Highly immunosuppressive myeloid cells correlate with early relapse after allogeneic stem cell transplantation

BACKGROUND

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative treatment for myeloid malignancies such as some acute myeloid leukemias (AML) and high-risk myelodysplastic syndromes (MDS). It aims to eradicate the malignant clone using immunocompetent donor cells (graft-versus-leukemia effect, GVL). Unfortunately, relapse is the primary cause of transplant failure mainly related on HLA loss or downregulation and upregulation of inhibitory ligands on blasts which result in donor immune effector dysfunctions.

METHODS

Between 2018 and 2021, we conducted a monocentric prospective study including 61 consecutive patients transplanted for AML or high-risk MDS. We longitudinally investigated immune cells at days + 30, + 90 and + 180 post-transplant from bone marrow and peripheral blood. We assessed the dynamics between myeloid derived suppressor cells (MDSCs) and T-cells.

RESULTS

Among the 61 patients, 45 did not relapse over the first 12 months while 16 relapsed during the first year post-transplant. Through months 1 to 6, comparison with healthy donors revealed an heterogenous increase in MDSC frequency. In all recipients, the predominant MDSC subset was granulocytic with no specific phenotypic relapse signature. However, in relapsed patients, in vitro and in vivo functional analyses revealed that MDSCs from peripheral blood were highly immunosuppressive from day + 30 onwards, with an activated NLRP3 inflammasome signature. Only circulating immunosuppressive MDSCs were statistically correlated to circulating double-positive Tim3+LAG3+ exhausted T cells.

CONCLUSION

Our simple in vitro functional assay defining MDSC immunosuppressive properties might serve as an early biomarker of relapse and raise the question of new preventive treatments targeting MDSCs in the future. Trial registration NCT03357172.

Rapid synthesis process and characterization for high purity sodium thioantimoniate nonahydrate

For the first time, Na₃SbS₄·9H₂O, also known as Schlippe's salt, has been synthesized through high-energy ball milling. This innovative synthesis way allows for obtaining high purity thioantimonate nonahydrate with around 90% yield in only approximately four hours. To validate the synthesis route described herein, the crystal structure has been refined, at room temperature, through high-resolution X-ray diffraction, pair distribution function analysis and energy dispersive spectrometry. Dehydration and rehydration of the compound have also been studied by thermogravimetric analysis and differential scanning calorimetry.

AB0410 EVOLUTION OF MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE IN PATIENTS TREATED WITH JAK INHIBITORS FOR RHEUMATIC DISEASES (JAKPIC STUDY)

Background

Monoclonal Gammopathy of Undetermined Significance (MGUS) is common in patients with inflammatory rheumatic diseases but there are scarce data regarding the effect of disease-modifying antirheumatic drugs (DMARDs) on this pre-malignant condition. Recently, preclinical data and phase I trial have shown efficacy of JAK inhibitors (JAKi) in multiple myeloma.

Objectives

We aimed to evaluate the impact of JAKi on MGUS when initiated for an active rheumatic disease.

Methods

Patients with monoclonal abnormality prior to JAKi initiation for an active rheumatic disease were identified through the MAJIK-SFR Registry, a french multicentre prospective study, and a call for observation via the “Club Rhumatismes et Inflammations”. Clinical and biological data were collected using a standardised case report form.

Results

Nineteen patients were identified, 10 women and 9 men, with a mean age of 65 years and a diagnosis of rheumatoid arthritis (n=14), psoriatic arthritis (n=3) or spondyloarthritis (n=2). The JAKi prescribed was baricitinib (n=8), tofacitinib (n=6) or upadacitinib (n=5), with a mean duration of 13 months.

Sixteen patients had individualized serum monoclonal protein (IgG Kappa n=9; IgG Lambda n=6; IgM Kappa n=3; IgA Lambda n=1) ranging from 0,16g/dL to 2,3g/dL. With a follow-up of 2 to 47 months, 8 of 16 patients experienced a decrease in serum monoclonal protein level and 8 had a stable serum monoclonal protein level. The maximal decrease observed was an initial IgG Kappa of 2.3g/dL decreasing to 0.2g/dL at month 14. During follow-up, two patients did not have any detectable serum monoclonal protein on serum electrophoresis (initial value of 5.2g/l and 1.6g/l), but still a positive immunofixation. One patient had bone marrow aspirate with 8% of plasma cells before JAKi introduction and 3% after 4 months of treatment.

Three patients did not have initial measurable spike but a positive immunofixation that became negative at month 8 and 11 (IgG Lambda, n=2) or stable (IgG Kappa, n=1).

Conclusion

This study brings reassuring and promising data on the MGUS evolution in patients treated with JAKi for rheumatic diseases, which may guide the choice of treatment in patients with both conditions.

References

[1]Berenson JR, To J, Spektor TM, et al. A Phase I Study of Ruxolitinib, Lenalidomide, and Steroids for Patients with Relapsed/Refractory Multiple MyelomaClin Cancer Res. 2020 May 15;26(10):2346-2353.

