Effects of sulfamethazine and tetracycline at molecular, cellular and tissue levels in Eisenia fetida earthworms

Soil contamination by antibiotics is a global issue of great concern that contributes to the rise of bacterial antibiotic resistance and can have toxic effects on non-target organisms. This study evaluated the variations of molecular, cellular, and histological parameters in Eisenia fetida earthworms exposed to sulfamethazine (SMZ) and tetracycline (TC), two antibiotics commonly found in agricultural soils. The earthworms were exposed for 14 days to a series of concentrations (0, 10, 100, and 1000 mg/kg) of both antibiotics. SMZ and TC did not affect the survival of E. fetida, however, other effects at different levels of biological complexity were detected. The two highest concentrations of SMZ reduced the viability of coelomocytes. At the highest TC concentration, there was a noticeable decline in cell viability, acetylcholinesterase activity (neurotoxicity), and the relative presence of mucopolysaccharides in the epidermis (mucous production). Glutathione S-transferase activity decreased in all TC treatments and at the highest SMZ concentration. However, levels of malondialdehyde and protein carbonyls did not change, suggesting an absence of oxidative stress. Tetracycline was neurotoxic to E. fetida and changed the integrity of the epidermis. Both antibiotics altered the intestinal microbiota of E. fetida, leading to a reduction in the relative abundance of bacteria from the phyla Proteobacteria and Bacteroidetes, while causing an increase in the phylum Actinobacteroidota. All observed changes indicate that both SMZ and TC can disrupt the earthworms' immune system and gut microbiome, while fostering the growth of bacteria that harbour antibiotic resistance genes. Finally, both antibiotics exerted additional metabolic and physiological effects that increased the vulnerability of E. fetida to pathogens.

Assessment of sulfamethoxazole and oxytetracycline uptake and transformation in Eisenia fetida earthworms

The scientific community is becoming increasingly concerned about the recent detection of transformation products (TPs) of antimicrobials (AMs) and their presence in the food chain. There are growing concerns about the potential consequences on food safety and the proliferation of antimicrobial resistance. In this work, the transformation process of sulfamethoxazole (SMX) and oxytetracycline (OTC) in soil was thoroughly evaluated. For that purpose, soils were homogeneously contaminated at three concentration levels of SMX and OTC, independently, and samples were analysed after 7 and 14 days by Ultra High-Performance Liquid Chromatography coupled to a triple quadrupole mass spectrometer (UHPLC-MS/MS). The results have demonstrated a remarkable transformation, particularly noteworthy for SMX, as it exhibited an 89 % - 94 % decrease in concentration within the initial 7 days of the experiment. In addition, to assess whether terrestrial organisms would be able to accumulate the AMs, Eisenia fetida (E. fetida) earthworms were exposed to the above-mentioned concentration levels of AMs in soil. Both AMs were accumulated in the organisms after 14 days, but higher bioaccumulation factor values (BCF) were determined for SMX (0.52-17.84) compared to OTC (0.02-0.21) at all tested concentrations. The analyses were extended to search for TPs in earthworms and soils using a suspect screening approach. Concretely, by means of UHPLC-high resolution mass spectrometry (UHPLC-HRMS) three TPs were identified at 2a and 2b of confidence level. To the best of our knowledge, one SMX-TP and one OTC-TP were identified in earthworms and soil, respectively, for the first time in the present work. Earthworms did not experience weight loss or mortality in the presence of these AMs at levels found in the environment, but there was a decrease in riboflavin levels, which is linked to changes in the immune system. This study represents a significant advancement in understanding the impact of AMs in soil and their subsequent entry into the food chain. It also provides valuable insights into the potential effects of AMs and their TPs on organisms.

Implementation of cancer prevention practices in primary care: results of a cohort study in Chile 2018-2022

OBJECTIVES

The burden of cancer is increasing rapidly in Latin America. Primary care has an essential role in cancer prevention, but implementation levels of prevention practices are not well known. This study evaluated implementation levels and associated factors of cancer preventive practices in primary care over time.

STUDY DESIGN

The study incorporated a retrospective multicentre cohort study.

METHODS

A population of 59,949 patients registered at three primary care clinics was followed from January 2018 to December 2022 in Santiago, Chile. We studied human papillomavirus (HPV) and hepatitis B virus (HBV) immunisation, brief counselling for smoking cessation and alcohol consumption, and cervical and breast cancer screening practices. Standardised electronic medical records were utilised as the source of information. Social, clinical, and organisational factors associated with prevention practices were studied.

