The stigma of intellectual disability in Spain: a nationally representative survey

BACKGROUND

Stigma towards people with intellectual disability affects various aspects of their lives, including access to employment, housing, health and social care services. Furthermore, this stigma reduces their social opportunities and is even reflected in laws that diminish their autonomy. Due to the practical significance of this issue, the aim of this research is to explore for the first time the social stigma associated with intellectual disability in a representative sample of the Spanish population.

METHOD

A cross-sectional quantitative descriptive study was conducted, involving a representative sample of the population (N = 2746). The study includes descriptive analyses and hierarchical regressions to examine various dimensions of stigma, such as attitudes, attributions, and intentions of social distance.

RESULTS

Medium levels of stigma are found regarding attitudes and attributions towards people with intellectual disability, while levels are medium-low concerning the intention of social distance. The most reliable indicators of stigma across its various dimensions encompass attitudes, attributions, and the intention of social distance. Factors that contribute to lower stigma include knowing someone with an intellectual disability, being willing to discuss intellectual disability with an acquaintance who has it and having a progressive political ideology. People with intellectual disability show more negative attributions towards themselves. Living with a person with an intellectual disability is another predictor of more stigmatising attitudes, but less intention of social distance. Results are mixed regarding age, gender, and educational level.

CONCLUSION

Combating the stigmatisation of people with intellectual disabilities must include comprehensive actions to address attitudes, attributions and behavioural intentions. Public policies, such as national campaigns and programmes, should include contact with and open conversations about intellectual disability, and sensitivity to sociodemographic variables.

Executive summary of the consensus document on the management of perioperative anemia in Spain

Perioperative anemia is an independent risk factor for postoperative morbidity and mortality. However, conceptual, logistical and administrative barriers persist that hinder the widespread implementation of protocols for their management. The project coordinator convened a multidisciplinary group of 8 experienced professionals to develop perioperative anemia management algorithms, based on a series of key points (KPs) related to its prevalence, consequences, diagnosis and treatment. These KPs were assessed using a 5-point Likert scale, from "strongly disagree [1]" to "strongly agree [5]". For each KP, consensus was reached when receiving a score of 4 or 5 from at least 7 participants (>75%). Based on the 36 KPs agreed upon, diagnostic-therapeutic algorithms were developed that we believe can facilitate the implementation of programs for early identification and adequate management of perioperative anemia, adapted to the characteristics of the different institutions in our country.

Generation of a novel three-dimensional scaffold-based model of the bovine endometrium

Bovine in vitro endometrial models that resemble tissue function in vivo are needed to study infertility, long-term uterine alterations induced by pathogens and impact of endocrine disruptor chemicals on reproductive function and other reproductive system complications that cause high economic losses in livestock species. The present study aimed to generate an innovative, reproducible, and functional 3D scaffold-based model of the bovine endometrium structurally robust for long term-culture. We developed a multicellular model containing both endometrial epithelial and stromal cells. Epithelial cells organized to form a luminal-like epithelial layer on the surface of the scaffold. Stromal cells produced their own extracellular matrix forming a stable subepithelial compartment that physiologically resembles the normal endometrium. Both cell types released prostaglandin E2 and prostaglandin F2α following a treatment with oxytocin and arachidonic acid. Additionally signal pathways mediating oxytocin and arachidonic acid stimulation of prostaglandin synthesis were analyzed by real time PCR (RT-PCR). Oxytocin receptor (OXTR), prostaglandin E2 receptor 2 (EP2), prostaglandin E2 receptor 4 (EP4), prostaglandin F receptor (PTGFR), prostaglandin E synthase (PTGES), PGF-synthase (PGFS) and prostaglandin-endoperoxide synthase 2 (COX-2) expression was detected in both control and treatment groups, however, only significant changes in abundance of OXTR mRNA transcripts were found. The results obtained by this study are a step forward in bovine in vitro culture technology. This 3D scaffold-based model provides a platform to study regulatory mechanisms involved in endometrial physiology and can set the basis for a broader tool for designing and testing novel therapeutic strategies for recurrent uterine pathologies.

Association of HER2DX with pathological complete response and survival outcomes in HER2-positive breast cancer

BACKGROUND

The HER2DX genomic test predicts pathological complete response (pCR) and survival outcome in early-stage HER2-positive (HER2+) breast cancer. Here, we evaluated the association of HER2DX scores with (i) pCR according to hormone receptor status and various treatment regimens, and (ii) survival outcome according to pCR status.

MATERIALS AND METHODS

Seven neoadjuvant cohorts with HER2DX and clinical individual patient data were evaluated (DAPHNe, GOM-HGUGM-2018-05, CALGB-40601, ISPY-2, BiOnHER, NEOHER and PAMELA). All patients were treated with neoadjuvant trastuzumab (n = 765) in combination with pertuzumab (n = 328), lapatinib (n = 187) or without a second anti-HER2 drug (n = 250). Event-free survival (EFS) and overall survival (OS) outcomes were available in a combined series of 268 patients (i.e. NEOHER and PAMELA) with a pCR (n = 118) and without a pCR (n = 150). Cox models were adjusted to evaluate whether HER2DX can identify patients with low or high risk beyond pCR status.

RESULTS

HER2DX pCR score was significantly associated with pCR in all patients [odds ratio (OR) per 10-unit increase = 1.59, 95% confidence interval 1.43-1.77; area under the ROC curve = 0.75], with or without dual HER2 blockade. A statistically significant increase in pCR rate due to dual HER2 blockade over trastuzumab-only was observed in HER2DX pCR-high tumors treated with chemotherapy (OR = 2.36 (1.09-5.42). A statistically significant increase in pCR rate due to multi-agent chemotherapy over a single taxane was observed in HER2DX pCR-medium tumors treated with dual HER2 blockade (OR = 3.11, 1.54-6.49). The pCR rates in HER2DX pCR-low tumors were ≤30.0% regardless of treatment administered. After adjusting by pCR status, patients identified as HER2DX low-risk had better EFS (P < 0.001) and OS (P = 0.006) compared with patients with HER2DX high-risk.

CONCLUSIONS

HER2DX pCR score and risk score might help identify ideal candidates to receive neoadjuvant dual HER2 blockade in combination with a single taxane in early-stage HER2+ breast cancer.

Prognostic value of intrinsic subtypes in hormone-receptor-positive metastatic breast cancer: systematic review and meta-analysis

BACKGROUND

In hormone receptor-positive (HoR+) breast cancer (BC), gene expression analysis identifies luminal A (LumA), luminal B (LumB), human epidermal growth factor receptor 2 (HER2)-enriched (HER2-E), basal-like (BL) intrinsic subtypes and a normal-like group. This classification has an established prognostic value in early-stage HoR+ BC. Here, we carried out a trial-level meta-analysis to determine the prognostic ability of subtypes in metastatic BC (MBC).

MATERIALS AND METHODS

We systematically reviewed all the available prospective phase II/III trials in HoR+ MBC where subtype was assessed. The primary endpoint was progression-free survival (PFS)/time to progression (TTP) of the LumA subtype compared to non-LumA. Secondary endpoints were PFS/TTP of each individual subtype, according to treatment, menopausal and HER2 status and overall survival (OS). The random-effect model was applied, and heterogeneity assessed through Cochran's Q and I². Threshold for significance was set at P < 0.05. The study was registered in PROSPERO (ID: CRD42021255769).

