A Comprehensive, FAIR File Format for Neuroanatomical Structure Modeling

With advances in microscopy and computer science, the technique of digitally reconstructing, modeling, and quantifying microscopic anatomies has become central to many fields of biological research. MBF Bioscience has chosen to openly document their digital reconstruction file format, the Neuromorphological File Specification, available at www.mbfbioscience.com/filespecification (Angstman et al., 2020). The format, created and maintained by MBF Bioscience, is broadly utilized by the neuroscience community. The data format's structure and capabilities have evolved since its inception, with modifications made to keep pace with advancements in microscopy and the scientific questions raised by worldwide experts in the field. More recent modifications to the neuromorphological file format ensure it abides by the Findable, Accessible, Interoperable, and Reusable (FAIR) data principles promoted by the International Neuroinformatics Coordinating Facility (INCF; Wilkinson et al., Scientific Data, 3, 160018,, 2016). The incorporated metadata make it easy to identify and repurpose these data types for downstream applications and investigation. This publication describes key elements of the file format and details their relevant structural advantages in an effort to encourage the reuse of these rich data files for alternative analysis or reproduction of derived conclusions.

UV/Vis absorption spectroelectrochemistry of folic acid

UV/Vis absorption spectroelectrochemistry is a very promising analytical technique due to the complementary information that is simultaneously obtained from electrochemistry and spectroscopy. In this work, this technique is used in a parallel configuration to study the oxidation of folic acid in alkaline medium. Herein, UV/Vis absorption spectroelectrochemistry has been used to detect both the oxidation products and the folic acid consumed at the electrode/solution interface, allowing us to develop an analytical protocol to quantify vitamin B9 in pharmaceutical tablets. Linear ranges of three orders of magnitude have been achieved in basic medium (pH = 12.9), obtaining high repeatability and low detection limits. The spectroelectrochemical determination of folic acid in pharmaceutical tablets at alkaline pH values is particularly interesting because of the changes that occur in the optical signal during the electrochemical oxidation of FA, providing results with very good figures of merit and demonstrating the utility and versatility of this hyphenated technique, UV/Vis absorption spectroelectrochemistry.

Clinical risk factors for early mortality in patients with community-acquired septic shock. The importance of adequate source control

OBJECTIVE

To evaluate the incidence and risk factors for early mortality (EM) in the ICU in patients with community-acquired septic shock (CASS).

DESIGN

A retrospective cohort study of patients with CASS admitted to the ICU (2003-2016).

SETTING

ICU at a University Hospital in Spain.

PATIENTS

All consecutive patients admitted to the ICU with CASS.

INTERVENTIONS

None.

MAIN VARIABLES OF INTEREST

CASS was defined according to the Sepsis-3 definitions. EM were defined as occurring within of 72h following ICU admission. A multinomial logistic regression analysis was performed to identify the risk factors associated with early deaths.

RESULTS

During the study period, 625 patients met the Sepsis-3 criteria and admitted with CASS. 14.4% of all patients died within the first 72h. Of 161 patients who died in the ICU, 90 (55.9%) died within the first 72h. The percentage of early and late mortality did not vary significantly during the study period. The need and adequacy of source control were significantly lower in patients with EM. In the multivariate analysis, ARDS, non-respiratory infections, bacteremia and severity at admission were variables independently associated with EM. The only factor that decreased EM was adequate source control in patients with infections amenable to source control.

CONCLUSIONS

The incidence of EM has remained stable over time, which means that more than half of the patients who die from CASS do so within the first 72h. Infections where adequate source control can be performed have lower EM.

Co-designing a training package to promote health/oral health for people experiencing homelessness

Background

In Scotland, 31,333 households were assessed as experiencing homelessness in 2019/20. This population present high morbidity and mortality which is a public health issue. Their health needs have been identified within Scottish policy as part of the broad goal of reducing inequalities and poverty. Those experiencing homelessness face multiple exclusions that must be addressed by practitioners from all health and social care sectors. Frontline staff have identified they often do not have adequate information and/or training on wider health issues linked with their client's needs. The aim of this research is to co-produce training resources to support front-line staff to discuss and to promote health and oral health.

Methods

Community-based participatory research that used online workshops to listen to the views of people with lived experience, practitioners and students from health and third sector, and policy makers regarding accessibility of services and practitioner approach towards those experiencing homelessness. Content analysis will be used to identified recurrent themes.

Results

The preliminary findings shown that lack of empathy from practitioners, continuity of care and stigma are barriers to access services. This is informing a co-designed knowledge exchange training packaged to help practitioners to improve knowledge and ability to promote health/oral health and to engage with people experiencing homelessness or at risk of becoming homeless. Educational materials (e-book on health promotion, comics books on barriers to access services, and a guide to promote oral health) compose this training package.

Conclusions

The training package allows adaptations to different settings and contexts and will be an important resource to be used by practitioners from different fields to prevent and tackle homelessness. Participants are sharing important views related to the need of a human rights and social justice-based approach to health promotion.

