Statements by scientific organizations can, and should, shape society

Statements based on the best current scientific data and analyses that bear directly on societal issues, especially ones that are critical to societal justice, equity, and health, are practical responsibilities of professional scientific organizations. And they often have impact.

Follow the citations: Tracing pathways of "race as biology" assumptions in medical algorithms in eGFR and spirometry

Despite overwhelming evidence to the contrary, the concept of 'race' as a biological unit continues to persist in various scientific disciplines, notably in the field of medicine. This paper explores the persistence of 'race as biology' in medical research via examining select citational practices that have perpetuated this problematic concept. Citations serve as a cornerstone in scientific literature, signifying reliability and expert affirmation. By analyzing citation threads and historical patterns, we aim to shed light on the creation and perpetuation of false scientific truths and their impact on medical research, training, and practice. We focus on two prominent examples, eGFR and Spirometry, and trace key articles' citational histories, highlighting the flawed evidence in support of racial corrections in medical assessments. The eGFR equation incorporates 'race' as a factor based on the erroneous belief that Black individuals have higher muscle mass than white individuals. Our analysis reveals that key cited sources for this belief lack robust and well-developed datasets. Similarly, Spirometry measurements incorporate racial correction factors, relying on questionable evidence dating back to the Civil War era. Citations serve as a cornerstone in scientific literature, signifying reliability and expert affirmation. They play a crucial role in shaping theoretical positions and validating data and assumed knowledge. Evaluating citation threads and key articles consistently referenced over time can reveal how falsehoods and erroneous assertions are constructed and maintained in scientific fields. This study underscores the need for critical examination of citational practices in medical research and urges a shift toward a more cautious approach when citing sources that support 'race as biology.' The paper calls for a reevaluation of pedagogical approaches and assigned readings in medical education to prioritize an anti-racist perspective in future research endeavors.

Capacities for peace, and war, are old and related to Homo construction of worlds and communities

The capacities required for both peace and war predate 100,000 years ago in the genus Homo are deeply entangled in the modes by which humans physically and perceptually construct their worlds and communities, and may not be sufficiently captured by economic models.

Healing Hanuman's Army: Veterinary Care as a Core Component of One Health Principles in a Southeast Asian Monkey Forest

Wildlife that inhabit urban landscapes face the dual challenge of negotiating their positions in their group while navigating obstacles of anthropogenically modified landscapes. The dynamics of urban environments can result in novel injuries and mortalities for these animals. However, these negative impacts can be mitigated through planning, and onsite veterinary care like that provided by the Ubud Monkey Forest in Bali, Indonesia. We examined 275 recorded injuries and mortalities among six social groups of long-tailed macaques (Macaca fascicularis) brought to the veterinary clinic from 2015-2018. We fit the probabilities of injury vs. death among macaques brought to the clinic using a multilevel logistic regression model to infer the relationship between injury vs. death and associated demographic parameters. Males were more likely to sustain injuries and females were more likely to die. The frequency of injuries and mortalities changed over the four-year study period, which was reflected in our model. The odds of mortality were highest among young macaques and the odds of injury vs. mortality varied across the six social groups. We categorized injuries and mortalities as "natural" or "anthropogenic". Most injuries and mortalities were naturally occurring, but powerlines, motorized vehicles, and plastic present ongoing anthropogenic threats to macaque health. Most wounds and injuries were successfully treated, with healthy animals released back to their group. We suggest other sites with high levels of human-alloprimate interplays consider the Ubud Monkey Forest veterinary office as a model of care and potentially adopt their approaches.

Humans are biocultural, science should be too

COVID-19 is restructuring societies. Loneliness is a global health threat. Large language models are outputting biased health care information, and human-artificial intelligence (AI) interfaces are reshaping how we live. For most humans, technology, biology, and society are hopelessly entangled. Are the sciences prepared to tackle the contemporary human experience?

Environmental violence: a tool for planetary health research

From climate change to toxic pollution and the interactive effects of multiple pollution streams, human health is under siege. Human-produced environmental risks to health and wellbeing are high and contributing to patterns of global morbidity, mortality, economic inequality, displacement, and insecurity. The implications of human-produced environmental harms to global health are complex just as are their causes. The concept of environmental violence offers a potentially robust frame for engaging this issue. We argue that a more specified and structured framework and definition of environmental violence-focusing on human-produced harms by way of pollution emissions-is both timely and beneficial for engaging the complexities of global public health. To clarify why and how this is the case, we review the literature for publications that use the term environmental violence and we subsequently propose a specific definition focused on human-produced pollution along with a framework for tracking and analysing environmental violence and its constituent components. Finally, we discuss the potential value of our framework for research and policy making regarding human health.

