Implementation of esophageal endoscopic submucosal dissection in Spain: Results from the nationwide registry

INTRODUCTION AND AIMS

The outcomes of endoscopic submucosal dissection (ESD) in the esophagus have not been assessed in our country. Our primary aim was to analyze the effectiveness and safety of the technique.

MATERIAL AND METHODS

Analysis of the prospectively maintained national registry of ESD. We included all superficial esophageal lesions removed by ESD in 17 hospitals (20 endoscopists) between January 2016 and December 2021. Subepithelial lesions were excluded. The primary outcome was curative resection. We conducted a survival analysis and used logistic regression analysis to assess predictors of non-curative resection.

RESULTS

A total of 102 ESD were performed on 96 patients. The technical success rate was 100% and the percentage of en-bloc resection was 98%. The percentage of R0 and curative resection was 77.5% (n=79; 95%CI: 68%-84%) and 63.7% (n=65; 95%CI: 54%-72%), respectively. The most frequent histology was Barrett-related neoplasia (n=55 [53.9%]). The main reason for non-curative resection was deep submucosal invasion (n=25). The centers with a lower volume of ESD obtained worse results in terms of curative resection. The rate of perforation, delayed bleeding and post-procedural stenosis were 5%, 5% and 15.7%, respectively. No patient died or required surgery due to an adverse effect. After a median follow-up of 14months, 20patients (20.8%) underwent surgery and/or chemoradiotherapy, and 9 patients died (mortality 9.4%).

CONCLUSIONS

In Spain, esophageal ESD is curative in approximately two out of three patients, with an acceptable risk of adverse events.

Pollen production in olive cultivars and its interannual variability

BACKGROUND AND AIMS

Olive (Olea europaea subsp. europaea var. europaea) is the most extensively cultivated fruit crop worldwide. It is considered a wind-pollinated and strictly outcrossing crop. Thus, elevated pollen production is crucial to guarantee optimum fruit set and yield. Despite these facts, the variability of pollen production within the cultivated olive has been scarcely studied. This study aimed to characterize this feature by analysing a representative set of worldwide olive cultivars.

METHODS

We evaluated the average number of pollen grains per anther in 57 principal cultivars over three consecutive years. We applied a standard generalized linear model (GLM) approach to study the influence of cultivar, year and the previous year's fruit load on the amount of pollen per anther. Additionally, the K-means method was used for cluster analysis to group cultivars based on their pollen production capacity.

KEY RESULTS

Pollen production per anther was highly variable among olive cultivars. The cultivar significantly accounted for 51.3 % of the variance in pollen production and the year for 0.3 %. The interaction between the two factors explained 8.4 % of the variance, indicating that not all cultivars were equally stable in producing pollen across the years. The previous year's fruit load and its interaction with the year were significant, but barely accounted for 1.5 % of the variance. Olive cultivars were classified into four clusters according to their capacity to produce pollen. Interestingly, the fourth cluster was composed of male-sterile cultivars, which presumably share this character by inheritance.

CONCLUSIONS

Pollen production per anther varied extensively within the cultivated olive. This variation was mainly driven by the cultivar and its interaction with the year. The differential capacity of olive cultivars to produce pollen should be considered not only for designing new orchards but also gardens where this species is used as an ornamental.

Use of fine capillaries for cryopreservation of Caenorhabditis elegans by vitrification

Caenorhabditis elegans is an exceptional model organism. More than twenty thousand different strains have been developed, increasing knowledge on countless topics. However, the traditional method to cryopreserve this nematode, based on slow freezing, usually reaches recovery rates of around 35% for the L1 and L2 larval stages. Here, we propose two alternative methods to cryopreserve this nematode based on vitrification that are applicable in common laboratories and allow the selective individual cryopreservation of this organism. These new methods require ultra-high warming rates, which are achieved by employing very thin capillaries as the nematode container, and a very low final concentration of cryoprotectants, which, as compared to slow freezing, reduce toxicity damage. The recovery rate was 98.5% for larvae (L1 - L4) and 84.3% for adults. Given these results, our procedures offer an alternative to cryopreserve this nematode (larvae and adults) with higher recovery rates, avoiding expensive requirements. Indeed, it only needed a container with liquid nitrogen and a warming bath for water at 37 °C. The high performance of this approach has been revealed by preserving the long-term memory and, probably, the connectome of this nematode.

