Dose-dependent expression of claudin-5 is a modifying factor in schizophrenia

Schizophrenia is a neurodevelopmental disorder that affects up to 1% of the general population. Various genes show associations with schizophrenia and a very weak nominal association with the tight junction protein, claudin-5, has previously been identified. Claudin-5 is expressed in endothelial cells forming part of the blood-brain barrier (BBB). Furthermore, schizophrenia occurs in 30% of individuals with 22q11 deletion syndrome (22q11DS), a population who are haploinsufficient for the claudin-5 gene. Here, we show that a variant in the claudin-5 gene is weakly associated with schizophrenia in 22q11DS, leading to 75% less claudin-5 being expressed in endothelial cells. We also show that targeted adeno-associated virus-mediated suppression of claudin-5 in the mouse brain results in localized BBB disruption and behavioural changes. Using an inducible 'knockdown' mouse model, we further link claudin-5 suppression with psychosis through a distinct behavioural phenotype showing impairments in learning and memory, anxiety-like behaviour and sensorimotor gating. In addition, these animals develop seizures and die after 3-4 weeks of claudin-5 suppression, reinforcing the crucial role of claudin-5 in normal neurological function. Finally, we show that anti-psychotic medications dose-dependently increase claudin-5 expression in vitro and in vivo while aberrant, discontinuous expression of claudin-5 in the brains of schizophrenic patients post mortem was observed compared to age-matched controls. Together, these data suggest that BBB disruption may be a modifying factor in the development of schizophrenia and that drugs directly targeting the BBB may offer new therapeutic opportunities for treating this disorder.

173 Size Matters: a Follicle-of-Origin Effect on the Preovulatory Epigenetic Constitution of Germinal Vesicle-Stage Porcine Oocytes

The goal of this study was to evaluate global levels of a variety of histone modifications at different lysine (K) residues on Histone 3 (H3) within the chromatin of porcine germinal vesicle (GV)-stage oocytes that were aspirated from follicles of different sizes. We hypothesised that we would see evidence of a transition from open, transcriptionally active chromatin (in oocytes from smaller, growing follicles) to more closed, transcriptionally silent chromatin associated with fully grown oocytes (aspirated from large, preovulatory follicles). Cumulus-enclosed oocytes were aspirated from small (<3 mm) or large (>7 mm) follicles from abattoir-derived pig ovaries. Oocytes were denuded immediately after aspiration and then immunoprobed with antibodies specific for trimethylated (me3) H3K4, H3K9me3, and H3K27me3. Background-corrected nuclear fluorescence levels for each histone mark were collected from multiple oocytes from each of at least three experimental replicates (aspiration days). Data were subjected to one-way ANOVA with a Bonferroni multiple testing correction to determine whether there were differences in fluorescence intensities in the nuclei (germinal vesicles) of oocytes from small v. large follicles. Oocytes from large follicles displayed more intense nuclear staining for all 3 histone marks: average nuclear H3K4me3 intensity was 31.4% higher (P = 0.0004), H3K9me3 was 70.3% higher (P = 0.0218), and H3K27me3 was 32.0% higher (P = 0.0231) in oocytes from large follicles. An ancillary analysis of the data revealed no effect (P > 0.1) of pubertal status (i.e. whether small and large follicles were aspirated from pre- v. post-pubertal ovaries) on the intensity of nuclear fluorescence for any of the marks evaluated. In continuation, 3 oocytes from both follicle types were collected on each of 6 aspiration days (i.e. 18 individual oocytes from each follicle type), and the mRNA from these were used for an RT-qPCR experiment to detect the relative abundance of transcripts from 21 different genes coding for histone methyltransferase or demethylase enzymes in oocytes from large v. small follicles. Of the 21 genes tested, 5 genes (KDM4C, KDM4D, KDM5B, KDM5C, and SETD7) were not detectable in our individual oocyte samples, but transcripts from 6 of the 16 remaining genes (KDM6A, KMT2B, MLL3, SETD1B, SETDB1, and SUV39H2) were shown to be significantly more abundant in oocytes from large follicles (at least 2-fold greater abundance and P < 0.05). Although our expectation-that histone marks (and related transcripts) would consistently reflect a globally “repressive” chromatin configuration in oocytes from large follicles and a more “open” configuration in oocytes from small follicles-turned out to be untrue, the evidence suggests that the epigenetic constitution of oocytes from small follicles may indeed vary from that of oocytes from large, preovulatory follicles, and this phenomenon warrants further investigation.