RESULTS

The cohort attrition level was 17.1%. Most of the population was of a low socioeconomic status, and 70% visited a primary health centre yearly. Implementation rates of immunisation practices were 90.84% for HPV and 80.94% for HBV in 2022. In contrast, brief counselling for smoking and alcohol consumption was below 20% during the study period. Cervical cancer screening decreased by 25.58% between 2018 and 2022, whereas breast cancer screening reached only 41.71% of the target population. Opportunistic medical visits were strongly associated with brief counselling and breast cancer screening.

CONCLUSION

Implementation practices for cancer prevention in a Chilean primary care cohort are high for immunisation and very low for brief counselling and screening practices. A comprehensive non-medical-based model is needed to improve cancer prevention in primary care.

Antimicrobials in Eisenia fetida earthworms: A comprehensive study from method development to the assessment of uptake and degradation

In this work, an accurate analytical method was developed for the simultaneous analysis of twenty-seven antimicrobials (AMs) in earthworms using liquid chromatography coupled to a triple quadrupole mass spectrometry detector (UHPLC-MS/MS). Adequate apparent recoveries (80-120 %) and limits of quantification (LOQ) (1 μg·kg-1 - 10 μg·kg-1) were obtained, with the exception of norfloxacin (34 μg·kg-1). The method was applied to evaluate the accumulation of sulfamethazine (SMZ) and tetracycline (TC) in earthworms after performing OECD-207 toxicity test, in which Eisenia fetida (E. fetida) organisms were exposed to soils spiked with 10 mg·kg-1, 100 mg·kg-1 or 1000 mg·kg-1 of SMZ and TC, individually. The results confirmed the bioaccumulation of both AMs in the organisms, showing a greater tendency to accumulate SMZ since higher bioconcentration factor values were obtained for this compound at the exposure concentrations tested. In addition, the degradation of both AMs in both matrices, soils and earthworms was studied using liquid chromatography coupled to a q-Orbitrap high resolution mass spectrometry detector. Thirteen transformation products (TPs) were successfully identified, eight of them being identified for the first time in soil/earthworm (such as 4-Amino-3-chloro-n-(4,6-dimethylpyrimidin-2-yl)benzenesulfonamide or 4-(dimethylamino)-1,11,12a-trihydroxy-6,6-dimethyl-3,7,10,12-tetraoxo-3,4,4a,5,5a,6,7,10,12,12a-decahydrotetracene-2-carboxamide, among others) and their formation/degradation trend over time was also studied. Regarding the biological effects, only SMZ caused changes in earthworm growth, evidenced by weight loss in earthworms exposed to concentrations of 100 mg·kg-1 and 1000 mg·kg-1. Riboflavin decreased at all concentrations of SMZ, as well as at the highest concentration of TC. This indicates that these antibiotics can potentially alter the immune system of E. fetida. This research represents a significant advance in improving our knowledge about the contamination of soil by AM over time. It investigates the various ways in which earthworms are exposed to AMs, either by skin contact or ingestion. Furthermore, it explores how these substances accumulate in earthworms, the processes by which earthworms break them down or metabolise them, as well as the resulting TPs. Finally, it examines the potential effects of these substances on the environment.

Horizontal flow aerated constructed wetlands for municipal wastewater treatment: The influence of bed depth

The influence of bed depth on the performance of aerated horizontal constructed wetlands was investigated at the pilot plant scale. Two horizontal flow subsurface constructed wetlands (HF) intensified units of different bed depth (HF1: 0.90 m and HF2: 0.55 m, 0.8 m and 0.5 m water level, respectively) were fitted with forced aeration, while a third one (HFc, 0.55 m bed depth, 0.5 m water level) was used as control and not aerated. The three HF units were operated in parallel, receiving the same municipal wastewater pre-treated in a hydrolytic up-flow sludge blanket anaerobic digester. Applied surface loading rates (SLR) ranged from 20 to 80 g biochemical oxygen demand (BOD5)/m2·d and from 3.7 to 6.7 g total nitrogen (TN)/m2·d, while it ranges from 6 to 23 g BOD5/m2·d and from 1.1 to 1.7 g TN/m2·d in the control unit. Removal of total suspended solids (TSS) and BOD5 was usually close to a 100 % in all units, whilst chemical oxygen demand (COD) removal was higher for the HF1 unit (97 % on average, range of 96-99 %) than for HF2 (92 %, 82-98 %) and HFc (94 %, 86-99 %). TN removal reached on average 33 % (16-43 %) in HFc, 37 % (10-76 %) in HF2 and 51 % (21-79 %) in HF1. High TN removal required a longer aeration time for nitrification and higher effluent recirculation ratio to enhance denitrification. The results indicate that artificial aeration and a high bed depth allows to increase the SLR by a factor of 4 in HF1 but only by a factor of 2 in HF2.