RESULTS

Seven studies were included (2536 patients). Non-LumA represented 55.2% and was associated with worse PFS/TTP than LumA [hazard ratio (HR) 1.77, P < 0.001, I² = 61%], independently of clinical HER2 status [P_{subgroup difference} (P_sub) = 0.16], systemic treatment (P_sub = 0.96) and menopausal status (P_sub = 0.12). Non-LumA tumors also showed worse OS (HR 2.00, P < 0.001, I² = 65%), with significantly different outcomes for LumB (PFS/TTP HR 1.46; OS HR 1.41), HER2-E (PFS/TTP HR 2.39; OS HR 2.08) and BL (PFS/TTP HR 2.67; OS HR 3.26), separately (PFS/TTP P_sub = 0.01; OS P_sub = 0.005). Sensitivity analyses supported the main result. No publication bias was observed.

CONCLUSIONS

In HoR+ MBC, non-LumA disease is associated with poorer PFS/TTP and OS than LumA, independently of HER2, treatment and menopausal status. Future trials in HoR+ MBC should consider this clinically relevant biological classification.

Carbon footprint, economic benefits and sustainable fishing: Lessons for the future from the Western Mediterranean

Ensuring an economically viable, sustainable and low CO₂ emission extractive fishery is critical in order to achieve the life below water UN sustainable development goals and the climate change commitments of Paris agreement. This challenge is even more relevant in the most overexploited region of the world: The Mediterranean Sea. Here, we use the socio-ecological system of the Spanish Mediterranean commercial fisheries (Northern Alboran Sea, Northern Spain and the Balearic Islands) to develop an integrative impact assessment, including detailed socio-economic, ecosystem indices of the trophic structure of extractive fishery and CO₂ emission analyses combining different gear, vessel size classes as well as a wide range estimation of carbon release from the seafloor by bottom trawling. Northern Alboran Sea preferentially requires reduction in purse seine fishery while in Northern Spain bottom trawling should be reduced first to reach sustainable exploitation. Fuel CO₂ footprint of purse seine and bottom trawling are among the lowest footprints of animal protein production, but considering sweeping released CO₂ from the seafloor the bottom trawling footprint becomes the animal protein production with the highest footprint. Moreover, the lowest bottom released CO₂ estimation overrides 2.7-10 times the CO₂ buried in the seafloor through the biological pump in trawled areas potentially turning the continental shelf from a CO₂ sink to a CO₂ source. Net profit per fuel derived CO₂ emission for all fleets is lower than 1€ kgCO₂^-1, being lowest for large bottom trawler (0.025 € kgCO₂^-1). Thus, urgent mitigation and adaptation measures are necessary to obtain sustainable fishery in terms of net profit, sustainable seafood extraction and CO₂ emission reduction. Our study provides scientific bases to develop these measures such as the restriction of harmful fishing gear in carbon rich river influenced areas, reduction of bottom contact of the fishing gear, favouring purse seine fishery and smaller bottom trawlers.

Effect of high hydrostatic pressure processing on the rennet coagulation kinetics and physicochemical properties of sheep milk rennet-induced gels

The effects of high hydrostatic pressure on the constituents and coagulation ability and their effect on cheese production of sheep milk have not been studied in detail. The objective of this work was to evaluate the effect of high hydrostatic pressure processing on the coagulation kinetics and physicochemical properties of sheep milk and to explore how such treatment could improve the cheesemaking process. Five batches of milk were tested: 1 untreated control batch and 4 batches each subjected to a different pressure (150, 300, 450, or 600 MPa) for 5 min at 10°C. As treatment pressure increased, values of electrical conductivity and oxidation-reduction potential were found to decrease. However, no significant reduction in pH was recorded. Treatment pressures >300 MPa produced milk with lower lightness (luminosity) and a more yellow and green hue. Pressures >150 MPa resulted in micellar fragmentation, as well as significant increases in particle size, viscosity, and water-holding capacity as a consequence of the denaturing of soluble proteins. High-pressure treatments increased the solubility of colloidal calcium phosphate, leading to a considerable increase in the concentration of minerals in the serum phase. The highest concentrations of calcium and phosphorus in the rennet whey of milk were reached at 300 MPa. Curd coagulation time was reduced by 28% at pressures >300 MPa, and an increase in the curd firming rate was observed. As treatment pressure increased to 450 MPa, the firmness, elasticity, and the percentage creep recovery of gels increased, whereas values of compliance and fracture strain were reduced. Thus, we can conclude that 300 MPa is the optimum treatment pressure for milk intended for cheesemaking by enzymatic coagulation. This pressure produced milk with optimal coagulation kinetics and water-holding properties with the least loss of fat and protein to the whey.

SNP discovery and association study for growth, fatness and meat quality traits in Iberian crossbred pigs

Iberian pigs and its crosses are produced to obtain high-quality meat products. The objective of this work was to evaluate a wide panel of DNA markers, selected by biological and functional criteria, for association with traits related to muscle growth, fatness, meat quality and metabolism. We used 18 crossbred Iberian pigs with divergent postnatal growth patterns for whole genome sequencing and SNP discovery, with over 13 million variants being detected. We selected 1023 missense SNPs located on annotated genes and showing different allele frequencies between pigs with makerdly different growth patterns. We complemented this panel with 192 candidate SNPs obtained from literature mining and from muscle RNAseq data. The selected markers were genotyped in 480 Iberian × Duroc pigs from a commercial population, in which phenotypes were obtained, and an association study was performed for the 1005 successfully genotyped SNPs showing segregation. The results confirmed the effects of several known SNPs in candidate genes (such as LEPR, ACACA, FTO, LIPE or SCD on fatness, growth and fatty acid composition) and also disclosed interesting effects of new SNPs in less known genes such as LRIG3, DENND1B, SOWAHB, EPHX1 or NFE2L2 affecting body weight, average daily gain and adiposity at different ages, or KRT10, NLE1, KCNH2 or AHNAK affecting fatness and FA composition. The results provide a valuable basis for future implementation of marker-assisted selection strategies in swine and contribute to a better understanding of the genetic architecture of relevant traits.

Unravelling the drivers of variability in body condition and reproduction of the European sardine along the Atlantic-Mediterranean transition

Body condition and reproduction data are broadly used to assess the health status of fish because of its implications for recruitment and ecosystem structure. Sardina pilchardus is a small pelagic distributed throughout both Mediterranean and Eastern Atlantic. Seasonal trend analysis of energy storage and reproduction was carried out in sardines from two areas along the Atlantic-Mediterranean transition: Southern Portugal-Gulf of Cádiz (POR-GC) (Atlantic Ocean) and Alboran Sea (Alb) (Mediterranean Sea) from 2019 to 2021. Energetic condition was estimated using tissue and mesenteric fat content, hepatosomatic index (HSI), and the relative condition factor (Kn). Sex, reproductive developmental stage, and gonadosomatic index (GSI) were also obtained. In addition, the oceanographic and meteorological characteristics of the areas were analysed. Results showed that seasonal Kn, tissue and mesenteric fat content, and HSI values of POR-GC specimens exceeded Alb's with summer arrival, period in which sardine acquires reserves to allocate them to reproduction. These differences could be associated to greater productivity of the former area mainly due to rivers discharges and trade winds intensification during summer (from July to September). Furthermore, gonad maturation of POR-GC stock occurred before the Alb. However, no spawning capable individuals were identified until February in POR-GC. In contrast, in Alb it was observed a remarkable fraction of spawning capable and active spawner individuals in October. We hypothesized the migration of mature individuals from POR-GC to the spawning areas located in the Alb. Seasonal genetic population studies are required to untangle it and reliably evaluate the environmental effect on the stocks.

P-796 Intraovarian injection of plasma rich in growth factors improves ovarian reserve and reproductive outcomes in women with diminished ovarian reserve

Study question

Does Plasma rich in growth factors (PRGF) ovarian injection increase the ovarian reserve biomarkers in women with diminished ovarian reserve?

Summary answer

PRGF injection increased Antimüllerian hormone (AMH) levels and antral follicular count (AFC) since the first follow-up after treatment allowing the initiation of ovarian stimulation cycles.

