Cortical inhibition on TMS-EEG: interstimulus interval effect on short-interval paired-pulse

In mental disorders, paired-pulse (PP) transcranial magnetic stimulation and electroencephalography (TMS-EEG) recordings usage is increasing to directly evaluate the cortical inhibition of motor and nonmotor regions. One of the most common measures to assess the inhibition is the short-interval cortical inhibition (SICI), which depends on the interstimulus interval (ISI). This measure has been widely used in the motor cortex. However, the number of studies that evaluate other nonmotor regions, such as the dorsolateral prefrontal cortex (DLPFC), are increasing and there is still little knowledge on how the ISI affects those areas.In this pilot study, six subjects underwent a SICI protocol over the DLPFC using ISI values of 2 and 4ms with the aim of comparing them. TMS-EEG signals for both ISIs were characterized regarding the amplitude and latency of the TMS-evoked potentials (TEP) P60 and N100. Whereas the variation of cortical inhibition between ISIs is almost significant for N100, with higher inhibition for an ISI of 2ms, for TEP P60 the variation was not appreciable. Findings are in accordance with the ones in the state-of-the-art obtained in the motor cortex and suggest that a greater inhibition is likely to be produced with an ISI of 2ms.Clinical relevance- This pilot study indicates that cortical inhibition might be better assessed when DLPFC is stimulated with an ISI of 2ms in the SICI protocol.

Identification and comparison of the main variables affecting early university dropout rates according to knowledge area and institution

The dropout rate in universities is a widely studied issue that concerns both universities and public organizations. Most studies focus on quantifying the phenomenon and identifying the variables involved. This paper uses a multidisciplinary approach to parameterize the factors that define the entry profile of undergraduates at the national level in Spain in collaboration with three universities in different regions and with different disciplines. The aim is to reduce the dropout rate in the first year of study towards a degree. The research questions focus on the weighting of personal variables about students by tutors and whether there are differences in the weighting systems for the main variables as differentiated by discipline, university and/or region. The document is organized to describe the method and context of the study, present the main results, show the application of the survey instrument in a case study, and provide conclusions. The method is based on the two fundamental factors, including the influence of certain student characteristics at matriculation and the importance of a positive experience in the first year of the degree. The study is focused on two elements that inspire the current proposal: the need to identify and rapidly detect students who, due to their entry characteristics, are at a greater risk of dropout and the importance of guaranteeing a good start in the first year of the degree. The study uses a multidisciplinary approach and combines qualitative and quantitative methods to gather data. The study also uses a survey instrument that measures the risk of student dropout based on the weighting of personal variables by tutors. The results of the study have allowed us to categorize the main variables of the student profile that affect the risk of dropout and establish them as aspects to be monitored by the tutors in the first weeks. Furthermore, it has been shown that although there are no significant differences in the averages of dropout risk calculated with either global or specific weighting systems (by centre or studies), there is a tendency observed by the tutors that the weighted averages generated by disciplinary focus are closer to identifying the student's real risk of dropping out.

Children and adolescents exposed to maltreatment already exhibit epigenetic patterns suggestive of heightened low-grade inflammation

Introduction

Childhood maltreatment (CM) is one of the best described environmental risk factors for developing any psychiatric disorder, while it also confers increased odds for obesity, cardiometabolic disorders and all-cause mortality. Inflammation has been suggested to mediate the widespread clinical effects of CM. Previously, Ligthart et al. (2016) identified a polyepigenetic signature of circulating CRP levels, a measure of chronic low-grade inflammation, that has been reliably associated with a wide array of complex disorders. The study of this biomarker could dilucidate the mechanistic relationship between CM and psychiatric outcomes.

Objectives

Thus, CRP-associated epigenetic modifications were explored regarding proximal exposure to CM.

Methods

Genomic DNA was extracted from peripheral blood mononuclear cells of 157 children and adolescents (7 to 17 years old). Exposure to CM was assessed following the TASSCV criteria. Genome-wide DNA methylation was assessed by means of the EPIC array. Fifty-two out of the 58 original CRP-associated CpG sites surpassed quality control and were included in the analysis. Age, sex, psychopathological status and cell type proportions were included as covariates.

Results

DNA methylation at 12 out of 52 CpG sites (23%) was significantly associated with exposure to CM (p < .05); 8 of these associations survived correction for multiple testing (q < .05).

Conclusions

This is the first study to date to explore the relationship between childhood maltreatment and an epigenetic signature of chronic low-grade inflammation. Our findings underscore the presence of immune dysregulation early after exposure to CM; further studies are needed to assess the long-term clinical implications of this signature in psychiatric patients.

Disclosure

No significant relationships.

Reinforcing the new diagnosis of Complex Post-Traumatic Stress disorder (CPTSD) of ICD-11: exploring the clinical outcomes in youth exposed to complex trauma

Introduction

Youth exposed to complex trauma (CT) show an increased risk of psychiatric morbidity, including a wide range of psychiatric disorders. However, to date, there is no specific diagnosis in the DSM-5 that capture the clinical complexity of these patients. Properly, the last version of the ICD-11 includes a diagnosis termed Complex Post-Traumatic Stress Disorder (CPTSD), which considers the pattern of post-traumatic stress symptoms, plus life-impairing disturbances in self-organization (emotion dysregulation, negative self-concept and interpersonal problems). Clinical research about CPTSD, especially in younger population, is still limited.

Objectives

To explore the symptomatology of CPTSD in a sample of youth exposed to CT and its association with worse clinical outcomes.

Methods

187 youth aged 7 to 17 years participated in the EPI_young_stress_project (116 with current psychiatric disorder and 71 healthy controls). CT was evaluated following the TASSCV criteria. To identify CPTSD symptomatology, we performed an exploratory factor analysis including CBCL and TEIQue items. The global level of functioning was measured by CGAS.