Key messages

Development of a co-designed knowledge exchange training package to improve practitioners' knowledge and ability to communicate and to engage with people experiencing homelessness. To empower people experiencing homelessness regarding positive health/oral health behavior change.

Healthcare needs of young people transitioning back to the community after a custodial sentence

Background

People in prison have poorer health outcomes than the general population, added by the long-term impact of incarceration on mortality. Young people in custody face extra challenges associated with the stage of development. There is a lack of a tailored approach and policy to young people when transitioning back to the community. This paper draws from a PhD research that looked at the challenges to access healthcare during the transition back to the community. The specific question is: What are young people's healthcare needs when released from custodial sentences?

Methods

An ethnographic study conducted in Scotland in partnership with a community-based organisation. The participants were eight young people and ten practitioners that work in health and social care. Participatory observation and in-depth interviews were used to collect data during July 2019 and March 2020. Data analysis was conducted with Reflexive thematic analysis. NVivo supported data management.

Results

The identified needs were individualised issues, structural factors, mental health, substance use and geographical disposition of services. There is a need for mental support and continuity of care associated with substance use. The demand for local services is vital for healthcare provision. Healthcare needs go beyond the necessity of services and health issues. They are associated with stigma in the interaction with practitioners. Institutional practices and practitioners' attitudes reinforce non-explicit forms of discrimination and health inequalities.

Conclusions

Practitioners and policymakers need to focus on the person-centred approach. They need to listen to young people. Data showed a need for specific services, like mental health and drug use. Moreover, practitioners need to avoid stigmatisation and discrimination by a caring practice. Public health and social care policies need to address stigma and access to services for young people after a custodial sentence.

Key messages

It is necessary to avoid stigmatisation and improve access to services for young people transitioning back to the community after a custodial sentence. Public Health and social care policies need to address this marginalised group by offering person-centred approaches, continuity of care and support during re-entry.

Altered atrial restitution dynamics and refractoriness in metabolic syndrome due to up-regulation of potassium repolarizing currents increases susceptibility to atrial fibrillation

Background

Metabolic alterations, such as Metabolic Syndrome (MS), describe an association of factors including diabetes, hypertension, obesity and dyslipidemia, linked to higher risk and prevalence of overall cardiovascular disease, arrhythmogenesis and sudden cardiac death. Obese and diabetic patients have shown an increased risk for developing atrial fibrillation (AF). However, underlying mechanisms are not understood.

Purpose

To study the effects of MS and obesity remodeling in atrial restitution dynamics, frequency-dependent adaptation, refractoriness and its potential susceptibility to AF.

Methods

Electrophysiological experimental data from High-fat (HF-O, standard rabbit chow with an additional 15% fat) and Hig-fat High-Sucrose Metabolic Syndrome (HFHS-MS, 10% hydrogenated coconut oil and 5% lard, 15% high-sucrose dissolved in water) rabbit models were used to adjust computational models atrial electrophysiology remodeling under each condition. Additionally, isoproterenol and AF conditions were considered to challenge both in-silico models. Validation and sensitivity analysis were performed for each model parameters. Computational simulations in conditions of pacing at different pacing cycle lengths was assessed at 100, 125, 150, 200, 250, 350, 450, 500, 650, 750, 850, 1000 ms. Restitution dynamics were automatically determined and analyzed, as well as restitution slopes and presence of automaticity, early after-depolarizations, alternans and cardiac arrhythmia induction.

Results

Shortening of action potential duration and refractoriness in the left atrium was observed under HFHS-MS. Upstroke velocity, maximum excitability and sodium availability were altered both in HF-O and HFHS-MS. HF-O remodeling showed presence of alternans at high pacing frequencies. Repolarization restitution was shortened in conditions of ISO and MS-AF. Restitution slopes were >1 in HF-O and HFHS-MS, which was correlated to higher susceptibility to AF, and further increased in MS-AF. Under MS-AF, abbreviation in APD in both atria, resulted in increased reentrant frequencies in AF, which was exacerbated under IK1 up-regulation, increasing atrial vulnerability.

Conclusions

HFHS-MS underlies modifications in atrial electrophysiology including shorter refractoriness in HFHS-MS, as well as modifications in atrial excitability, which may be pro-arrhythmic mainly at high frequency rates. This could be explained in part by an up-regulation of outward potassium channels. These results could partially explain increased susceptibility for AF in MS.

Funding Acknowledgement

Type of funding sources: None.

Long-term outcomes among a cohort of 4296 implantable cardioverter-defibrillator patients: insights from the UMBRELLA study

Background

Large observational real-world studies describing modern implantable cardioverter-defibrillator (ICD) populations with long-term follow-up are lacking.

Purpose

To assess the incidence of arrhythmias in a cohort of contemporary patients undergoing ICD implant from 2005 and 2017 and to analyze the arrhythmic risk and mortality according to their clinical profiles.