CTAD Task Force Paper: Neuropsychiatric Symptoms in AD: Clinical Trials Targeting Mild Behavioral Impairment: A Report from the International CTAD Task Force

The International CTAD Task Force (TF) addressed challenges related to designing clinical trials for agitation in dementia, presenting accomplishments from the two previous TFs on neuropsychiatric symptoms (NPS). In addition, this TF proposed a paradigm shift in NPS assessment and management, presenting Mild Behavioral Impairment (MBI) as a clinical syndrome. MBI is marked by later-life emergent and persistent NPS in dementia-free older persons (ranging from cognitively unimpaired to subjective cognitive decline to mild cognitive impairment), which facilitates earlier detection and better prognostication of Alzheimer's disease (AD). The TF has made the following recommendations for incorporation of NPS into AD preventative trials: (1) clinical trials targeting improvement in MBI symptoms should be undertaken; (2) treatment trials for MBI should be disease specific and confirm the diagnosis of participants using biomarkers; trials should include measures sensitive to cognitive changes in preclinical AD, which can serve as outcome measures, in addition to changes in biomarker levels; (3) as a first step, pharmacotherapeutic trials should address the full MBI complex as well as the specific symptoms/domains that constitute MBI; (4) clinical trials using problem-adaptation psychotherapy to target affective MBI should be considered; and (5) MBI should be considered in AD trials of disease modifying therapies. The well-validated and widely-used MBI Checklist (MBI-C) is an appropriate symptom rating scale for these studies, as it was developed specifically to identify and measure MBI in dementia-free persons. Other scales such as the Neuropsychiatric Inventory (NPI) may be used, although administration at two timepoints may be necessary to operationalize the MBI criterion of symptom persistence.

Informal waste pickers in guayaquil: Recycling rates, environmental benefits, main barriers, and troubles

Systems for managing municipal solid waste are typically ineffective in developing nations because of governments' deficient financial and administrative frameworks, poor rules, and a lack of suitable infrastructure and human resources. The informal sector plays an essential role in these systems by reprocessing waste into secondary raw materials, reducing collection and disposal costs, and, most importantly, benefiting the environment by avoiding incineration and landfilling. However, their actual contributions remain unknown. The present paper aims to understand the role of informal waste pickers (IWPs) in the waste management system of Guayaquil City and their environmental impact through the calculations of the carbon footprint (CF) avoided due to their aid. The survey design gathered information on their personal profiles, types, and rates of collected recyclables, market conditions, their main barriers, and troubles regarding their formalization. The results of the survey demonstrate that waste picking is mostly a male-driven activity, the average daily mass collected per IWP is 13 kg, the most collected recyclable waste is polyethylene terephthalate, their average monthly income is $179, and the total avoided CF of the entire informal waste picking process is almost 14 thousand tons of CO2 eq yearly. Further, IWPs prefer to operate alone, and only 16% of them would join a cooperative, despite their numerous financial, logistical, and personal challenges.

Midbrain and pons MRI shape analysis and its clinical and CSF correlates in degenerative parkinsonisms: a pilot study

OBJECTIVES

To conduct brainstem MRI shape analysis across neurodegenerative parkinsonisms and control subjects (CS), along with its association with clinical and cerebrospinal fluid (CSF) correlates.

METHODOLOGY

We collected demographic and clinical variables, performed planimetric and shape MRI analyses, and determined CSF neurofilament-light chain (NfL) levels in 84 participants: 11 CS, 12 with Parkinson's disease (PD), 26 with multiple system atrophy (MSA), 21 with progressive supranuclear palsy (PSP), and 14 with corticobasal degeneration (CBD).

RESULTS

MSA featured the most extensive and significant brainstem shape narrowing (that is, atrophy), mostly in the pons. CBD presented local atrophy in several small areas in the pons and midbrain compared to PD and CS. PSP presented local atrophy in small areas in the posterior and upper midbrain as well as the rostral pons compared to MSA. Our findings of planimetric MRI measurements and CSF NfL levels replicated those from previous literature. Brainstem shape atrophy correlated with worse motor state in all parkinsonisms and with higher NfL levels in MSA, PSP, and PD.

