The prognosis of patients with refractory or relapsed AML (R/R-AML) is very limited. To (re)achieve complete remission, there has recently been increasing evidence that the combination of venetoclax (VEN) with chemotherapy is associated with improved outcomes., Patients and Methods: Our retrospective, single-center study of 53 R/R-AML patients with a median follow-up time of 11.0 months compared standard salvage chemotherapy (FLAG-Ida or HAM in n = 35 patients) with a combination of venetoclax (VEN) and FLAG-Ida (FLAVIDA in n = 18 patients) concerning safety and efficacy., Results: Regarding the primary endpoints, there was a statistically significant increased event free survival (EFS) in the FLAVIDA group compared to patients with standard chemotherapy based on the univariate log-rank-test and in the multivariate Cox regression analysis (HR 0.22 [95% CI 0.05, 0.97]). There were no differences between the two groups in terms of patients developing febrile neutropenia CTCAE III° and IV° or a delay in hematological recovery. In addition, a clear trend towards an improved overall response rate (78% vs. 51%) was demonstrated in the FLAVIDA group., Conclusions: The FLAVIDA regimen represents a promising treatment alternative for R/R AML patients with a high response rate and significantly improved EFS compared to standard chemotherapy., (© 2024 The Author(s). European Journal of Haematology published by John Wiley & Sons Ltd.)

Background: Several clinical guidelines recommend chronic inhaled therapy for pwCF (people with cystic fibrosis) and chronic Pseudomonas aeruginosa infection of the lungs., Methods: To demonstrate what kind of therapy regimens are used in Germany, we retrospectively analysed chronic inhaled antibiotic therapy within the cohort of the German CF Registry in 2020. For comparison we also analysed the use of inhaled antibiotics in pwCF with intermittent Pseudomonas or without Pseudomonas infection., Results: A total of 1960 pwCF had chronic P. aeruginosa infection and were retrospectively evaluated. Almost 90% (n = 1751) received at least one inhaled antibiotic. The most commonly used inhaled antibiotic was colistin solution for inhalation (55.2%), followed by aztreonam solution for inhalation (32.6%) and tobramycin solution for Inhalation (30%). Almost 56% of adults and 44% of children alternated two antibiotics for inhalation. In children, alternating colistin + tobramycin was the most often used regimen. In adults, only 23% used colistin + tobramycin; there was a wide range of treatment regimens among adults using two inhaled antibiotics alternately. 2456 pwCF had no Pseudomonas infection, but almost 24% had a chronic inhaled antibiotic therapy, while 56% of 361 pwCF and intermittent chronic Pseudomonas infection had a chronic inhaled antibiotic therapy., Conclusion: In all three groups the most commonly used inhaled antibiotic was colistin solution for inhalation. Almost 56% of adults and 44% of children with chronic Pseudomonas infection alternated two antibiotics for inhalation. It will be interesting to see how the introduction of the highly effective modulator elexacaftor/tezacaftor/ivacaftor will change the use of inhaled antibiotics., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Cooperation should only evolve if the direct and/or indirect benefits exceed the costs. Hence, cooperators are expected to generate selective benefits for themselves and the kin-group while defectors will impose costs. The subsocial spider, Australomisidia ergandros, shows consistent cooperation and defection tactics while foraging. Cooperative individuals are consistently likely to share prey with other group members whereas defector spiders rarely share the prey they acquired. Here, we assess costs and benefits of cooperation, and the causal determinants behind cooperative and defective phenotypes. We constructed experimental kin-colonies of A. ergandros composed of pure cooperative or defector foragers and show that pure cooperative groups had higher hunting success as they acquired prey more quickly with greater joint participation than pure defector groups. Importantly, defectors suffered higher mortality than cooperators and lost considerable weight. A social network approach using subadult spiders revealed that foraging tactic is sex dependent with males cooperating more frequently than females. Our results provide a rare empirical demonstration of sex-specific male cooperation that confer individual and kin-group benefits., (© 2023. The Author(s).)

Background: Pulmonary disease is the major cause for morbidity and mortality in cystic fibrosis (CF). In CF, forced expiratory volume in 1 s (FEV1) referenced against a healthy population (FEV1%predicted) and body mass index (BMI) do not allow for the comparison of disease severity across age and gender., Objectives: We aimed to determine updated FEV1 and BMI percentiles for patients with CF and to study their dependence on mortality attrition., Methods: Age- and height-adjusted FEV1 and BMI percentiles for CF patients aged 6-50 years were calculated from 4,947 patients of the German CF Registry for the period 2016-2019 utilizing quantile regression and a Generalized Additive Model for Location, Scale and Shape (GAMLSS). Further, survival-adjusted percentiles were estimated., Results: In patients with CF, FEV1 increased throughout childhood until maximal median values at 16 years in females (2.46 L) and 18 years in males (3.27 L). During adulthood, FEV1 decreased substantially. At 17 years of age, the 25th BMI percentile of patients with CF (females 18.50 and males 18.15 kg/m2) was below the 10th BMI percentile of the German reference cohort. From the age of 20 years, survival (96.3%) decreased tremendously. At 50 years of age (survival 15.0%), the 50th CF-specific FEV1 or BMI percentile among the survivors corresponded to the 92.5th percentile among the total CF birth cohort., Conclusions: Continuously updated disease-specific FEV1 and BMI percentiles with correction for survival may serve as age-independent measure of disease severity in CF (accessible via https://cfpercentiles.statup.solutions)., (© 2023 S. Karger AG, Basel.)