What is known already

Several techniques based on in vitro activation, ovarian fragmentation and stem cell ovarian transplantation have been proposed to reactivate ovarian function and increase IVF success in women with premature ovarian insufficiency and poor ovarian response. However, less invasive and feasible approaches are still required for those patients where egg donation is the only practical option.

Platelet rich plasma (PRP) and PRGF contain a high concentration of platelets, which carry more than 800 types of proteins, cytokines, hormones, and chemoattractants. Indeed, intraovarian PRP injection has recently been used in different case series and cohort studies of POI women with encouraging results.

Study design, size, duration

Retrospective study with 104 women aging 23-45 years who received a PRGF intraovarian injection (REGENERA-Ovario) was conducted between 2020 and 2021 at IVIRMA Alicante (Spain). Study was approved by the IRB committee of La Fe University Hospital (2112-FIVI-109-SH).

Participants/materials, setting, methods

Patients underwent a PRGF injection (Endoret kit; B.T.I. Biotechnology Institute S.L, Spain) in both ovaries and a follow up of ovarian reserve biomarkers (AFC, AMH) and follicle stimulating hormone (FSH) to evaluate follicular reactivation seeking IVF or spontaneous pregnancy. The follow up visits ranged from 1 to 5 months and were developed on a monthly basis after treatment or after menses recovery in POI. Study variables were compared to basal levels with a paired t-test.

Main results and the role of chance

Overall, 104 women (age: 38.7±2.0 years; BMI: 22.1±2.9) with diminished ovarian reserves underwent a PRGF intraovarian injection (3.3±0.8ml PRGF/each ovary). Prior to treatment, our cohort was characterized high serum FSH (21.8±4.1mIU/mL), low AMH levels (0.25±0.37ng/ml), and an ovarian volume of 6.3±2.3cm3.

Eighty-eight of them fulfilled the 1st follow up visit and showed an increase of serum AMH (0.25±0.37ng/ml vs. 0.32±0.36ng/ml, p = 0.008), and AFC in both ovaries (2.1±1.9 vs. 3.2±2.4, p &lt; 0.0001) compared to basal levels, achieving ovarian reactivation in 55.9% of them and IVF cycle initiation in 19.3%. These improvements were higher 2 months after treatment (55 patients), with increased antral follicles (AFC-2: 2.9±2.5, p = 0.0001) and ovarian activation in 58.2%, and IVF start in 43.9% of patients. Similar results were observed during the 3rd follow up accomplished by 30 women and lasted until the 5th visit (n = 8), although the reduced patient number at this point.

A total of 44 IVF cycles were started and oocyte pick-up was successfully developed in 72.7% of them with a mean number of 3.3±4.2MII oocytes, 1.8±2.1 fertilized oocytes and 1.5±2.0 embryos per cycle. Indeed, 6 pregnancies were obtained during this period, 2 of them after embryo transfer and 4 by natural conception.

Limitations, reasons for caution

Our results are encouraging but a large cohort of patients with a longer follow up period is needed to establish the efficacy and duration of the PRGF positive ovarian effects. Moreover, a proper comparison with a control group with the same characteristics and no PRGF intervention is still required.

Wider implications of the findings

PRGF intraovarian injection reactivates follicle growth and allows IVF cycle initiation and embryo generation in a poor prognosis population of patients with diminished ovarian reserve. The effects persisted for several months after treatment.

Trial registration number

2112-FIVI-109-SH

P-341 The effect of endometriosis on implantation success after single embryo transfer of a high-quality euploid blastocyst

Study question

Does endometriosis limit the embryo competence to implant in patients undergoing transfer of a single high-quality euploid blastocyst?

Summary answer

Although implantation competence of euploid blastocysts after deferred single-embryo transfers (SET) decreases in endometriosis patients, the effect is not observed when high-quality embryos are transferred.

What is known already

Endometriosis, a frequent gynecological disease, is often associated with female infertility and worse IVF clinical outcomes. Multiple factors may be involved in the subfertility of those patients. Although both defective embryo and altered endometrial receptivity may compromise implantation, evidences suggest a major role of embryo in the endometriosis impaired reproductive outcomes. However, few studies examine implantation after transfer of high-quality euploid embryos. Two studies on this issue suggested that endometriosis does not impact on pregnancy rates but either the embryo morphology was not considered, or a small sample size was used even including transfers with more than one single embryo.

Study design, size, duration

Retrospective multicenter cohort study on the competence of euploid embryos from patients with endometriosis (n = 277) compared with disease-free control women (n = 4677). Implantation and other clinical outcomes (positive pregnancy test, live birth: LB, miscarriages) were examined after SET to ascertain the effect of endometriosis on embryo competence. Results were firstly analyzed in single transferred embryos with any morphological graduation but also when only single high-quality blastocyst (A+B according ASEBIR embryo grading) were transferred.

Participants/materials, setting, methods

Our study involved women aged 18-42 years old undergoing IVF after preimplantation genetic testing for aneuploidies (PGT-A) in IVIRMA Clinics between 2012 and 2019. Severe male factors and patients with altered karyotype or chromosomopathies in previous embryos or pregnancies were excluded. Presence of endometriosis was revealed at the time of surgery or after pelvic ultrasound or NMR. Chi-square test for categorical variables or Student’s-test for quantitative variables were used to assess the statistical significance (P &lt; 0.05).

Main results and the role of chance

A total of 394 euploid blastocyst from endometriosis patients were included in the analysis while 6581 belonged to the control group. Up to 91.5 % were transferred after vitrification-warming in a deferred cycle (338 and 6043 in endometriosis and control groups) while the rest were transferred in the same cycle of embryo biopsy or even the oocyte retrieval. Among the frozen-transferred blastocysts, 76.85% and 74.93% from endometriosis and control women were high-quality embryos on the day of transfer (p = 0.51). Data showed slight but not significant differences in the positive pregnancy test (57.76% vs. 61.37%) and implantation outcomes (49.11% vs. 53.74%) between endometriosis and control group when both frozen and fresh SET were considered. Focusing on deferred SET of euploid blastocysts with any ASEBIR grade, both the proportion of positive test (56.08% vs. 61.82%; p = 0.04) and implanted blastocyst (47.77% vs. 54.34%, p = 0.02) were significantly lower in endometriosis than in the control group. However, they did result in similar amounts of LB (39.14% vs. 43.39%; p = 0.15). Moreover, when the top-quality embryos were examined, none of the clinical outcomes after deferred SET of euploid blastocysts where significantly different between endometriosis and control group (implantation: 50.88% vs. 57.43%; LB: 41.55% vs. 45.60%; p &gt; 0.05).

Limitations, reasons for caution

Results should be interpreted with caution due to the retrospective nature of the study. Although groups were as homogeneous as possible, multivariate regression models to avoid confounding factors are still pending. Reproductive outcomes only after fresh SET or considering to the severity of the disease have not been evaluated yet.

Wider implications of the findings

Although further research is required to surely state no association between endometriosis and embryo reproductive competence, our results suggest a similar pregnancy prognosis in women with or without endometriosis when a high-quality euploid blastocyst is available for transfer. Future prospective studies should take into consideration the quality of the embryo.

Trial registration number

Not applicable

AB0560 CLINICAL, SEROLOGICAL AND IMAGING CHARACTERISTICS OF LATIN AMERICAN PATIENTS WITH LUPUS MYOCARDITIS: A CASE-CONTROL STUDY

Background

Lupus myocarditis (LM) is an uncommon manifestation of systemic lupus erythematosus (SLE),

with a prevalence of 9% that tends to be lower in recent studies; it can range from subclinical to life-threatening manifestations (1). The clinical and immunological characteristics of LM have not been established in Latin American patients.

Objectives

To determine the clinical, serological, and imaging characteristics of patients with LM.

