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In future 6G wireless networks, it is important to ensure that equal opportunity is offered to citizens and businesses regardless of location with a dynamic and efficient expansion of the infrastructure. Dynamic coverage and connectivity extension mechanisms exploiting multiple types of Mobile Access Points (MAPs) during a short amount of time for covering areas that cannot be easily reached, are developed by DEDICAT 6G project. This service is called Coverage Extension as a Service (CEaaS). This paper proposes a system architecture for CEaaS and the functionalities that the DEDICAT 6G platform will offer. This includes context awareness (i.e. knowledge about users and technology recognition), coverage extension decision making (i.e. MAP and swarm operation) and network operation decision making (i.e. MAP-user association and radio access technology selection). Furthermore, performance results of DEDICAT 6G framework for CEaaS are presented.

Pallavi Mishra,1 Ajay S Vamadevan,1,2 Ambuj Roy,3 Rohit Bhatia,4 Nitish Naik,3 Sandeep Singh,3 Gideon Senyo Amevinya,5 Ernest Amoah Ampah,5 Yolanda Fernandez,6 Caroline Free,7 Amos Laar,5 Dorairaj Prabhakaran,1,8,9 Pablo Perel,6 Helena Legido-Quigley10,11 1Health Systems Unit, Centre for Chronic Disease Control, New Delhi, India; 2Goa Institute of Management, Goa, India; 3Department of Cardiology, All India Institute of Medical Science, New Delhi, India; 4Department of Neurology, All India Institute of Medical Science, New Delhi, India; 5Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana; 6Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK; 7Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK; 8Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; 9Research and Policy, Public Health Foundation of India, Gurugram, India; 10Saw Swee Hock School of Public Health, National University of Singapore, Singapore; 11Department of Health Services Research & Policy, London School of Hygiene and Tropical Medicine, London, UKCorrespondence: Pablo PerelCentre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, WC1E 7HT, UKTel +44 20 7636 8636Email Pablo.Perel@lshtm.ac.ukIntroduction: In 2016, cardiovascular diseases (CVDs) led to 17.9 million deaths worldwide, representing 31% of all global deaths. CVDs are the leading cause of mortality worldwide and significant barriers to achieving the sustainable development goals. Modern medicines have been significant in improving health outcomes. However, non-adherence to medication is one of the reasons behind adverse health-related outcomes among patients suffering from atherosclerotic cardiovascular disease in low- and middle-income countries.Patients and Methods: This qualitative study was conducted at two tertiary care hospitals in India and Ghana. A total of 35 in-depth interviews were conducted with atherosclerosis cardiovascular disease (ASCVD) patients. The data were analysed thematically using the Capability Opportunity and Motivation (COM-B) framework.Findings: The findings were summarised under three important broad themes of the COM-B framework: capability, opportunity and behaviour. Under capability, comprehension of disease, medication schedule, and unplanned travel affected adherence among patients. Cost of medication, insurance and access were the critical factors under opportunity, which negatively influenced medication adherence. Mood, beliefs about treatment and outcome expectations under motivation led to non-adherence among patients. Apart from these factors, some important health system factors such as health care experience and trust in the facilities and reliance on alternative medication also affected adherence in both countries.Conclusion: This study has highlighted that the health system factors have dominantly influenced adherence to medication in India and Ghana. In India, we found participants to be satisfied with their health care provided at the government hospitals. However, limited time for consultation, lack of well-stocked pharmacy and unclear prescription negatively influenced adherence among participants in India and Ghana. The study emphasises that the health system needs to be strengthened, and the patients’ belief system needs to be explored to address the issue of medication adherence in LMICs.Keywords: non-communicable diseases, atherosclerotic cardiovascular disease, public health, qualitative research

