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Oncological studies have shown that patients consider small benefits sufficient to make adjuvant chemotherapy worthwhile. We sought to determine the minimal survival benefits that patients considered enough to legitimate allogeneic haematopoietic stem cell transplantation (HCT) and the factors associated with patient preferences. One hundred eighty-four patients having previously received allogeneic HCT at our centre were included and completed a questionnaire exploring patient expectations elicited by time trade-off scenarios as well as quality of life (QoL), symptoms of graft-versus host disease (GvHD) and sociodemographic characteristics. The majority of patients considered a minimal survival benefit of at least 5 (38.6%) or 10 years (41.9%) sufficient to justify HCT, with less than 5% considering survival p = 0.007) and cure rates (p = 0.0001); that is, younger patients at HCT were more likely to accept smaller survival and cure rates. Pre-transplant risk score, QoL, GvHD score and sociological factors did not seem to influence patients’ expectations. In conclusion, patient expectations of treatment were much higher than what had been reported in oncological studies. Patients who experienced HCT considered a survival superior to 1 year and cure rates above 50% sufficient to make it worthwhile. Younger patients were more likely to accept smaller benefits; no other predictors for preferences could be detected.

The world population is increasing rapidly together with the demand for healthy fresh food. Greenhouse industry can play an important role, but encounters difficulties finding skilled staff to manage crop production. Artificial intelligence (AI) reaches breakthroughs in several areas, however, not yet in horticulture. An international competition on “autonomous greenhouses” aims in combining horticultural expertise with AI to make breakthroughs in fresh food production with fewer resources. Five international teams with different background in horticulture and AI participated in a growing experiment. Each team had a 96-m2 modern greenhouse compartment at WUR to grow remotely a cucumber crop ('Hi-Power') during a 4-months period. Each compartment was equipped with standard actuators and sensors, heating, ventilation, screening, artificial lighting, fogging, CO2 supply and irrigation. Climate control set points were remotely determined by teams using own AI algorithms, actuators were operated by a climate and irrigation process computer. Additionally, teams sent instructions for the crop pruning strategy. Measurements and set points were exchanged via a digital interface. Achievements in AI-controlled compartments were compared with a reference compartment, operated manually by three commercial growers. Teams used additional individually chosen sensors such as RGB or thermal cameras, temperature-humidity-light-sensor-networks, root-zone sensors, sap-flow meters or crop-weighing sensors. Teams' strategies for remote control ranged from supervised, unsupervised and reinforcement machine learning. Teams were judged and received points on several aspects: 50% for net profit, 20% for sustainability indicators, energy- and water-use-efficiency and CO2 consumption, 30% for their artificial intelligence algorithms, novelty, level of autonomous control, robustness and scalability. The results obtained by different teams in terms of climate and growing strategies, different resource use efficiency and net profit are presented in this paper. One of the AI-controlled compartments achieved overall better results than the manual grown reference compartment.

Greenhouses and indoor farming systems play an important role in providing fresh and nutritious food for the growing global population. Farms are becoming larger and greenhouse growers need to make complex decisions to maximize production and minimize resource use while meeting market requirements. However, highly skilled labor is increasingly lacking in the greenhouse sector. Moreover, extreme events such as the COVID-19 pandemic, can make farms temporarily less accessible. This highlights the need for more autonomous and remote-control strategies for greenhouse production. This paper describes and analyzes the results of the second &ldquo, Autonomous Greenhouse Challenge&rdquo, In this challenge, an experiment was conducted in six high-tech greenhouse compartments during a period of six months of cherry tomato growing. The primary goal of the greenhouse operation was to maximize net profit, by controlling the greenhouse climate and crop with AI techniques. Five international teams with backgrounds in AI and horticulture were challenged in a competition to operate their own compartment remotely. They developed intelligent algorithms and use sensor data to determine climate setpoints and crop management strategy. All AI supported teams outperformed a human-operated greenhouse that served as reference. From the results obtained by the teams and from the analysis of the different climate-crop strategies, it was possible to detect challenges and opportunities for the future implementation of remote-control systems in greenhouse production.