Systemic racism in science: Reactions matter

Massive amounts of data and countless analyses collected across decades of scholarly research demonstrate unequivocally that bias and inequity based on race (in other words, racism) have occurred and still occur throughout society in the United States (the same can be said for many other nations). American higher education is one of the places where racism has been, and still is, well documented again and again and again. Not unexpectedly, six of the nine justices on the US Supreme Court recently chose to disregard these facts and argue for a "race neutral" approach in college admissions.

Super-resolution and apodization with discrete adaptive optics

High-resolution imaging is of great importance in various fields. The use of pupil phase-only filters (PPF) exceeds the diffraction limit of the imaging system in a simple way. When dealing with distorted wavefronts, however, PPF require that aberrations be compensated for. In this paper, we introduce a novel technique consisting of the use of discrete adaptive optics with PPFs so that the compensating device implements the PPF at the same time. Analysis of the theory for point spread function reshaping using PPFs has enabled us to develop a new approach to characterizing apodizing filters. A validation experiment has been carried out, the first of its kind to our knowledge, in which a number of PPFs were combined with two levels of compensation. Our experimental results are discussed.

Identification of new variants and candidate genes in women with familial premature ovarian insufficiency using whole-exome sequencing

PURPOSE

To identify candidate variants in genes possibly associated with premature ovarian insufficiency (POI).

METHODS

Fourteen women, from 7 families, affected by idiopathic POI were included. Additionally, 98 oocyte donors of the same ethnicity were enrolled as a control group. Whole-exome sequencing (WES) was performed in 14 women with POI to identify possibly pathogenic variants in genes potentially associated with the ovarian function. The candidate genes selected in POI patients were analysed within the exome results of oocyte donors.

RESULTS

After the variant filtering in the WES analysis of 7 POI families, 23 possibly damaging genetic variants were identified in 22 genes related to POI or linked to ovarian physiology. All variants were heterozygous and five of the seven families carried two or more variants in different genes. We have described genes that have never been associated to POI pathology; however, they are involved in important biological processes for ovarian function. In the 98 oocyte donors of the control group, we found no potentially pathogenic variants among the 22 candidate genes.

CONCLUSION

WES has previously shown as an efficient tool to identify causative genes for ovarian failure. Although some studies have focused on it, and many genes are identified, this study proposes new candidate genes and variants, having potentially moderate/strong functional effects, associated with POI, and argues for a polygenic etiology of POI in some cases.

P-340 The endometrial switch following progesterone exposure correlates with uterine peristalsis

Study question

What is the effect of the changes of the endometrium following progesterone exposure on uterine peristalsis?

Summary answer

Uteri with a greater increase endometrial thickness after progesterone exposure have significantly greater uterine peristalsis (UP). Therefore, endometrial compaction is associated with quieter uteri.

What is known already

Endometrial compaction is considered a sign of adequate response to progesterone. However, it is not always possible to visualize it. Little is known about endometrial switch following progesterone and its consequences after frozen embryo transfer, although it is hypothesized that increased endometrial growth after the window of implantation may be related to an increase in endogenous or exogenous oestrogen causing impairment of progesterone function. On the other hand, the role of progesterone in inhibiting endometrial contractile function is well known. Consequently, both the change in endometrial thickness and uterine contractility are indicators of progesterone function.

Study design, size, duration

This retrospective observational was carried out in Instituto Bernabeu of Alicante. The study included 215 patients with at least three previous implantation failures after egg donation treatment, which underwent uterine peristalsis assessment the day of embryo transfer from June 2017 to December 2021.

Participants/materials, setting, methods

UP assessment was performed using 4D ultrasound, recording a video for 6 minutes. UP variable was split in quartiles, and then the last quartile (UP ≥ 1,5 contractions per minute) was considered the hypercontractility group. All patients had performed an ultrasound to assess endometrial thickness between 7 to 10 days before embryo transfer. Endometrial compaction has been considered when it has decreased. Endometrial switch (ES) is considered the percentage between both endometrial measures.

Main results and the role of chance

The mean age of patients was 40,11 years who underwent an average of 3,75 embryo transfers. The average UP was 1,09 contractions per minute. The average ES was 9% of increased endometrium. Only 83 (38,6%) patients had endometrial compaction. To assess the association between UP and endometrial switch after progesterone exposure a univariate assessment was performed using Pearson’s correlation resulting in a negative correlation (r=-0,16; p = 0,019). It was used the hypercontractility group for performing bivariate logistic regression was performed to examine the effect of independent variables (previous miscarriages, previous pregnancies, C-section, endometriosis, adenomyosis, myomatosis and endometrial preparation) on ES. Greater ES is statistically associated to greater UP with OR 1,013 (95%IC: 1,002 to 1,025; p = 0,041).