Purpose: To investigate patterns of short- and long-term variations in corneal epithelial thickness (CET) after myopic laser in situ keratomileusis (LASIK) using anterior segment optical coherence tomography (AS-OCT) combined with Placido disk-based topography. Methods: In this retrospective study, 36 subjects (72 eyes) who underwent LASIK myopic surgery and 53 healthy subjects (106 eyes) who served as controls were enrolled. AS-OCT (MS-39) was performed in all patients before, 1 day, 1 month, and 6 months after surgery. Statistical analysis was performed to analyze CET changes over time after LASIK and to detect patterns of definitive CET remodeling compared to healthy subjects. Multivariate analysis was performed to look for possible predictors of final CET. Results: There was no statistically significant difference between groups in terms of demographic and anterior segment parameters (all P > 0.05). After LASIK, all sectors and rings got thicker over time (1.62–8.32 μm; P < 0.01). Except for the central sector, all areas achieved the thickest CET value one day after surgery with a progressive epithelial thinning between 1 and 6 months of follow-up. Changes on CET occurred independently of the grade of myopia before LASIK or final refraction (P > 0.05). None of the clinical variables studied, including diopters corrected, were found to be correlated with final CET (P > 0.05). Conclusion: Independent of anterior segment parameters and diopters corrected, CET becomes thicker after LASIK surgery. Central and inner ring sectors thicken more than those more peripheral. CET remodeling after myopic LASIK should be taken into consideration when planning refractive surgery.

Background: Otitis media prevalence is high for Australian Aboriginal and Torres Strait Islander children and associated with developmental impacts. Access to allied health services can also be challenging for Aboriginal and Torres Strait Islander families. To address this, the Family-Centred Consultation Model (FCCM) was developed. The FCCM involved three main components in a ‘cycle of care’: (1) a pre-session phone-call between the allied health professional (AHP) and parent/carer; (2) a face-to-face session; and (3) a follow-up phone-call.Method: The FCCM was trialled in a hearing and development clinic incorporating audiology, speech pathology and occupational therapy services, and co-located within an Aboriginal and Torres Strait Islander primary health service. This study used a qualitative description approach to explore the perceptions and experiences of parents/carers (n = 11) and AHPs (n = 3) in accessing or delivering services using the FCCM.Results: Parents/carers felt comfortable with the FCCM and perceived it to be responsive to their needs. AHPs perceived it was both rewarding and challenging, and enabled holistic, flexible and customised services.Conclusion: This study highlights the potential for brief intervention and family-centred approaches to enhance service accessibility for some Aboriginal and Torres Strait Islander consumers.

This deliverable reports the activity conducted in the work package 4 on the design and development of mechanisms for the dynamic coverage and connectivity extension through the exploitation of innovative devices (e.g., drones, robots, connected cars, other mobile assets like forklifts in a warehouse, etc.). The objective is to enable the dynamic, opportunistic set up of dynamic coverage and connectivity extensions for covering areas that cannot be easily reached, where infrastructure is required only for a finite, short amount of time, or where regular network infrastructure has been damaged e.g., due to terrorist actions or natural disasters. The document starts from an update of the state of the art for coverage extension (on Mobile Access Point (MAP), decision making exploiting MAP, knowledge and context/situation awareness, Radio Access Network (RAN) management and network management and orchestration) and benchmarks the project’s investigation against the state of the art. For example, a large volume of research has been conducted in recent years on MAP. DEDICAT 6G is focusing on four use cases: Smart Warehousing with the utilization of Automated Guided Vehicle (AGV) and mobile asset for improving operations, Enhanced experiences with dynamic MAPs closer to moving audiences, Public safety with the utilization of diverse assets (Drones, AGVs, etc.) and Smart highway with the use of cars and roadside infrastructures. Second, DEDICAT 6G proposes preliminary considerations to harmonize the research and development of innovative mechanisms for coverage extension. On the one hand, D4.1 deliverable recalls DEDICAT 6G network architecture and the functional and non-functional requirements defined in WP2 and maps the mechanisms for dynamic coverage and connectivity extensions to the functional model. On the other hand, D4.1 discusses about design considerations and modelling methodologies. It describes the prototypes in terms of Software / Hardware (e.g., robots, drones, cars, IoT devices) used to validate the technology enablers in the Proof of Concept (PoC) and relevant models to align the simulation frameworks parameters such as deployment scenarios, traffic models and channel models. Finally, D4.1 presents preliminary studies/implementation of strategies for dynamic coverage and connectivity extension (e.g., strategies to deploy MAPs, to manage MAPs, to associate users to MAPs, to count people with IoT devices). For example, DEDICAT 6G investigates different strategies which can be applied at RAN level to extend the coverage of the network by means of MAPs. This includes complex optimization problems aiming to decide the optimal number of MAP entities to deploy, the optimal positions of MAPs in continuous space, the configuration of the radio network of the MAP, the dynamic association of multiple users to multiple access points and the finding of the nearest docking station for charging to provide the required coverage and connectivity extension and to ensure the QoS expected by the mobile nodes.