Outcomes of hematopoietic stem cell transplantation (HSCT) are influenced by comorbidities, disease type, and status at transplantation. Several prognostic scores can be used, such as the disease risk index (DRI) or the hematopoietic cell transplantation-specific comorbidity index (HCT-CI). Recently, a new prognostic tool, the disease risk comorbidity index (DRCI), combining the DRI and the HCT-CI, was published. The DRCI determines 6 patient groups (very low risk [VLR], low risk [LR], intermediate risk 1 [IR-1], intermediate risk 2 [IR-2], high risk [HR], and very high risk [VHR]) with a significant predictive value for overall survival (OS), disease-free survival (DFS), relapse incidence (RI), and graft-versus-host disease-free/relapse-free survival (GRFS). However, the DRCI has not been evaluated for patients allografted with partially in vitro T cell depleted (pTDEP) grafts. In our center, we offer pTDEP to reduce graft-versus-host disease for patients in complete remission at transplant time. In this retrospective study, we investigated the DRCI in 404 adult patients (including 37.6% pTDEP) undergoing a first HSCT for hematological malignancies from 2008 to 2018. Because of the small number of patients in LR, VLR and LR were combined for analysis. In the entire cohort, 2-year OS was 84.4% (95% CI, 71.6% to 97.2%) for LR, 61.6% (54.8% to 68.4%) for IR-1, 45.7% (33.3% to 58.1%) for IR-2, 31% (19.4% to 42.6%) for HR, and 30.9% (14.5% to 47.3%) for VHR (P < .001). In addition, the DRCI was predictive of DFS, RI, and GRFS but not of nonrelapsed mortality and graft-versus-host disease. Our study confirms similar results with the original publication but gives less accurate prognosis information than the DRI and HCT-CI when used separately. In conclusion, the DRCI does not seem to offer more relevant information than the DRI and HCT-CI to help physicians and patients for the HSCT decision.

This report details the activities carried out in 2019 in the KB DDHT project 8 “Exploring the potential of non-destructive and non-invasive sensor technologies in food supply chains”. It compiles all four deliverables of this project as a single narrative. There are five case studies at the core of this project which address animal welfare, indoor farming, inspection of fresh food products, personalized nutrition advise and food fraud detection. Multiple activities were planned in these case studies with main focus on sensor technologies for non-destructive and non-invasive sensing. One of the key activities was to conduct a survey of sensor technologies applicable and potentially suitable for each case study. In addition, for each case study, one or more experiments were conducted which involved data acquisition using novel sensors as well as building knowledge on data analysis of data from the new sensors. Furthermore, as one of the goal of this project is to explore new sensor technologies, it is expected that this project will generate valuable data. Therefore, focus was also on FAIR data sharing and management. A workshop was organized in collaboration with WDCC on this topic. Most of the case studies also aligned with OnePlanet Research centre, and as a result multiple experiments are in planning for 2020 in cooperation with OnePlanet.

Introduction Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established therapeutic modality for a variety of hematological malignancies and congenital disorders. One of the major complications of the procedure is graft-versus-host-disease (GVHD) initiated by T cells co-administered with the graft. Removal of donor T cells from the graft is a widely employed and effective strategy to prevent GVHD, although its impact on post-transplant immune reconstitution might significantly affect anti-tumor and anti-infectious responses. Several approaches of T cell depletion (TCD) exist, including in vivo depletion using anti-thymocyte globulin (ATG) and/or post-transplant cyclophosphamide (PTCy) as well as in vitro manipulation of the graft. In this work, we analyzed the impact of different T cell depletion strategies on immune reconstitution after allogeneic HSCT. Methods We retrospectively analysed data from 168 patients transplanted between 2015 and 2019 at Geneva University Hospitals. In our center, several methods for TCD are being used, alone or in combination: 1) In vivo T cell depletion using ATG (ATG-Thymoglobulin 7.5 mg/kg or ATG-Fresenius 25 mg/kg); 2) in vitro partial T cell depletion (pTCD) of the graft obtained through in vitro incubation with alemtuzumab (Campath [Genzyme Corporation, Cambridge, MA]), washed before infusion and administered at day 0, followed on day +1 by an add-back of unmanipulated grafts containing about 100 × 106/kg donor T cells. The procedure is followed by donor lymphocyte infusions at incremental doses starting with 1 × 106 CD3/kg at 3 months to all patients who had received pTCD grafts with RIC in the absence of GVHD; 3) post-transplant cyclophosphamide (PTCy; 50 mg/kg) on days 3 and 4 post-HSCT. Absolute counts of CD3, CD4, CD8, CD19 and NK cells measured by flow cytometry during the first year after allogeneic HSCT were analyzed. Measures obtained from patients with mixed donor chimerism or after therapeutic DLI were excluded from the analysis. Cell numbers during time were compared using mixed-effects linear models depending on the TCD. Multivariable analysis was performed taking into account the impact of clinical factors differing between patients groups (patient's age, donor type and conditioning). Results ATG was administered to 77 (46%) patients, 15 (9%) patients received a pTCD graft and 26 (15%) patients received a combination of both ATG and pTCD graft. 24 (14%) patients were treated with PTCy and 26 (15%) patients received a T replete graft. 60% of patients had a reduced intensity conditioning (RIC). 48 (29%) patients received grafts from a sibling identical donor, 94 (56%) from a matched unrelated donor, 13 (8%) from mismatched unrelated donor and 13 (8%) received haploidentical grafts. TCD protocols had no significant impact on CD3 or CD8 T cell reconstitution during the first year post-HSCT (Figure 1). Conversely, CD4 T cells recovery was affected by the ATG/pTCD combination (coefficient ± SE: -67±28, p=0.019) when compared to the T cell replete group (Figure 1). Analysis of data censored for acute or chronic GVHD requiring treatment or relapse revealed a delay of CD4 T cell reconstitution in the ATG and/or pTCD treated groups on (ATG:-79±27, p=0.004; pTCD:-100±43, p=0.022; ATG/pTCD:-110±33, p Conclusion Our results indicate that all TCD protocols with the only exception of PTCy are associated with a delayed recovery of CD4 T cells whereas pTCD of the graft, alone or in combination with ATG, significantly improves NK and B cell reconstitution. Figure 1 Disclosures No relevant conflicts of interest to declare.