Long-term cryostorage does not negatively affect the recovery of Caenorhabditis elegans

Cryostorage of Caenorhabditis elegans nematodes is important to maintain the many lines used for research. The standard method uses 15% of glycerol in M9-Buffer and a cooling rate of 1 °C/min; then worms can be stored in a -80 °C freezer or in liquid nitrogen. The recovery of C. elegans from stocks stored in liquid nitrogen is reported to be in the range of 35-45% and slightly decreases after years of storage. The storage at -80 °C is also considered safe, but the recovery is not as high as in liquid nitrogen. These observations have not been experimentally reported and therefore require verification. In this study, the standard methods were used in a set of experiments to compare the recovery of larvae and adult worms stored at -80 °C or in liquid nitrogen, after short- (a week) or long-term storage (3.5 years). No differences were observed in recovery, either for the time of storage or for the temperature of storage. Recovery of larvae was 32% at -80 °C and 36% in liquid nitrogen after 3.5 yr and that was not significantly different from the 7-d recovery rates. Adult worm recovery was below 5% for all treatments. These results suggest that both methods of storage can be used to successfully store C. elegans larvae for at least 3.5 years.

Influence of genetic and interannual factors on the phenolic profiles of virgin olive oils

Phenolic compounds in virgin olive oil (VOO) contribute to its health properties, organoleptic features and oxidative stability. In this study, a total of 44 olive tree cultivars categorized by the International Olive Council to be among the most internationally widespread varieties were exhaustively and homogenously evaluated by analysis of the VOO phenolic profile during three consecutive crop seasons. Differences among cultivars resulted in up to 15-fold variations in the total phenol concentration. The 'cultivar' factor contributed the most to the variance (66.8% for total phenolic concentration) for almost all the phenols. However, the 'interannual variability' factor and the interaction 'cultivar x interannual variability' exhibited significant influences on specific phenols. According to the phenolic profile of the VOOs, we determined the presence of three groups of cultivars marked by the predominance of secoiridoid derivatives, which supports the phenolic profile as a criterion to be considered in olive breeding programs.

Avoiding sexual interference: herkogamy and dichogamy in style dimorphic flowers of Narcissus broussonetii (Amaryllidaceae)

Spatial (herkogamy) or temporal (dichogamy) separation of sex organs are mechanisms considered to restrict self-pollination and promote outcrossing. Additionally, avoidance of self-interference is proposed to be the driving force for the evolution of these mechanisms, particularly in self-incompatible species. However, species with anthers and stigmas at different levels may increase the rate of imprecise pollen transfer, resulting in pollen discounting. Non-reciprocal stylar dimorphism has been considered a transitional, unstable stage towards the evolution of reciprocal style dimorphism (distyly), to simultaneously avoid interference and lack of precision. In this study we investigate the spatial and temporal separation of sex organs in a population of the style dimorphic and self-incompatible Narcissus broussonetii and their consequences in the reciprocity between the sex organs of morphs and their fecundity. First, we evaluated the relative growth of sex organs after anthesis. Then, we studied the stigma receptivity along the flower lifespan including its effect on seed production in both morphs. Finally, given the weak reciprocity between the sex organs of morphs of this species, we estimated population genetic diversity parameters in Long- and Short-styled plants to explore differences between them as a result of rates of inbreeding due to different mating strategies. We observed that Long-styled plants and Short-styled plants present different strategies to avoid sexual interference and both of them had negative consequences in the reciprocity between the sex organs of morphs. Long-styled plants exhibited a delay in stigma receptivity and a higher growth rate of the style after anthesis, while Short-styled plants presented higher herkogamy and no delay in stigma receptivity. These findings suggest that the avoidance of self-interference, in stylar dimorphic Narcissus species, seems to be more critical than improving of reciprocity between the sex organs of morphs. This might explain why reciprocal herkogamy (distyly) is rare in the genus.