Methods

We conducted a single-center, case-control study that enrolled hospitalized patients between 2012 and 2020 in Colombia. Fifteen LM patients (cases) were matched by age and sex with thirty non-LM patients (controls). Descriptive, comparative, and logistic regression analyses were performed.

Results

Patients with LM were mostly females (93.3%) with a mean age of 28.2 years. The major affected clinical domains associated was renal (80%). Myocardial involvement occurred after SLE diagnosis with a mean of 5.1 years. Dyspnea (73.3%) was the main clinical manifestation. Troponin was high in 92.3% and echocardiographic findings included decreased left ventricular ejection fraction (LVEF) in the 60% of cases (mean 40%), diastolic dysfunction (61.5%), left ventricular dilatation (53.3%) and global hypokinesia 35.7%. The most common valvulopathy was mild mitral regurgitation. Nine LM patients underwent cardiac magnetic resonance. In this modality, mean LVEF was 38%, increased regional intensity on T2-weighted images, increased myocardial potentiation ratio on T1, and non-ischemic enhancement (mainly epicardial) was presented on 85.7%, 60%, and 57.1%, respectively. All patients received glucocorticoids and cyclophosphamide. Comparisons of the demographic, clinical, serological between LM and non-LM groups are shown in Table 1.

Table 1.

Demographic, clinical and serological characteristics.

VariableLM (n=15)Non-LMP-valueFemale93.3%100%0.333Age SLE24.9 (SD 12)28.3 (SD 13.9)0.515Clinical domainsCutaneous46.7%90%0.003Articular60%76.7%0.245Hematological60%83.3%0.086Serosal53.3%36.7%0.227Renal80%76.7%0.560Neuropsyquiatric6.7%26.7%0.115Vascular13.3%50%0.017PCR mg/dL10.1 (SD 9.3)2.8 (SD 4.6)0.0004Erythrocyte sedimentation rate mm/H52.9 (SD 25.7)43.9 (SD 32.9)0.267Creatinine mg/dL1.4 (SD 0.9)1.9 (SD 2.5)0.294C3 mg/dL57.4 (SD 22.4)86.2 (SD 29.9)0.002C4 mg/dL9.6 (SD 8.3)16.4 (SD 9.3)0.009Anti-dsDNA86.7%52.4%0.034SLEDAI score14.7 (SD 5.7)6.8 (SD 7.6)0.0003

SD: Standard deviation

Bivariate logistic regression showed that LM was independently associated with anti-dsDNA (OR 1.17, IC 1.04 – 1.31, p= 0.004), higher SLEDAI score (OR 1.17, IC 1.04 – 1.31, p=0,006), higher RCP (OR 1.21, IC 1.04 – 1.4, p=0.013), lower C3 (OR 0.96, IC 0.93 – 0.98, p:0,06) and lower C4 (OR 0.90 IC 0.82 – 0.99 P=0,036), highlighting its relationship with disease activity.

Conclusion

LM is a potentially severe manifestation and occurs in patients with higher disease activity, as was evidenced in the present study by low complement, anti-dsDNA and SLEDAI score. In the proper clinical context, noninvasive diagnostic tests should detect myocardial involvement in SLE.

References

[1]du Toit, Riette et al. “Outcome of clinical and subclinical myocardial injury in systemic lupus erythematosus - A prospective cohort study.” Lupus vol. 30,2 (2021): 256-268. doi:10.1177/0961203320976960

Disclosure of Interests

None declared

COVID-19 L·OVE repository is highly comprehensive and can be used as a single source for COVID-19 studies

Background and Objective

The coronavirus disease 2019 Living OVerview of Evidence (COVID-19 L·OVE) is a public repository and classification platform for COVID-19 articles. The repository contains more than 430,000 articles as of September 20, 2021 and intends to provide a one-stop shop for COVID-19 evidence. Considering that systematic reviews conduct high-quality searches, this study assesses the comprehensiveness and currency of the repository against the total number of studies in a representative sample of COVID-19 systematic reviews.

Methods

Our sample was generated from all the studies included in the systematic reviews of COVID-19 published during April 2021. We estimated the comprehensiveness of COVID-19 L·OVE repository by determining how many of the individual studies in the sample were included in the COVID-19 L·OVE repository. We estimated the currency as the percentage of studies that was available in the COVID-19 L·OVE repository at the time the systematic reviews conducted their own search.

Results

We identified 83 eligible systematic reviews that included 2,132 studies. COVID-19 L·OVE had an overall comprehensiveness of 99.67% (2,125/2,132). The overall currency of the repository, that is, the proportion of articles that would have been obtained if the search of the reviews was conducted in COVID-19 L·OVE instead of searching the original sources, was 96.48% (2,057/2,132). Both the comprehensiveness and the currency were 100% for randomized trials (82/82).

Conclusion

The COVID-19 L·OVE repository is highly comprehensive and current. Using this repository instead of traditional manual searches in multiple databases can save a great amount of work to people conducting systematic reviews and would improve the comprehensiveness and timeliness of evidence syntheses. This tool is particularly important for supporting living evidence synthesis processes.

Page kidney after pediatric kidney transplantation: a case report

INTRODUCTION

Page kidney (PK) is a rare condition caused by parenchymal compression due to a subcapsular hematoma. Irreversible damage of the graft may occur if this condition is not recognized and treated properly.

CLINICAL CASE

We describe the case of a 16-year-old man with chronic renal failure secondary to corticosteroid-resistant nephrotic syndrome (CRNS) caused by NPHS2 mutations. The patient underwent a 5th fifth living-related KT. The graft was placed intraperitoneally and reperfused well without complications. On the 4th postoperative day his labs demonstrated raising creatinine associated with refractory hypertension, gross hematuria and anemia. Urgent ultrasound revealed a subcapsular hematoma with signs of parenchymal compression. PK phenomenon was suspected and urgent surgical intervention decided.

COMMENTS

PK is a rare but an emergence potentially treatable and reversible complication after pediatric KT. Early diagnosis based on clinical suspicion and suggestive imaging are the key points for a favorable outcome.

Consequences of a low protein diet on the liver and longissimus dorsi transcriptome of Duroc × Iberian crossbred pigs

Low protein diets supplied during the growing period of pigs can diminish their growth rate and increase the intramuscular fat (IMF) content which affects the sensorial and technological characteristics of the products. In the present study, the effects of a low protein diet supplied during the growing period of Duroc × Iberian crossbred pigs on several phenotypic traits and on liver and longissimus dorsi transcriptome were analysed at the beginning (EARLY) and at the end (LATE) of the growing period. Two experimental groups of 10 crossbred pigs each were fed two isocaloric diets with different protein content: control diet (C) with 16.5% protein and 0.8% lysine and low protein diet (LP) with 11% CP and 0.6% lysine. Animals fed LP diet have a slower growth than those fed C diet, but no effect of LP diet was observed on the IMF content. The transcriptomes of liver and longissimus dorsi were characterised and quantified through RNA-sequencing (RNA-seq). In liver, 134 and 480 differentially expressed annotated genes and new isoforms (DEGs) were detected between C and LP diets for EARLY and LATE animals, respectively. In muscle, 128 and 68 DEGs were detected at EARLY and LATE time-points. Functional interpretation revealed that LP diet may inhibit immune system molecules and processes in both tissues at EARLY stage. In liver, the DEGs mainly affect lipid and cholesterol metabolic processes, while in muscle, the expression changes would be involved in growth, development and meat quality. In conclusion, a low protein diet supplied during the growing period seems to slow down the growth of Duroc × Iberian crossbred pigs, but it also seems to affect multiple biological processes that could compromise the immune system of Duroc × Iberian crossbred pigs. Therefore, these results question the adequacy of this type of regime in Duroc × Iberian pigs that must be studied in greater depth before being implemented.