Acknowledgements

MAJIK-SFR Registry and Club Rhumatismes et Inflammations

Disclosure of Interests

None declared

Wharton's jelly-derived stromal cells and their cell therapy applications in allogeneic haematopoietic stem cell transplantation

For decades, mesenchymal stromal cells (MSCs) have been of great interest in the fields of regenerative medicine, tissue engineering and immunomodulation. Their tremendous potential makes it desirable to cryopreserve and bank MSCs to increase their accessibility and availability. Postnatally derived MSCs seem to be of particular interest because they are harvested after delivery without ethical controversy, they have the capacity to expand at a higher rate than adult‐derived MSCs, in which expansion decreases with ageing, and they have demonstrated immunological and haematological supportive properties similar to those of adult‐derived MSCs. In this review, we focus on MSCs obtained from Wharton's jelly (the mucous connective tissue of the umbilical cord between the amniotic epithelium and the umbilical vessels). Wharton's jelly MSCs (WJ‐MSCs) are a good candidate for cellular therapy in haematology, with accumulating data supporting their potential to sustain haematopoietic stem cell engraftment and to modulate alloreactivity such as Graft Versus Host Disease (GVHD). We first present an overview of their in‐vitro properties and the results of preclinical murine models confirming the suitability of WJ‐MSCs for cellular therapy in haematology. Next, we focus on clinical trials and discuss tolerance, efficacy and infusion protocols reported in haematology for GVHD and engraftment.

Omasal flow of nonstructural carbohydrates and nitrogenous compounds in lactating dairy cows fed diets containing timothy cut in the afternoon or morning

Shifting the cutting of grass from morning to afternoon has been shown to increase the concentration of nonstructural carbohydrates (NSC) in forages. We compared the effects of diets (66:34, forage:concentrate ratio) containing a mix (% of the diet dry matter) of baleages (46.5%) and silages (19.3%) harvested from timothy cut in the afternoon (p.m.-cut TIM diet) or morning (a.m.-cut TIM diet) on omasal flows of NSC and nitrogenous fractions, ruminal and total-tract digestibilities of nutrients, plasma concentration of AA, and milk yield and composition. Eight ruminally cannulated Holstein cows averaging (mean ± standard deviation) 31.4 ± 6.13 kg/d of milk, 136 ± 17.0 d in milk, and 611 ± 66.4 kg of body weight in the beginning of the experiment were used in a crossover design with 21-d periods (14 d for diet adaptation and 7 d for data and sample collection). Intake of total ethanol-soluble carbohydrates (TESC; +150 g/d), starch (+129 g/d), and total NSC (TESC plus starch = +278 g/d) was greater with feeding the p.m.- than the a.m.-cut TIM diet. Likewise, the apparent ruminal digestibilities of TESC (+149 g/d), starch (+167 g/d), and total NSC (+316 g/d) increased in the p.m.-cut TIM diet. Diets, however, had no effect on the omasal flows and apparent ruminal and total-tract digestibilities of dry matter and organic matter. Intake of N increased in cows fed the p.m.- versus the a.m.-cut TIM diet (562 and 528 g/d, respectively) despite no effect of diets on dry matter intake. Diets did not affect the omasal flows of total nonammonia N, total bacterial nonammonia N, nonammonia and nonbacterial N, and individual AA, and the efficiency of microbial protein synthesis in the rumen. Contrarily, supply of rumen-degradable protein increased (+9.2%) in cows fed the p.m.-cut TIM diet, with this response driven by the 6.4% increase in N intake. Plasma concentrations of essential and nonessential AA followed the omasal flow of AA and were not changed by diets. Feeding the p.m.- versus the a.m.-cut diet significantly increased yields of 4% fat-corrected milk and milk fat, and tended to increase energy-corrected milk, milk true protein, and milk lactose yields. Overall, feeding the p.m.-cut TIM diet to mid-lactation dairy cows did not improve microbial protein synthesis and omasal flow of AA, and these responses were in line with the lack of a treatment effect on dry matter intake.

A data-driven spike sorting feature map for resolving spike overlap in the feature space

Objective.Spike sorting is the process of extracting neuronal action potentials, or spikes, from an extracellular brain recording, and assigning each spike to its putative source neuron. Spike sorting is usually treated as a clustering problem. However, this clustering process is known to be affected by overlapping spikes. Existing methods for resolving spike overlap typically require an expensive post-processing of the clustering results. In this paper, we propose the design of a domain-specific feature map, which enables the resolution of spike overlap directly in the feature space.Approach.The proposed domain-specific feature map is based on a neural network architecture that is trained to simultaneously perform spike sorting and spike overlap resolution. Overlapping spikes clusters can be identified in the feature space through a linear relation with the single-neuron clusters for which the neurons contribute to the overlapping spikes. To aid the feature map training, a data augmentation procedure is presented that is based on biophysical simulations.Main results.We demonstrate the potential of our method on independent and realistic test data. We show that our novel approach for resolving spike overlap generalizes to unseen and realistic test data. Furthermore, the sorting performance of our method is shown to be similar to the state-of-the-art, but our method does not assume the availability of spike templates for resolving spike overlap.Significance.Resolving spike overlap directly in the feature space, results in an overall simplified spike sorting pipeline compared to the state-of-the-art. For the state-of-the-art, the overlapping spike snippets exhibit a large spread in the feature space and do not appear as concentrated clusters. This can lead to biased spike template estimates which affect the sorting performance of the state-of-the-art. In our proposed approach, overlapping spikes form concentrated clusters and spike overlap resolution does not depend on the availability of spike templates.