CONCLUSION

Atypical parkinsonisms present different brainstem shape patterns which correlate with clinical severity and neuronal degeneration. In MSA, shape analysis could be further explored as a potential diagnostic biomarker. By contrast, shape analysis appears to have a rather limited discriminant value in PSP.

KEY POINTS

• Atypical parkinsonisms present different brainstem shape patterns. • Shape patterns correlate with clinical severity and neuronal degeneration. • In MSA, shape analysis could be further explored as a potential diagnostic biomarker.

Innovative in vivo and in vitro bioassays for the establishment of toxicity thresholds of pollutants in sediment quality assessment using polychaetes and their immune cells

Sediment toxicity testing has become a crucial component for assessing the risks posed by contaminated sediments and for the development of sediment quality assessment strategies. Commonly used organisms for bioassays with estuarine sediments include amphipods, Arenicola marina polychaetes and echinoids. Among the latter, the Sea Urchin Embryo test (SET) is the most widely used. However, one relevant limitation of this bioassay is the unavailability of gametes all year-round, particularly outside the natural spawning seasons. Consequently, the establishment of an appropriate and complementary model organism for a continuous assessment of sediment quality is recommended. A reliable assessment of the hazards resulting from pollutants in sediments or pore water, can be achieved with ecologically relevant species of sediment such as the polychaete Hediste diversicolor, which is widespread in estuaries and has the capacity to accumulate pollutants. The aim of this work was to develop reliable in vivo and in vitro bioassays with H. diversicolor and its coelomocytes (immune cells) to determine the toxicity thresholds of different contaminants bounded to sediments or resuspended into water. Polychaetes were exposed to sublethal concentrations of CuCl₂ (in vivo) and a non-invasive method for collection of polychaetes coelomocytes was applied for the in vitro bioassay, exposing cells to a series of CuCl₂ and AgNPs concentrations. Same reference toxicants were used to expose Paracentrotus lividus following the SET (ICES Nº 51; Beiras et al., 2012) and obtained toxicity thresholds were compared between the two species. In vivo exposure of polychaetes to high concentrations of Cu produced weight loss and histopathological alterations. After in vitro approaches, a significant decrease in coelomocytes viability was recorded for both toxicants, in a monotonic dose-response curve, at very short-exposure times (2 h). The toxicity thresholds obtained with polychaetes were in line with the ones obtained with the SET, concluding that their sensitivity is similar. In conclusion, in vivo and in vitro bioassays developed with H. diversicolor are accurate toxicity screenings of pollutants that could be bounded to sediments or dissolved in the pore water, and may complement the SET outside the spawning period of the echinoderms. The bioassays herein developed could be applied not only to establish the toxicity thresholds of individual compounds or mixtures, but also to assess the toxicity of field collected sediments.

Removal of emerging pollutants by a 3-step system: Hybrid digester, vertical flow constructed wetland and photodegradation post-treatments

The removal of emerging pollutants from municipal wastewater was studied for the first time using a three-step pilot-scale system: 1) hybrid digester (HD) as first step, 2) subsurface vertical flow constructed wetland (VF) as second step, and 3) photodegradation (PD) unit as third step or post-treatment. The HD and VF units were built and operated in series with effluent recirculation at pilot scale. For the PD post-treatment, three alternatives were studied at lab-scale, i) UVC irradiation at 254 nm (0.5 h exposure time), ii) UVA irradiation at 365 nm using a TiO₂-based photocatalyst and iii) sunlight irradiation using a TiO₂-based photocatalyst, the last two for 1 and 2 h. Alternative iii) was also tested at pilot-scale. Degradation of nine compounds was evaluated: acetaminophen (ACE), caffeine (CAF), carbamazepine (CBZ), ketoprofen (KET), ibuprofen (IBU), diclofenac (DCL), clofibric acid (ACB), bisphenol A (BPA), and sotalol (SOT). Overall, the HD-VF-UVC system completely removed (>99.5 %) ACE, CAF, KET, IBU, DCL and ACB, and to a lesser extent SOT (98 %), BPA (83 %) and CBZ (51 %). On the other hand, the HD-VF-UVA/TiO₂ system (at 2 h) achieved >99.5 % removal of ACE, CAF, KET, IBU and DCL while ACB, BPA, CBZ and SOT were degraded by 83 %, 81 %, 78 % and 68 %, respectively. Working also at 2 h of exposure time, in summer conditions, the HD-VF-Sol/TiO₂ system achieved >99.5 % removal of ACE, CAF, KET, IBU, DCL and ACB, and to a minor extent BPA (80 %), SOT (74 %) and CBZ (69 %). Similar results, although slightly lower for SOT (60 %) and CBZ (59 %), were obtained in the pilot sunlight plus TiO₂ catalyst unit. However, the use of sunlight irradiation with a TiO₂-based photocatalyst clearly showed lower removal efficiency in autumn conditions (i.e., 47 % SOT, 31 % CBZ).