Results

Preliminary results pointed that youth exposed to CT showed greater internalizing (p<.001) and externalizing (p<.001) symptomatology. Regardless of their current primary diagnosis based on DSM-5, youth exposed to CT reported more CPTSD symptomatology (p<.001). Moreover, youth with CPTSD showed greater use of psychotropic drugs (p<.001), higher and longer hospitalizations (p=.002) and worse overall functioning (p<.001).

Conclusions

The inclusion of the CPTSD in future versions of mental disorders manuals should increase the implementation of early specific trauma interventions, which may improve victims’ lives and reduce the risk of worse clinical outcomes.

Disclosure

No significant relationships.

Cognitive stimulation has potential for brain activation in individuals with Rett syndrome

BACKGROUND

Knowledge regarding neuropsychological training in Rett syndrome (RS) is scarce. The aim of this study was to assess the outcome and the duration of the effect of cognitive stimulation on topographic electroencephalography (EEG) data in RS.

METHODS

Twenty female children diagnosed with RS were included in the analysis. Girls with RS conducted a cognitive task using an eye-tracker designed to evaluate access and choice skills. EEG data were acquired during the experimental procedure including two 10-min baseline stages before and after the task. Topographical changes of several EEG spectral markers including absolute and relative powers, Brain Symmetry Index and entropy were assessed.

RESULTS

Topographic significance probability maps suggested statistical decreases on delta activity and increases on beta rhythm associated with the cognitive task. Entropy increased during and after the task, likely related to more complex brain activity. A significant positive interaction was obtained between Brain Symmetry Index and age showing that the improvement of interhemispheric symmetry was higher in younger girls (5-10 years).

CONCLUSIONS

According to our findings, significant alterations of brain rhythms were observed during and after cognitive stimulation, suggesting that cognitive stimulation may have effects on brain activity beyond the stimulation period. Finally, our promising results also showed an increase brain symmetry that was especially relevant for the younger group. This could suggest an interaction of the eye-tracking cognitive task; however, further studies in this field are needed to assess the relation between brain asymmetries and age.

Can Wolf Spider Mothers Detect Insecticides in the Environment? Does the Silk of the Egg-Sac Protect Juveniles from Insecticides?

The use of pesticides for plague control in agroecosystems generates a threat to wildlife and a major problem for human health. Pesticide compounds are also an important source of water and atmosphere contamination. Although insecticides are effective on their target organisms, they often affect organisms that are not their target. The aim of the present study was to research the effects of 3 types of neurotoxic insecticides-a pyrethroid (cypermethrin), a neonicotinoid (imidacloprid), and an organophosphate (chlorpyrifos)-on behavioral and physiological parameters of Pardosa saltans spider (Lycosidae). Our study analyzed for the first time the exploratory behavior of the spider mothers in the presence of these 3 insecticides on their egg-sacs and also on the ground. We also evaluated the oxidative stress effects on the juveniles hatched in the egg-sac protected by silk in relation to variations in detoxification enzymes (catalase, glutathione reductase, superoxide dismutase, glutathione-S-transferase, and glutathione peroxidase) and lipid peroxidation (reactive oxygen species [ROS]). The results show that these insecticides are repellents for mothers (cypermethrin is the most repellent), and maternal behavior is modified after detection of an insecticide on their egg-sac but mothers do not abandon their egg-sacs. These neurotoxic insecticides affect the juveniles inside their egg-sac. Cypermethrin and chlorpyrifos caused more oxidative stress in juveniles than did imidacloprid. The ROS generated by these insecticides seemed to be adequately eliminated by the juveniles' antioxidant systems. Environ Toxicol Chem 2021;40:2861-2873. © 2021 SETAC.

Implementation of an Integrated Care Model for Frequent-Exacerbator COPD Patients: A Controlled Prospective Study

INTRODUCTION

Frequent-exacerbator COPD (fe-COPD) associated with frequent hospital admissions have high morbidity, mortality and use of health resources. These patients should be managed in personalized integrated care models (ICM). Accordingly, we aimed to evaluate the long-term effectiveness of a fe-COPD ICM on emergency room (ER) visits, hospital admissions, days of hospitalization, mortality and improvement of health status.

METHODS

Prospective-controlled study with analysis of a cohort of fe-COPD patients assigned to ICM and followed-up for maximally 7 years that were compared to a parallel cohort who received standard care. All patients had a confirmed diagnosis of COPD with a history of ≥2 hospital admissions due to exacerbations in the year before enrollment. The change in CAT score and mMRC dyspnea scale, hospital admissions, ER visits, days of hospitalization, and mortality were analyzed.

RESULTS

141 patients included in the ICM were compared to 132 patients who received standard care. The ICM reduced hospitalizations by 38.2% and ER visits by 69.7%, with reduction of hospitalizations for COPD exacerbation, ER visits and days of hospitalization (p<0.05) compared to standard care. Further, health status improved among the ICM group after 1 year of follow-up (p=0.001), effect sustained over 3 years. However, mortality was not different between groups (p=0.117). Last follow-up CAT score>17 was the strongest independent risk factor for mortality and hospitalization among ICM patients.

CONCLUSIONS

An ICM for fe-COPD patients effectively decreases ER and hospital admissions and improves health status, but not mortality.

P–626 A freeze-all strategy improves clinical pregnancy rate in patients with few available embryos

Study question

Is elective frozen blastocyst transfer an advantageous strategy for all patients?

Summary answer

A freeze-all strategy improves the outcomes in patients with few available embryos.

What is known already

With the aim of defining the best moment to perform embryo transfer, in recent years, relevance has been given to the understanding of the implantation window, however oocyte and embryo quality are key factors that are not to be disregarded.

It has been suggested that a freeze-all strategy and subsequent frozen embryo transfers improve pregnancy rates. However, it is unclear whether this strategy benefits all kind of patients (i.e. with or without surplus embryos, etc).

In this study, we aim to provide an answer on which patients may benefit of a freeze-all policy and a subsequent frozen embryo transfer.

Study design, size, duration

This retrospective cohort study includes infertile patients aged 21 to 44 years old, without previous history of recurrent failure of ART (including recurrent miscarriages). Enrolments took place between January 2015 and November 2019 and cycles with oocyte donation and PGT were excluded. Embryo transfers were performed in: 1) a fresh cycle (ET) or 2) a deferred cycle with surplus frozen embryos (FET) or embryos that were frozen in a freeze-all policy (FET-FA).