Factors contributing to ice nucleation and sequential freezing of leaves in wheat

Anatomical, metabolic and microbial factors were identified that contribute to sequential freezing in wheat leaves and likely contribute to supercooling in the youngest leaves and potentially meristematic regions. Infrared thermography (IR) has been used to observe wheat leaves freezing independently and in an age-related sequence with older leaves freezing first. To determine mechanisms that might explain this sequence of freezing several analytical approaches were used: (1) The size of xylem vessels, in proximity to where freezing initiated, was measured to see if capillary freezing point depression explained sequential freezing. The sequence of freezing in the four youngest leaves was correlated, with the largest vessels freezing first. (2) Carbohydrate and amino acids were analyzed to determine if solute concentrations as well as interactions with membranes explained the freezing sequence. Sucrose was highly correlated to the freezing sequence for all leaves suggesting a prominent role for this sugar as compared to other simple sugars and fructans. Among individual free amino acids proline and serine were correlated to the freezing sequence, with younger leaves having the highest concentrations. (3) Microflora within and on leaf surfaces were determined to measure potential freezing initiation. Levels of bacteria and fungi were correlated to the freezing sequence for all leaves, and species or genera associated with high ice nucleation activity were absent in younger leaves. Moisture content and transcript expression of ice binding proteins were also measured. As expected, our results show that no single mechanism explains the freezing sequence observed via infrared analyses. While these multiple mechanisms are operative at different levels according to the leaf age, they seem to converge when it comes to the protection of vital meristematic tissues. This provides potential phenotypic characters that could be used by breeders to develop more winter-hardy genotypes.

Mobilized Multipotent Hematopoietic Progenitors Promote Expansion and Survival of Allogeneic Tregs and Protect Against Graft Versus Host Disease

Allogeneic Hematopoietic Stem Cell Transplantation (Allo-HSCT) is routinely performed with peripheral blood stem cells (PBSCs) mobilized by injection of G-CSF, a growth factor which not only modulates normal hematopoiesis but also induces diverse immature regulatory cells. Based on our previous evidence that G-CSF-mobilized multipotent hematopoietic progenitors (MPP) can increase survival and proliferation of natural regulatory T cells (Tregs) in autoimmune disorders, we addressed the question how these cells come into play in mice and humans in an alloimmune setting. Using a C57BL/6 mouse model, we demonstrate that mobilized MPP enhance the immunosuppressant effect exerted by Tregs, against alloreactive T lymphocytes, both in vitro and in vivo. They do so by migrating to sites of allopriming, interacting with donor Tregs and increasing their numbers, thus reducing the lethality of graft-versus-host disease (GVHD). Protection correlates likewise with increased allospecific Treg counts. Furthermore, we provide evidence for a phenotypically similar MPP population in humans, where it shares the capacity to promote selective Treg expansion in vitro. We postulate that G-CSF-mobilized MPPs might become a valuable cellular therapy to expand donor Tregs in vivo and prevent GVHD, thereby making allo-HSCT safer for the treatment of leukemia patients.

[Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study]

BACKGROUND AND AIM

Angiotensin converting enzyme (ACE) type 2 is the receptor of SARSCoV-2 for cell entry into lung cells. Because ACE-2 may be modulated by ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there are concern that patients treated with ACEIs and ARBs are at higher risk for COVID-19 infection or severity. This study sought to analyse the association of severe forms of COVID-19 and mortality with hypertension and a previous treatment with ACEI and ARB.

METHODS

Prospective follow-up of 433 consecutive patients hospitalised for COVID-19 pneumonia confirmed by PCR or highly probable on clinical, biological, and radiological findings, and included in the COVHYP study. Mortality and severe COVID-19 (criteria: death, intensive care unit, or hospitalisation >30 days) were compared in patients receiving or not ACEIs and ARBs. Follow-up was 100% at hospital discharge, and 96.5% at >1month.

RESULTS

Age was 63.6±18.7 years, and 40%) were female. At follow-up (mean 78±50 days), 136 (31%) patients had severity criteria (death, 64 ; intensive care unit, 73; hospital stay >30 days, 49). Hypertension (55.1% vs 36.7%, P<0.001) and antihypertensive treatment were associated with severe COVID-19 and mortality. The association between ACEI/ARB treatment and COVID-19 severity criteria found in univariate analysis (Odds Ratio 1.74, 95%CI [1.14-2.64], P=0.01) was not confirmed when adjusted on age, gender, and hypertension (adjusted OR1.13 [0.59-2.15], P=0.72). Diabetes and hypothyroidism were associated with severe COVID-19, whereas history of asthma was not.

CONCLUSION

This study suggests that previous treatment with ACEI and ARB is not associated with hospital mortality, 1- and 2-month mortality, and severity criteria in patients hospitalised for COVID-19. No protective effect of ACEIs and ARBs on severe pneumonia related to COVID-19 was demonstrated.