Methods

UMBRELLA (NTC01561144) is a prospective, multicentre, nationwide study of ICD patients followed by remote monitoring. All device information was automatically stored through the remote monitoring system and a blinded review of all the stored arrhythmic episodes was performed. The study outcomes were first appropriate ICD therapy and all-cause death.

Results

The study population consisted of 4296 patients (61.9±12.9 years, ischaemic cardiomyopathy (ICM): n=2150, dilated cardiomyopathy (DCM): n=1166, valvular heart disease (VHD): n=119, hypertrophic cardiomyopathy (HCM): n=294, arrhythmogenic right ventricular cardiomyopathy (ARVC): n=71, Brugada syndrome (BS): n=143, long QT syndrome (LQTS): n=43, and adult congenital heart disease (ACHD): n=60)). Primary prevention (PP) was the main indication (n=2758).

During a mean follow-up of 46.6±27.3 months, 16,067 episodes of sustained ventricular arrhythmia (SVA) occurred in 1344 patients. Appropriate ICD therapy was delivered to 85.7% (n=13,767) episodes of SVA in 1173 patients (27.3% of population). A higher risk of first appropriate ICD therapy was observed in VHD (HR: 1.94, 95% CI: 1.43–2.62), ARVC (HR: 1.84, 95% CI: 1.28–2.66), ICM (HR: 1.51, 95% CI: 1.29–1.78), and DCM (HR: 1.28, 95% CI: 1.07–1.53) whereas patients with HCM (HR: 0.72, 95% CI: 0.54–0.96) and BS (HR: 0.25, 95% CI: 0.14–0.45) were at significantly lower risk (Figure 1A). In multivariate analysis (Table 1), age, gender, atrial fibrillation (AF), secondary prevention, LVEF ≤35%, and QRS width emerged as clinical predictors of appropriate ICD therapy, whereas CRT-D correlated with lower risk. An independently higher risk was found in DCM, VHD, and ARVC, and a lower risk in BS patients.

At follow-up, 590 deaths (13.4% of population) were reported. Patients with ICM (HR 3.90, 95% CI: 2.58–5.90), DCM (HR 3.33, CI 95%: 2.18–5.10), and VHD (HR 3.97, CI 95%: 2.25–6.99) had worse prognoses and it was significantly better in BS patients (HR 0.11, 95% CI: 0.01–0.67, p=0.017) (Figure 1B). In multivariate analysis, age, gender, AF, renal failure, diabetes and reduced LVEF, emerged as independent predictors of all-cause death (Table 1).

Conclusions

Irrespective of the aetiology, contemporary ICD patients with an arrhythmic substrate derived from left ventricular systolic dysfunction had a similar risk of ICD life-saving interventions and death.

Funding Acknowledgement

Type of funding sources: None. Table 1Figure 1

Craniopharyngioma, Chronotypes and Metabolic Risk Profile

Aim: To investigate the potential association among Craniopharyngioma (CP), chronotypes and metabolic risk profile. Subjects and Methods: The study population included 28 patients (46.4% males; 42.6 ± 15.8 years) and 28 controls, age, gender and BMI matched (46.4% males; 46.5 ± 12.9 years). In this study sample, we evaluated: anthropometric measurements (waist circumference, WC; BMI), plasma glucose, lipid profile, and systolic (SBP) and diastolic (DBP) blood pressure. Morningness-Eveningness was measured with the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), which included 19 questions about preferred sleep time and daily performance. Results: in both patients and controls grade I obesity was detected in 15 subjects (53.6%), grade II obesity in 13 subjects (46.4%). In the patient group, the mean score of chronotype was 47.8 ± 12.6. In particular, 9 patients (32.1%) exhibited the morning chronotype, 6 (21.4%) the intermediate chronotype and 13 (46.4.%) the evening chronotype. No significant difference was found in gender and age among the chronotype categories. Patients with the evening chronotype had higher blood pressure values and worse metabolic parameters than those with the morning chronotype. In the control group, the mean score of the chronotype was 57.6 ± 9.5. In particular, 16 (57.1%) subjects exhibited the morning chronotype, 10 (35.7%) the intermediate chronotype and only 2 (7.1.%) the evening chronotype. The prevalence of intermediate and evening chronotypes was higher in females than males (p = 0.021), while males have a higher prevalence of the morning chronotype. Subjects with intermediate and evening chronotypes had worse metabolic parameters than those with the morning chronotype. In patients, the chronotype score was inversely correlated to WC, BMI, SBP, DBP, plasma glucose, total cholesterol, triglycerides, LDL cholesterol and positively correlated with HDL cholesterol. No correlation was found between age and chronotype. In controls, the chronotype score was inversely correlated to WC, BMI, plasma glucose, total cholesterol, LDL cholesterol. No correlation was found among chronotype and age, blood pressure, triglycerides, HDL cholesterol. Considering the whole population of the study (patients and controls), at logistic regression the chronotype score was significantly associated with the presence of CP. Conclusions: for the first time thus far, our study puts the light on the association of the CP with chronotypes and metabolic alterations in this disease, which are the main determinants of the reduced quality of life, higher morbidity and mortality in this setting of patients. This finding suggests that alterations of chronotype might represent an adjunctive risk for CP patients and a possible target for their integrate management.