POS0770 DIFFERENTIAL CLINICAL PRESENTATION BETWEEN SLE RUPHUS PATIENTS AND SLE NON-RHUPUS PATIENTS: A CASE-CONTROL STUDY

Background:

Rhupus is a term that describe the coexistence of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Rhupus patients have symmetrical, erosive arthritis, characteristic SLE manifestations and an array of autoantibodies including rheumatoid factor (RF), anti-cyclic citrullinated peptides (anti-CCP), anti-dsDNA, and anti-Sm.1 Joint involvement is common in SLE patients (90%), but only 1% to 9,7% have rhupus.2 Due to its low prevalence, there is still a lack of evidence on its presentation and differences with other SLE patients without rhupus.

Objectives:

To examine the rhupus prevalence and to compare the clinical and serological characteristics between rhupus, and non-rhupus SLE patients (SLE with arthritis (SLEa), and SLE without arthritis (SLEwa)).

Methods:

We performed a case-control study. Rhupus patients (cases) were matched 1:1 with non-rhupus SLE patients (controls). Descriptive statistics were calculated and rhupus, SLEa, and SLEwa were compared.

Results:

A total of 72 patients were included, 24 patients in each group; most were female (87.5%). The median age at rhupus onset was 36.5 years (IQR 30-42.5). RA preceded rhupus in half of the patients, 29% were initially diagnosed as SLE, and 21% were initially diagnosed as rhupus. The median duration of RA was 66 months (IQR 30-144).

In the descriptive analysis of rhupus patients, the most affected joints were the proximal interphalangeal and metacarpophalangeal joints (87.5%), followed by the wrists (79.1%). Regarding immunological findings, RF and anti-CCP were positive in 87.5% and 50% of the patients, respectively. As to radiographic findings, the median number of erosions in the hands and wrists was 2 (IQR 0-5) and the median number of joints with narrowed joint space was 7 (IQR: 1.5 - 13.5). In terms of treatment, 95.8% received corticosteroids (median 10 mg/day), 91.6% antimalarials, 79.1% methotrexate, 41.6% leflunomide, and 25.0% rituximab.

Patients with rhupus were older and had less renal and hematological involvement than patients with SLEa and SLEwa. SLEa patients had higher seropositivity for anti-RNP and anti-Sm, higher neurological involvement, and higher SLEDAI-2K scores than rhupus patients. Comparisons of other clinical and serological variables between SLE rhupus and non-ruphus patients are shown in table 1 and figure 1.

Table 1.

Clinical and serological manifestations in rhupus, articular SLE, and non-articular SLE

VariablesRHUPUSM (IQR)SLE with arthritisM (IQR)SLE without arthritisM (IQR)P value RHUPUS vs. SLE with arthritisp value RHUPUSvs. SLE without arthritisAge (years) M (IQR)40 (31.5 – 49)29 (21.5 – 45)33 (19.5 – 37.5)0.0430.013CPR M (IQR)2.3 (1– 8.5)1.6 (0.3– 3.6)0.9 (0.2– 2.5)0.3370.032Positive anti-RNP N (%)7 (29.1%)14 (58.3%)7 (29.1%)0.0421.000Positive anti-Sm N (%)5 (20.8%)15 (62.5%)6 (25%)0.0030.500SLEDAI – 2K score M (IQR)4.5 (1 – 7)9 (2 – 18)7 (3.5 – 15)0.0450.082Figure 1.

Differences in the frequencies of organic alterations. w/o: without.

Conclusion:

Patients with rhupus were older and had lower SLEDAI-2K scores compared with those non-rhupus. Furthermore, renal, neurological, and hematological manifestations were more common in non-rhupus patients than in rhupus patients.

References:

[1]Antonini L, et al. Rhupus: a systematic literature review. Autoimmun Rev. 2020;19(9):102612.

[2]Tani C, et al. Rhupus syndrome: Assessment of its prevalence and its clinical and instrumental characteristics in a prospective cohort of 103 SLE patients. Autoimmun Rev. 2013; 12:537–41.

Disclosure of Interests:

None declared

Mental health consequences of the Covid-19 outbreak in Spain. A longitudinal study of the alarm situation and return to the new normality

AIMS

The objective is to conduct a longitudinal analysis of the effects of the pandemic and alarm situation on the mental health of the general population at three points in time: two weeks after beginning the confinement, after a month, and after two months, when the lockdown was lifted and the country returned to the new normality.

METHODS

The evaluations were carried out by means of an online survey, with a sample of 3480 persons in the first data collection and 1041 and 569 persons in the successive evaluation periods. The presence of depressive symptoms, anxiety and posttraumatic stress disorder (PTSD) was evaluated by means of screening tests. Sociodemographic data, Covid-19 variables, loneliness, psychological well-being, social support, discrimination and a sense of belonging, were collected.

RESULTS

Depressive symptoms increased significantly throughout the confinement, decreasing at the last assessment but not dropping to previous levels. In anxiety, there are no significant changes between the three evaluations, but a downward trend can be seen over time. Regarding the symptomatology of PTSD, a downward trend is observed throughout the three evaluations, with significantly lower scores between the first and third assessments. The different regression models developed reveal the importance of perceived loneliness and spiritual well-being as the main predictors of mental health, as well as the importance of the lower age for depression and the female gender for anxiety and PSTD.

CONCLUSIONS

This research shows that the pandemic has had a negative impact on our mental health, which still does not seem to be at pre-crisis levels, although it has improved as the emergency situation subsides. These results underline the importance of paying greater attention to mental health, and reveal key variables such as spiritual well-being and perceived loneliness in which to intervene from different care services, as well as younger people and women as vulnerable groups on which to focus more attention.

Immune microenvironment characterisation and dynamics during anti-HER2-based neoadjuvant treatment in HER2-positive breast cancer

Despite their recognised role in HER2-positive (HER2+) breast cancer (BC), the composition, localisation and functional orientation of immune cells within tumour microenvironment, as well as its dynamics during anti-HER2 treatment, is largely unknown. We here investigate changes in tumour-immune contexture, as assessed by stromal tumour-infiltrating lymphocytes (sTILs) and by multiplexed spatial cellular phenotyping, during treatment with lapatinib-trastuzumab in HER2+ BC patients (PAMELA trial). Moreover, we evaluate the relationship of tumour-immune contexture with hormone receptor status, intrinsic subtype and immune-related gene expression. sTIL levels increase after 2 weeks of HER2 blockade in HR-negative disease and HER2-enriched subtype. This is linked to a concomitant increase in cell density of all four immune subpopulations (CD3+, CD4+, CD8+, Foxp3+). Moreover, immune contexture analysis showed that immune cells spatially interacting with tumour cells have the strongest association with response to anti-HER2 treatment. Subsequently, sTILs consistently decrease at the surgery in patients achieving pathologic complete response, whereas most residual tumours at surgery remain inflamed, possibly reflecting a progressive loss of function of T cells. Understanding the features of the resulting tumour immunosuppressive microenvironment has crucial implications for the design of new strategies to de-escalate or escalate systemic therapy in early-stage HER2+ BC.