Myeloid-Derived Suppressor Cells in the Context of Allogeneic Hematopoietic Stem Cell Transplantation

Myeloid-derived suppressor cells (MDSCs) are innate immune cells that acquire the capacity to suppress adaptive immune responses. In the context of allogeneic hematopoietic stem cell transplantation (allo-HSCT), MDSCs (in the donor graft and in the recipient, after allo-HSCT) might mediate immune suppression through multiple mechanisms. However, it remains unclear how MDSCs can be distinguished from their normal myeloid counterparts in the hematopoietic stem cell donor graft and during immune reconstitution after allo-HSCT in the recipient. Our ability to understand their exact role in allo-HSCT is limited by the absence of a specific gene signature or surface markers for identifying MDSCs among myeloid cells and by their plasticity in different microenvironments. According to various studies, MDSCs might induce transplant tolerance and control graft vs. host disease (GVHD), but their impact on the graft vs. tumor effect (GVT) is not fully understood. In fact, we know that MDSCs commonly expand in patients with cancer, and they are thought to promote hematological malignancy progression. However, little is known about whether depleting them might be an effective strategy for enhancing GVT effects. Here, we review data published over the past 40 years on allo-HSCT to delineate the different MDSC subsets, and their abilities to induce transplant tolerance and preserve the GVT effect. This review will provide a basis for determining whether one MDSC subset might be proposed as the most appropriate candidate for cellular therapies, due to its ability to modulate GVHD.

French validation and adaptation of the Grobman nomogram for prediction of vaginal birth after cesarean delivery

OBJECTIVE

To validate Grobman nomogram for predicting vaginal birth after cesarean delivery (VBAC) in a French population and adapt it.

STUDY DESIGN

Multicenter retrospective study of maternal and obstetric factors associated with VBAC between May 2012 and May 2013 in 6 maternity units. External validation and adaptation of the prenatal and intrapartum Grobman nomograms for vaginal birth prediction after cesarean delivery in a French cohort.

RESULTS

The study included 523 women with previous cesarean deliveries; 70% underwent a trial of labor for a subsequent delivery (n=367) with a success rate of 65% (n=240). In the univariate analysis, 5 factors were associated with successful VBAC: previous vaginal delivery before the cesarean (P<0.001), the number of previous vaginal deliveries (P<0.001), and a favorable cervix at delivery room admission, cervical effacement (P=0.035), or cervical dilatation at least 3cm (P<0.001), or a Bishop score >6 (P=0.03). A potentially recurrent indication (defined as arrest of dilation or descent as the indication for the previous cesarean) (P=0.039), a hypertensive disorder during pregnancy (P=0.05), and labor induction (P=0.017) were each associated with failed VBAC. External validation of the prenatal and intrapartum Grobman nomograms showed an area under the ROC curve of 69% (95% CI: 0.638, 0.736) and 65% (95% CI: 0.599, 0.700) respectively. Adaptation of the nomogram to the French cohort resulted in the inclusion of the following factors: maternal age, body mass index at last prenatal visit, hypertensive disorder, gestational age at delivery, recurring indication, cervical dilatation, and induction of labor. Its area under the curve to predict successful VBAC was 78% (95% CI: 0.738, 0.825).

CONCLUSION

The nomogram to predict VBAC developed by Grobman et al. is validated in the French population. Adaptation to the French population, by excluding ethnicity, appeared to improve its performance. Impact of the nomogram use on the caesarean section rate has to be validated in a randomized control trial.

Metal accumulation and detoxification mechanisms in mycorrhizal Betula pubescens

Metal detoxification in plants is a complex process that involves different mechanisms, such as the retention of metals to the cell wall and their chelation and subsequent compartmentalization in plant vacuoles. In order to identify the mechanisms involved in metal accumulation and tolerance in Betula pubescens, as well as the role of mycorrhization in these processes, mycorrhizal and non-mycorrhizal plants were grown in two industrial soils with contrasting concentrations of heavy metals. Mycorrhization increased metal uptake at low metal concentrations in the soil and reduced it at high metal concentrations, which led to an enhanced growth and biomass production of the host when growing in the most polluted soil. Our results suggest that the sequestration on the cell wall is the main detoxification mechanism in white birch exposed to acute chronic metal-stress, while phytochelatins play a role mitigating metal toxicity inside the cells. Given its high Mn and Zn root-to-shoot translocation rate, Betula pubescens is a very promising species for the phytoremediation of soils polluted with these metals.

Mercury contamination level and speciation inventory in Lakes Titicaca & Uru-Uru (Bolivia): Current status and future trends