Background: Phthiriasis palpebrarum is an eyelid involvement secondary to an infestation of the eyelids by Phthirus pubis and has a low incidence. Case presentation: A 7-year-old male child presented in the emergency room at Henares Hospital in Madrid (Spain) with a history of repeated episodes of itchiness, blepharitis, warmth sensation, and moderate discomfort of 2 months duration in both eyes. Slit-lamp examination revealed lice and nits at the roots of the eyelashes. Many treatments have been described for the treatment of phthiriasis pubis. In this case, mechanical removal and treatment with vaseline ointment were performed. Conclusion: A careful slit-lamp examination to identify the nits and lice in the eyelashes and careful removal is necessary for the best evolution.

Leisure participation is a key occupation of childhood, providing opportunities for engaging in preferred activities and interests, relaxation, socialisation, and development of skills and strengths outside of the ‘academic’ and ‘productivity’ domains. It has been demonstrated that children with developmental disabilities do not participate in leisure activities to the same extent as their peers; and when they do, these are more home-based, sedentary, solitary and not necessarily activities they prefer. This disparity with peers increases over time, leading to lower leisure participation rates in the adolescent and adult years. The purpose of this doctoral project was to explore and understand the community leisure participation of a group of children whose needs have received relatively little research attention – children with occupational performance and participation challenges, whose difficulties are not recognised as part of an identified disability or health condition. For the purpose of this thesis, these children are defined as children who experience functional difficulties in their ability to perform and participate in the everyday activities they need and want to do, such as self-care, productivity, social relationships, play and leisure (children’s occupations); however, their difficulties and needs are not recognised as part of an identified disability or health condition. An improved understanding of the meaning and experience of leisure participation for this group of children will help address their needs by identifying factors that support their participation in and enjoyment of leisure, in order to sustain this over the longer term. Specific research aims were:1. To examine and better understand the leisure participation of these children, including their leisure participation profile, parent priorities and goals, and child and parent aspirations for future community leisure participation.2. To observe and explore the children’s participation in a supported community leisure program designed in collaboration with occupational therapy.3. To explore, in-depth, the experiences and perceptions of these children and their parents regarding community-based leisure participation broadly, following their supported leisure participation experience.4. To investigate how an opportunity to participate in a supported community leisure program impacts these children and their parents, and whether it has potential to act as a bridge towards their further community participation. This study utilised a mixed methods approach with a convergent design. Purposeful sampling was used to recruit 20 children, aged 5 to 10 years, with occupational performance and participation challenges, and their parent/s, from two occupational therapy services in Brisbane, Australia. A key part of being involved in this research study was for children to participate in a supported leisure program, Circus Club, which was designed in partnership with occupational therapy and based within a natural community setting. This program sought to provide children with the opportunity to participate in a positive leisure experience within a fun, non-competitive, social environment, while also promoting physical activity and skill development. Data were collected using child and parent questionnaires and assessments, observations of children during participation in Circus Club, and semi-structured in-depth interviews with children and parents. Findings indicate that, although children had an interest and desire to participate in community-based leisure activities, this was often compromised by a range of developmental, personal, activity and environmental factors. Past negative experiences, lack of suitable community programs, and parental concerns about their child not keeping up or not being supported appropriately were identified as key barriers. Findings also suggest that these children are at risk of having their needs unrecognised or downplayed simply because they do not have a clear diagnosis and thus, do not qualify for additional support. Facilitating ‘just right’ challenges, connections with others, having fun, and a supportive coaching style were found to be powerful enablers of a positive leisure experience for children with occupational performance and participation challenges. Importantly, this study found that the supported leisure program, Circus Club, appeared to provide children and parents with a positive participatory experience from which they indicated they could move onto other community participation. This study contributes to and builds upon existing research by bringing attention and further understanding to the leisure participation needs of children with occupational performance and participation challenges, whose difficulties are not recognised as part of an identified disability or health condition. Frameworks such as the International Classification of Functioning, Disability and Health, and the Person-Environment-Occupation model, together with the tenets of Self-Determination Theory, can assist occupational therapists to identify and promote factors that support more meaningful and positive leisure participatory experiences to meet the needs, goals, skills, and abilities of all children. Participation-focused interventions that embed rehabilitation and health goals within natural community leisure settings are discussed. Recommendations for the design and delivery of more inclusive community leisure program options are also presented. This requires a collaborative approach with partnerships between families, health practitioners, leisure coaches and community organisations. ​​​​​​​