Participants/materials, setting, methods

Patients with blastocysts transfer were included. PGT cycles were excluded.

The number of cycles complying with the inclusion criteria were: 617 ICSI cycles. Fresh embryo transfers (ET) were performed in 396 cycles (43 with a subsequent Frozen embryo transfer, FET). Frozen embryo transfers following a freeze-all strategy (FET-FA) were performed in 221 cycles.

Clinical pregnancy rates (CPR) and Cumulative clinical pregnancy rates (CCPR) were calculated and compared among those groups.

Main results and the role of chance

Mean age of patients was 36.1 ± 3.7 years old (mean ± SD). In average, 1.83 ± 0.41 (mean ± SD) embryos were transferred.

Following the first transfer (either ET and FET-FA), CPR was 40.4% and 58.4% (ET and FET-FA, respectively). Following the subset analysis of 2 age groups (≤38 & &gt;38 years-old); in the ≤38-group, CPR was 45.2% and 58.9% (ET and FET-FA, respectively), while in &gt; 38-group, the rates were 30.8% and 54.8% (ET and FET-FA, respectively); p &lt; 0.05. CCPR were also significantly better in the FET-FA group: 51.3% vs 66.8% and 33.8% vs 58.1% in the ≤38-group and &gt;38-group, respectively.

Additionally, CPR was analysed independently for patients with ≤2 usable embryos (1 attempt) or ≥ 3 usable embryos (surplus embryos after first attempt).

When a single attempt was possible; in the ≤38-group, CPR was 36.1% and 56.9% (ET and FET-FA, respectively) while in the &gt;38-group, the rates were 24.7% and 63.6% (ET and FET-FA, respectively); p &lt; 0.05. When surplus embryos were available, no difference in CPR (or CCPR) between ET and FET-FA groups were observed. After first attempt CPR were 58.4% and 48.2% in the ≤38-group & &gt;38-group, respectively; while CCPR were 69.8% and 57.1% in the ≤38-group & &gt;38-group, respectively.

Limitations, reasons for caution

Although the authors consider that the patient population is of optimal size, a detailed analysis of the stimulation protocol and hormonal values (estradiol and progesterone) during treatment, and its potential relation to the outcomes, should follow.

Wider implications of the findings: In our setting, the data suggests that freeze-all strategy (with subsequent frozen embryo transfer) over fresh transfer is advantageous for patients with few available embryos (1 or 2 embryos for a single attempt). This increases the chances to pregnancy in 30.3% in the ≤38-group and 77.9% in the &gt;38-group.

Trial registration number

Not applicable

Prevalence and correlates of suicidal behaviour in adolescents with bipolar disorder

Objective

To examine the prevalence and correlates of suicidal behavior among adolescents with bipolar disorder (BD).

Methods

47 adolescents, ages 12 to 19 years (15.8 ± 2), meeting DSM-5 criteria for BD-I (n=40) and BD-II (n=7) were assessed using the KSADS-PL and tested with a battery of tests measuring mood, psychotic symptoms, life events and functioning. History of suicidal attempts (SA) was ascertained using the K-SADS-PL.Results: One third (n=15, 32%) of the BD sample had a lifetime history of SA. There were no differences in socio-demographics factors between SA versus non- SA. BD adolescents with lifetime SA, were more likely to have lower weight at birth, a lifetime history of comorbid eating disorder, non-suicidal self-injurious behavior, 2nd degree family history of suicide attempt, and more stressful life events as compared with non-attempters. Adolescents with lifetime history of SA also showed statistically significant higher scores in depression, suicidal ideation and anxiety as compared with BD adolescents without lifetime SA. Logistic regression analysis found that the most robust correlates of SA in adolescents with BD were having 2nd degree family history of SA, the interaction of self-injury behavior and comorbid eating disorder and increased number of life events. Limitations: Retrospective data. Small sample size. Since this is a cross-sectional study, no inferences regarding causality can be made. Conclusion: One third of the adolescents with BD have attempted suicide. These results are in agreement with previous studies. History of SA in adolescents with BD is strongly associated with family history of suicidal behavior, lifetime self-injury behavior with comorbid eating disorder and increased number of stressful life events.

Disclosure

No significant relationships.

Implementation of an Integrated Care Model for Frequent-Exacerbator COPD Patients: A Controlled Prospective Study

INTRODUCTION

Frequent-exacerbator COPD (fe-COPD) associated with frequent hospital admissions have high morbidity, mortality and use of health resources. These patients should be managed in personalized integrated care models (ICM). Accordingly, we aimed to evaluate the long-term effectiveness of a fe-COPD ICM on emergency room (ER) visits, hospital admissions, days of hospitalization, mortality and improvement of health status.

METHODS

Prospective-controlled study with analysis of a cohort of fe-COPD patients assigned to ICM and followed-up for maximally 7 years that were compared to a parallel cohort who received standard care. All patients had a confirmed diagnosis of COPD with a history of ≥2 hospital admissions due to exacerbations in the year before enrollment. The change in CAT score and mMRC dyspnea scale, hospital admissions, ER visits, days of hospitalization, and mortality were analyzed.

RESULTS

141 patients included in the ICM were compared to 132 patients who received standard care. The ICM reduced hospitalizations by 38.2% and ER visits by 69.7%, with reduction of hospitalizations for COPD exacerbation, ER visits and days of hospitalization (p<0.05) compared to standard care. Further, health status improved among the ICM group after 1 year of follow-up (p=0.001), effect sustained over 3 years. However, mortality was not different between groups (p=0.117). Last follow-up CAT score>17 was the strongest independent risk factor for mortality and hospitalization among ICM patients.

CONCLUSIONS

An ICM for fe-COPD patients effectively decreases ER and hospital admissions and improves health status, but not mortality.