Cultivar influence on variability in olive oil phenolic profiles determined through an extensive germplasm survey

Despite the evident influence of the cultivar on olive oil composition, few studies have been devoted to exploring the variability of phenols in a representative number of monovarietal olive oils. In this study, oil samples from 80 cultivars selected for their impact on worldwide oil production were analyzed to compare their phenolic composition by using a method based on LC-MS/MS. Secoiridoid derivatives were the most concentrated phenols in virgin olive oil, showing high variability that was significantly due to the cultivar. Multivariate analysis allowed discrimination between four groups of cultivars through their phenolic profiles: (i) richer in aglycon isomers of oleuropein and ligstroside; (ii) richer in oleocanthal and oleacein; (iii) richer in flavonoids; and (iv) oils with balanced but reduced phenolic concentrations. Additionally, correlation analysis showed no linkage among aglycon isomers and oleocanthal/oleacein, which can be explained by the enzymatic pathways involved in the metabolism of both oleuropein and ligstroside.

Persistence of Long-Term Memory in Vitrified and Revived Caenorhabditis elegans

Can memory be retained after cryopreservation? Our research has attempted to answer this long-standing question by using the nematode worm Caenorhabditis elegans, a well-known model organism for biological research that has generated revolutionary findings but has not been tested for memory retention after cryopreservation. Our study's goal was to test C. elegans' memory recall after vitrification and reviving. Using a method of sensory imprinting in the young C. elegans, we establish that learning acquired through olfactory cues shapes the animal's behavior and the learning is retained at the adult stage after vitrification. Our research method included olfactory imprinting with the chemical benzaldehyde (C₆H₅CHO) for phase-sense olfactory imprinting at the L1 stage, the fast-cooling SafeSpeed method for vitrification at the L2 stage, reviving, and a chemotaxis assay for testing memory retention of learning at the adult stage. Our results in testing memory retention after cryopreservation show that the mechanisms that regulate the odorant imprinting (a form of long-term memory) in C. elegans have not been modified by the process of vitrification or by slow freezing.

Relative Susceptibility of New Olive Cultivars to Spilocaea oleagina, Colletotrichum acutatum, and Pseudocercospora cladosporioides

The evaluation of the relative susceptibility of new cultivars to the main diseases of a crop is a key point to consider prior to their release to the nursery industry. This study provides a rigorous characterization of the resistance of 15 new olive cultivars and their genitors ('Arbequina,' 'Frantoio,' and 'Picual') to the three main aerial diseases, peacock spot, anthracnose, and cercosporiosis caused by Spilocaea oleagina, Colletotrichum acutatum, and Pseudocercospora cladosporioides, respectively. To do so, developing leaves and detached green-yellowish fruit were inoculated in laboratory tests with S. oleagina and C. acutatum, respectively, using conidial suspensions of both pathogens. Additionally, a previously validated rating scale was used to assess the incidence of leaves with symptoms of S. oleagina or P. cladosporioides and the fruit rot incidence of C. acutatum in the trees for four years under field conditions. As a result, only two of the cultivars were susceptible to peacock spot, most likely because these new cultivars were previously screened for resistance to the disease on previous phases of the breeding program. Conversely, the 15 cultivars were susceptible or moderately susceptible to cercosporiosis. Five of the 15 new cultivars were classified as resistant to anthracnose, with four of them descendants of 'Frantoio' × 'Picual' crosses. In addition, the cultivars resistance to C. acutatum showed a negative linear correlation with the total phenols content of olive oil. This information regarding disease reaction of the new olive cultivars is essential for nursery industry and growers.