Garcia-Ribera JM, Garrido A, Gil E, Gomez M, Gomez J, Pinto AG, Haro JM, Hernando M, Insigna MG, Iriberri M, Jimenez N, Jimenez X, Larrauri A, Leon F, Lopez-Fresneña N, Lopez C, Lopez-Atanes Juan Antonio Lopez-Rodriguez M, Lopez-Cortacans G, Marcos A, Martin J, Martin V, Martinez-Cortés M, Martinez-Martinez R, Martinez de Salazar AD, Martinez I, Marzola M, Mata N, Molina JM, de Dios Molina J, Molinero E, Mortier P, Muñoz C, Murru A, Olmedo J, Ortí RM, Padrós R, Pallejà M, Parra R, Pascual J, Pelayo JM, Pla R, Plana N, Aznar CP, Gomez BP, Zapata AP, Pijoan JI, Polentinos E, Puertolas B, Puig MT, Quílez A, Quintana MJ, Quiroga A, Rentero D, Rey C, Rius C, Rodriguez-Blazquez C, Rojas MJ, Romero Y, Rubio G, Rumayor M, Ruiz P, Saenz M, Sanchez J, Sanchez-Arcilla I, Sanz F, Serra C, Serra-Sutton V, Serrano M, Sola S, Solera S, Soto M, Tarrago A, Tolosa N, Vazquez M, Viciola M, Vieta E, Vilagut G, Yago S, Yañez J, Zapico Y, Zorita LM, Zorrilla I, Zurbano SL, Perez-Solá V. Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic

Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.

Machine learning analysis including social determinants of health for predication of mortality following transcatheter aortic valve implantation: a single center experience

Funding Acknowledgements

Type of funding sources: None.

Introduction

Social determinants of health (SDOH) are increasingly being recognized as critical, independent prognosticators in cardiovascular disease. Despite this, little is known about the role of SDOH in predicting outcomes following transcatheter aortic valve implantation (TAVI).

Purpose

To assess the value of adding census-derived SDOH in developing machine learning (ML) models for prediction of all-cause mortality in patients following TAVI.

Methods

A total of 398 patients, who underwent TAVI in 2019, were studied. Clinical, demographic, echocardiographic (echo) and census-derived SDOH data were collected. All-cause mortality at 1 year was the endpoint. A general linear ML model was fit with 100 iterations and a 70:30 training-test split. We compared the predictive performance of the model with and without adding SDOH. The SDOH included in the ML model were race (white vs. non-white), % zip code population as female, and zip code average yearly income less than $45,000.

Results

Baseline SDOH, demographic, clinical, and echo data are shown in Table 1. Following univariate and multivariate predictor analysis, the following input data were used for the ML model without the SDOH: post TAVI all-cause hospitalizations, history of outpatient hemodialysis, atrial fibrillation, heart failure with reduced ejection fraction, myocardial infarction, coronary artery disease and beta-blockers. The ML model with SDOH used the same input as well as the SDOH variables. The model with vs. without SDOH had a median AUC of 0.75 vs. 0.73 (p = 0.9957).

Conclusions

Despite not reaching statistical significance, our ML model provides a holistic picture of mortality predictors. Larger studies are needed to more assess the predictive value of SDOH post TAVI. Abstract Figure. Baseline patient characteristics  Abstract Figure. ML Model: Area Under Curve

Microsurgical Anatomy of the Anterior Circulation of the Brain Adjusted to the Neurosurgeon's Daily Practice

The study of cerebrovascular anatomy can be difficult and may take time due to its intrinsic complexity. However, it can also be difficult for the following reasons: the excessive description of neuroanatomy making articles hard to read, the unclear clinical application of what is written, the use of simplified or intricate schematic drawings that are not always appropriate for effective teaching, the poor quality of neuroanatomy dissections and the use of unusual views of figures that are not strictly related to the most frequent neuroimages to be interpreted in daily practice. Because of this, we designed an article that incorporates original and accurate anatomical dissections in an attempt to improve its comprehensibility. Five formalin-fixed adult cadaveric heads, whose vessels were injected with a colored silicone mixture (red for arteries and blue for veins), were dissected and examined under a microscope with magnifications from 3× to 40×. Special emphasis has been placed on correlating topographic anatomy with routine neuroimaging studies from computed tomographic angiography (CTA) and digital subtraction angiography (DSA). The essential surgical anatomy in a neurosurgeon’s daily practice is also described. The cadaveric dissections included in this study contribute to the understanding of the cerebrovascular anatomy necessary for the neurosurgeon’s daily practice.