Lifetime psychopathology in child and adolescent offspring of parents diagnosed with schizophrenia or bipolar disorder: a 2-year follow-up study

Having one parent diagnosed with a severe mental disorder is considered one of the main risk factors for developing that disorder in adulthood, and it also increases the risk of a wide range of mental disorders in the offspring. The aim of this study is to compare the prevalence of several psychopathological diagnoses, the presence of prodromal symptoms, and global functioning in offspring of parents with schizophrenia or bipolar disorder and in offspring of controls at baseline and 2-year follow-up. This study included 41 offspring of parents with schizophrenia, 90 offspring of parents with bipolar disorder, and 107 offspring of controls (mean age 11.7 ± 3.2 at baseline and 13.9 ± 3.2 at follow-up). The prevalence of psychopathology and comorbidity was higher in offspring of parents with schizophrenia and offspring of parents with bipolar disorder than in offspring of controls at baseline and at 2-year follow-up. Interestingly, mood disorders were more prevalent in offspring of parents with bipolar disorder and disruptive disorders were more prevalent in offspring of parents with schizophrenia. Prodromal symptoms were more frequent in offspring of parents with schizophrenia than in offspring of controls, while the offspring of parents with bipolar disorder showed an intermediate pattern. Finally, global functioning was lower in the offspring of parents with schizophrenia than the offspring of parents with bipolar disorder and the offspring of controls. Screening patients' children is clinically relevant, since, as a group, they have an elevated risk of developing a psychiatric disorder and of experiencing their first symptoms during childhood and adolescence.

Installing oncofertility programs for common cancers in limited resource settings (Repro-Can-OPEN Study): An extrapolation during the global crisis of Coronavirus (COVID-19) pandemic

PURPOSE

The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer.

METHODS

As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer.

RESULTS

All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings.

CONCLUSIONS

Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.

DNA methylation and mRNA expression of imprinted genes in blastocysts derived from an improved in vitro maturation method for oocytes from small antral follicles in polycystic ovary syndrome patients

STUDY QUESTION

Does imprinted DNA methylation or imprinted gene expression differ between human blastocysts from conventional ovarian stimulation (COS) and an optimized two-step IVM method (CAPA-IVM) in age-matched polycystic ovary syndrome (PCOS) patients?

SUMMARY ANSWER

No significant differences in imprinted DNA methylation and gene expression were detected between COS and CAPA-IVM blastocysts.

WHAT IS KNOWN ALREADY

Animal models have revealed alterations in DNA methylation maintenance at imprinted germline differentially methylated regions (gDMRs) after use of ARTs. This effect increases as more ART interventions are applied to oocytes or embryos. IVM is a minimal-stimulation ART with reduced hormone-related side effects and risks for patients. CAPA-IVM is an improved IVM system that includes a pre-maturation step (CAPA), followed by an IVM step, both in the presence of physiological compounds that promote oocyte developmental capacity.

STUDY DESIGN, SIZE, DURATION

For DNA methylation analysis 20 CAPA-IVM blastocysts were compared to 12 COS blastocysts. For RNA-Seq analysis a separate set of 15 CAPA-IVM blastocysts were compared to 5 COS blastocysts.

PARTICIPANTS/MATERIALS, SETTING, METHODS

COS embryos originated from 12 patients with PCOS (according to Rotterdam criteria) who underwent conventional ovarian stimulation. For CAPA-IVM 23 women were treated for 3-5 days with highly purified hMG (HP-hMG) and no hCG trigger was given before oocyte retrieval. Oocytes were first cultured in pre-maturation medium (CAPA for 24 h containing C-type natriuretic peptide), followed by an IVM step (30 h) in medium containing FSH and Amphiregulin. After ICSI, Day 5 or 6 embryos in both groups were vitrified and used for post-bisulphite adaptor tagging (PBAT) DNA methylation analysis or RNA-seq gene expression analysis of individual embryos. Data from specific genes and gDMRs were extracted from the PABT and RNA-seq datasets.

MAIN RESULTS AND THE ROLE OF CHANCE

CAPA-IVM blastocysts showed similar rates of methylation and gene expression at gDMRs compared to COS embryos. In addition, expression of major epigenetic regulators was similar between the groups.

LIMITATIONS, REASONS FOR CAUTION

The embryos from the COS group were generated in a range of culture media. The CAPA-IVM embryos were all generated using the same sperm donor. The DNA methylation level of gDMRs in purely in vivo-derived human blastocysts is not known.

WIDER IMPLICATIONS OF THE FINDINGS

A follow-up of children born after CAPA-IVM is important as it is for other new ARTs, which are generally introduced into clinical practice without prior epigenetic safety studies on human blastocysts. CAPA-IVM opens new perspectives for patient-friendly ART in PCOS.

STUDY FUNDING/COMPETING INTEREST(S)

IVM research at the Vrije Universiteit Brussel has been supported by grants from the Institute for the Promotion of Innovation by Science and Technology in Flanders (Agentschap voor Innovatie door Wetenschap en Technologie-IWT, project 110680), the Fund for Research Flanders (Fonds voor Wetenschappelijk Onderzoek-Vlaanderen-FWO-AL 679 project, project G.0343.13), the Belgian Foundation Against Cancer (HOPE project, Dossier C69Ref Nr 2016-119) and the Vrije Universiteit Brussel (IOF Project 4R-ART Nr 2042). Work in G.K.'s laboratory is supported by the UK Biotechnology and Biological Sciences Research Council and Medical Research Council. The authors have no conflicts of interest.

The honey bee gut microbiota: strategies for study and characterization

Gut microbiota research is an emerging field that improves our understanding of the ecological and functional dynamics of gut environments. The honey bee gut microbiota is a highly rewarding community to study, as honey bees are critical pollinators of many crops for human consumption and produce valuable commodities such as honey and wax. Most significantly, unique characteristics of the Apis mellifera gut habitat make it a valuable model system. This review discusses methods and pipelines used in the study of the gut microbiota of Ap. mellifera and closely related species for four main purposes: identifying microbiota taxonomy, characterizing microbiota genomes (microbiome), characterizing microbiota-microbiota interactions and identifying functions of the microbial community in the gut. The purpose of this contribution is to increase understanding of honey bee gut microbiota, to facilitate bee microbiota and microbiome research in general and to aid design of future experiments in this growing field.