Étude observationnelle d’évolution de la COVID-19 dans une population de patients hémodialysés avec étude d’impact des comorbidités

Introduction

Nos patients dialysés ont été particulièrement exposés à la pandémie de COVID-19.

Description

Nous rapportons une étude observationnelle rétrospective de notre cohorte de patients hémodialysés repliés en secteur COVID de mars 2020 à fin mars 2021 (1 an).

Méthodes

Nous avons observé dans cette population, l’âge, le sexe, l’ancienneté en dialyse, le type de variant si disponible, les comorbidités principales, la prise d’immunosuppresseurs, l’existence d’une néoplasie active, la présence d’un diabète, d’un terrain vasculaire sévère, d’une pathologie respiratoire, le lieu de vie, les symptômes au moment du diagnostic, la prise en charge et l’évolution.

Résultats

Sur cette cohorte de 122 patients, l’âge moyen est de 71 ans (médiane 72,5 ans), 11 (9 %) vivaient en EHPAD, l’ancienneté moyenne en dialyse est de 9,5 ans (médiane 6,35 ans). Quatre-vingt-douze ont contracté le virus historique (α), 15 le variant β, 3 le variant γ et 12 n’ont pas été qualifiés. Quatre patients (3 %) étaient sous immunosuppresseurs, 9 (7 %) avaient une néoplasie active dont 2 sont décédés, 58 (47,5 %) étaient diabétiques, 15 (12 %) présentaient une pathologie respiratoire dont 4 sont décédés, 86 (70,5 %) un terrain vasculaire sévère dont 18 sont décédés sur 19 décès au total. L’IMC moyen était de 26,7 (médiane 25,8). Cinq parmi les 22 patients avec troubles cognitifs sont décédés.

Soixante (49 %) ont été pris en charge à domicile.

Quarante-deux (34,4 %) patients ont été hospitalisés, 20 en réanimation dont 8 sont décédés.

Quarante-six (37,5 %) patients ont développé une forme asymptomatique, 25 (20,5 %) une forme modérée, 32 (26 %) une forme sévère et 12 (10 %) une forme grave d’emblée.

La mortalité est de 15,5 % (19 patients décédés).

Conclusion

Dans notre cohorte, la prise d’immunosuppresseurs, les troubles cognitifs, ou l’institutionnalisation ne semblent pas être des facteurs aggravants. En revanche, le terrain vasculaire sévère semble être un élément de gravité.

P–079 A spontaneous LH peak before triggering for intrauterine insemination with donor sperm (IUI-D) is associated to lower live birth rates

Study question

Are live birth rates after IUI with donor sperm (IUI-D) and controlled ovarian stimulation comparable between women with a spontaneous LH peak vs those without?

Summary answer

Biochemical, clinical, ongoing pregnancy rates and live birth rates were higher among women without an LH peak.

What is known already

It is common clinical practice to trigger ovulation in IUI cycles once specific criteria are met; if a natural LH surge appears, adjusting the IUI timing may become necessary. Pregnancy rates seem to be slightly better when IUI is scheduled in relation to the presence or absence of an LH peak in non-stimulated cycles. In IUI with stimulated cycles, however, there is no consensus in the medical literature regarding the best moment to program the IUI, due to different inclusion criteria, different IUI timing and definition of LH peak among studies.

Study design, size, duration

Retrospective cohort study of 9,657 IUI-D cycles performed between 2012 and 2019 in one fertility center. IUI-D without LH peak (n = 6,679) versus IUI-D with LH peak (n = 2,978) were compared. Differences in pregnancy outcomes between study groups were evaluated using a Pearson’s Chi2 test. A p < 0.05 was considered statistically significant.

Participants/materials, setting, methods

The definition used to define an LH peak is > 10UI/L in the last follicular control. In cases without an LH peak, when at least one dominant follicle reached 17mm, ovulation was triggered with human chorionic gonadotropin in the following 24h, and IUI-D was performed 38h after triggering. In cases with an LH peak, ovulation was triggered the 6h following the detection, and IUI-D was also performed 38h later.

Main results and the role of chance

The women BMI and age were comparable between groups, with a mean±SD of 35.2±4.8 years old, and 24.3±4.7 for BMI. Other characteristics such as number of previous inseminations, type of stimulation drug, initial dose, total dose, stimulation length and number of follicles > 16mm in the last follicular control were also comparable. As expected, the LH level at the last follicular control was different between groups, with a mean of 5.1UI/L in the no-LH peak and 21.4IU/L in the LH peak group. The group without an LH peak had higher biochemical, clinical, ongoing and live birth rates compared to the group with LH peak: 27.7% vs. 20.7%; 19.5% vs. 15.5%; 17.7% vs. 13.7%; 16.3% vs. 12.6%, respectively (p-value<0.001).