Background: The AML EBMT Cytogenetic Risk score is a new prognostic model recently published (Canaani et al. Leukemia. 2019 Aug;33(8):1944-1952; Nagler el al. Am J Hematol. 2020 Jun 12) combining cytogenetics and FLT3ITD status for AML patients in complete remission (CR) at transplant time. The AML EBMT Cytogenetic Risk score is prognostic for leukemia-free survival (LFS), overall survival (OS), GVHD-free/relapse-free survival (GRFS) and cumulative incidence of relapse (CIR). In our centre, we frequently offer in-vitro partial T-cell depleted graft (pTDEP) for patient in CR to decrease morbidity and mortality associated with graft-versus-host disease (GvHD). Currently, The AML EBMT Cytogenetic Risk score has not been evaluated in this population. Aims: We investigate the impact of the AML EBMT Cytogenetic Risk score for 3 years OS, LFS, GRFS, CIR and NRM in a cohort with patients allografted with pTDEP graft. Methods: All consecutive ≥18 years patients who received a first allograft for AML between 2008 and 2018 with data available to determine The AML EBMT Cytogenetic Risk score in CR at transplant time were included. OS and LFS were investigated with the Kaplan-Meier method and we used the cumulative incidence estimator as defined by Fine and Gray to calculate CIR (with NRM as competing event), NRM (with relapse as competing event) and GvHD (with relapse as competing event). Results: 135 patients were included, median age at transplant time was 56 years (range: 19-74), 44% were female, median Karnofsky index was 90 (80-100). 21% of graft were from HLA identical, 57% from matched unrelated donor, 10% from mismatched unrelated donor and 12% from haploidentical donor. Stem cell source was peripheral blood in 89% and bone marrow in 11%. Partial in-vitro T-cell depletion (pTDEP) was performed in 40% of HSCT. Reduced-intensity (RIC) was performed in 62%. Median follow-up was 3.1 year (range 1.3-10 years) for living patients. Among the 135 patients, 4 (3%) were assigned in the favourable (Fav), 58 (43%) in the intermediate/FLT3wt (Int/FLT3wt), 36 (27%) in the intermediate/FLT3ITD (Int/FLT3ITD), and 37 (27%) in the adverse (adv) risk group. 3-years OS for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 75% (32-100%), 65% (52-77%), 60% (43-77%) and 28% (10-45%), respectively (p=0.033) (Fig 1A). 3-years LFS for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 75% (95%CI: 32-100%), 60% (47-73%), 49% (32-66%) and 25% (8-42%), respectively (p=0.028) (Fig 1B). 3-years GRFS for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 75% (32-100%), 45% (31-58%), 39% (22-55%) and 14% (0-27%), respectively (p=0.008) (Fig 1C). 3-years CIR for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 0%, 22% (11-33%), 31% (15-47%) and 56% (37-75%), respectively (p=0.02). 3-years NRM for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 25% (95%CI: 0-75%), 17% (7-28%), 21% (6-35%) and 17% (2-32%), respectively (p=0.92). 3-years grade 2-4 aGVHD for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 0%, 35% (22-47%), 19% (2-36%) and 42% (25-58%), respectively (p=0.46). 3-years cGVHD for Fav, Int/FLT3wt, Int/FLT3ITD and Adv was 25% (95%CI: 0-75%), 17% (6-27%), 22% (7-38%) and 21% (6-35%), respectively (p=0.9). In addition to The AML EBMT Cytogenetic Risk score, variables with a significance in univariate for OS with a p-value ≤0.1 (Karnofsky index [ Conclusion: In the analysis of our retrospective cohort including 40% of pTDEP patients, we confirm that the AML EBMT cytogenetic risk is prognostic for relevant outcomes (OS, LFS, GRFS, CIR) of HSCT. Similarly with recently published data, we confirm this prognostic model can help physicians and patients in transplant choice and remains valid for patients undergoing HSCT with in-vitro graft manipulation. Disclosures No relevant conflicts of interest to declare.