Vitellogenesis in spiders: first analysis of protein changes in different reproductive stages of Polybetes pythagoricus

Vitellogenesis represents one of the most vital processes of oviparous species during which various proteins, carbohydrates, and lipids are synthesized and stored inside the developing oocytes. Through analyzing protein changes in the midgut diverticula, hemolymph, and ovaries of females throughout the different vitellogenic stages of the spider Polybetes pythagoricus, we determined the origin of the different proteins involved in the formation of lipovitellins (LVs) along with the existence of a linkage between the hemocyanin and this vital process. An increase in the total protein content of the midgut diverticula, hemolymph, and ovary occurred throughout vitellogenesis followed by a decrease in those levels after laying. The presence of hemocyanin in egg and in LV2, as well as its accumulation in the ovary throughout the vitellogenesis process, was determined. Considering that all biologic processes depend on the correct structure and function of proteins, this study establishes, for the first time for the Order Araneae, the coexistence of three different origins of vitellogenesis-related proteins: one predominantly ovarian involving peptides of 120, 75, 46, and 30 kDa; another extraovarian one originated from the midgut diverticula and represented by a 170 kDa peptide, and a third hemolymphatic one, represented by the 67 kDa peptide.

[Bronchiectasis]

Bronchiectasis is defined as irreversible dilatation of the bronchial lumen. Bronchiectasis not due to cystic fibrosis is the third most common chronic inflammatory disease of the airway, after asthma and chronic obstructive pulmonary disease (CPOD). The pathogenesis of the disease is characterised by chronic dilatation, with irreversible and usually progressive destruction of the bronchial wall as a consequence of the vicious pathogenic circle described by E. Cole, of infection, inflammation, injury to the mucociliary system, and cyclical repair of the airway. The disease can have different causes, and usually presents with cough and chronic expectoration, and repeated, acute, infectious exacerbations. Suspected diagnosis is clinical, and must be confirmed by high resolution computerised tomography. The treatment comprises diverse regimens aimed at controlling infection and bronchial inflammation. Nutritional aspects should be considered as part of treatment, as well as the management of secretions, muscle training and the management of complications and comorbidities.

First study on lipid dynamics during the female reproductive cycle of Polybetes pythagoricus (Araneae: Sparassidae)

Spiders are valuable to humans, not only for their role in health but also as biologic pest controllers. In oviparous species, lipids are the main energy source for embryo development and the growth and survival of larvae. Using the spider Polybetes pythagoricus (Holmberg, 1875) as an experimental model, we studied the fluctuations in lipids and fatty acids occurring in tissues related to vitellogenesis. Different reproductive stages (previtellogenesis, early vitellogenesis, vitellogenesis, and postvitellogenesis) were determined histologically. Gonadosomatic and hepatosomatic indices were first used in spiders. The midgut diverticula proved to be the organ with the highest lipid concentration, with triacylglycerols as the major component. Phospholipids were the principal lipids transported. In vitellogenesis, a major accumulation of lipids occurred in the ovary, principally phosphatidylethanolamine (41%); it probably synthesized in the midgut diverticula before being released into the hemolymph for transport and accumulation in the ovary. Phosphatidylethanolamine is possibly involved in maintaining membrane fluidity and in the function of the electron transport chain. The principal fatty acids in the different organs were palmitic, stearic, oleic, and linoleic acids. During vitellogenesis, the ovaries become enriched in polyunsaturated fatty acids. The lipid patterns in the male midgut diverticula, muscle, and hemolymph were similar to those of the previtellogenic or postvitellogenic females.

An improved IVM method for cumulus-oocyte complexes from small follicles in polycystic ovary syndrome patients enhances oocyte competence and embryo yield

STUDY QUESTION

Are meiotic and developmental competence of human oocytes from small (2-8 mm) antral follicles improved by applying an optimized IVM method involving a prematuration step in presence of C-Type Natriuretic Peptide (CNP) followed by a maturation step in presence of FSH and Amphiregulin (AREG)?

SUMMARY ANSWER

A strategy involving prematuration culture (PMC) in the presence of CNP followed by IVM using FSH + AREG increases oocyte maturation potential leading to a higher availability of Day 3 embryos and good-quality blastocysts for single embryo transfer.

WHAT IS KNOWN ALREADY

IVM is a minimal-stimulation ART with reduced hormone-related side effects and risks for the patients, but the approach is not widely used because of an efficiency gap compared to conventional ART. In vitro systems that enhance synchronization of nuclear and cytoplasmic maturation before the meiotic trigger are crucial to optimize human IVM systems. However, previous PMC attempts have failed in sustaining cumulus-oocyte connections throughout the culture period, which prohibited a normal cumulus-oocyte communication and precluded an adequate response by the cumulus-oocyte complex (COC) to the meiotic trigger.

STUDY DESIGN, SIZE, DURATION

A first prospective study involved sibling oocytes from a group of 15 patients with polycystic ovary syndrome (PCOS) to evaluate effects of a new IVM culture method on oocyte nuclear maturation and their downstream developmental competence. A second prospective study in an additional series of 15 women with polycystic ovaries characterized and fine-tuned the culture conditions.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Fifteen women with PCOS (according to Rotterdam criteria) underwent IVM treatment after 3-5 days of highly purified human menopausal gonadotropin (HP-hMG) stimulation and no human chorionic gonadotropin (hCG) trigger before oocyte retrieval. A first study was designed with sibling oocytes to prospectively evaluate the impact of an IVM culture method: 24 h PMC with CNP + 30 h IVM with FSH and AREG, on embryo yield, in comparison to the standard (30 h) IVM clinical protocol (Group I, n = 15). A second prospective study was performed in 15 women with polycystic ovaries, to characterize and optimize the PMC conditions (Group II, n = 15). The latter study involved the evaluation of oocyte meiotic arrest, the preservation of cumulus-oocyte transzonal projections (TZPs), the patterns of oocyte chromatin configuration and cumulus cells apoptosis following the 24 and 46 h PMC. Furthermore, oocyte developmental potential following PMC (24 and 46 h) + IVM was also evaluated. The first 20 good-quality blastocysts from PMC followed by IVM were analysed by next generation sequencing to evaluate their aneuploidy rate.