Limitations, reasons for caution

The main limitation of the study is its retrospective nature. Also, a definition of LH peak based in absolute values was used; a definition based in relative values may lead to different results.

Wider implications of the findings: A definition of LH peak based on absolute numbers is imprecise, and the cut-off of 10UI/L does not allow a good scheduling for IUI. A LH peak based on relative values could improve the detection of patients starting ovulation and the accuracy in programming IUI.

Trial registration number

Not applicable

O-171 Altered meiotic spindle morphology and composition in in vitro matured oocytes

Study question

How does the meiotic spindle tubulin PTMs of MII oocytes matured in vitro compare to that of MII oocytes matured in vivo?

Summary answer

MII cultured in vitro present detyrosinated tubulin in the spindle microtubules, while MII oocytes matured in vivo do not.

What is known already

A functional spindle is required for chromosomal segregation during meiosis, but the role of tubulin post-translational modifications (PTMs) in spindle meiotic dynamics remains poorly characterized. In contrast with GVs matured in vitro within the cumulus oophorous, in vitro maturation of denuded GVs to the MII stage (GV-MII) is associated with spindle abnormalities, chromosome misalignment and compromised developmental potential. Although aneuploidy rates in GV-MII are not higher than in vivo matured MII, disorganized chromosomes may contribute to compromised developmental potential. However, to date, spindle PTMs morphology of GV-MII has not been compared to that of in vivo cultured MII oocytes.

Study design, size, duration

GV (n = 125), and MII oocytes (n = 24) were retrieved from hormonally stimulated women, aged 20 to 35 years old. GVs were matured to the MII stage in vitro in G-2 PLUS medium for 30h; the maturation rate was 68,2%; the 46 GV-MII oocytes obtained were vitrified, stored, and warmed before fixing and subjecting to immunofluorescent analysis. In vivo matured MII oocytes donated to research were used as controls.

Participants/materials, setting, methods

Women were stimulated using a GnRH antagonist protocol, with GnRH agonist trigger. Trigger criterion was ≥2 follicles ≥18mm; oocytes were harvested 36h later. Spindle microtubules were incubated with antibodies against alpha tubulin and tubulin PTMs (acetylation, tyrosination, polyglutamylation, Δ2-tubulin, and detyrosination); chromosomes were stained with Hoechst 33342 and samples subjected to confocal immunofluorescence microscopy (ZEISS LSM780), with ImageJ software analysis. Differences in spindle morphometric parameters were assessed by non-parametric Kruskal–Wallis and Fisher’s exact tests.

Main results and the role of chance

Qualitatively, Δ2-tubulin, tyrosination and polyglutamylation were similar for both groups. Acetylation was also present in both groups, albeit in different patterns: while in vivo matured MII oocytes showed acetylation at the poles, GV-MII showed a symmetrical distribution of signal intensity, but discontinuous signal on individual microtubule tracts, suggesting apparent islands of acetylation. In contrast, detyrosination was detected in in vivo matured MII oocytes but was absent from GV-MII. Regarding spindle pole morphology, of the four possible phenotypes described in the literature (double flattened and double focused; flattened-focused, focused-flattened, with the first word characterizing the cortex side of the spindle), we observed double flat shaped spindle poles in 86% of GV-MII oocytes (25/29) as opposed to 40.5% (15/37) for the in vivo matured MII oocytes (p = 0.0004, Fisher’s exact test). Further morphometric analysis of the spindle size (maximum projection, major and minor axis length) and the metaphase plate position (proximal to distal ratio, angle) revealed decreased spindle size in GV-MII oocytes (p = 0.019, non parametric Kruskal- Wallis test).

Limitations, reasons for caution

Oocytes retrieved from hyperstimulation cycles could be intrinsically impaired since they failed to mature in vivo. Our conclusions should not be extrapolated to IVM in non-stimulated cycles, as in this model, the cumulus oophorus is a major factor in oocyte maturation and correlation with spindle dynamics has been inferred.

Wider implications of the findings

The metaphase II spindle stability compared to the mitotic or metaphase I meiotic one justifies the presence of PTMs such as acetylation and glutamylation, which are found in stable, long-lived microtubules. The significance of the absence of detyrosinated microtubules in the MII-GV group remains to be determined

Trial registration number

not applicable

Efficiency and efficacy of vitrification in 35 654 sibling oocytes from donation cycles

STUDY QUESTION

Is oocyte vitrification/warming as efficient and effective as using fresh oocytes in donation cycles?

SUMMARY ANSWER

IVF with vitrified donor oocytes is less efficient than using fresh oocytes, but its efficacy remains comparable to that of fresh cycles.