Hematopoietic Stem and Progenitor Cells are crucial in the maintenance of lifelong production of all blood cells. These Stem Cells are highly regulated to maintain homeostasis through a delicate balance between quiescence, self-renewal and differentiation. However, this balance is altered during the hematopoietic recovery after Hematopoietic Stem and Progenitor Cell Transplantation. Transplantation efficacy can be limited by inadequate Hematopoietic Stem Cells number, poor homing, low level of engraftment, or limited self-renewal. As recent evidences indicate that estrogens are involved in regulating the hematopoiesis, we sought to examine whether natural estrogens (estrone or E1, estradiol or E2, estriol or E3 and estetrol or E4) modulate human Hematopoietic Stem and Progenitor Cells. Our results show that human Hematopoietic Stem and Progenitor Cell subsets express estrogen receptors, and whose signaling is activated by E2 and E4 on these cells. Additionally, these natural estrogens cause different effects on human Progenitors in vitro. We found that both E2 and E4 expand human Hematopoietic Stem and Progenitor Cells. However, E4 was the best tolerated estrogen and promoted cell cycle of human Hematopoietic Progenitors. Furthermore, we identified that E2 and, more significantly, E4 doubled human hematopoietic engraftment in immunodeficient mice without altering other Hematopoietic Stem and Progenitor Cells properties. Finally, the impact of E4 on promoting human hematopoietic engraftment in immunodeficient mice might be mediated through the regulation of mesenchymal stromal cells in the bone marrow niche. Together, our data demonstrate that E4 is well tolerated and enhances human reconstitution in immunodeficient mice, directly by modulating human Hematopoietic Progenitor properties and indirectly by interacting with the bone marrow niche. This application might have particular relevance to ameliorate the hematopoietic recovery after myeloablative conditioning, especially when limiting numbers of Hematopoietic Stem and Progenitor Cells are available.

Children with developmental disabilities participate in more solitary, sedentary, and home-based leisure activities than active physical pursuits or community-based activities. Clinical experience suggests that children with less well-recognized developmental difficulties also have compromised leisure experiences; however, this has not been fully investigated. This study engaged 20 school-age children with developmental difficulties in a community-based circus program, designed in collaboration with occupational therapists. The program included activities such as trampolining, trapeze, and acrobatics. Semi-structured interviews with children and parents explored children's leisure experiences both at circus and more broadly. Qualitative content analysis revealed that friendships, having fun, and being physically active were highly valued aspects of leisure. The coaching style and “just right” level of challenge within programs were identified as central to children's engagement and sense of competence. Participating in a supported leisure program such as circus appeared to promote children's engagement in community leisure, at least in the short term.