MAIN RESULTS AND THE ROLE OF CHANCE

PMC in presence of CNP followed by IVM using FSH and AREG increased the meiotic maturation rate per COC to 70%, which is significantly higher than routine standard IVM (49%; P ≤ 0.001). Hence, with the new system the proportion of COCs yielding transferable Day 3 embryos and good-quality blastocysts increased compared to routine standard IVM (from 23 to 43%; P ≤ 0.001 and from 8 to 18%; P ≤ 0.01, respectively). CNP was able to prevent meiosis resumption for up to 46 h. After PMC, COCs had preserved cumulus-oocyte TZPs. The blastocysts obtained after PMC + IVM did not show increased aneuploidy rates as compared to blastocysts from conventional ART.

LIMITATIONS REASONS FOR CAUTION

The novel IVM approach in PCOS patients was tested in oocytes derived from small antral follicles which have an intrinsically low developmental potential. Validation of the system would be required for COCs from different (larger) follicular sizes, which may involve further adjustment of PMC conditions. Furthermore, considering that this is a novel strategy in human IVM treatment, its global efficiency needs to be confirmed in large prospective randomized controlled trials. The further application in infertile patients without PCOS, e.g. cancer patients, remains to be evaluated.

WIDER IMPLICATIONS OF THE FINDINGS

The findings of this pilot study suggest that the efficiency gap between IVM and conventional IVF can be reduced by fine-tuning of the culture methods. This novel strategy opens new perspectives for safe and patient-friendly ART in patients with PCOS.

STUDY FUNDING/COMPETING INTEREST(S)

IVM research at the Vrije Universiteit Brussel has been supported by grants from: the Institute for the Promotion of Innovation by Science and Technology in Flanders (Agentschap voor Innovatie door Wetenschap en Technologie-IWT, project 110680); the Fund for Research Flanders (Fonds Wetenschappelijk Onderzoek-Vlaanderen-FWO, project G.0343.13), the Belgian Foundation Against Cancer (HOPE project, Dossier C69). The authors have no conflicts of interest.

A study on the bioequivalence of lithium and valproate salivary and blood levels in the treatment of bipolar disorder

Lithium (Li) and valproate (VPA) are used in the treatment of bipolar disorder (BD), with narrow therapeutic window requiring periodic control of serum levels. This prevents intoxication, lack of efficacy due to low serum concentrations, and allows monitoring adherence. We aimed at evaluating the bioequivalence of salivary and blood levels of LI or VPA in a sample of adult BD patients. Secondarily, lithium bioequivalence was evaluated across different patients' lifespans. BD patients treated with either Li or VPA underwent contemporary standard serum and salivary measurements. Blood levels of both drugs were taken according to standard procedures. Li salivary levels were performed by an adapted potentiometric method on the AVL9180 electrolyte analyzer. VPA salivary levels were taken with an immune-assay method with turbidimetric inhibition. A total of 50 patients (38 on Li, 12 on VPA) were enrolled. Blood-saliva bioequivalence for VPA was not found due to a high variability in salivary measures. Li measures resulted in a high correlation (r=0.767, p<0.001), showing no partial correlation with age (r=0.147, p=0.380). Li salivary test is a reliable method of measuring Li availability and is equivalent to serum levels. Potential advantages of Li salivary testing are its non-invasive nature and the possibility of doing the test during the usual appointment with the psychiatrist.

Serology and longevity of immunity against Echinococcus granulosus in sheep and llama induced by an oil-based EG95 vaccine

An oil-based formulation of the EG95 vaccine to protect grazing animals against infection with Echinococcus granulosus was formulated in Argentina. The efficacy of the vaccine was monitored by serology in sheep and llama (Lama glama) and was compared to the serology in sheep previously published using a QuilA-adjuvanted vaccine. Long-term efficacy was also tested in sheep by challenging with E. granulosus eggs of the G1 strain 4 years after the beginning of the trial. The serological results for both sheep and llama were similar to those described previously, except that there was a more rapid response after the first vaccination. A third vaccination given after 1 year resulted in a transient boost in serology that lasted for about 12 months, which was similar to results previously described. Sheep challenged after 4 years with three vaccinations presented 84·2% reduction of live cysts counts compared with control group, and after a fourth vaccination prior to challenge, this reduction was 94·7%. The oil-based vaccine appeared to be bio-equivalent to the QuilA vaccine.

Stress assessment based on EEG univariate features and functional connectivity measures

The biological response to stress originates in the brain but involves different biochemical and physiological effects. Many common clinical methods to assess stress are based on the presence of specific hormones and on features extracted from different signals, including electrocardiogram, blood pressure, skin temperature, or galvanic skin response. The aim of this paper was to assess stress using EEG-based variables obtained from univariate analysis and functional connectivity evaluation. Two different stressors, the Stroop test and sleep deprivation, were applied to 30 volunteers to find common EEG patterns related to stress effects. Results showed a decrease of the high alpha power (11 to 12 Hz), an increase in the high beta band (23 to 36 Hz, considered a busy brain indicator), and a decrease in the approximate entropy. Moreover, connectivity showed that the high beta coherence and the interhemispheric nonlinear couplings, measured by the cross mutual information function, increased significantly for both stressors, suggesting that useful stress indexes may be obtained from EEG-based features.

Human in vitro oocyte maturation is not associated with increased imprinting error rates at LIT1, SNRPN, PEG3 and GTL2

STUDY QUESTION

Does in vitro maturation (IVM) of cumulus-enclosed germinal vesicle (GV) stage oocytes retrieved from small antral follicles in minimally stimulated cycles without an ovulatory hCG dose induce imprinting errors at LIT1, SNRPN, PEG3 and GTL2 in human oocytes?