Limitations, reasons for caution

It is a retrospective study based in patients with multiple implantation failure. It is possible that our conclusions couldn't be the same in patients with good prognosis.

Wider implications of the findings

Assessment of endometrial changes and uterine peristalsis provide information about the response of the uterus to progesterone exposure. However, more studies assessing it prospectively both would be interesting to define which population has high risk to develop situations with inadequate progesterone response.

Trial registration number

Not applicable

P-370 The vaginal microbiome in the first trimester of pregnancy is different in spontaneous versus IVF gestation

Study question

Are there differences in the vaginal microbiome of pregnant women who had a spontaneous pregnancy compared to those who required IVF?

Summary answer

The composition of the vaginal microbiome at 12 week's gestation is different in women who achieve the pregnancy spontaneously or by IVF.

What is known already

The vaginal microbiome plays an important role in women's reproductive health, finding associations between different microbiome patterns and the presence of infertility and embryo implantation failure in IVF. Additionally, recent studies show a correlation between obstetrics and perinatal outcomes and the composition of vaginal microbiota in pregnant women, as well as an increased risk of obstetrics complications in pregnant women after IVF.

Study design, size, duration

Observational, prospective and multicentre study. A total of 64 women were enrolled between January 2020 and June 2021. Spontaneous pregnancies n = 30; and IVF pregnancies n = 34.

Participants/materials, setting, methods

Vaginal swabs were obtained by speculum exam at 12 weeks of gestation in two public hospitals and a fertility private clinic in Spain, to evaluate the differences in vaginal microbiome between both cohorts. The microbiome composition was analyzed by sequencing the V3-V4 region of the 16S rRNA on the Illumina MiSeq platform.

Main results and the role of chance

There were no significant differences in socio-demographic characteristics between groups, except for an expected higher maternal age in the IVF cohort.

Lactobacillus was the most prevalent genus in both groups. When we compared the beta diversity of vaginal microbial by cohort a significant difference was obtained (p = 0.001).

Gardenella, Neisseria, Prevotella and Staphyloccocus were significantly enriched in the IVF group (p = 0.01).

A further evaluation of the four most abundant Lactobacillus species showed that Lactobacillus iners was dominant in IVF pregnancies (15.2%) compared to spontaneous (9.8%) (p = 0.002). On the other hand, Lactobacillus  gasseri showed a lower abundance in vaginal microbiome from women belonged to IVF (9.2%) vs spontaneous pregnant group (13.8%) (p = 0.005).

These findings allowed us to create a model to identify a microbial signature. This model is able to discriminate between IVF and spontaneous pregnancies.

Limitations, reasons for caution

The main limitation of our study is the small sample size. Larger studies are needed to corroborate our findings and their relationship with important aspects such as obstetric and perinatal complications.

Wider implications of the findings

The microbiome composition is different between both cohorts. The microbiome found in our IVF cohort has been also associated with obstetric complications as preterm delivery in previous studies. This suggest that the microbiome composition could be a plausible etiology for a higher risk of adverse pregnancy outcomes in IVF patients.

Trial registration number

Not applicable

P-024 Identification of spermatogenic infertility phenotypes using next generation sequencing

Study question

Can next generation sequencing (NGS) contribute to diagnoses male idiopathic infertility?

Summary answer

A male factor gene panel identifies pathogenic variants associated to spermatogenic failure in oligozoospermia and cryptozoospermia patients.

What is known already

In 50% of cases, infertility is due to a male factor problem. Although the causes of male infertility are heterogeneous, genetic causes account for approximately 30% of cases. Some phenotypes have been associated with specific genetic disorders such as chromosomal abnormalities and chromosome Y microdeletions. However, current genetic studies explain only 4% of cases, whilst most cases of male factor infertility remain without a clear diagnosis. Therefore, new techniques that explain the cause of male infertility are needed. Advances in NGS allowed us to study a large number of genes involved in spermatogenesis process in patients with idiopathic infertility.

Study design, size, duration

A retrospective study was performed from July 2020 until May 2021. A total of 30 patients with abnormal seminal count parameters (oligozoospermic and cryptozoospermic) were included in the male factor gene panel study. Patients carrying Y-chromosome microdeletions or abnormal karyotype were excluded. The control group included 20 normozoospermic healthy donors selected on the basis of normal semen parameters according to the WHO criteria (2010).