Co-composting of forest and industrial wastes watered with pig manure

Co-composting of forest-derived wastes (chestnut forest burr, CST; scrubland biomass, SRB; industrial sludge, MDFS, from the Medium Density Fibreboard production process) watered with pig manure (PM) may constitute a feasible management technique for both solid and liquid streams. PM provided water and improved the carbon to nitrogen (C/N) ratio. Four piles of 1.8-2.4 m³ were conformed: A (SRB, with compaction bulk density), B (SRB, without compaction), C (SRB and MDFS at a volumetric ratio of 3:1) and D (CST). Thermophilic temperatures were maintained for 8 (B), 16 (A), 28 (C) and 40 (D) days. Stable compost was obtained after 35 (A, B, C) and 48 (D) days. Hygienization was only complete in piles C and D. N losses were higher in piles A (39.3%) and B (33.6%) in relation to C (17.0%) and D (8.9%) which could be attributed to the characteristics of MDFS and CST. Increasing the matrix size from 340 L to around 2000 L led to a higher intensity of the thermophilic phase. Besides, compaction significantly increased the temperature during composting. PM was added at ratios ranging from 1.8 to 2.5 L/kg dry matter, being favoured by pre-drying of solid wastes.

Toulouse Alzheimer's Clinical Research Center Recovery after the COVID-19 Crisis: Telemedicine an Innovative Solution for Clinical Research during the Coronavirus Pandemic

In the context of the COVID-19 pandemic (1)(2) declared by the World Health Organization in March 2020, the French government decided to lockdown the entire country on March 17th. Consequently, the ongoing recruitment of participants for the INSPIRE study (3, 4) was temporarily interrupted on March 16th and the 123 future participants programmed until April 30th were postponed (5). In France, only emergencies were allowed to be physically seen. As an alternative for the other patients, Telemedicine has become essential. France authorized the reimbursement of these new techniques by the National Health Insurance; allowing rapid deployment of online consultations to be used to maintain the level of care (6).

Identifying Better Outcome Measures to Improve Treatment of Agitation in Dementia: A Report from the EU/US/CTAD Task Force

For the second time in the past 3 years, the EU-US CTAD Task Force addressed challenges related to designing clinical trials for agitation in dementia, which is one of the most disruptive aspects of the condition for both patients and caregivers. Six recommendations emerged from the Task Force meeting: 1 - Operationalizing agitation criteria established by the IPA; 2 - Combining clinician- and caregiver-derived outcomes as primary outcome measures; 3 - Using global ratings to define clinically meaningful effects and power studies; 4 - Improving the accuracy of caregiver reports by better training and education of caregivers; 5 - Employing emerging technologies to collect near real-time behavioral data; and 6 - Utilizing innovative trial designs and increasing the use of biomarkers to maximize the productivity of clinical trials for neuropsychiatric symptoms.

Selection of an optimal culture medium and the most responsive viability assay to assess AgNPs toxicity with primary cultures of Eisenia fetida coelomocytes

Earthworm immune cells (coelomocytes) have become a target system in ecotoxicology due to their sensitivity against a wide range of pollutants, including silver nanoparticles (AgNPs). Presently, in vitro approaches (viability assays in microplate, flow cytometry, cell sorting) with primary cultures of Eisenia fetida coelomocytes have been successfully used to test the toxicity and the dissimilar response of cell subpopulations (amoebocytes and eleocytes) after PVP-PEI coated AgNPs and AgNO₃ exposures. In order to obtain reliable data and to accurately assess toxicity with coelomocytes, first an optimal culture medium and the most responsive assay were determined. AgNPs posed a gradual decrease in coelomocytes viability, establishing the LC₅₀ value in RPMI-1640 medium at 6 mg/l and discarding that the observed cytotoxicity was attributable to its coating agent PVP-PEI. Exposure to AgNPs caused selective cytotoxicity in amoebocytes, which correlated with the Ag concentrations measured in sorted amoebocytes and reinforced the idea of dissimilar sensitivities among amoebocytes and eleocytes. Silver nano and ionic forms exerted similar toxicity in coelomocytes. The in vitro approaches with coelomocytes of E. fetida performed in this study have the capacity to predict impairments caused by pollutants at longer exposure levels and thus, provide rapid and valuable information for eco(nano)toxicology.