SUMMARY ANSWER

There is no significant increase in imprinting mutations at LIT1, SNRPN, PEG3 and GTL2 after IVM of cumulus-enclosed GV oocytes from small antral follicles in minimally stimulated cycles without hCG priming.

WHAT IS KNOWN ALREADY

Animal models have generally demonstrated correct methylation imprint establishment for in vitro grown and matured oocytes. For human IVM, well-designed studies allowing conclusions on imprint establishment are currently not available.

STUDY DESIGN, SIZE, DURATION

Immature oocyte-cumulus complexes from 2 to 9 mm follicles were retrieved in polycystic ovary syndrome (PCOS) subjects in minimally stimulated cycles without hCG priming and matured in vitro. In vivo grown oocytes were retrieved after conventional ovarian stimulation for IVF/ICSI or after ovulation induction. Imprinting error rates at three maternally methylated (LIT1, SNRPN and PEG3) and one paternally methylated (GTL2) imprinted genes were compared in 71 in vitro and 38 in vivo matured oocytes.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The limiting dilution bisulfite sequencing technique was applied, allowing increased sensitivity based on multiplex PCR for the imprinted genes and the inclusion of non-imprinted marker genes for cumulus cell DNA contamination.

MAIN RESULTS AND THE ROLE OF CHANCE

In vitro as well as in vivo matured oocytes showed only a few abnormal alleles, consistent with epimutations. The abnormalities were more frequent in immature than in mature oocytes for both groups, although no significant difference was reached. There was no statistically significant increase in imprinting errors in IVM oocytes.

LIMITATIONS, REASONS FOR CAUTION

This single cell methylation analysis was restricted to a number of well-selected imprinted genes. Genome-wide methylation analysis of single human oocytes is currently not possible.

WIDER IMPLICATIONS OF THE FINDINGS

IVM is a patient-friendly alternative to conventional ovarian stimulation in PCOS patients and is associated with reduced gonadotrophin costs and avoidance of OHSS. The results of this study show for the first time that optimized human IVM procedures have no significant effects on the establishment of maternal DNA methylation patterns at LIT1, SNRPN, PEG3 and GTL2.

STUDY FUNDING/COMPETING INTERESTS

This study was supported by research funds from Agentschap voor Innovatie door Wetenschap en Technologie (IWT-TBM 110680), Wetenschappelijk Fonds Willy Gepts (WFWG 2011) and German Research Foundation (HA 1374/12-2). There are no competing interests.

SLC29A3 mutation in a patient with syndromic diabetes with features of pigmented hypertrichotic dermatosis with insulin-dependent diabetes, H syndrome and Faisalabad histiocytosis

AIMS

Atypical forms of diabetes may be caused by monogenic mutations in key genes controlling beta-cell development, survival and function. This report describes an insulin-dependent diabetes patient with a syndromic presentation in whom a homozygous SLC29A3 mutation was identified.

METHODS

SLC29A3 was selected as the candidate gene based on the patient's clinical manifestations, and all exons and flanking regions in the patient's genomic DNA were sequenced.

RESULTS

A homozygous splice mutation (c.300+1G>C) resulting in a frameshift and truncated protein (p.N101LfsX34) was identified. The patient had insulin-dependent diabetes, congenital deafness, short stature, hyperpigmented patches on the skin, dysmorphic features, cardiomegaly, arthrogryposis, hepatosplenomegaly, anaemia with erythroblastopenia, and an inflammatory syndrome with fever and arthritis; she also presented with a fibrotic mediastinal mass. These clinical features overlapped with pigmented hypertrichosis with insulin-dependent diabetes (PHID), H syndrome, Faisalabad histiocytosis and sinus histiocytosis with massive lymphadenopathy (SHML), all of which are also caused by SLC29A3 mutations.

CONCLUSION

This is the most severe case reported of SLC29A3 mutations with cumulative features of all these syndromes. This extreme severity coincides with the most N-terminal location of the truncation mutation, thereby affecting all alternative transcripts of the gene. This case report extends the clinical variability of homozygous SLC29A3 mutations that result in a spectrum of multisystemic manifestations.

Reproduction of wild boar in a cropland and coastal wetland area: implications for management

The reproductive parameters of a wild boar population located in a coastal landscape with a mosaic of cropland and wetland habitats were analysed and compared with those observed in wild boar populations living in other habitats. A total of 296 reproductive tracts of females captured year round at the Aiguamolls de l’Empordà Natural Park were collected and analysed from 2000 to 2010. The foetuses were counted, sexed and aged and the mating and birth periods were determined. The weight and age of each female were also recorded. In accordance with the pattern observed in most European populations, a marked main mating season from October to January was observed. Within this season, there was a peak during November and December, in which 64% of the conception dates were recorded. The proportion of breeding females, ovulation rate and litter size increased with the weight of the reproductive females. A mean litter size of 5.01 ± 1.33 (range from two to eight) foetuses was recorded. This value is the highest known litter size recorded in wild Iberian populations and is similar to values observed in central Europe. Furthermore, it is not in accordance with the pattern reported for other European populations in which a positive correlation between litter size and latitude was observed. The most likely explanation for the high reproductive output in the study area is the availability of food year round, and especially the high consumption of crops such as maize and sunflower. Our results suggest that colonisation of cropland and wetland areas is contributing to the rise in the wild boar population density. Control strategies should consider not only reducing numbers of adult females but also applying measures to reduce food resources available to wild boar.

An auditory brain–computer interface evoked by natural speech

Brain–computer interfaces (BCIs) are mainly intended for people unable to perform any muscular movement, such as patients in a complete locked-in state. The majority of BCIs interact visually with the user, either in the form of stimulation or biofeedback. However, visual BCIs challenge their ultimate use because they require the subjects to gaze, explore and shift eye-gaze using their muscles, thus excluding patients in a complete locked-in state or under the condition of the unresponsive wakefulness syndrome. In this study, we present a novel fully auditory EEG-BCI based on a dichotic listening paradigm using human voice for stimulation. This interface has been evaluated with healthy volunteers, achieving an average information transmission rate of 1.5 bits min⁻¹ in full-length trials and 2.7 bits min⁻¹ using the optimal length of trials, recorded with only one channel and without formal training. This novel technique opens the door to a more natural communication with users unable to use visual BCIs, with promising results in terms of performance, usability, training and cognitive effort.