Extra-intestinal Manifestations at Diagnosis in Paediatric- and Elderly-onset Ulcerative Colitis are Associated With a More Severe Disease Outcome: A Population-based Study

BACKGROUND AND AIMS

Data on extra-intestinal manifestations [EIM] and their impact on the disease course of ulcerative colitis [UC] in population-based cohorts are scarce, particularly in paediatric- and elderly-onset UC patients. The aims of this population-based study were to assess: 1] the occurrence of EIM in paediatric- and elderly-onset UC; 2] the factors associated with EIM; and 3] their impact on long-term disease outcome.

METHODS

Paediatric-onset [< 17 years at diagnosis] and elderly-onset UC patients [> 60 years at diagnosis] from a French prospective population-based registry [EPIMAD] were included. Data on EIM and other clinical factors at diagnosis and at maximal follow-up were collected.

RESULTS

In all, 158 paediatric- and 470 elderly-onset patients were included [median age at diagnosis 14.5 and 68.8 years, median follow-up 11.2 and 6.2 years, respectively]. EIM occurred in 8.9% of childhood- and 3% of elderly-onset patients at diagnosis and in 16.7% and 2.2% of individuals during follow-up [p < 0.01], respectively. The most frequent EIM was joint involvement [15.8% of paediatric onset and 2.6% of elderly-onset]. Presence of EIM at diagnosis was associated with more severe disease course [need for immunosuppressants or biologic therapy or colectomy] in both paediatric- and elderly-onset UC (hazard ratio [HR] = 2.0, 95% confidence interval [CI]: 1.0-4.2; and HR = 2.8, 0.9-7.9, respectively). Extensive colitis was another independent risk factor in both age groups.

CONCLUSIONS

Elderly-onset UC patients had lower risk of EIM either at diagnosis or during follow-up than paediatric-onset individuals. EIM at diagnosis predicted more severe disease outcome, including need for immunosuppressive or biologic therapy or surgery, in both paediatric- and elderly-onset UC.

Impetigo: A need for new therapies in a world of increasing antimicrobial resistance

WHAT IS KNOWN AND OBJECTIVE

Impetigo is a highly contagious bacterial skin infection and is one of the most common skin infections in children. Antibiotics are the first-line treatment when multiple lesions exist, but with an increasing prevalence of antibiotic-resistant bacteria the successful management of impetigo in the future is an area of concern.

COMMENT

Current treatment options that favour the use of oral antibiotic therapy are increasingly problematic. Widespread use of these agents contributes to antimicrobial resistance and has adverse consequences for individuals and communities. There is a need for new topical antimicrobials and antiseptics as an alternative treatment strategy.

WHAT IS NEW AND CONCLUSION

To successfully treat impetigo into the future and ensure that therapy does not contribute to bacterial resistance, additional research is required to ascertain the usefulness of alternative agents, including new topical antimicrobials and antiseptics.

Temporal trends in Giardia occurrence in the Grand River and surrounding tributaries, Waterloo, Ontario (2005-2013), a retrospective analysis of surveillance data

Giardia contamination in the Grand River Watershed (south-western Ontario, Canada) was monitored from 2005 to 2013 as part of FoodNet Canada. Our study objectives were to describe the temporal pattern of Giardia occurrence and determine whether water quality parameters and bacterial indicators could act as effective markers for Giardia occurrence. Water samples were collected monthly from the Grand River near a drinking water intake point (2005-2013) and also collected intermittently from other areas in the watershed during the study period. Samples were tested for Giardia cysts using the US EPA method 1623. Samples were also tested for chemical and microbial water quality indicators. Univariable and multivariable linear regression models were built to examine whether temporal, water quality and bacterial indicators were associated with Giardia cyst concentration. Giardia cysts were identified in 89% of samples (n = 228), with highest measured concentrations downstream of a waste water treatment plant outfall. Year and season were found to be predictors for Giardia occurrence. Concentrations were significantly higher in the winter and fall compared to the summer, and significantly higher in 2007 compared to other study years. After controlling for season, year and sampling location, dissolved oxygen was the only variable significantly associated with Giardia cyst concentration. Seasonal peaks in Giardia cyst concentrations in samples collected near the intake for the drinking water plant did not align with the seasonal peak in human Giardiasis cases in this region that are reported annually by public health authorities. This suggests that the risk of contracting Giardiasis from treated drinking water in this community is possibly low when the treatment plant is functioning adequately. Instead, waterborne exposure is likely the result of seasonal behaviours surrounding recreational water use. Therefore, the collective findings of our study are important to help inform future risk management studies and guide public health protection policies.