The Châtelperronian Neanderthals of Cova Foradada (Calafell, Spain) used imperial eagle phalanges for symbolic purposes

Evidence for the symbolic behavior of Neanderthals in the use of personal ornaments is relatively scarce. Among the few ornaments documented, eagle talons, which were presumably used as pendants, are the most frequently recorded. This phenomenon appears concentrated in a specific area of southern Europe during a span of 80 thousand years. Here, we present the analysis of one eagle pedal phalange recovered from the Châtelperronian layer of Foradada Cave (Spain). Our research broadens the known geographical and temporal range of this symbolic behavior, providing the first documentation of its use among the Iberian populations, as well as of its oldest use in the peninsula. The recurrent appearance of large raptor talons throughout the Middle Paleolithic time frame, including their presence among the last Neanderthal populations, raises the question of the survival of some cultural elements of the Middle Paleolithic into the transitional Middle to Upper Paleolithic assemblages and beyond.

How to Manage Frail Older Adults in the Community? Proposal of a Health Promotion Program Experienced in a City of 16,638 Inhabitants in France

BACKGROUND

Health promotion programs could prevent and delay frailty and functional decline. However, in practice, the planning and establishment of such a program is a challenge for health care providers. We report an experimental model of screening and management for frail elderly conducted in Cugnaux, city of 16,638 inhabitants in France, by the Toulouse Gerontopole and the social care service of the Cugnaux City Hall.

METHODS

A frailty screening self-administered questionnaire (FiND questionnaire) was sent to community-dwelling residents of 70 years old and over of Cugnaux. The completed questionnaires were analyzed and the subjects were classed into three groups: robust, frail, mobility disability, based on their score. Frail subjects and those with mobility disability invited to undergo a frailty assessment in the premises of the town hall realized by a nurse in order to identify the causes of their frailty and propose them a personalized intervention plan (PIP).

RESULTS

The FiND questionnaire was sent to the residents of Cugnaux of 70 years old and over (n=2,003). After two mailings, 860 (42.9%) completed questionnaires were received. Mean age of the responders was 79.0 ± 6.2 years and 59.6% women (n= 511). According to the questionnaires analysis, 393 (45.7%) were robust, 212 (24.6%) frail, 240 (27.9%) had a mobility disability and 15 (1.7%) could not be classified due to missing data. 589 (68.5%) subjects accepted to be contacted by the Gerontopole nurse. The assessment by the nurse was proposed to frail subjects and those with mobility disability (n=313). Until 31 December 2016, 136 patients have been evaluated. The mean age was 80.1±5.4 and most patients were women (69.9%). The mean ADL score was 5.8±0.5 and the IADL showed a mean score of 6.9±1.7. According to Fried definition of frailty, 76 patients (55.9%) were pre-frail, and 35 (25.7%) frail. Concerning the frailty domains identified, 75 patients (55.1%) showed the alteration of physical performance, 70 (51.5%) thymic disorders and 46 (33.8%) sensory disorders. Preventive interventions proposed in the PIP were mostly physical interventions (86.8%, n=118) followed by cognitive (61.8%, n=84) and nutritional (39.7%, n=54) interventions.

DISCUSSION

This project shows the feasibility to implement a care model in the community. It permitted a large identification of frail elderly people in the city population, insuring their assessment and clinical follow up to maintain their capacities and referring them to social services.

Enhanced discrimination of basophilic cells on mussel digestive gland tissue sections by means of toluidine-eosin staining