Summary Background Seasonal malaria chemoprevention (SMC) aims to prevent malaria in children during the high malaria transmission season. The Achieving Catalytic Expansion of SMC in the Sahel (ACCESS-SMC) project sought to remove barriers to the scale-up of SMC in seven countries in 2015 and 2016. We evaluated the project, including coverage, effectiveness of the intervention, safety, feasibility, drug resistance, and cost-effectiveness. Methods For this observational study, we collected data on the delivery, effectiveness, safety, influence on drug resistance, costs of delivery, impact on malaria incidence and mortality, and cost-effectiveness of SMC, during its administration for 4 months each year (2015 and 2016) to children younger than 5 years, in Burkina Faso, Chad, The Gambia, Guinea, Mali, Niger, and Nigeria. SMC was administered monthly by community health workers who visited door-to-door. Drug administration was monitored via tally sheets and via household cluster-sample coverage surveys. Pharmacovigilance was based on targeted spontaneous reporting and monitoring systems were strengthened. Molecular markers of resistance to sulfadoxine–pyrimethamine and amodiaquine in the general population before and 2 years after SMC introduction was assessed from community surveys. Effectiveness of monthly SMC treatments was measured in case-control studies that compared receipt of SMC between patients with confirmed malaria and neighbourhood-matched community controls eligible to receive SMC. Impact on incidence and mortality was assessed from confirmed outpatient cases, hospital admissions, and deaths associated with malaria, as reported in national health management information systems in Burkina Faso and The Gambia, and from data from selected outpatient facilities (all countries). Provider costs of SMC were estimated from financial costs, costs of health-care staff time, and volunteer opportunity costs, and cost-effectiveness ratios were calculated as the total cost of SMC in each country divided by the predicted number of cases averted. Findings 12 467 933 monthly SMC treatments were administered in 2015 to a target population of 3 650 455 children, and 25 117 480 were administered in 2016 to a target population of 7 551 491. In 2015, among eligible children, mean coverage per month was 76·4% (95% CI 74·0–78·8), and 54·5% children (95% CI 50·4–58·7) received all four treatments. Similar coverage was achieved in 2016 (74·8% [72·2–77·3] treated per month and 53·0% [48·5–57·4] treated four times). In 779 individual case safety reports over 2015–16, 36 serious adverse drug reactions were reported (one child with rash, two with fever, 31 with gastrointestinal disorders, one with extrapyramidal syndrome, and one with Quincke's oedema). No cases of severe skin reactions (Stevens-Johnson or Lyell syndrome) were reported. SMC treatment was associated with a protective effectiveness of 88·2% (95% CI 78·7–93·4) over 28 days in case-control studies (2185 cases of confirmed malaria and 4370 controls). In Burkina Faso and The Gambia, implementation of SMC was associated with reductions in the number of malaria deaths in hospital during the high transmission period, of 42·4% (95% CI 5·9 to 64·7) in Burkina Faso and 56·6% (28·9 to 73·5) in The Gambia. Over 2015–16, the estimated reduction in confirmed malaria cases at outpatient clinics during the high transmission period in the seven countries ranged from 25·5% (95% CI 6·1 to 40·9) in Nigeria to 55·2% (42·0 to 65·3) in The Gambia. Molecular markers of resistance occurred at low frequencies. In individuals aged 10–30 years without SMC, the combined mutations associated with resistance to amodiaquine (pfcrt CVIET haplotype and pfmdr1 mutations [86Tyr and 184Tyr]) had a prevalence of 0·7% (95% CI 0·4–1·2) in 2016 and 0·4% (0·1–0·8) in 2018 (prevalence ratio 0·5 [95% CI 0·2–1·2]), and the quintuple mutation associated with resistance to sulfadoxine–pyrimethamine (triple mutation in pfdhfr and pfdhps mutations [437Gly and 540Glu]) had a prevalence of 0·2% (0·1–0·5) in 2016 and 1·0% (0·6–1·6) in 2018 (prevalence ratio 4·8 [1·7–13·7]). The weighted average economic cost of administering four monthly SMC treatments was US$3·63 per child. Interpretation SMC at scale was effective in preventing morbidity and mortality from malaria. Serious adverse reactions were rarely reported. Coverage varied, with some areas consistently achieving high levels via door-to-door campaigns. Markers of resistance to sulfadoxine–pyrimethamine and amodiaquine remained uncommon, but with some selection for resistance to sulfadoxine–pyrimethamine, and the situation needs to be carefully monitored. These findings should support efforts to ensure high levels of SMC coverage in west and central Africa. Funding Unitaid.

BACKGROUND: Tracheal intubation failure in patients with difficult airway is still not uncommon. While videolaryngoscopes such as the Glidescope offer better glottic vision due to an acute-angled blade, this advantage does not always lead to an increased success rate because successful insertion of the tube through the vocal cords may be the limiting factor. We hypothesize that combined use of Glidescope and fiberscope used only as a dynamic guide facilitates tracheal intubation compared to a conventional Glidescope technique with a preshaped nondynamic stylet. METHODS: One hundred sixty adult patients with predicted difficult airway were randomly assigned to a conventional Glidescope (standard Glidescope group) or a combined Glidescope + fiberscope group intubation. In the Glidescope + fiberscope group under direct vision from the Glidescope, tracheal intubation was performed using the fiberscope as a guide without using fiberoptic vision, while in the standard Glidescope group, a conventional stylet-guided intubation technique was performed. We evaluated the rate of tracheal intubation success at first attempt as the primary end point (Fisher exact test). The difference between groups in airway injury, time to successful intubation, and the need for an alternative technique was also evaluated. RESULTS: First-attempt intubation success was higher in the Glidescope + fiberscope group than in the standard Glidescope group (91% vs 67%; P = .0012; fragility index, 8; absolute risk reduction, 24% [95% CI, 12%-36%]). Median time to successful tracheal intubation was shorter in the Glidescope + fiberscope group (50 vs 64 seconds; P = .035). Airway injury rate was lower in the Glidescope + fiberscope group than in the standard Glidescope group (1% vs 11%; P = .035; fragility index, 1; absolute risk reduction, 10% [95% CI, 3%-18%]). Alternative rescue technique requirements to achieve tracheal intubation were higher in the standard Glidescope group (24% vs 4%; P < .001; fragility index, 7). CONCLUSIONS: The use of a dynamic, flexible guide during a Glidescope laryngoscopy in patients with a predicted difficult airway compared to a standard intubation technique improves first-attempt intubation success, decreases the incidence of airway injury and time to successful intubation, as well as the need of an alternative technique to succeed.