The BeSMART (Best Supportive Management for Adults Referred with Tonsillopharyngitis) multicentre observational study

Introduction Tonsillopharyngitis is the most common ear, nose and throat emergency admission, with 80,000 episodes recorded in England in 2015-2016. Despite this, there is a paucity of evidence addressing the supportive management of tonsillopharyngitis in inpatients. The aim of this retrospective multicentre observational study was to consider the Best Supportive Management for Adults Referred with Tonsillopharyngitis (BeSMART) in the inpatient setting, and to establish any associations between practice and outcomes. Methods Seven hospitals in North West England and North East Scotland participated in the study. Overall, 236 adult patients admitted with tonsillopharyngitis were included. The main outcome measures were interval to return to soft diet, length of stay (LOS), pain scores and readmissions. Results Women were more likely to seek professional help before presenting to secondary care (p=0.04). Patients admitted at the weekend were more likely to have a shorter LOS (p=0.03). There was no relationship between day of admission and seniority or specialty of the doctor initially seen. Prescription of corticosteroid, analgesia and a higher initial intravenous fluid infusion rate were not related to a shorter LOS. Conclusions This study is the first to yield valuable insights into the inpatient management of tonsillopharyngitis. This work represents part of an ongoing project to establish the evidence for common medical interventions for sore throat. Patient and professional surveys as well as a prospective interventional study are planned for the future.

Combined efficacy of Vigna radiata (L.) R. Wilczek and Amorphophallus paeoniifolius (Dennst.) Nicolson on serum lipids in albino rats

Coronary Artery Disease (CAD) is a major killer disease throughout the world. Dyslipidemia is a major contributor to the risk of CAD. Several dietary articles traditionally used in India and other South Asian countries reduced dyslipidemia. The present study was undertaken to evaluate the combined effect of Mung bean (Vigna radiata) and Elephant foot yam (Amorphophallus paeoniifolius) on serum lipids and atherogenic indices in albino rats and to compare it with a standard drug Cholestyramine. Thirty healthy albino rats of both sexes (150-200 g) were randomized to 5 groups of 6 animals each. The grouping were done based on the following criteria: Group I: Normal Control Group, Group II: (Standard Group): Cholestyramine resin 5 mg/kg bw, Group III: (Half Dose Group): Drug powder at 540 mg/kg bw, Group IV: (Effective Dose Group): Drug powder at 1080 mg/kg bw, and Group V: (Double Dose Group): Drug powder at 2160 mg/kg bw. Lipid profile was estimated at the beginning and after 30 days of treatment. The Effective and Double doses of the drug reduced Total cholesterol along with levels of Triglycerides, Low density lipoprotein and Very low density lipoprotein levels significantly (p < 0.01) along with a significant (p < 0.01) increase in high density lipoproteins (HDL) in rats. There was also significant (p < 0.01) improvement in atherogenic indices like Castelli Risk Index I, Non HDL C/HDL, Castelli risk Index II, TG/HDL, Atherogenic coefficient and Atherogenic Index of Plasma. The combination of powdered sprouted mung bean and yam powder have excellent lipid lowering potential.

Lymphocyte density determined by computational pathology validated as a predictor of response to neoadjuvant chemotherapy in breast cancer: secondary analysis of the ARTemis trial

BACKGROUND

We have previously shown lymphocyte density, measured using computational pathology, is associated with pathological complete response (pCR) in breast cancer. The clinical validity of this finding in independent studies, among patients receiving different chemotherapy, is unknown.

PATIENTS AND METHODS

The ARTemis trial randomly assigned 800 women with early stage breast cancer between May 2009 and January 2013 to three cycles of docetaxel, followed by three cycles of fluorouracil, epirubicin and cyclophosphamide once every 21 days with or without four cycles of bevacizumab. The primary endpoint was pCR (absence of invasive cancer in the breast and lymph nodes). We quantified lymphocyte density within haematoxylin and eosin (H&E) whole slide images using our previously described computational pathology approach: for every detected lymphocyte the average distance to the nearest 50 lymphocytes was calculated and the density derived from this statistic. We analyzed both pre-treatment biopsies and post-treatment surgical samples of the tumour bed.

RESULTS

Of the 781 patients originally included in the primary endpoint analysis of the trial, 609 (78%) were included for baseline lymphocyte density analyses and a subset of 383 (49% of 781) for analyses of change in lymphocyte density. The main reason for loss of patients was the availability of digitized whole slide images. Pre-treatment lymphocyte density modelled as a continuous variable was associated with pCR on univariate analysis (odds ratio [OR], 2.92; 95% CI, 1.78-4.85; P < 0.001) and after adjustment for clinical covariates (OR, 2.13; 95% CI, 1.24-3.67; P = 0.006). Increased pre- to post-treatment lymphocyte density showed an independent inverse association with pCR (adjusted OR, 0.1; 95% CI, 0.033-0.31; P < 0.001).