Changes in the cell type composition of the digestive gland epithelium constitute a common and recognized biological response to stress in mussels. Usually, these changes are identified as alterations in the relative proportion of basophilic cells, determined in tissue sections stained with hematoxylin-eosin (H&E) and measured in terms of volume density of basophilic cells (Vv_BAS) after stereological quantification. However, the identification and discrimination of basophilic cells may be a difficult issue, even for a trained operator, especially when, in circumstances of environmental stress, basophilic cells lose their basophilia and the perinuclear area of digestive cells gains basophilia. Thus, the present study was aimed at exploring the best available practices (BAPs) to identify and discriminate basophilic cells on tissue sections of mussel digestive gland. In a first step, a thorough screening of potentially suitable staining methods was carried out; the final selection included several trichrome staining methods and some of their variants, as well as toluidine-based stains. Next, the sample processing (fixation/dehydration steps) was optimized. Toluidine-eosin (T&E) staining after fixation in 4% formaldehyde at 4 °C for 24 h was considered the BAP to identify and discriminate basophilic cells in the digestive gland of mussels. Using the mussel Mytilus galloprovincialis as a target organism, this approach was successfully applied to quantify Vv_BAS values after automated image analysis and compared with the conventional H&E staining in different field and laboratory tests. It is worth noting that Vv_BAS values were always higher after T&E staining than after H&E staining, apparently because discrimination of basophilic cells was enhanced. Thus, until more data are available, any comparison with Vv_BAS values obtained in previous studies using H&E staining must be done cautiously. Finally, the T&E staining was successfully used to discriminate basophilic cells in tissue sections of other marine molluscs of ecotoxicological interest, including Mytilus edulis, Mytilus trossulus, Crassostrea gigas and Littorina littorea.

On Practical Issues for Stochastic STDP Hardware With 1-bit Synaptic Weights

In computational neuroscience, synaptic plasticity learning rules are typically studied using the full 64-bit floating point precision computers provide. However, for dedicated hardware implementations, the precision used not only penalizes directly the required memory resources, but also the computing, communication, and energy resources. When it comes to hardware engineering, a key question is always to find the minimum number of necessary bits to keep the neurocomputational system working satisfactorily. Here we present some techniques and results obtained when limiting synaptic weights to 1-bit precision, applied to a Spike-Timing-Dependent-Plasticity (STDP) learning rule in Spiking Neural Networks (SNN). We first illustrate the 1-bit synapses STDP operation by replicating a classical biological experiment on visual orientation tuning, using a simple four neuron setup. After this, we apply 1-bit STDP learning to the hidden feature extraction layer of a 2-layer system, where for the second (and output) layer we use already reported SNN classifiers. The systems are tested on two spiking datasets: a Dynamic Vision Sensor (DVS) recorded poker card symbols dataset and a Poisson-distributed spike representation MNIST dataset version. Tests are performed using the in-house MegaSim event-driven behavioral simulator and by implementing the systems on FPGA (Field Programmable Gate Array) hardware.

The ROSAS Cohort: A Prospective, Longitudinal Study of Biomarkers for Alzheimer's Disease. Strategy, Methods and Initial Results

OBJECTIVE

The aims of the Research Of biomarkers in Alzheimer's diseaSe (ROSAS) study were to determine the biofluid and imaging biomarkers permitting an early diagnosis of Alzheimer's disease and better characterisation of cognitive and behavioural course of the pathology. This paper outlines the overall strategy, methodology of the study, baseline characteristics of the population and first longitudinal results from the ROSAS cohort.

METHODS

Longitudinal prospective monocentric observational study performed at the Alzheimer's disease Research centre in Toulouse. A total of 387 patients were studied and analyzed in 3 groups: 184 patients with dementia of Alzheimer's type, 96 patients with memory disorders without dementia (Mild Cognitive Impairment) and 107 patients without abnormal memory tests (control group), and were followed up during 4 years. Patient's sociodemographic characteristics, risk factors, medical conditions, previous and current medications, neuropsychological assessment and overall cognitive status were recorded. Blood and urine samples were collected at every year, Magnetic Resonance Imaging were performed at inclusion, after one year of follow-up and at the end of the study.

RESULTS

At baseline, three different groups of the cohort differed interestingly in age, level of education, and in percentage of ApoEε4 carriers whereas the history of cardiovascular and endocrine pathologies were similar among the groups. During the follow-up period (3-4 years) 42 mild cognitive impairment patients (43.8%) progressed to dementia, 7 controls progressed into mild cognitive impairment and 1 patient in the control group converted from mild cognitive impairment group to dementia of Alzheimer's type group. During the first year of follow up, the incidence of progression from mild cognitive impairment to dementia of Alzheimer's type was 12.7 per 100, during the second year 33.9 per 100 and 46.7 per 100 for the third year.

CONCLUSION

This paper presents the baseline characteristics of the unique French prospective monocenter study in which the natural course of dementia of Alzheimer's type was evaluated. Future analysis of blood and urine samples collection from the ROSAS study will permit to identify possible biofluid biomarkers predicting the early stages of the dementia of Alzheimer's type and risk of progression from Mild Cognitive Impairment to Alzheimer's disease.