Participants/materials, setting, methods

Genomic DNA extraction from blood-EDTA of the patients was performed using the commercial MagMax DNA MultiSample Ultra kit and the King-Fisher automated extractor (ThermoFisher®). Next Generation Sequencing (NGS) was done using a panel with 426 genes involved in the spermatogenesis process. Panel sequencing for identification of genetic variants was performed using Nextera Enrichment technology (Illumina®). FASTAQ data were processed using BWA and GATK algorithms. VCF files were analyzed using Variant Interpreter software.

Main results and the role of chance

After data analysis, we observed that eight of the thirty patients studied were carriers of mutations in least one of the genes included in the panel (8/30, 26.7%). We identified the following pathogenic variants: a missense mutation (Phe1052Val) and a deletion (Phe508del) of CFTR gene (2/30, 6.6%), two frameshifts (Asp128GlufsTer34 and Lys1299Ter) of CEP290 (2/30, 6.6%), a missense mutation (Tyr284Cys) of GNRHR gene (1/30, 3.3%), a missense mutation (Tyr416Cys) of SCN5A gene (1/30, 3.3%), a deletion (Ser83del) of NANOS1 gene (1/30, 3.3%), a stop gained in splice region Arg341Ter of TEX14 gene (1/30, 3.3%), a splicing donor c.362 + 2T>C of ESR2 gene (1/30, 3.3%) and a missense mutation (Ser321Leu) of DNAH5 gene (1/30, 3.3%), which are related to spermatogenesis failure. Additionally, some variants classified as benign have been identified, which are not associated with pathogenicity. All the variants identified are related with male infertility, affecting spermatogenesis process, such as congenital bilateral absence of the vas deferens (CFTR), reproductive system syndrome (CEP190), endocrine disorder (GNRHR, hypogonadotropic hypogonadism), testis expressed (SCN5A), spermatogenic failure (NANOS1, TEX14 and ESR2) and syndromic infertility (DNAH5). Nevertheless, no pathogenic mutations associated to spermatogenic failure were observed in the control group.

Limitations, reasons for caution

The main limitation of this study is the small number of patients included. Further studies including a higher number of males with idiopathic infertility are warranted to confidently link the genetic variants included in our gene panel to spermatogenic failure.

Wider implications of the findings

The gene list included in our panel represents a step-forward in the diagnosis screening of males with altered sperm parameters. Our results may add in the knowledge of male factor infertility in order to provide etiologic factors towards a personalized treatment and adequate genetic counselling.

Trial registration number

Not applicable

Cohort dominance rank and "robbing and bartering" among subadult male long-tailed macaques at Uluwatu, Bali

Robbing and bartering is a habitual behavior among free-ranging long-tailed macaques (Macaca fascicularis) at a single site in Bali, Indonesia. The behavior consists of three main elements: (1) a macaque takes an item from a human; (2) the macaque maintains possession of the item; then (3) the macaque releases or hands off the item after accepting a food offer from a human. In this paper, we analyze data on individual variation in robbing and bartering among subadult males in relation to dominance rank. Using focal animal sampling we collected 197 observation hours of data on 13 subadult males from two groups (6 from Celagi; 7 from Riting) at the Uluwatu temple site from May 2017 to March 2018, recording 44 exchanges of items for food from 92 total robberies following 176 total attempts. We also measured dominance rank using interaction data from our focal animals. Dominance rank was strongly positively correlated with robbery efficiency in Riting, but not Celagi, meaning that more dominant Riting subadult males exhibited fewer overall robbery attempts per successful robbery. We suggest the observed variation in robbing and bartering practices indicates there are crucial, yet still unexplored, social factors at play for individual robbing and bartering decisions.

Identification of vaginal microbiome associated with IVF pregnancy

The factors that cause a preterm birth (PTB) are not completely understood up to date. Moreover, PTB is more common in pregnancies achieved by in-vitro fertilization (IVF) than in spontaneous pregnancies. Our aim was to compare the composition of vaginal microbiome at 12 weeks of gestation between women who conceived naturally or through IVF in order to study whether IVF PTB-risk could be related to vaginal microbiome composition. We performed an observational, prospective and multicentre study among two public hospitals and a fertility private clinic in Spain. Vaginal swabs from 64 pregnant women at 12 weeks of gestation were collected to analyse the microbiome composition by sequencing the V3-V4 region of the 16S rRNA. Our results showed that the vaginal microbiome signature at 12 weeks of pregnancy was different from women who conceived naturally or through IVF. The beta diversity and the genus composition were different between both cohorts. Gardnerella, Neisseria, Prevotella, and Staphylococcus genus were enriched genus in the vaginal microbiome from the IVF group, allowing us to create a balance model to predict both cohorts. Moreover, at species level the L. iners abundance was higher and L. gasseri was lower in the IVF group. As a conclusion, our findings were consistent with a proposed framework in which IVF pregnancy are related to risk for preterm birth (PTB) suggesting vaginal microbiome could be the reason to the relation between IVF pregnancy and risk for PTB.