Mortality and morbidity of heart failure treated with digoxin. A propensity-matched study

BACKGROUND

The role of digoxin in the prognosis of patients with heart failure (HF) remains unclear.

AIMS

To evaluate the relationship of commencing treatment with digoxin (CTDig) with the mortality and the morbidity of patients with HF.

METHODS

Prospective study over 8 years on 4467 patients with HF. Main outcomes were all-cause and cardiovascular mortality, hospitalisations and visits. We analyse the independent relationship of CTDig, with the mortality and the morbidity, stratifying patients for cardiovascular comorbidity, after propensity score-matching for potential confounders (1421 patients who CTDig vs. another 1421 patients non-exposed to digoxin).

RESULTS

During a median follow up of 46.1 months, 1872 patients (65.9%) died, and 2203 (77.5%) were hospitalised. CTDig was associated with a lower all-cause mortality (HR = 0.90 [95% CI, 0.84-0.97]), and cardiovascular mortality (HR = 0.87 [0.81-0.96]), hospitalisation (HR = 0.91 [0.86-0.97]), 30-day readmission for HF (HR = 0.88 [0.79-0.95]), and visits (HR = 0.94 [0.90-0.98]) (p < 0.001 in all cases), after adjustment for the propensity to take digoxin, other medications, and other potential confounders. These effects of digoxin were independent of gender, or type of HF (systolic or non-systolic).

CONCLUSION

The data suggest that therapy with digoxin is associated with an improved mortality and morbidity of HF, including women and patients with non-systolic HF.

Effect of gallic acid on Aspergillus carbonarius growth and ochratoxin A production

The aim of the present study was to investigate the gallic acid influence on Aspergillus carbonarius growth and ochratoxin A (OTA) biosynthesis. A mixed inoculum was used in Czapek Yeast Extract Agar and growth and OTA production was observed at 100 to 500 mg/l of the phenolic compound. Slower colony growth rates and longer lag phases were observed with increasing concentration and 500 mg/l was totally inhibitory for A. carbonarius growth. OTA production decrease was observed even at the lower concentration assayed. Gallic acid could be used as a natural antimicrobial for the control of ochratoxigenic A. carbonarius.

Heat Induced Charge Transfer in the Solid Solution Co3–xTx[Fe(CN)6]2 yH2O with T = Mn, Ni, Cu, Zn and Cd

Cobalt hexacyanoferrates have a relatively low energy barrier for the charge transfer between cobalt and iron atoms. That energy barrier can be overcome by irradiation with light in the ultraviolet-blue region or through the sample heating. Such feature for that charge transfer process is determined by structural and compositional factors. In this contribution the role of a second metal partially substituting to Co in the material composition on the heat induced charge transfer is studied. Samples of the solid solution Co3–xTx[Fe(CN)6]2yH2O with T = Mn, Ni, Cu, Zn and Cd, were prepared by a simple synthetic route and their behavior on moderate heating, from 80 to 160 °C, was evaluated. The behavior of the solid solution on heating was followed by infrared, X-ray diffraction and Mössbauer data. The heat induced charge transfer appears to be favored once the crystal water is removed, when the metal-metal interaction, through the CN bridges, reaches its maximum strength. From this fact, when a metal like Cu, Zn and Cd, with a relatively weak interaction with the coordinated water molecules and, as a consequence, with a low dehydration temperature, is present in the material structure, a lower activation energy is required to be able the heat induced charge transfer. Even in the presence of a second divalent transition metal occupying a fraction of the structural sites for Co, the charge transfer was observed, which is particularly pronounced in the 120–140 °C temperature range. The heat-induced charge transfer was also evaluated from the photo-induced inverse process in the heated samples using photo-acoustic spectroscopy.

Atypical depression is associated with suicide attempt in bipolar disorder

OBJECTIVE

There is a dearth of research focusing on factors associated with suicide attempts. High rates of atypical depression have been reported in studies including unipolar and bipolar II patients. In this study, the association between suicide attempt and atypical depression, in addition to other major risk factors, was evaluated in 390 bipolar I and II out-patients.

METHOD

Variables were defined according to DSM-IV criteria, and assessed with a Structured Interview for DSM-IV (axis I and II). History of suicide attempt was obtained through interviews with patients and relatives. Attempters and non-attempters were compared using univariate and multivariate analysis.

RESULTS

Attempters showed significantly higher rates of atypical depression, family history of completed suicide, depression at index episode and cluster B personality disorder.

CONCLUSION

Our results highlight the relevance of atypical depression in bipolar disorder. A more accurate identification of potential attempters may contribute to the development of effective preventive treatment strategies.

[Identification of immunoreactive antigens of Leptospira interrogans]

A batch of 28 llama (Lama gama) sera from Jujuy province in Argentina was studied in order to identify immune reactive antigens to Leptospira interrogans. Different antigenic preparations from the bacterium were used to study the immune reactivity by the microagglutination (MAT), ELISA and Western immunoblot tests. A control pool of positive bovine sera was used. All the llama sera were negative to MAT as well as to ELISA. Two of the llama sera and the positive bovine sera pool rendered positive results when evaluated by Western immunoblot, allowing the identification of immune reactive proteins. These proteins were identified by MALDI-TOF. A periplasmic flagellin of Leptospira interrogans serovar Lai STR called FlaB1 was identified from the reactive llama sera, and an external membrane lipoprotein of Leptospira interrogans serovar Ballum called LipL21 was identified from the pool of bovine positive sera. These proteins could be used in a new ELISA applied to the early diagnosis of leptospirosis in different kind of cattle or wild reservoirs.