WHAT IS KNOWN ALREADY

Oocyte vitrification is used to preserve the reproductive potential of oocytes. A small number of randomized controlled trials carried out by experienced groups have shown that this technique provides fertilization, pregnancy, implantation and ongoing pregnancy rates comparable to those of fresh oocytes. However, large registry-based analyses have consistently reported lower live birth rates (LBRs) in cycles using vitrified oocytes. It is not clear whether this decrease may be due to the effect of vitrification per se on the oocytes or to the lower efficiency of the technique, as some of the oocytes do not survive after warming.

STUDY DESIGN, SIZE, DURATION

Retrospective cohort analysis of 1844 cycles of oocyte donation (37 520 oocytes), each donor in the study provided enough oocytes for at least one reception cycle with fresh oocytes (2561 cycles) and one reception cycle with vitrified oocytes (2471 cycles) from the same ovarian stimulation (sibling oocytes). Overall, 35 654 oocytes were considered in the analysis. All embryo transfers (n = 5032) were carried out between 2011 and 2017.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Differences in reproductive outcomes after the first embryo transfer were evaluated using Pearson's Chi-squared test and regression analysis adjusted for recipient's age, BMI, sperm origin and state, day of embryo transfer, morphological score and number of transferred embryos. We performed two additional sub-analyses, to test whether the efficiency and/or effectiveness of vitrification/warming impacts reproductive results. One analysis included paired cycles where the same number of fresh and vitrified oocytes were available for ICSI (SAME sub-analysis), while the second analysis included those cycles with a 100% survival rate post-warming (SAME100 sub-analysis).

MAIN RESULTS AND THE ROLE OF CHANCE

Baseline and cycle characteristics of participants were comparable between groups. Overall, fertilization rates and embryo morphological scores were significantly lower (P < 0.001) when using vitrified oocytes; moreover, vitrified oocytes also resulted in lower reproductive outcomes than sibling fresh oocytes using both unadjusted and adjusted analyses: ongoing pregnancy (32.1% versus 37.5%; P < 0.001; OR 0.88, 95% CI 0.77, 1.00) and live birth (32.1% versus 31.9%; P = 0.92; OR 1.16, 95% CI 0.90, 1.49). However, when the efficiency of warming was taken into account, reproductive outcomes in recipients became comparable: ongoing pregnancy (33.5% versus 34.1%; P = 0.82; OR 1.11, 95% CI 0.87, 1.43) and LBR (32.1% versus 32%; P = 0.97; OR 1.15, 95% CI 0.89, 1.48). Moreover, after selecting only cycles that, in addition to having the same number of oocytes available for ICSI, also had 100% post-warming survival rate in the vitrified group, reproductive outcomes were also comparable between fresh and vitrified oocytes: ongoing pregnancy (34.8% versus 32.4%; P = 0.42; OR 1.32, 95% CI 0.98, 1.77) and live birth (32.9% versus 31.0%; P = 0.52; OR 1.27, 95% CI 0.95, 1.71), indicating that reproductive outcomes of these cycles are affected by the efficiency of the vitrification/warming technique performed rather than the oocyte damage due to the fast cooling process to which oocytes are subjected.

LIMITATIONS, REASONS FOR CAUTION

An open vitrification system was used for all cases, and oocyte vitrification/warming was performed by experienced embryologists with consistently high survival rates; caution must be exerted when extrapolating our results to data obtained using other open vitrification systems, closed vitrification systems or to IVF units with survival rates <90%.

WIDER IMPLICATIONS OF THE FINDINGS

This is the largest cohort study comparing reproductive outcomes of vitrified and fresh sibling donor oocytes to date. We found that, when the number of oocytes available after warming is equal to the number of fresh oocytes, reproductive results including live birth are comparable. Consequently, the efficiency of vitrification must be taken into account to achieve the same reproductive outcomes as with fresh oocytes. We recommend implementing strict indicators of vitrification/warming efficiency in clinics and refining vitrification/warming protocols to maximize survival.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by intramural funding of Clínica EUGIN and by the Secretary for Universities and Research of the Ministry of Economy and Knowledge of the Government of Catalonia (GENCAT 2015 DI 048). The authors declare no conflicts of interest.

TRIAL REGISTRATION NUMBER

N/A.

Risk factors assessment in fibular free flap mandibular reconstruction

INTRODUCTION

The fibular free flap (FFF) is the best choice method for mandibular reconstruction. However, the failure and the complications risk factors (RF) are not yet fully identified. This study aims to analyze these RF in order to improve the success rate.

MATERIAL

This retrospective study includes all patients who benefited from a FFF mandibular reconstruction between the first of January, 2014 and the thirty-first of December, 2018 in the Department of Stomatology and Maxillofacial Surgery department of the CHU Saint-Pierre Hospital, Brussels, Belgium.