e14034 Background: Cancer patients under cytotoxic treatment with fever used to have an average time of antibiotics administration of 11h (median 3h43min) when admitted and identified at the Emergency Room Service in the third level Central University Hospital of Asturias. International guidelines recommend antibiotic administration in the first hour: the so called “Golden Hour”. This delay implies an increase in patient morbidity as well as the cost of managing this complication. Methods: Data was collected from our electronic registry after proper authorization and corresponding anonymization. Pareto and fishbone diagrams were built to point out the possible causes and to stratify them in related subgroups. We measured: Number of visits to ER with fever and Number of inpatients with Febrile Neutropenia diagnosis, Time from the admission to antibiotic administration, Average stay of inpatients with Febrile Neutropenia diagnosis. A protocol associated to electronic tools and validated international scores was designed for patients at Febrile Neutropenia risk and launched on March 2019. Results: 66 patients were included since January 2018. Baseline data showed that the median time to antibiotics indication was 3h50min (average 4h38min) with a median delay of 18min to the administration (average 1h06min), a median of 3h54min (average 10h09min) time to antibiotic administration. When the protocol was activated, median time to antibiotic indication was 30min (average (1h08min) with a median 41min (average 40min) delay in administration, and a median of 1h30min (average 1h42min) time to antibiotic administration. Those with activation of the protocol had average length of stay of 1d13h40min vs. 5d11h18min in those to whom this protocol was not applied. Conclusions: A continuous evaluation effort and the design of appropriate protocols and interventions will increase the efficiency of the oncology patient care process with febrile neutropenia, by reducing unnecessary variability and costs.

TPS6109 Background: Advanced endometrial cancer (EC) patients relapse despite treatment with combination chemotherapy and have a short progression-free survival (PFS). Data from the TGCA suggest opportunities to targeting DNA repair in women with EC. Particularly type 4 (High copy number or serous like, with frequent TP53 mutations) and type 2 (microsatellite instability hypermutated) EC can be associated with defects in double strand break DNA repair by homologous recombination (HR) and could potentially be targeted by olaparib. We propose a placebo-controlled, multicenter, two-arm, phase II trial comparing olaparib versus placebo in maintenance therapy after chemotherapy in patients with advanced/metastatic EC. Methods: The primary objective of this trial is to evaluate the efficacy of maintenance olaparib in comparison to placebo after platinum based chemotherapy, defined by PFS according to Recist. Key eligibility criteria include: advanced/metastatic histologically confirmed EC (excepted carcino-sarcoma, small cells& neuroendocrine); prior surgery, adjuvant chemotherapy, radiation and hormonal therapy are permitted; objective or stable response after first-line chemotherapy is mandatory. 147 patients are randomized (2:1) after chemotherapy to receive Olaparib 300mg twice daily or placebo in maintenance after at least 4 cycles of platinum based chemotherapy. Olaparib/placebo is continued until disease progression, unacceptable toxicity, or withdrawal. Stratification is on IHC P53 and MMR status. Primary hypothesis is a 66.7% relative increase in the median PFS rate in the olaparib arm (from 4.5 to 7.5 months), corresponding to a 0.60 Hazard Ratio. Secondary endpoints include PFS according to P53, MMR and NGS HRD status, PFS2, disease specific survival, time to subsequent therapy, overall survival, objective response, disease control rate, patient reported outcomes (assessed via EORTC QLQ-C30 and EORTC QLQ-EN24, EORTC-FA, EQ5D) and safety. Trial is recruiting in France (in February n= 40 randomization). Conclusion: this will be the first study that evaluate the efficacy of olaparib in maintenace after chemotherapy in advanced/metastastic EC, stratified on molecular profil. Clinical trial information: NCT03745950.