Survival study and factors associated with mortality in Chilean patients on peritoneal dialysis infected with SARS-CoV-2

The Covid-19 pandemic has been responsible for millions of deaths worldwide. Patients with comorbidities- such as those on peritoneal dialysis (PD)- present higher morbidity and mortality than the general population. We prospectively evaluated all Chilean patients on PD (48 centres) and followed those who had Covid-19 from the beginning of the Covid-19 pandemic in Chile (March 2020) to January 2021 (start of vaccination campaign). We described demographic history, comorbidities, factors related to infection, need for hospitalisation and death due to Covid-19. During the study period, 106 adults on PD were infected by SARS-CoV-2, with a mean age of 53.1 (±16.3) and of which 53.9% were female. From that group, 54.8% required hospitalisation and 24.5% (n = 26) died due to Covid-19. Most of the patients (63.4%) were infected at home and 22.8% during hospitalisation for other reasons. There was a significant association for Covid-19 mortality with: being ≥60 years old, diabetes, time on PD ≥5 years, need for hospitalisation and hospital-acquired infection. At 90 days of follow-up, all deaths associated to Covid-19 occurred before 40 days. We conclude that patients on PD without Covid-19 vaccination have a high mortality and need for hospitalisation associated to Covid-19. To avoid this negative outcome, it is necessary to intensify strategies to avoid contagion, especially in those ≥60 years old, with diabetes and/or ≥5 years spent on PD.

There and back again: The biosocial dynamics of returning from the field

BACKGROUND

Leaving "home" to pursue fieldwork is a necessity but also a rite of passage for many biological anthropology/human biology scholars. Field-based scientists prepare for the potential changes to activity patterns, sleep schedules, social interactions, and more that come with going to the field. However, returning from extended fieldwork and the reverse-culture shock, discomforts, and mental shifts that are part of the return process can be jarring, sometimes traumatic experiences. A failure to acknowledge and address such experiences can compromise the health and wellbeing of those returning.

AIMS

We argue for an engaged awareness of the difficult nature of returning from the field and offer suggestions for individuals and programs to better train and prepare PhD students pursuing fieldwork.

MATERIALS & METHODS

Here, we offer personal stories of "coming back" and give professional insights on how to best ready students and scholars for returning from fieldwork.

DISCUSSION/CONCLUSION

By bringing forward and normalizing the difficulty of the fieldwork-return process, we hope that this reflection acts as a tool for future scholars to prepare to come home as successfully and consciously as possible.

Biology versus bias Joseph L. Graves Jr. and Alan H. Goodman Columbia University Press, 2021. 320 pp

[Figure: see text].

P–546 Exome sequencing and preimplantation genetic testing for unexplained recurrent fetal malformations

Study question

Could patient suffering unexplained recurrent fetal malformations be benefit of PGT-M by exome sequencing mutations identification?

Summary answer

Patients suffering unexplained recurrent fetal malformations could be benefit of the use of exome sequencing in combination to PGT-M to have a healthy live birth.

What is known already

Fetal malformations account for approximately 3% of live births and causes include: chromosomal abnormalities, exposure to toxic substances or teratogens and infections. Recently, studies have shown that several monogenic diseases are linked to fetal abnormalities. However, because of the large number of potential genes, genetic testing is challenging. Exome sequencing is widely used to detect genetic mutations and has emerged as a useful tool for finding the genetic cause of fetal abnormalities. The aim of this study was to show how exome sequencing in patients suffering unexplained recurrent fetal malformations in combination to PGT-M could lead to successful healthy newborn.

Study design, size, duration

Case report of a non-consanguineous couple with unexplained, recurrent fetal malformations. Couple were recruited during clinical consultation for unexplained recurrent fetal malformations at a private reproductive medicine clinic. The couple had two malformed fetus with the same congenital abnormalities: hydrocephalus, cerebellar vermis agenesis, cerebellar hypoplasia and enlarged cisterna magna. Patients signed written informed consent regarding to exome testing. For fetal sample, informed consent was obtained from parents.