RESULTS

Thirty patients benefited from this intervention. The overall success rate was 90%. Majority of the patients were men (67%) (mean age: 52 years). The main associated co-morbidities were: alcohol (50%), tobacco consumption (67%) and previous radiotherapy (20%). The mean operative time was 9,5hours. The morbidities rates at the receiving site (RS) and the donor site (DS) were respectively 43% and 30%. Infection and dehiscence of the RS were the main complications. Statistical analysis identified RF for RS infections: atherosclerosis and operative time; RS dehiscence (previous cervical dissection and secondary reconstruction); flap necrosis (ischemia time, rate of infection at the recipient site, history of radiation therapy, alcohol consumption, National Nosocomial Infection Surveillance score (NNISS), and history of cervical dissection); and DS morbidities (NNISS and dehiscence rate at the DS in the early period).

CONCLUSION

The FFF mandibular reconstruction offers a significant success rate. Nevertheless, this study highlighted several failure and complications RF of the procedure. Previous neck dissection and radiotherapy, operative and the ischemia time, were RF associated with complication at the RS. Furthermore, the NNIS score and the dehiscence rate were also reported as RF for FFF necrosis.

Hydro-climatic changes of wetlandscapes across the world

Assessments of ecosystem service and function losses of wetlandscapes (i.e., wetlands and their hydrological catchments) suffer from knowledge gaps regarding impacts of ongoing hydro-climatic change. This study investigates hydro-climatic changes during 1976-2015 in 25 wetlandscapes distributed across the world's tropical, arid, temperate and cold climate zones. Results show that the wetlandscapes were subject to precipitation (P) and temperature (T) changes consistent with mean changes over the world's land area. However, arid and cold wetlandscapes experienced higher T increases than their respective climate zone. Also, average P decreased in arid and cold wetlandscapes, contrarily to P of arid and cold climate zones, suggesting that these wetlandscapes are located in regions of elevated climate pressures. For most wetlandscapes with available runoff (R) data, the decreases were larger in R than in P, which was attributed to aggravation of climate change impacts by enhanced evapotranspiration losses, e.g. caused by land-use changes.

Undetectable viral RNA in oocytes from SARS-CoV-2 positive women

A central concern for the safe provision of ART during the current coronavirus disease 2019 (CODIV-19) pandemic is the possibility of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through gametes and preimplantation embryos. Unfortunately, data on SARS-CoV-2 viral presence in oocytes of infected individuals are not available to date. We describe the case of two women who underwent controlled ovarian stimulation and tested positive to SARS-CoV-2 infection by PCR on the day of oocyte collection. The viral RNA for gene N was undetectable in all the oocytes analyzed from the two women.

Fiber-based angular filtering for high-resolution Brillouin spectroscopy in the 20-300 GHz frequency range

Brillouin spectroscopy emerges as a promising non-invasive tool for nanoscale imaging and sensing. One-dimensional semiconductor superlattice structures are eminently used for selectively enhancing the generation or detection of phonons at few GHz. While commercially available Brillouin spectrometers provide high-resolution spectra, they consist of complex experimental techniques and are not suitable for semiconductor cavities operating at a wide range of optical wavelengths. We develop a pragmatic experimental approach for conventional Brillouin spectroscopy that can integrate a widely tunable excitation-source. Our setup combines a fibered-based angular filtering and a spectral filtering based on a rotating single etalon and a double grating spectrometer for sequential reconstruction of Brillouin spectra. This configuration allows probing confined acoustic phonon modes in the 20-300 GHz frequency range with excellent laser rejection and high spectral resolution. Remarkably, our scheme based on the excitation and collection of the enhanced Brillouin scattering signals through the optical cavity allows for better angular filtering with decreasing phonon frequency. It can be implemented for the study of cavity optomechanics and stimulated Brillouin scattering over broadband optical and acoustic frequency ranges.

See, feel, act: Hierarchical learning for complex manipulation skills with multisensory fusion

Humans are able to seamlessly integrate tactile and visual stimuli with their intuitions to explore and execute complex manipulation skills. They not only see but also feel their actions. Most current robotic learning methodologies exploit recent progress in computer vision and deep learning to acquire data-hungry pixel-to-action policies. These methodologies do not exploit intuitive latent structure in physics or tactile signatures. Tactile reasoning is omnipresent in the animal kingdom, yet it is underdeveloped in robotic manipulation. Tactile stimuli are only acquired through invasive interaction, and interpretation of the data stream together with visual stimuli is challenging. Here, we propose a methodology to emulate hierarchical reasoning and multisensory fusion in a robot that learns to play Jenga, a complex game that requires physical interaction to be played effectively. The game mechanics were formulated as a generative process using a temporal hierarchical Bayesian model, with representations for both behavioral archetypes and noisy block states. This model captured descriptive latent structures, and the robot learned probabilistic models of these relationships in force and visual domains through a short exploration phase. Once learned, the robot used this representation to infer block behavior patterns and states as it played the game. Using its inferred beliefs, the robot adjusted its behavior with respect to both its current actions and its game strategy, similar to the way humans play the game. We evaluated the performance of the approach against three standard baselines and show its fidelity on a real-world implementation of the game.