Runs of homozygosity provide a genome landscape picture of inbreeding and genetic history of European autochthonous and commercial pig breeds

ROHs are long stretches of DNA homozygous at each polymorphic position. The proportion of genome covered by ROHs and their length are indicators of the level and origin of inbreeding. Frequent common ROHs within the same population define ROH islands and indicate hotspots of selection. In this work, we investigated ROHs in a total of 1131 pigs from 20 European local pig breeds and in three cosmopolitan breeds, genotyped with the GGP Porcine HD Genomic Profiler. plink software was used to identify ROHs. Size classes and genomic inbreeding parameters were evaluated. ROH islands were defined by evaluating different thresholds of homozygous SNP frequency. A functional overview of breed-specific ROH islands was obtained via over-representation analyses of GO biological processes. Mora Romagnola and Turopolje breeds had the largest proportions of genome covered with ROH (~1003 and ~955 Mb respectively), whereas Nero Siciliano and Sarda breeds had the lowest proportions (~207 and 247 Mb respectively). The highest proportion of long ROH (>16 Mb) was in Apulo-Calabrese, Mora Romagnola and Casertana. The largest number of ROH islands was identified in the Italian Landrace (n = 32), Cinta Senese (n = 26) and Lithuanian White Old Type (n = 22) breeds. Several ROH islands were in regions encompassing genes known to affect morphological traits. Comparative ROH structure analysis among breeds indicated the similar genetic structure of local breeds across Europe. This study contributed to understanding of the genetic history of the investigated pig breeds and provided information to manage these pig genetic resources.

Palbociclib in combination with endocrine therapy versus capecitabine in hormonal receptor-positive, human epidermal growth factor 2-negative, aromatase inhibitor-resistant metastatic breast cancer: a phase III randomised controlled trial-PEARL

BACKGROUND

Palbociclib plus endocrine therapy (ET) is the standard treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative, metastatic breast cancer (MBC). However, its efficacy has not been compared with that of chemotherapy in a phase III trial.

PATIENTS AND METHODS

PEARL is a multicentre, phase III randomised study in which patients with aromatase inhibitor (AI)-resistant MBC were included in two consecutive cohorts. In cohort 1, patients were randomised 1 : 1 to palbociclib plus exemestane or capecitabine. On discovering new evidence about estrogen receptor-1 (ESR1) mutations inducing resistance to AIs, the trial was amended to include cohort 2, in which patients were randomised 1 : 1 between palbociclib plus fulvestrant and capecitabine. The stratification criteria were disease site, prior sensitivity to ET, prior chemotherapy for MBC, and country of origin. Co-primary endpoints were progression-free survival (PFS) in cohort 2 and in wild-type ESR1 patients (cohort 1 + cohort 2). ESR1 hotspot mutations were analysed in baseline circulating tumour DNA.

RESULTS

From March 2014 to July 2018, 296 and 305 patients were included in cohort 1 and cohort 2, respectively. Palbociclib plus ET was not superior to capecitabine in both cohort 2 [median PFS: 7.5 versus 10.0 months; adjusted hazard ratio (aHR): 1.13; 95% confidence interval (CI): 0.85-1.50] and wild-type ESR1 patients (median PFS: 8.0 versus 10.6 months; aHR: 1.11; 95% CI: 0.87-1.41). The most frequent grade 3-4 toxicities with palbociclib plus exemestane, palbociclib plus fulvestrant and capecitabine, respectively, were neutropenia (57.4%, 55.7% and 5.5%), hand/foot syndrome (0%, 0% and 23.5%), and diarrhoea (1.3%, 1.3% and 7.6%). Palbociclib plus ET offered better quality of life (aHR for time to deterioration of global health status: 0.67; 95% CI: 0.53-0.85).

CONCLUSIONS

There was no statistical superiority of palbociclib plus ET over capecitabine with respect to PFS in MBC patients resistant to AIs. Palbociclib plus ET showed a better safety profile and improved quality of life.

Metabolomic Profiling of Bos taurus Beef, Dairy, and Crossbred Cattle: A Between-Breeds Meta-Analysis

Cattle breeds may differ substantially in their metabolism. However, the metabolomes of dairy and beef cattle are not well-known. Knowledge of breed-specific metabolic features is essential for biomarker identification and to adopt specific nutritional strategies. The muscle hypertrophy (mh), a beef cattle phenotype present in Asturiana de los Valles (AV) but absent in Asturiana de la Montaña (AM) and Holsteins, may underlie such differences. We compared the plasma metabolomes of Holstein, AV, AM, and crossbred cattle recipients selected for meta-analysis within an embryo transfer (ET) program. Blood samples were collected on day 0 (oestrus) and day 7 (prior to ET) (N = 234 samples × 2 days). Nuclear magnetic resonance quantified N = 36 metabolites in plasma, and more metabolic differences between breeds were found on day 0 (N = 19 regulated metabolites) than on day 7 (N = 5). AV and AM largely differed from Holstein cattle (N = 55 and 35 enriched metabolic pathways, respectively); however, AV and AM differed in N = 6 enriched pathways. Metabolic activity was higher in AV than in Holstein cattle, as explained in part by the mh phenotype. The metabolomic characterization of breeds facilitates biomarker research and helps to define the healthy ranges of metabolite concentrations.

Patient blood management during the COVID-19 pandemic: a narrative review

As COVID-19 disease escalates globally, optimising patient outcome during this catastrophic healthcare crisis is the number one priority. The principles of patient blood management are fundamental strategies to improve patient outcomes and should be given high priority in this crisis situation. The aim of this expert review is to provide clinicians and healthcare authorities with information regarding how to apply established principles of patient blood management during the COVID-19 pandemic. In particular, this review considers the impact of the COVID-19 pandemic on blood supply and specifies important aspects of donor management. We discuss how preventative and control measures implemented during the COVID-19 crisis could affect the prevalence of anaemia, and highlight issues regarding the diagnosis and treatment of anaemia in patients requiring elective or emergency surgery. In addition, we review aspects related to patient blood management of critically ill patients with known or suspected COVID-19, and discuss important alterations of the coagulation system in patients hospitalised due to COVID-19. Finally, we address special considerations pertaining to supply-demand and cost-benefit issues of patient blood management during the COVID-19 pandemic.

Phase III study to evaluate patient's preference of subcutaneous versus intravenous trastuzumab in HER2-positive metastatic breast cancer patients: Results from the ChangHER study (GEICAM/2012-07)

OBJECTIVE

We compared patients' preferences for intravenous (IV-t) versus subcutaneous (SC-t) trastuzumab administration.

METHODS

Phase III, open-label, multicentre study in HER2-positive metastatic breast cancer. Patients were receiving IV-t for at least 4 months without progression. Randomisation was 1:1 to administer 2 cycles of SC-t with vial followed by 2 cycles with single injection device (SID) or the reverse sequence (600mg SC-t every 3 weeks for 4 cycles).

PRIMARY OBJECTIVE

patients' preference for IV-t versus SC-t; secondary objectives: patients' preference for vial versus SID, healthcare professional (HCP) preference and safety.

RESULTS

We randomised 166 patients in 26 sites. Median number of previous lines of chemotherapy and/or endocrine therapy was 1 (1-7). Median duration of prior IV-t was 1.8 years (0.3-14). Of the159 patients completing the questionnaires, 86.2% preferred SC-t, 6.9% preferred IV-t, and 6.9% had no preference. Patients preferred SID (59.2%) over vial (26.3%). Most (87.2%) HCP preferred SC-t of whom 51.3% and 28.2% preferred SID and vial respectively. Related adverse events included G1-2 injection site reactions in 18 patients (10.8%), G1 pain in 8 (4.8%), G1-2 allergic reaction in 2 (1.2%), one G3 heart failure and 1 G2 ejection fraction decrease.

CONCLUSIONS

SC-t is preferred with no safety impact.