High Susceptibility of Olive Cultivar FS-17 to Alternaria alternata in Southern Spain

Traditional olive orchards in Spain have been planted at a density of 70 to 80 trees per ha with three trunks per tree. During the last decade, the hedgerow orchard, in which planting density is approximately 2,000 trees per ha, was developed. In 2006 and 2007, we noted a severe outbreak of fruit rot in FS-17, a new cultivar from Italy, in an experimental hedgerow planting in Córdoba, southern Spain. The incidence of fruit rot in 'FS-17' was 80% in January of 2006 and 24% in January of 2007. Cvs. Arbosana, IRTA-i18 (a selected clone from 'Arbequina'), and Koroneiki had no symptoms in either year of the study. Disease incidence in 'Arbequina' was <0.1% only in 2006. Affected fruits were soft with gray-white skin and they eventually mummified. Black-green sporodochia were observed on the surface of diseased fruits. A fungus was isolated from diseased fruits on potato dextrose agar (PDA) and incubated at 22 to 26°C with a 12-h photoperiod. After 8 days of growing on PDA, fungal colonies formed conidial chains having a main axis with up to 10 conidia and secondary and tertiary short branches with two to four conidia. Conidia were obpyriform, ovoid, or ellipsoidal, without a beak or with a short beak, had up to four transverse septa, and measured 11.7 to 24.7 (mean 19.6) μm long and 7.7 to 13.0 (mean 9.6) μm wide at the broadest part of the conidium. The length of the beak of conidia was variable, ranging from 0 to 28.6 (mean 5.5) μm. The fungus was identified as Alternaria alternata (1). Pathogenicity tests were performed by spraying 40 mature fruits of 'FS-17' with a spore suspension (1 × 10⁶ spores per ml). The same number of control fruits was treated with water. After 21 days, inoculated fruit developed symptoms that had earlier been observed in the field. A. alternata was reisolated from lesions on all infected fruits. The fungus was not isolated from any of the control fruits. The experiment was performed twice. The new growing system and the high susceptibility of some olive cultivars, such as FS-17, may result in a high incidence of disease caused by a pathogen that is generally characterized as weakly virulent. To our knowledge, this is the first report of A. alternata causing a severe outbreak of fruit rot on olive trees in the field. References: (1) B. M. Pryor and T. J. Michailides. Phytopathology 92:406, 2002.

Incidence trends in pertussis in the Autonomous Region of Madrid, Spain: 1982-2005

The objective of this study was to describe the incidence (1982-2005) and epidemiologic characteristics of pertussis cases (1998-2005) in the Autonomous Region of Madrid using data drawn from the epidemiologic surveillance network and computerised hospital discharge data. In the 1990s, the trend in the pertussis incidence in the Autonomous Region of Madrid was clearly falling. The typical seasonal pattern of pertussis remained. A peak in incidence were observed in 2000, and another peak, 2.5 times higher, in 2003. They affected all age groups, but children under one year of age were the most frequent cases, followed by the five to nine year-olds. The greatest increase was seen in the age groups from 10 to 14 and from five to nine. Since 2002, the proportion of cases diagnosed serologically has increased. The incidence of hospital discharges among small children exceeded that of reported cases. More than half of the cases with known vaccination status had received at least three doses of vaccine. The upward trend observed since 2002 could be due to improved case detection, availability of serologic techniques, and a rise in the susceptible population aged five to 14 years. The fact that epidemic peaks continue to occur and that there is a seasonality to the disease seems to indicate that despite the vaccination programme the circulation of the bacteria has not been interrupted. The introduction of the acellular vaccine in 2000 does not appear to have played a significant role in the increase in disease incidence.

Preliminary results of an olive cultivar trial at high density

In the last decade, a new concept of olive orchards based on densities of around 2000 trees/ha arose. Its main advantage is the totally mechanised harvesting that drastically reduces the labour needed to collect the crop. In order to evaluate the suitability of 5 olive cultivars (Arbequina, Arbequina IRTA-i·18, Arbosana, Koroneiki, and Fs-17) to this planting system, a comparative trial was set up in 1999 and the initial results are presented in this study. Koroneiki was the most precocious cultivar, but all the rest bear 3 years after planting. Arbequina and Arbosana had the highest accumulated olive yield 6 years after planting. However, the differences in oil content mitigated the variability in yield. Therefore, accumulated oil yields were not significantly different for all the cultivars under study, except for Fs-17. No significant differences were found between Arbequina and its selected clone Arbequina IRTA-i·18 for any of the traits evaluated. The oleic acid content was low in Arbequina and Fs-17, intermediate in Arbosana, and high in Koroneiki. In conclusion, Arbosana showed a similar suitability to Arbequina for high-density orchards due to its high productivity in the first years after planting and its high oleic acid content. In addition, this cultivar is resistant to Spilocea oleagina and Colletotricum spp. in the area of the trial, Córdoba, southern Spain.