Aquatic ecosystems of the Bolivian Altiplano (∼3800 m a.s.l.) are characterized by extreme hydro-climatic constrains (e.g., high UV-radiations and low oxygen) and are under the pressure of increasing anthropogenic activities, unregulated mining, agricultural and urban development. We report here a complete inventory of mercury (Hg) levels and speciation in the water column, atmosphere, sediment and key sentinel organisms (i.e., plankton, fish and birds) of two endorheic Lakes of the same watershed differing with respect to their size, eutrophication and contamination levels. Total Hg (THg) and monomethylmercury (MMHg) concentrations in filtered water and sediment of Lake Titicaca are in the lowest range of reported levels in other large lakes worldwide. Downstream, Hg levels are 3-10 times higher in the shallow eutrophic Lake Uru-Uru than in Lake Titicaca due to high Hg inputs from the surrounding mining region. High percentages of MMHg were found in the filtered and unfiltered water rising up from <1 to ∼50% THg from the oligo/hetero-trophic Lake Titicaca to the eutrophic Lake Uru-Uru. Such high %MMHg is explained by a high in situ MMHg production in relation to the sulfate rich substrate, the low oxygen levels of the water column, and the stabilization of MMHg due to abundant ligands present in these alkaline waters. Differences in MMHg concentrations in water and sediments compartments between Lake Titicaca and Uru-Uru were found to mirror the offset in MMHg levels that also exist in their respective food webs. This suggests that in situ MMHg baseline production is likely the main factor controlling MMHg levels in fish species consumed by the local population. Finally, the increase of anthropogenic pressure in Lake Titicaca may probably enhance eutrophication processes which favor MMHg production and thus accumulation in water and biota.

Mycorrhization protects Betula pubescens Ehr. from metal-induced oxidative stress increasing its tolerance to grow in an industrial polluted soil

In recent years, the use of woody plants in phytoremediation has gained popularity due to their high biomass production and their association with mycorrhizal fungi, which can improve their survival and development rates under stress conditions. In this study, mycorrhized and non-mycorrhized white birch plants (Betula pubescens Ehr.) were grown in control and a metal-polluted industrial soil. After 60days of culture, plant growth and metal accumulation, the content of photosynthetic pigments and oxidative-stress markers, as well as the enzymatic activities and gene expressions of antioxidant enzymes were measured. According to our results, mycorrhized birch plants grown in control soil showed an increased activity and gene expression of catalase and ascorbate peroxidase, along with hydrogen peroxide overproduction, which could support the importance of the reactive oxygen species as signaling molecules in the regulation of plant-fungus interactions. Additionally, in polluted soil mycorrhized plants had higher biomass but lower metal accumulation, probably because the symbiotic fungus acted as a barrier to the entrance of metals into the host plants. This behavior led to mitigation in the oxidative challenge, reduced hydrogen peroxide content and diminished activities of the antioxidant enzymes in comparison to non-mycorrhized plants.

A clinical and neurophysiological motor signature of Unverricht-Lundborg disease

OBJECTIVES

Unverricht-Lundborg disease (ULD) is the most common form of progressive myoclonus epilepsy. Cerebellar dysfunction may appear over time, contributing along with myoclonus to motor disability. The purpose of the present work was to clarify the motor and neurophysiological characteristics of ULD patients.

METHODS

Nine patients with genetically proven ULD were evaluated clinically (medical history collected from patient charts, the Scale for the Assessment and Rating of Ataxia and Unified Myoclonus Rating Scale). Neurophysiological investigations included EEG, surface polymyography, long-loop C-reflexes, somatosensory evoked potentials, EEG jerk-locked back-averaging (JLBA) and oculomotor recordings. All patients underwent brain MRI. Non-parametric Mann-Whitney tests were used to compare ULD patients' oculomotor parameters with those of a matched group of healthy volunteers (HV).

RESULTS

Myoclonus was activated by action but was virtually absent at rest and poorly induced by stimuli. Positive myoclonus was multifocal, often rhythmic and of brief duration, with top-down pyramidal temporospatial propagation. Cortical neurophysiology revealed a transient wave preceding myoclonus on EEG JLBA (n=8), enlarged somatosensory evoked potentials (n=7) and positive long-loop C-reflexes at rest (n=5). Compared with HV, ULD patients demonstrated decreased saccadic gain, increased gain dispersion and a higher frequency of hypermetric saccades associated with decreased peak velocity.

CONCLUSION

A homogeneous motor pattern was delineated that may represent a ULD clinical and neurophysiological signature. Clinical and neurophysiological findings confirmed the pure cortical origin of the permanent myoclonus. Also, oculomotor findings shed new light on ULD pathophysiology by evidencing combined midbrain and cerebellar dysfunction.

MR imaging of adult acute infectious encephalitis

BACKGROUND

Imaging is a key tool for the diagnosis of acute encephalitis. Brain CT scan must be urgently performed to rule out a brain lesion with mass effect that would contraindicate lumbar puncture. Brain MRI is less accessible than CT scan, but can provide crucial information with patients presenting with acute encephalitis.

METHOD

We performed a literature review on PubMed on April 1, 2015 with the search terms "MRI" and "encephalitis".

RESULTS

We first described the various brain MRI abnormalities associated with each pathogen of acute encephalitis (HSV, VZV, other viral agents targeting immunocompromised patients or travelers; tuberculosis, listeriosis, other less frequent bacterial agents). Then, we identified specific patterns of brain MRI abnomalies that may suggest a particular pathogen. Limbic encephalitis is highly suggestive of HSV; it also occurs less frequently in encephalitis due to HHV6, syphillis, Whipple's disease and HIV primary infection. Rhombencephalitis is suggestive of tuberculosis and listeriosis. Acute ischemic lesions can occur in patients presenting with severe bacterial encephalitis, tuberculosis, VZV encephalitis, syphilis, and fungal infections.