Participants/materials, setting, methods

Sample of the affected fetus were provided. Parental genomic DNA was extracted from peripheral blood. Exome sequencing was performed using TrusightOne (Illumina®). FASTAQ data were processed through BWA and GATK algorithm. VCF files were analysed using Variant Interpreter software. After genetic counselling, PGT-M was performed using linkage polymorphic markers analysis and mutation sequencing. Embryo biopsy was carried at blastocyst stage. Embryos were vitrified and one healthy embryo was thaw and transfer in a subsequent cycle.

Main results and the role of chance

An homozygous novel pathogenic mutation c.641 C>T (p.Ala214Val) in FVLCR2 gene was found. The parents were heterozygous carriers revealing that the detected variant follow an autosomal recessive pattern. The FLVCR2 (14q24.3) gene encodes a transmembrane protein that belongs to the major facilitator superfamily of secondary carriers that transport small solutes in response to chemiosmosis ion gradients, such as calcium. Mutations in this gene are related to fetal central nervous system defects. This disorder is diagnosed prenatally and is lethal. PGT-M was recommended during genetic counselling. After control ovarian stimulation 14 oocytes were retrieved and finally 4 embryos were suitable for embryo biopsy at blastocyst stage. One embryo was diagnosed as healthy, two affected and one heterozygous carrier. The healthy embryo was thaw and transferred and a healthy male baby was born.

Limitations, reasons for caution

Exome sequencing has technical limitations: only covers mutations in coding regions and does not cover noncoding regions of the genome. It also cannot reliably detect copy-number variants at single gene level.

Wider implications of the findings: This study offers strong evidence of exome-sequencing as a new diagnostic strategy and powerful tool discovering the underlying etiology of recurrent fetal malformations and identifying new genes important for human development. Using this strategy in combination with PGT-M, clinicians can help couples with recurrent fetal malformations to have healthy newborns.

Trial registration number

Not applicable

P–541 Identification of novel variants and candidate genes in women with familial idiopathic premature ovarian failure using whole-exome sequencing

Study question

Is it possible to identify a genetic cause of familial premature ovarian failure (POF) with whole-exome sequencing (WES)?

Summary answer

Whole-exome sequencing is the most efficient strategy to identify probably pathogenic mutations in different genes in pathologies of polygenic etiology such as premature ovarian failure.

What is known already

Premature ovarian failure is the loss of ovarian function before the age of 40, and it is a common cause of infertility in women. This pathology has a heterogeneous etiology. Some chromosomal and genetic alterations have been described, and could explain approximately 20% of cases. However, in most patients the origin remains unknown. Recent studies with next-generation sequencing (NGS) have identified new variants in candidate genes related with premature ovarian insufficiency (POI) or premature ovarian failure (POF). These genes are not only involved in processes such as folliculogenesis, but also with DNA damage repair, homologous recombination, and meiosis.

Study design, size, duration

Fourteen women, from 7 families, affected by idiopathic POF were included in the study from October 2019 to September 2020. Seven POF patients were recruited when they came to our clinic to undergo assisted reproductive treatment. In the anamnesis, it was found that they had relatives with a diagnosis of POF, who were also recruited for the study. The inclusion criteria were amenorrhea before 38 years old and analytical and ultrasound signs of ovarian failure.

Participants/materials, setting, methods

WES was performed using TrusightOne (Illumina®). Sequenced data were aligned through BWA tool and GATK algorithm was used for SNVs/InDel identification. VCF files were annotated using Variant Interpreter software. Only the variants shared by each family were extracted for analysis and these criteria were followed: (1) Exonic/splicing variants in genes related with POF or involved in biological ovarian functions (2) Variants with minor allele frequency (MAF) ≤0.05 and (3) having potentially moderate/strong functional effects.

Main results and the role of chance

Seventy-nine variants possibly related with the POF phenotype were identified in the seven families. All these variants had a minor allele frequency (MAF) ≤0.05 in the gnomAD database and 1000 genomes project. Among these candidate variants, two were nonsense, six splice region, one frameshift, two inframe deletion and 68 missense. Thirty-two of the missense variants were predicted to have deleterious effects by minimum two of the four in silico algorithms used (SIFT, PolyPhen–2, MutationTaster and PROVEAN). All variants were heterozygous, and all the families carried three or more candidate variants. Altogether, 43 probably damaging genetic variants were identified in 39 genes expressed in the ovary and related with POF/POI or linked to ovarian physiology. We have described genes that have never been associated to POF pathology, however they may be involved in key biological processes for ovarian function. Moreover, some of these genes were found in two families, for example DDX11, VWF, PIWIL3 and HSD3B1. DDX11 may function at the interface of replication-coupled DNA repair and sister chromatid cohesion. VWF gene is suggested to be associated with follicular atresia in previous studies. PIWIL3 functions in development and maintenance of germline stem cells, and HSD3B1 is implicated in ovarian steroidogenesis.