CONCLUSIONS

Lymphocyte density in pre-treatment biopsies was validated as an independent predictor of pCR in breast cancer. Computational pathology is emerging as a viable and objective means of identifying predictive biomarkers for cancer patients.

CLINICALTRIALS.GOV

NCT01093235.

Search for Neutrinoless Quadruple-β Decay of ^{150}Nd with the NEMO-3 Detector

We report the results of a first experimental search for lepton number violation by four units in the neutrinoless quadruple-β decay of ^{150}Nd using a total exposure of 0.19 kg yr recorded with the NEMO-3 detector at the Modane Underground Laboratory. We find no evidence of this decay and set lower limits on the half-life in the range T_{1/2}>(1.1-3.2)×10^{21}  yr at the 90% C.L., depending on the model used for the kinematic distributions of the emitted electrons.

Exploring approaches to dietetic assessment of a common task across different universities through assessment moderation

BACKGROUND

Assessment presents one of the greatest challenges to evaluating health professional trainee performance, as a result of the subjectivity of judgements and variability in assessor standards. The present study aimed to test a moderation procedure for assessment across four independent universities and explore approaches to assessment and the factors that influence assessment decisions.

METHODS

Assessment tasks designed independently by each of the four universities to assess student readiness for placement were chosen for the present study. Each university provided four student performance recordings for moderation. Eight different academic assessors viewed the student performances and assessed them using the corresponding university assessment instrument. Assessment results were collated and presented back to the assessors, together with the original university assessment results. Results were discussed with assessors to explore variations. The discussion was recorded, transcribed, thematically analysed and presented back to all assessors to achieve consensus on the emerging major learnings.

RESULTS

Although there were differences in absolute scores, there was consistency (12 out of 16 performances) in overall judgement decisions regarding placement readiness. Proficient communication skills were considered a key factor when determining placement readiness. The discussion revealed: (i) assessment instruments; (ii) assessor factors; and (iii) the subjectivity of judgement as the major factors influencing assessment.

CONCLUSIONS

Assessment moderation is a useful method for improving the quality of assessment decisions by sharing understanding and aligning standards of performance.

Phytochemical evaluation of roots of Plumbago zeylanica L. and assessment of its potential as a nephroprotective agent

Search for medicinal plants to treat kidney disorders is an important topic on phytotherapeutical research. Plumbago zeylanica L. is an important medicinal plant with hepatoprotective, anti-inflammatory, anti-diabetic, anti-cancer and anti-hyperlipidemic activities. In the present study, the protective effect of hydroalcoholic extract of P. zeylanica (HAPZ) in cisplatin induced nephrotoxicity was analyzed in Swiss albino mice. Treatment with higher dose (400 mg/kg) of HAPZ significantly reversed the adverse effect of cisplatin on kidney weight, serum urea and creatinine, indicating their renoprotective effect. The antioxidant effect of the drug is evident from its significant effect on Catalase, Glutathione peroxidase and lipid peroxidation activities.

Measurement of the Neutrino Mixing Angle θ_{23} in NOvA

This Letter reports new results on muon neutrino disappearance from NOvA, using a 14 kton detector equivalent exposure of 6.05×10^{20} protons on target from the NuMI beam at the Fermi National Accelerator Laboratory. The measurement probes the muon-tau symmetry hypothesis that requires maximal θ_{23} mixing (θ_{23}=π/4). Assuming the normal mass hierarchy, we find Δm_{32}^{2}=(2.67±0.11)×10^{-3}  eV^{2} and sin^{2}θ_{23} at the two statistically degenerate values 0.404_{-0.022}^{+0.030} and 0.624_{-0.030}^{+0.022}, both at the 68% confidence level. Our data disfavor the maximal mixing scenario with 2.6σ significance.

The BiPo-3 detector

The BiPo-3 detector is a low radioactive detector dedicated to measuring ultra-low natural contaminations of ²⁰⁸Tl and ²¹⁴Bi in thin materials, initially developed to measure the radiopurity of the double β decay source foils of the SuperNEMO experiment at the μBq/kg level. The BiPo-3 technique consists in installing the foil of interest between two thin ultra-radiopure scintillators coupled to low radioactive photomultipliers. The design and performances of the detector are presented. In this paper, the final results of the ²⁰⁸Tl and ²¹⁴Bi activity measurements of the first enriched ⁸²Se foils are reported for the first time, showing the capability of the detector to reach sensitivities in the range of some μBq/kg.