The mineralogy and structure of use-wear polish on chert

Polished edges of archaeological stone tools are commonly investigated to obtain information on the tools' uses in prehistory. Yet to this day, it remains unclear what exactly such polishes are and how they form. Answering these questions should allow the elaboration of new interpretative methods based on objective measurements. Two major competing hypotheses of polish formation have been proposed: abrasion and the formation of a thin amorphous film on the chert or flint surface. We employ reflectance infrared spectroscopy, a technique particularly sensitive to thin amorphous films, to investigate these two hypotheses. We found no added amorphous layer that would have formed upon friction against bone, antler, ivory or wood. Our observations suggest polish formation by abrasion, notwithstanding previous claims of added amorphous surface structures. This has implications for our understanding of the physical processes taking place during friction of chert and flint against different materials. Our results also open the possibility to propose new pathways for identifying different use-wear processes, based on the degree of abrasion.

Combustion of n-C3-C6 Linear Alcohols: An Experimental and Kinetic Modeling Study. Part I: Reaction Classes, Rate Rules, Model Lumping, and Validation

This work (and the companion paper, Part II) presents new experimental data for the combustion of n-C3-C6 alcohols (n-propanol, n-butanol, n-pentanol, n-hexanol) and a lumped kinetic model to describe their pyrolysis and oxidation. The kinetic subsets for alcohol pyrolysis and oxidation from the CRECK kinetic model have been systematically updated to describe the pyrolysis and high- and low-temperature oxidation of this series of fuels. Using the reaction class approach, the reference kinetic parameters have been determined based on experimental, theoretical, and kinetic modeling studies previously reported in the literature, providing a consistent set of rate rules that allow easy extension and good predictive capability. The modeling approach is based on the assumption of an alkane-like and alcohol-specific moiety for the alcohol fuel molecules. A thorough review and discussion of the information available in the literature supports the selection of the kinetic parameters that are then applied to the n-C3-C6 alcohol series and extended for further proof to describe n-octanol oxidation. Because of space limitations, the large amount of information, and the comprehensive character of this study, the manuscript has been divided into two parts. Part I describes the kinetic model as well as the lumping techniques and provides a synoptic synthesis of its wide range validation made possible also by newly obtained experimental data. These include speciation measurements performed in a jet-stirred reactor (p = 107 kPa, T = 550-1100 K, φ = 0.5, 1.0, 2.0) for n-butanol, n-pentanol, and n-hexanol and ignition delay times of ethanol, n-propanol, n-butanol, n-pentanol/air mixtures measured in a rapid compression machine at φ = 1.0, p = 10 and 30 bar, and T = 704-935 K. These data are presented and discussed in detail in Part II, together with detailed comparisons with model predictions and a deep kinetic discussion. This work provides new experimental targets that are useful for kinetic model development and validation (Part II), as well as an extensively validated kinetic model (Part I), which also contains subsets of other reference components for real fuels, thus allowing the assessment of combustion properties of new sustainable fuels and fuel mixtures.

Combustion of n-C3-C6 Linear Alcohols: An Experimental and Kinetic Modeling Study. Part II: Speciation Measurements in a Jet-Stirred Reactor, Ignition Delay Time Measurements in a Rapid Compression Machine, Model Validation, and Kinetic Analysis

This work presents new experimental data for n-C3-C6 alcohol, combustion (n-propanol, n-butanol, n-pentanol, n-hexanol). Speciation measurements have been carried out in a jet-stirred reactor (p = 107 kPa, T = 550-1100 K, φ = 0.5, 1.0, 2.0) for n-butanol, n-pentanol, and n-hexanol. Ignition delay times of ethanol, n-propanol, n-butanol, and n-pentanol/air mixtures were measured in a rapid compression machine at φ = 1.0, p = 10 and 30 bar, and T = 704-935 K. The kinetic subsets for alcohol pyrolysis and oxidation from the CRECK kinetic model have been systematically updated to describe the pyrolysis and high- and low-temperature oxidation of this series of fuels as described in Part I of this work (Pelucchi M.; Namysl S.; Ranzi E.Combustion of n-C3-C6 linear alcohol: an experimental and kinetic modeling study. Part I: reaction classes, rate rules, model lumping and validation. Submitted to Energy and Fuels, 2020). Part II describes in detail the facilities used for this systematic experimental investigation of n-C3-C6 alcohol combustion and presents a complete validation of the kinetic model by means of comparisons with the new data and measurements previously reported in the literature for both pyrolytic and oxidative conditions. Kinetic analyses such as rate of production and sensitivity analyses are used to highlight the governing reaction pathways and reasons for existing deviations, motivating possible further improvements in our chemistry mechanism.