The most recent literature on CO2 use by plants was examined. Already much is known on photosynthesis and CO2 assimilation. Genetic modification was shown to boost photosynthesis by 20%. Naturally, the plant adapts to CO2 concentration. Also in sweet pepper and tomato crops adaptation to lower CO2 levels were observed, yet the extend and the rate of adaptation is hard to predict. The gathered knowledge was used to simulate crop growth at various supply strategies of CO2. The goal was to reduce CO2 dosing while maintaining an economically viable tomato yield. Simulations showed that under normal light conditions the crop can maximally assimilate 15 kg CO2 m-2, while conventional CO2 dosage is more than triple resulting in much loss to the air. Continuous applications of 50 kg CO2 ha-1 hr-1 led to a yield reduction of 20% relative to 200 kg CO2. Further model wise optimization of the CO2 dosing resulted in much lower CO2 losses while reducing fruit yield with only 2%. In this scenario only 13 kg CO2 m-2 j-1 was supplied, at 450 ppm during roof opening of >10%. A further optimization was enabled by allowing a 2° higher ventilation temperature. The results give options for a much lower CO2 dosage in practice than currently used. De meest recente vakliteratuur omtrent CO2-benutting door planten is onderzocht. Over de fotosynthese en CO2-processen in planten is al zeer veel bekend. Deze kennis maakt het mogelijk in te grijpen in de genetica met fotosynthesetoenamen tot wel 20%. Plantaanpassing aan gewijzigde CO2-concentraties is natuurlijk en ook voor paprika en tomaat bekend, hoewel de mate en snelheid van adaptatie nog lastig te voorspellen is. De verworven kennis is gebruikt om de gewasgroei te modelleren voor diverse CO2-doseerstrategieën op zoek naar een sterk verhoogde CO2-benutting zonder oogstreductie. De berekeningen laten zien dat een onbelichte tomatenteelt jaarlijks maximaal 15 kg CO2 kan vastleggen, terwijl gangbare doseringen het drievoudige bedragen waarbij dus veel CO2 verloren gaat. Uit modelverkenningen met diverse niveaus van continue CO2-giften bleek dat bij een erg lage doseercapaciteit van 50 kg ha-1 uur-1 gedurende de lichtperiode het minste CO2-verlies optrad maar wel een 20% lagere gewasgroei gaf dan een capaciteit van 200 kg. Verdere optimalisatie van de CO2-dosering gaf veel minder CO2-verliezen en een productieverlies van slechts 2%. Dit kwam tot stand met een jaargift van 13 kg CO2 m-2 j-1 met lage doseersnelheid en slechts 450 ppm CO2 tijdens raamstanden>10%. Een vrij kleine verdere optimalisatie is mogelijk door een 2° verhoogde ventilatietemperatuur. De resultaten geven een goede leidraad voor een demonstratieproef in de praktijk.

The global population is increasing rapidly, together with the demand for healthy fresh food. The greenhouse industry can play an important role, but encounters difficulties finding skilled staff to manage crop production. Artificial intelligence (AI) has reached breakthroughs in several areas, however, not yet in horticulture. An international competition on &ldquo, autonomous greenhouses&rdquo, aimed to combine horticultural expertise with AI to make breakthroughs in fresh food production with fewer resources. Five international teams, consisting of scientists, professionals, and students with different backgrounds in horticulture and AI, participated in a greenhouse growing experiment. Each team had a 96 m2 modern greenhouse compartment to grow a cucumber crop remotely during a 4-month-period. Each compartment was equipped with standard actuators (heating, ventilation, screening, lighting, fogging, CO2 supply, water and nutrient supply). Control setpoints were remotely determined by teams using their own AI algorithms. Actuators were operated by a process computer. Different sensors continuously collected measurements. Setpoints and measurements were exchanged via a digital interface. Achievements in AI-controlled compartments were compared with a manually operated reference. Detailed results on cucumber yield, resource use, and net profit obtained by teams are explained in this paper. We can conclude that in general AI performed well in controlling a greenhouse. One team outperformed the manually-grown reference.