CONCLUSION

Brain MRI plays a crucial role in the diagnosis of acute encephalitis. It detects brain signal changes that reinforce the clinical suspicion of encephalitis, especially when the causative agent is not identified by lumbar puncture; it can suggest a particular pathogen based on the pattern of brain abnormalities and it rules out important differential diagnosis (vascular, tumoral or inflammatory causes).

Performance and nitrogen use efficiency in mid-lactation dairy cows fed timothy cut in the afternoon or morning

Shifting cutting from morning to afternoon has been shown to increase the concentration of nonstructural carbohydrates in forages. We hypothesized that, compared with a total mixed ration containing timothy baleage and silage cut in the morning (a.m.-cut TIM), a total mixed ration containing timothy baleage and silage cut in the afternoon (p.m.-cut TIM) would improve animal performance and N use efficiency in mid-lactation Holstein cows due to enhanced supply of ruminal fermentable energy. The objective of this study was to compare the effects of p.m.- versus a.m.-cut TIM on milk yield, concentrations and yields of milk components, ruminal metabolism, and plasma concentrations of AA in mid-lactation Holstein cows. Ten (6 ruminally cannulated) primiparous cows averaging 139±13 d in milk and 550±56 kg of body weight, and 6 (2 ruminally cannulated) multiparous cows averaging 128±11 d in milk and 632±57 kg of body weight at the beginning of the experiment, were used in a crossover design. Each period lasted 21 d with 14 d for diet adaptation and 7 d for data and sample collection. The concentration of nonstructural carbohydrates (water-soluble carbohydrates plus starch) was numerically greater in the p.m.- versus the a.m.-cut TIM and averaged 13.2±1.06% and 12.2±1.13%, respectively. Treatment × parity effects were observed for milk urea N, feed efficiency, and milk N efficiency, whereas parity effects were observed for nutrient intake, milk yield, and plasma concentration of several essential and nonessential AA. Intakes of dry matter (19.3 versus 18.6 kg/d) and nonstructural carbohydrates (2.56 versus 2.31 kg/d), and yields of 4% fat-corrected milk (23.1 versus 22.2 kg/d), energy-corrected milk (25.0 versus 24.1 kg/d), milk fat (0.91 versus 0.88 kg/d), and milk protein (0.77 versus 0.73 kg/d) were all greatest with feeding p.m.-cut TIM. Milk yield (23.5 versus 22.7 kg/d) tended to increase in cows fed p.m.-cut TIM. The ruminal fermentation profiles and plasma concentrations of AA were mostly unaffected by treatments. However, ruminal valerate (1.01 versus 1.17 mol/100 mol) and plasma Gly (172 versus 188 µM) were lowest with feeding p.m.-cut TIM. Overall, feeding mid-lactation dairy cows a total mixed ration that consisted of p.m.-cut timothy baleage and silage significantly increased dry matter intake and yields of milk, milk fat, and milk protein.

Secondary organic aerosol origin in an urban environment: influence of biogenic and fuel combustion precursors

Source contributions of organic aerosol (OA) are still not fully understood, especially in terms of quantitative distinction between secondary OA formed from anthropogenic precursors vs. that formed from natural precursors. In order to investigate the OA origin, a field campaign was carried out in Barcelona in summer 2013, including two periods characterized by low and high traffic conditions. Volatile organic compound (VOC) concentrations were higher during the second period, especially aromatic hydrocarbons related to traffic emissions, which showed a marked daily cycle peaking during traffic rush hours, similarly to black carbon (BC) concentrations. Biogenic VOC (BVOC) concentrations showed only minor changes from the low to the high traffic period, and their intra-day variability was related to temperature and solar radiation cycles, although a decrease was observed for monoterpenes during the day. The organic carbon (OC) concentrations increased from the first to the second period, and the fraction of non-fossil OC as determined by ¹⁴C analysis increased from 43% to 54% of the total OC. The combination of ¹⁴C analysis and Aerosol Chemical Speciation Monitor (ACSM) OA source apportionment showed that the fossil OC was mainly secondary (>70%) except for the last sample, when the fossil secondary OC only represented 51% of the total fossil OC. The fraction of non-fossil secondary OC increased from 37% of total secondary OC for the first sample to 60% for the last sample. This enhanced formation of non-fossil secondary OA (SOA) could be attributed to the reaction of BVOC precursors with NO_x emitted from road traffic (or from its nocturnal derivative nitrate that enhances night-time semi-volatile oxygenated OA (SV-OOA)), since NO₂ concentrations increased from 19 to 42 μg m⁻³ from the first to the last sample.

Open-angle glaucoma and paraoptic cyst: first description of a series of 11 patients

We report 11 patients who were referred to our institution for severe open-angle glaucoma who had a paraoptic cyst on MR imaging. All cysts were extraoptic and retrolaminar; most were deforming the adjacent optic nerve. Cysts had a high signal on T2 and FLAIR sequences, and a variable signal on T1 and variable echogenicity, suggesting different proteinaceous content. Arterial vascularization of the optic nerve was normal. Cyst volumes were inversely correlated with the severity of glaucoma on the same eye (P < .01-.05, Spearman correlation coefficient). We hypothesized that such cysts may reflect a valve mechanism, which would allow preservation of the translamina cribrosa pressure and thus could preserve visual function. The rarity of this association, together with the frequent mass effect of the cyst on the optic nerve, stresses the necessity of long-term follow-up in these patients.