Background: In cystic fibrosis, adequate nutrition contributes to good long-term prognosis. A body mass index (BMI) at or above the 50th percentile for age and sex in all children has been recommended. As researchers have described a depletion of fat-free mass despite normal BMI, longitudinal studies using more sensitive nutritional parameters are warranted. We evaluated anthropometric measurements in an attempt to identify early indicators of deteriorating nutritional status in our paediatric cohort., Methods: We analysed datasets from children and adolescents between 2 and 17.9 years with at least two entries for triceps skinfold thickness and upper arm circumference in our patient database between January 1995 and December 2018. Arm muscle area (AMA) was calculated, and all values were expressed as z-scores from CDC growth charts., Results: A total of 4,862 encounters from 161 paediatric patients (78 girls) were available, representing a median number of 28 visits during a median follow-up of 8.1 years per patient. Linear mixed effects models revealed relatively stable courses for weight, height, BMI and skinfold thickness up to adulthood. AMA was the only parameter which declined slightly (r = -0.036), particularly in boys. Kaplan-Meier-analyses showed that AMA was the earliest parameter to decrease below -1 z-score between 6 and 18 years., Conclusions: The present data suggest that compared with weight or BMI, AMA could serve as an earlier indicator of a deteriorating nutritional status. The benefit of assessing skinfold thickness and arm circumference routinely and calculating AMA from these measurements should be evaluated in large, prospective, multi-centre studies., Competing Interests: Declaration of Competing Interest Helmut Ellemunter reports personal fees from Vertex Pharmaceuticals, outside the submitted work. Markus Dumke reports honoraria of CF-TEAM Forschung, Innsbruck to STAT-UP, for statistical analysis during the conduct of the study. Gratiana Steinkamp reports fees for scientific work from CF-TEAM Forschung, Innsbruck during the conduct of the study., (Copyright © 2021. Published by Elsevier B.V.)

Abstract: Reference values are important for patient care as well as for comparisons between different centers or countries. We investigated two anthropometric reference datasets, the US Centers for Disease Control (CDC) growth charts and the German Health Interview and Examination Survey for Children and Adolescents Study (KiGGS) percentiles, which were established in Germany between 2003 and 2006. A smaller proportion of children with cystic fibrosis had decreased z scores <-2 with CDC (5.0% for weight and 3.0% for height) compared to KiGGS (7.4% for weight and 6.3% for height) values (P < 0.0001). Median z scores were higher using the CDC reference data. Thus, the choice of growth reference is important, may influence clinical management and must be considered when comparing the outcomes of different institutions., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

In groups of socially foraging animals, feeding behaviour may change with group size in response to varying cost-benefit trade-offs. Numerous studies have described group-size effects on group-average feeding behaviour, particularly emphasizing an increase in scrounging incidence for larger groups, where individuals (scroungers) feed from the food sources others (producers) discovered. However, individual variation in feeding behaviour remains unconsidered in the vast majority of these studies even though theoretical models predict individuals to specialize in feeding tactic and anticipate higher scrounger-type frequencies in larger groups. We combined group-level and individual-level analyses of group-size effects on social foraging in the subsocial spider Australomisidia ergandros Lending novel experimental support to model predictions, we found that individuals specialize in feeding tactic and that higher scrounging and lower producing incidence in larger groups were mediated through shifts in the ratio of feeding types. Further, feeding-type specialization was not explained by innate individual differences in hunting ability as all feeding types were equally efficient in prey capture when foraging alone. Context adaptivity of feeding behaviour might allow this subsocial species to succeed under varying socioecological conditions., (© 2016 The Author(s).)

We have detected extraplanar cold dust at distances out to >10 kiloparsecs, situated in the halo of the interacting galaxy NGC 4631. The dust emission disk is much thinner than the warped HI disk, and new structures emerge. In particular, a giant arc has been found that is linked to anomalies in the kinematical structure of the atomic gas. Most of the extraplanar dust is closely associated with HI spurs that have been found earlier [Weliachew, L., Sancisi, R. & Guelin, M. (1978) Astron. Astrophys. 65, 37-45; Rand, R. J. (1994) Astron. Astrophys. 285, 833-856]. These spurs obviously are traces of the interaction [Combes, F. (1978) Astron. Astrophys. 65, 47-55]. The dust emission within the plane reaches the border of the optical disk. The activity of the disk of NGC 4631 is moderately enhanced by the interaction, but no gas moving in the z-direction could be found [Rand, R. J., Kulkarni, S. R. & Hester, J. J. (1992) Astrophys. J. 396, 97-103; Golla, G., Dettmar, R.-J. & Domgorgen, H. (1996) Astron. Astrophys. 313, 439-447]. Hence, it seems unlikely that strong winds have deposited the high-z dust. Instead, the coincidence with the HI features suggests that we see a track left behind by the interaction. In addition, the HI shows a supershell formed by an impact [Rand, R. J. & Stone, J. M. (1996) Astron. J. 111, 190-196] in the zone where the dust trail crosses the disk. This region is also characterized by disturbances in the distribution of the Halpha light. The masses associated with the dust can be estimated only very roughly on the basis of the existing data; they are of the order of a few 10(9) M middle dot in circle of gas.