Seedling vigour as a preselection criterion for short juvenile period in olive breeding

The juvenile period represents a serious impediment in olive breeding programs. Seedlings with long juvenile period are of very low interest for the breeder because their evaluation considerably delays the first stages of the breeding process. For this reason, the influence of seedling vigour (measured as plant height or stem diameter) on the characteristics at the adult stage was studied to establish useful negative preselection criteria on the basis of that relationship. Olive progenies from crosses and open pollinations of 12 different parents carried out in 1998 and 1999 were evaluated in the greenhouse and, afterwards, during the first 3 years of bearing in the open field. The results obtained indicate that early evaluation and selection for juvenile period can be performed at the seedling stage in olive progenies on the basis of vigour measurements. Selection for short juvenile period was valid irrespective of parentage and, therefore, could be efficient in a general context. No relationship between juvenile period and yield or fruit traits was found so that this preselection criterion would have no adverse effects on these characters.

Selection for fruit removal force and related characteristics in olive breeding progenies

In the present work we discuss the possibility of breeding olives for suitability to mechanical harvesting. Variability in fruit removal force (FRF), and its correlation with fruit weight (FW) and yield were evaluated in reciprocal crosses of ‘Arbequina’, ‘Frantoio’ and ‘Picual’ cultivars. A wide range of variation was observed for FRF among the genotypes evaluated. A high correlation between FRF and FW was observed but not between FRF and yield. Analysis of variance showed significant differences among years but not among female genitors. Differences among genotypes, irrespective of their genitors, were also found, with the variance due to genotype being higher for FRF/FW than for FRF as dependent variable. Correlations of genotype data between years were significant for FRF/FW but not for FRF. The relatively low correlation values indicated that only some negative selection could be done on the basis of FRF/FW at the first stage of the breeding process, owing to the importance of the environmental variability. A more precise evaluation is needed during the successive stages of breeding, where several replicates per genotype are available.

Use of 19F NMR spectroscopy for measurement of cerebral blood flow: a comparative study using microspheres

19F NMR was used to determine washout curves of an inert, diffusible gas (CHF3) from the cat brain. The cerebral blood flow was estimated from a bi- or tri-phasic fit to the deconvoluted wash-out curve, using the Kety-Schmidt approach. Cerebral blood flow values determined by 19F NMR show the expected responsiveness to alterations in Paco2, but are approximately 28% lower than cerebral blood flow values determined simultaneously by radioactive microsphere techniques. High concentrations of CHF3 have little effect on intracranial pressure, mean arterial blood pressure or Paco2, but cause small changes in the blood flow to certain regions of the brain. We conclude that 19F NMR techniques utilizing low concentrations of CHF3 have potential for the noninvasive measurement of cerebral blood flow.

Cerebral blood flow and glucose metabolism in experimental brain edema

The relationship between cerebral blood flow (CBF) and cerebral metabolic rate of glucose (CMRgl) in the white matter was studied in a plasma infusion model of vasogenic edema in cats. Local CBF, as determined by iodoantipyrine testing, was found to be significantly decreased in edematous white matter (mean +/- standard error of the mean: 17.3 +/- 1.5 ml/100 gm/min) when compared with CBF in the contralateral control white matter (24.8 +/- 1.8 ml/100 gm/min). When the values for edematous brain were corrected for dilution, however, the local CBF averaged 25.3 +/- 1.7 ml/100 gm/min, which was similar to the control value. Local CMRgl was found to be significantly increased in plasma-infused white matter (16.3 +/- 2.2 mumol/100 gm/min) compared with that in control white matter (10.7 +/- 1.3 mumol/100 gm/min). This difference remained, despite correction for dilution and recalculation of local CMRgl values based on altered kinetic constants found in edematous brain. A similar increase in local CMRgl was noted with saline-infusion edema. It is concluded that the increased tissue water level does not alter CBF, but does induce an increase in anaerobic metabolism.