[Contribution of arterial spin labeling to the diagnosis of sudden and transient neurological deficit]

MRI is the gold standard exploration for sudden transient neurological events. If diffusion MRI is negative, there may be a diagnostic doubt between transient ischemic attack and other causes of transient neurological deficit. We illustrate how sequence arterial spin labeling (ASL), which evaluates cerebral perfusion, contributes to the exploration of transient neurological events. An ASL sequence was performed in seven patients with a normal diffusion MRI explored for a transient deficit. Cortical hyperperfusion not systematized to an arterial territory was found in three and hypoperfusion systematized to an arterial territory in four. ASL helped guide early management of these patients.

Cerebral tumor or pseudotumor?

Pseudotumoral lesions are uncommon but important to identity lesions. They can occur during inflammatory diseases (systemic diseases, vasculitis, demyelinating diseases), infectious, and vascular diseases. Also, in a patient with a treated tumor, pseudo-progression and radionecrosis must be differentiated from the tumoral development. Diagnosis can be difficult on an MRI scan, but some MRI aspects in conventional sequences, diffusion, perfusion and spectroscopy can suggest the pseudotumoral origin of a lesion. Imaging must be interpreted according to the context, the clinic and the biology. The presence of associated intracranial lesions can orientate towards a systemic or infectious disease. A T2 hyposignal lesion suggests granulomatosis or histiocytosis, especially if a meningeal or hypothalamic-pituitary involvement is associated. Non-tumoral lesions are generally not hyperperfused. In the absence of a definitive diagnosis, the evolution of these lesions, whether under treatment or spontaneous, is fundamental.

Strategies for Cd accumulation in Dittrichia viscosa (L.) Greuter: role of the cell wall, non-protein thiols and organic acids

Dittrichia viscosa (L.) Greuter is plant species commonly found in degraded zones of Asturias (Spain), where it accumulates high levels of Cd, but the mechanisms involved in this response in non-model plants have not been elucidated. In this way, we analysed the fraction of the total Cd bound to the cell walls, the ultrastructural localization of this metal, and non-protein thiol and organic acid concentrations of two clones of D. viscosa: DV-A (from a metal-polluted soil) and DV-W (from a non-polluted area). After 10 days of hydroponic culture with Cd, fractionation and ultrastructural localisation studies showed that most of the Cd accumulated by D. viscosa was kept in the cell wall. The non-protein thiol content rose in D. viscosa with Cd exposure, especially in the non-metallicolous DV-W clone, and in both clones we found with Cd exposure a synthesis de novo of phytochelatins PC2 and PC3 in shoots and roots and also of other phytochelatin-related compounds, particularly in roots. Regarding organic acids, their concentration in both clones decreased in shoots after Cd treatment, but increased in roots, mainly due to changes in the citric acid concentration. Thus, retention of Cd in the cell wall seems to be the first strategy in response to metal entry in D. viscosa and once inside cells non-protein thiols and organic acids might also participate in Cd tolerance.

[Deep vein thrombosis revealing myeloproliferative syndrome in two adolescents]

Deep vein thrombosis occurs in 30% of patients with essential thrombocythemia, but rarely at initial diagnosis. We report two pediatric patients with essential thrombocythemia revealed by atypical deep vein thrombosis. First, a 16-year-old girl presented Budd-Chiari syndrome revealed by a hemorrhagic shock. Clinical exam revealed isolated splenomegaly. A search for thrombophilia found a factor V Leiden homozygous mutation and a Jak2 mutation. Bone marrow biopsy confirmed the diagnosis of a myeloproliferative disorder. The second case, a 17-year-old girl, had a routine examination by her physician that revealed splenomegaly. Ultrasonography displayed thrombus in the splenic and portal vein. An isolated Jak2 mutation was found and a myeloproliferative disorder was confirmed by bone marrow biopsy. The diagnosis of myeloproliferative disorder was made in both patients presenting atypical venous thrombosis with a Jak2 mutation and confirmed by bone marrow biopsy. These initial presentations of myeloproliferative disorders are rare in childhood and possibly underdiagnosed.

Ontogenetic and spatiotemporal variability in anchoveta Engraulis ringens diet off Peru

In this study, historical data available since 1954 were used to get new insight to ontogenetic and spatiotemporal variability in Peruvian anchovy or anchoveta Engraulis ringens diet. Whatever the period, E. ringens foraged mainly on macrozooplankton and the importance of euphausiids in E. ringens diet appears directly related to euphausiids abundance. This bottom-up effect is also observed at smaller scale because the euphausiids fraction increased with E. ringens total length and euphausiids accessibility. Selecting the largest prey, the euphausiids, provides an energetic advantage for E. ringens in its ecosystem where oxygen depletion imposes strong metabolic constraints on pelagic fishes. This study illustrates the plasticity of E. ringens that allows it to cope with its highly variable environment.