Genome-wide detection of copy number variants in European autochthonous and commercial pig breeds by whole-genome sequencing of DNA pools identified breed-characterising copy number states

In this study, we identified copy number variants (CNVs) in 19 European autochthonous pig breeds and in two commercial breeds (Italian Large White and Italian Duroc) that represent important genetic resources for this species. The genome of 725 pigs was sequenced using a breed-specific DNA pooling approach (30-35 animals per pool) obtaining an average depth per pool of 42×. This approach maximised CNV discovery as well as the related copy number states characterising, on average, the analysed breeds. By mining more than 17.5 billion reads, we identified a total of 9592 CNVs (~683 CNVs per breed) and 3710 CNV regions (CNVRs; 1.15% of the reference pig genome), with an average of 77 CNVRs per breed that were considered as private. A few CNVRs were analysed in more detail, together with other information derived from sequencing data. For example, the CNVR encompassing the KIT gene was associated with coat colour phenotypes in the analysed breeds, confirming the role of the multiple copies in determining breed-specific coat colours. The CNVR covering the MSRB3 gene was associated with ear size in most breeds. The CNVRs affecting the ELOVL6 and ZNF622 genes were private features observed in the Lithuanian Indigenous Wattle and in the Turopolje pig breeds respectively. Overall, the genome variability unravelled here can explain part of the genetic diversity among breeds and might contribute to explain their origin, history and adaptation to a variety of production systems.

Development of a 64 SNV panel for breed authentication in Iberian pigs and their derived meat products

Spanish legislation regulates the labelling of Iberian pig meat and dry-cured products, which are labelled as "Ibérico" or "100% Ibérico" when they come from Duroc x Iberian crossbred or Iberian purebred pigs. Although the analytical authentication of breed origin is not mandatory, a genetic diagnostic tool is demanded by producers and consumers. We have designed a 64 Single Nucleotide Variant genotyping panel displaying extreme allelic frequencies between Duroc and Iberian purebred samples. Average proportions of Iberian alleles of 0.99, 0.01, 0.77 and 0.48 were estimated by admixture clustering analysis of known origin samples, for Iberian and Duroc purebred, 75% Iberian and 50% Iberian classes, respectively. A supervised analysis with 1419 samples showed some overlapping between contiguous classes, but the calculated degrees of separability ranged from 0.800 to 0.996, exceeding the threshold value (0.70) for considering suitable for prediction. Therefore, this panel is a useful genetic tool to infer purebred or crossbred Iberian origin of live animals, meat and dry-cured products.

Nuclear magnetic resonance analysis of female and male pre-hatching embryo metabolites at the embryo-maternal interface

INTRODUCTION

Bovine female and male embryos differentially release metabolites with signalling effects to culture media. However, it is unknown if the embryo-maternal interface (EMI) metabolome is modified by embryonic sex.

OBJECTIVE

To analyse using a combination of 1H NMR and a co-culture of endometrial cells the EMI.

RESULTS

Twenty-six metabolites were identified and quantified in the EMI, nine metabolites reflected the sex of the embryo rather than their presence.

CONCLUSIONS

1H NMR is sensitive enough to perform quantitative analysis of sex-induced differences in the EMI. These results may help to understand the embryo-maternal dialogue on the basis of embryonic sex.

Risk factors for major adverse cardiovascular events after osteoporotic hip fracture repair surgery

Osteoporotic hip fracture (OHF) is an increasingly frequent age-related pathology, which results in high rates of functional loss and mortality within the first year after surgery. This study assessed whether preoperative levels of brain natriuretic peptide (NT-proBNP) and troponin I were related to early occurrence (30d) of major adverse cardio-vascular events (MACE) after OHF repair surgery. During a 6-month period, perioperative clinical and analytical data from consecutive patients, without known history of cardiovascular disease and undergoing surgery for OHF repair at a single centre, were prospectively collected. MACE was defined as acute myocardial ischaemia or infarction, acute heart failure or cardiovascular death. amongst the 140 patients included, 23 (16.4%) developed postoperative MACE (MACE group) and 117 did not (Control group). Compared to those from control group, patients from MACE group were older, had poorer physical status (ASA III-IV), received preoperative red blood cell transfusion (RBCT) more frequently, presented with lower haemoglobin concentrations and higher NT-proBNP, creatinine and troponin I concentrations. Overall, RBCT requirements and 30d mortality rate were also higher in MACE group. However, in multivariate analysis, only preoperative RBCT, creatinine >1 mg/dL and NT-proBNP >450 pg/mL remained as independent preoperative risks factors for postoperative MACE, while 95% confidence intervals of odds ratios were wide. Though our findings require confirmation in a larger multicentre cohort, identifying risk factors for early postoperative MACE after OHF repair surgery, might facilitate assessing patients' risk prior to and following surgery, and targeting them the appropriate preventive and/or therapeutic interventions.

Fast fabrication of reusable polyethersulfone microbial biosensors through biocompatible phase separation

In biosensors fabrication, entrapment in polymeric matrices allows efficient immobilization of the biorecognition elements without compromising their structure and activity. When considering living cells, the biocompatibility of both the matrix and the polymerization procedure are additional critical factors. Bio-polymeric gels (e.g. alginate) are biocompatible and polymerize under mild conditions, but they have poor stability. Most synthetic polymers (e.g. PVA), on the other hand, present improved stability at the expense of complex protocols involving chemical/physical treatments that decrease their biological compatibility. In an attempt to explore new solutions to this problem we have developed a procedure for the immobilization of bacterial cells in polyethersulfone (PES) using phase separation. The technology has been tested successfully in the construction of a bacterial biosensor for toxicity assessment. Biosensors were coated with a 300  μm bacteria-containing PES membrane, using non-solvent induced phase separation (membrane thickness ≈ 300 μm). With this method, up to 2.3 × 10⁶ cells were immobilized in the electrode surface with an entrapment efficiency of 8.2%, without compromising cell integrity or viability. Biosensing was performed electrochemically through ferricyanide respirometry, with metabolically-active entrapped bacteria reducing ferricyanide in the presence of glucose. PES biosensors showed good stability and reusability during dry frozen storage for up to 1 month. The analytical performance of the sensors was assessed carrying out a toxicity assay in which 3,5-dichlorophenol (DCP) was used as a model toxic compound. The biosensor provided a concentration-dependent response to DCP with half-maximal effective concentration (EC₅₀) of 9.2 ppm, well in agreement with reported values. This entrapment methodology is susceptible of mass production and allows easy and repetitive production of robust and sensitive bacterial biosensors.

BOMET-QoL-10 questionnaire for breast cancer patients with bone metastasis: the prospective MABOMET GEICAM study

Background

Bone metastasis (BM) is the most common site of disease in metastatic breast cancer (MBC) patients. BM impacts health-related quality of life (HRQoL). We tested prospectively the psychometric properties of the Bone Metastasis Quality of Life (BOMET-QoL-10) measure on MBC patients with BM.

Methods

Patients completed the BOMET-QoL-10 questionnaire, the Visual Analogue Scale (VAS) for pain, and a self-perceived health status item at baseline and at follow-up visits. We performed psychometric tests and calculated the effect size of specific BM treatment on patients´ HRQoL.

Results

Almost 70% of the 172 patients reported symptoms, 23.3% experienced irruptive pain, and over half were receiving chemotherapy. BOMET-QoL-10 proved to be a quick assessment tool performing well in readability and completion time (about 10 min) with 0–1.2% of missing/invalid data. Although BOMET-QoL-10 scores remained fairly stable during study visits, differences were observed for patient subgroups (e.g., with or without skeletal-related events or adverse effects). Scores were significantly correlated with physician-reported patient status, patient-reported pain, symptoms, and perceived health status. BOMET-QoL-10 scores also varied prospectively according to changes in pain intensity.

Conclusions

BOMET-QoL-10 performed well as a brief, easy-to-administer, useful, and sensitive HRQoL measure for potential use for clinical practice with MBC patients.

Trial registration

NCT03847220. Retrospectively registered on clinicaltrials.gov (February the 20th 2019).

Association between PD1 mRNA and response to anti-PD1 monotherapy across multiple cancer types

Background

We hypothesized that the abundance of PD1 mRNA in tumor samples might explain the differences in overall response rates (ORR) observed following anti-PD1 monotherapy across cancer types.