Limitations, reasons for caution

Whole-exome sequencing has some limitations: does not cover noncoding regions of the genome, it also cannot detect large rearrangements, copy-number variants (large deletions/duplications), mosaic mutations, mutations in repetitive or high GC rich regions and mutations in genes with corresponding pseudogenes or other highly homologous sequences.

Wider implications of the findings: WES has previously shown to be an efficient tool to identify genes as cause of POF, and has demonstrated the polygenic etiology. Although some studies have focused on it, and many genes are identified, this study proposes new candidate genes and variants, having potentially moderate/strong functional effects, associated with POF.

Trial registration number

Not applicable

P–286 Uterine vascularity in women with previous caesarean section and its potential role in implantation failure: a retrospective cohort study

Study question

Does a previous Caesarean section affect uterine vascularisation the day of embryo transfer?

Summary answer

3D vascularisation parameters show less uterine irrigation in patients with previous Caesarean section

What is known already

A recent retrospective cohort study demonstrates that previous Caesarean section impairs live birth rates after assisted reproductive treatment (ART) compared to a previous vaginal delivery. Furthermore, it has been hypothesized about the mechanisms by which post-cesarean section niche may diminish clinical pregnancy rates. One of the hypothetical process mentioned has been a distorted contractility of the uterus caused by fibrosis, which can influence in the vascularisation of the endometrium.

Study design, size, duration

We retrospectively studied the uterine contractility and 3D vascularisation parameters in women who had an embryo transfer at the Instituto Bernabeu of Alicante, between 2018 and 2020 with one recurrent implantation failure (at least two good quality blastocysts transferred from egg donation treatment).

Participants/materials, setting, methods

Patients with large myomas (more than 4 cm), adenomyosis or polyp were excluded. In total, 196 patients were assessed on the day of embryo transfer which 12 patients had a previous caesarean section. Uterine contractility was analyzed using 4D ultrasound after 6 minutes of video recording. Vascularisation index and vascularisation flow index were assessed after the endometrial volume definition.

Main results and the role of chance

Baseline characteristics of both groups were comparable. 3D vascularization parameters were significantly lower in women with a previous caesarean section. Vascularization Index (VI) reached 0,8% in caesarean section group (CS group) versus 2,3% (p = 0,038) and vascularization flow index (VFI) was 0,2 in CS group versus 0,8 (p = 0,038) Despite uterine peristalsis showed less contractility in those patients with previous caesarean section (0,8 contractions per minute versus 1,1 contractions per minute), non-statistical differences were demonstrated (p = 0,154)

Limitations, reasons for caution

This study is limited by its retrospective design and the low number of cases.

Wider implications of the findings: The lower 3D vascularisation indexes support a post-Caesarean section vascular-related impaired perfusion as a hypothetical mechanism. Its correlation with a possible impairment in the embryo implantation after fertility treatments warrants further studies.

Trial registration number

Not applicable

P–588 Follicle-stimulating hormone receptor genotype and its influence on the results of double ovarian stimulation in IVF cycles

Study question

Does the follicle-stimulating hormone receptor (FSHR) genotype influence the results of the ovarian stimulation treatment in the luteal phase?

Summary answer

All patients undergoing in-vitro fertilization benefit from luteal phase ovarian stimulation, regardless of their follicle-stimulating hormone receptor genotype.

What is known already

Previous studies suggest that FSH receptor polymorphism in position 680 influences the response to ovarian stimulation in the luteal phase. It was observed that patients with SS genotype seems to require a higher dose to obtain an optimal ovarian response. Later, it was reported that, in patients with SS genotype, a better performance seems to be obtained by administering highly purified urinary FSH while, in SN patients, better results were obtained with recombinant FSH. In patients with NN genotype, no differences were found. Our aim was to test whether this concept is applicable to ovarian stimulation in the luteal phase.

Study design, size, duration

One hundred and thirty-four patients were included in a retrospective study between July 2017 and September 2020. In these patients, a double stimulation protocol was carried out and the FSH receptor was genotyped either as part of the pre-treatment fertility tests or for the current study. Patients with a double stimulation treatment who could not be genotyped were excluded from the analysis.

Participants/materials, setting, methods

To genotype the 680 position of the FSH receptor, a real-time PCR for allelic discrimination was carried out using StepOnePlus™ Real-Time PCR System (Applied Biosystems™. Ref: 4376600). Non-parametic tests were used to study the differences between the groups. They were performed with the software R Statistical Software, version 4.0.3.