Cd-induced phytochelatin synthesis in Dittrichia viscosa (L.) Greuter is determined by the dilution of the culture medium

In this paper, we examined Cd accumulation and PC synthesis in two clones of Dittrichia viscosa, one with a metallicolous (DV-A) and the other with a non-metallicolous origin (DV-W). The clones were cultured in vitro with 0 and 10 mg Cd L(-1) in both short-term treatments (up to 72 h) and over 10 days. We also examined the influence of the culture medium dilution and the PC-synthesis inhibitor, L-buthionine-sulfoximine (BSO), on these parameters. Similar Cd accumulation values were found in the two clones. No synthesis of new thiolic compounds was observed in Cd-treated plants cultured in vitro in Murashige and Skoog medium up to 72 h when compared to controls. Dilution of the culture medium affected PC production, increasing it in 1/2 MS and especially in 1/4 MS. Cd uptake did not increase in the same way, but still hyperaccumulation levels were exceeded in all Cd treatments. BSO addition increased the sensitivity of D. viscosa to Cd and diminished Cd accumulation. Nevertheless, a poor correlation between PCs and Cd accumulation capacity was observed since the highest Cd content did not correspond to the highest PC levels. All these results obtained suggest that PCs are important in Cd accumulation and detoxification in D. viscosa and also that other mechanisms might be involved in these traits.

Growth and physiological responses to cadmium stress of two populations of Dittrichia viscosa (L.) Greuter

Two clones of Dittrichia viscosa (L.) Greuter from contrasting populations, DV-A (metallicolous) and DV-W (non-metallicolous), were studied to compare Cd accumulation and tolerance. After 10 days of hydroponic culture with 0, 5, 10, and 15 mg Cd L(-1), metal accumulation and plant growth were measured as well as other stress markers such as decrease in the content of photosynthetic pigments, lipid peroxidation, phenols, H(2)O(2), and free proline. We also analyzed the activity of the antioxidant enzymes guaiacol and ascorbate peroxidases, catalase, superoxide dismutase, and glutathione reductase as well as their isoform patterns. Our results confirmed a high Cd tolerance and accumulation in both clones of D. viscosa, which suggests that these traits are constitutive in this species. However, when the Cd concentration in solution exceeded 10 mg Cd L(-1), DV-A was more tolerant than DV-W. The physiological mechanisms involved in Cd tolerance also differed between them, although phenols and guaiacol peroxidase played an important role in both clones. The effective Cd detoxification of DV-A consisted mainly in a promoted ascorbate peroxidase activity and better efficiency of catalase and glutathione reductase enzymes.

Iron ore weathering potentials of ectomycorrhizal plants

Plants in association with soil microorganisms play an important role in mineral weathering. Studies have shown that plants in symbiosis with ectomycorrhizal (ECM) fungi have the potential to increase the uptake of mineral-derived nutrients. However, it is usually difficult to study many of the different factors that influence ectomycorrhizal weathering in a single experiment. In the present study, we carried out a pot experiment where Pinus patula seedlings were grown with or without ECM fungi in the presence of iron ore minerals. The ECM fungi used included Pisolithus tinctorius, Paxillus involutus, Laccaria bicolor and Suillus tomentosus. After 24 weeks, harvesting of the plants was carried out. The concentration of organic acids released into the soil, as well as potassium and phosphorus released from the iron ore were measured. The results suggest that different roles of ectomycorrhizal fungi in mineral weathering such as nutrient absorption and transfer, improving the health of plants and ensuring nutrient circulation in the ecosystem, are species specific, and both mycorrhizal roots and non-mycorrhizal roots can participate in the weathering process of iron ore minerals.

Control of near-infrared supercontinuum bandwidth by adjusting pump pulse duration

We experimentally and numerically investigated the impact of input pump pulse duration on the near-infrared bandwidth of supercontinuum generation in a photonic crystal fiber. We continuously stretched the temporal duration of the input pump laser (centered at 1030 nm) pulses from 500 fs up to 10 ps, while keeping fixed the pump peak power. We observed that the long-wavelength edge of the supercontinuum spectrum is increased by 200 nm as the pump pulse duration grows from 500 fs to 10 ps. We provide a quantitative fit of the experimental results by means of numerical simulations. Moreover, we have explained the observed spectral broadening enhancement induced by pump pulse energy by developing an approximate yet fully analytical model for soliton energy exchange through a series of collisions in the presence of stimulated Raman scattering.

Modeling rare species distribution at the edge: the case for the vulnerable endemic Pyrenean desman in France

The endemic Pyrenean Desman (Galemys pyrenaicus) is an elusive, rare, and vulnerable species declining over its entire and narrow range (Spain, Portugal, France, and Andorra). The principal set of conservation measures in France is a 5-years National Action Plan based on 25 conservation actions. Priority is given to update its present distribution and develop tools for predictive distribution models. We aim at building the first species distribution model and map for the northern edge of the range of the Desman and confronting the outputs of the model to target conservation efforts in the context of environmental change. Contrasting to former comparable studies, we derive a simpler model emphasizing the importance of factors linked to precipitation and not to the temperature. If temperature is one of the climate change key factors, depicted shrinkage in Desman distribution could be lower or null at the northern (French) edge suggesting thus a major role for this northern population in terms of conservation of the species. Finally, we question the applied issue of temporal and spatial transferability for such environmental favourability models when it is made at the edge of the distribution range.