Patients and methods

RNASeqv2 data from 10 078 tumor samples representing 34 different cancer types was analyzed from TCGA. Eighteen immune-related gene signatures and 547 immune-related genes, including PD1, were explored. Correlations between each gene/signature and ORRs reported in the literature following anti-PD1 monotherapy were calculated. To translate the in silico findings to the clinical setting, we analyzed the expression of PD1 mRNA using the nCounter platform in 773 formalin-fixed paraffin embedded (FFPE) tumor samples across 17 cancer types. To test the direct relationship between PD1 mRNA, PDL1 immunohistochemistry (IHC), stromal tumor-infiltrating lymphocytes (sTILs) and ORR, we evaluated an independent FFPE-based dataset of 117 patients with advanced disease treated with anti-PD1 monotherapy.

Results

In pan-cancer TCGA, PD1 mRNA expression was found strongly correlated (r > 0.80) with CD8 T-cell genes and signatures and the proportion of PD1 mRNA-high tumors (80th percentile) within a given cancer type was variable (0%-84%). Strikingly, the PD1-high proportions across cancer types were found strongly correlated (r = 0.91) with the ORR following anti-PD1 monotherapy reported in the literature. Lower correlations were found with other immune-related genes/signatures, including PDL1. Using the same population-based cutoff (80th percentile), similar proportions of PD1-high disease in a given cancer type were identified in our in-house 773 tumor dataset as compared with TCGA. Finally, the pre-established PD1 mRNA FFPE-based cutoff was found significantly associated with anti-PD1 response in 117 patients with advanced disease (PD1-high 51.5%, PD1-intermediate 26.6% and PD1-low 15.0%; odds ratio between PD1-high and PD1-intermediate/low = 8.31; P < 0.001). In this same dataset, PDL1 tumor expression by IHC or percentage of sTILs was not found associated with response.

Conclusions

Our study provides a clinically applicable assay that links PD1 mRNA abundance, activated CD8 T-cells and anti-PD1 efficacy.

The involvement of the substance P/neurokinin 1 receptor system in viral infection: focus on the gp120 fusion protein and homologous dipeptide domains

The human immunodeficiency virus (HIV) envelope, via a key extracellular amino acid sequence, may simulate the functionality of native undecapeptide substance P (SP) acting through the host's neurokinin 1 (SP preferring) receptor (NK-1R). Human monocytes and macrophages express both NK-1Rs and SP. In HIV/AIDS the NK-1R may function as a chemokine-like G-protein coupled co-receptor that: 1) fuses to the outer envelope of HIV; 2) enables intracellular entry of the envelope-capsid-NK-1R complex; 3) co-opts immune defence via its physiological interaction with the SP-like envelope; 4) may contribute to resistance of CD4/chemokine entry inhibitor type drugs; 5) relaxes the blood-brain barrier to support entry of the HIV into the central nervous system, and 6) mediates most of the common clinical sequelae of HIV/AIDS (encephalopathy and AIDS dementia complex). The data support the idea that NK-1R antagonists could be useful to treat HIV/AIDS. Keywords: human immunodeficiency virus; NK-1 receptor; NK-1 receptor antagonist; aprepitant; fusion protein; virus.

Genomic diversity, linkage disequilibrium and selection signatures in European local pig breeds assessed with a high density SNP chip

Genetic characterization of local breeds is essential to preserve their genomic variability, to advance conservation policies and to contribute to their promotion and sustainability. Genomic diversity of twenty European local pig breeds and a small sample of Spanish wild pigs was assessed using high density SNP chips. A total of 992 DNA samples were analyzed with the GeneSeek Genomic Profiler (GGP) 70 K HD porcine genotyping chip. Genotype data was employed to compute genetic diversity, population differentiation and structure, genetic distances, linkage disequilibrium and effective population size. Our results point out several breeds, such as Turopolje, Apulo Calabrese, Casertana, Mora Romagnola and Lithuanian indigenous wattle, having the lowest genetic diversity, supported by low heterozygosity and very small effective population size, demonstrating the need of enhanced conservation strategies. Principal components analysis showed the clustering of the individuals of the same breed, with few breeds being clearly isolated from the rest. Several breeds were partially overlapped, suggesting genetic closeness, which was particularly marked in the case of Iberian and Alentejana breeds. Spanish wild boar was also narrowly related to other western populations, in agreement with recurrent admixture between wild and domestic animals. We also searched across the genome for loci under diversifying selection based on F_ST outlier tests. Candidate genes that may underlie differences in adaptation to specific environments and productive systems and phenotypic traits were detected in potentially selected genomic regions.

Overview of nuclear bodies and their classification in the Terminologia Histologica

BACKGROUND

Nuclear bodies (NB) are membrane-less subnuclear organelles that perform important functions in the cell, such as transcription, RNA splicing, processing and transport of ribosomal pre-RNA, epigenetic regulation, and others. The aim of the work was to analyse the classification of NB in the Terminologia Histologica (TH) and biological and bibliographical databases.

MATERIALS AND METHODS

The semantic structure of the Nucleoplasm section in the TH was analysed and unsystematic bibliographical search was made in the PubMed, SciELO, EMBASE databases and European Bioinformatics Institute (EMBL-EBI) biology database to identify which structures are classified as NB.

RESULTS

It was found that the terms Corpusculum convolutum, Macula interchromatinea and Corpusculum PML are not correctly classified in the TH, since they are subordinated under the term Chromatinum and not under Corpusculum nucleare. The bibliography consulted showed that 100%, 92.6% and 81.5% of articles mentioned Corpusculum convolutum, Macula interchromatinea and Corpusculum PML, respectively as nuclear bodies.

CONCLUSIONS

It is suggested to relocate the terms Corpusculum convolutum, Macula interchromatinea and Corpusculum PML with the name of Corpusculum nucleare and the incorporation of two new entities to the Histological Terminology according to the information collected: paraspeckles and histone locus body.

Changes in dietary intake, plasma carotenoids and erythrocyte membrane fatty acids in breast cancer survivors after a lifestyle intervention: results from a single-arm trial

BACKGROUND

The influence of nutrition on breast cancer prognosis is still inconclusive and therefore dietary interventions incorporating dietary biomarkers are needed to confirm compliance with dietary goals and clarify biological mechanisms. The present study assessed whether a lifestyle intervention in breast cancer survivors could affect dietary biomarkers of fruit and vegetables and fatty acids.

METHODS

In this phase II single-arm trial, 37 overweight/obese early stage breast cancer patients completed a 12-week diet and exercise intervention. The intervention involved 1-h weekly diet sessions delivered by a dietician and 75-min bi-weekly physical activity sessions of moderate-to-high intensity led by trained monitors. Before and after the intervention, three 24-h dietary recalls were carried out to calculate nutrient intakes and, in addition, blood samples were taken to measure plasma carotenoids, vitamin E and retinol concentrations and erythrocyte membrane fatty acid (EFA) composition. Wilcoxon signed rank tests were used to assess changes in dietary and biomarkers measurements over the intervention period.

RESULTS

After the intervention, there was a significant increase in the intake of dietary carotenoids (+15.1% compared to baseline) but not plasma carotenoids levels (+6.3%). Regarding the EFA levels, we observed a significant decrease in percentage of saturated fatty acids (-1.4%) and n-6 polyunsaturated fatty acids (-2.9%) and an increase in monounsaturated fatty acids (1.7%) and total and long-chain n-3 polyunsaturated fatty acids (by 13.1% and 13.7%, respectively). A favourable decrease in the ratio of long-chain n-6 to n-3 polyunsaturated fatty acids (-9.1%) was also observed.

CONCLUSIONS

After a short-term diet and exercise intervention in overweight/obese breast cancer survivors, we observed significant changes in dietary nutrients and fatty acid biomarkers, suggesting positive dietary changes that could be relevant for breast cancer prognosis.