Main results and the role of chance

The results of ovarian stimulation in the luteal phase were better compared to the conventional follicular phase. Statistically significant differences (p < 0.001) were found in the number of retrieved oocytes (5.06 versus 3.51), retrieved MII (4.13 versus 2.91), fertilized oocytes (3.22 versus 1.81) and blastocysts formed (1.79 versus 0.62). Furthermore, these differences remained regardless of the genotype for the 680 position of the FSH receptor in all groups (p < 0.05).

In addition, better results were obtained in the luteal phase in patients who have been stimulated with the type of gonadotropin that already had better performance in the follicular phase for its genotype, that is, highly purified urinary FSH in SS patients and recombinant FSH in SN patients, compared to other types of gonadotropin (p < 0.05).

We also observed that stimulation in the luteal phase lasts longer and consume more gonadotropins than in the follicular phase. This is especially notable in the case of patients with SS genotype, who required slightly higher consumption of gonadotropins compared to the other genotypes in the luteal phase, as had previously been observed in the follicular phase for this genotype.

Limitations, reasons for caution

The retrospective study design and the sample size could be a limitation. Furthermore, we cannot determine whether the improvement in luteal phase performance is related to differences in the physiological environment between phases of the cycle or is caused by a possible activation of the ovary from the previous stimulation.

Wider implications of the findings: All patients undergoing in-vitro fertilization seems to benefit from luteal phase ovarian stimulation, regardless of their genotype for FSHR. In addition, the pharmacogenetic recommendation when choosing the type of FSH for ovarian stimulation should be the same both in the follicular phase and in the luteal phase.

Trial registration number

Not applicable

P–540 A feasible diagnostic approach for the cryptic subtelomeric traslocations in early recurrent miscarriage patients by preimplantation genetic testing (PGT)

Study question

Could cryptic subtelomeric traslocations in early recurrent miscarriage patients be diagnosed by preimplantation genetic testing?

Summary answer

PGT is a powerful tool to detect subtelomeric cryptic traslocations identifying the cause of early recurrent miscarriage and allowing subsequent genetic counselling. What is known already: Chromosome translocations are frequently associated with birth defects, spontaneous early pregnancy losses and infertility. However, submicroscopic traslocations (so-called cryptic traslocations) are too small to be detected by conventional karyotyping.. Due to balanced status, high resolution molecular techniques as arrayCGH are not able to detect it. Thus, cryptic traslocations detection is challenging. PGT is able to detect CNVs at higher resolution than routine karyotyping. Therefore, the recurrent diagnosis of CNV at embryo level could suggest a subchromosomal parental traslocation. The aim of this study is to investigate the feasibility of using PGT as an indicator of parental balanced cryptic traslocations.

Study design, size, duration

We included three couples who underwent PGT for unexplained repeated pregnancy loss (RPL) in our clinic from February 2020 to November 2020. Common established causes of RPL (uterine anomalies, antiphospholipid syndrome, immunological, hormonal and metabolic disorders) were previously rouled-out. Even couple karyotypes were normal. Twenty-three embryos from those couples were biopsied at blastocyst and analysed for CNVs detection using low coverage whole genome NGS.

Participants/materials, setting, methods

PGT by NGS was performed by Veriseq-NGS (Illumina), with previous whole genome amplification. Fluorescence in situ hybridization (FISH) using parental blood samples were performed to validate the origin of subchromosomal number variation. Commercially available subtelomeric specific probes were selected according to the CNV identified and the procedures were performed according to the manufacturer’s protocols.

Main results and the role of chance

Overall, CNVs of terminal duplication and deletion that imply unbalanced traslocation derivatives were detected in the 43.5% of biopsied embryos. For couple 1, 4 out of 5 embryos (80%) carried deletion of telomeric region on chromosomes 5 and 21. Three out of 6 biopsed embyos (50%) were diagnosed with subchromosomal copy variants at telomeric region on chromosomes 6 and 16 for couple 2. In the case of couple 3, three out of 12 embryos (25%) were carriers of CNV at subtelomeric region on chromosomes 2 and 6. The size of CNVs detected ranges from 8Mb to 20Mb. Accurate diagnosis with the parental study was made by FISH. The combination of probes to detect the structural chromosome alteration were: Tel5qter-LSI21q, Tel6pter-CEP16 and Tel6pter-CEP6 for each couple respectively. The FISH studies reveal that CNVs were inherited from one parent carrying the balanced cryptic traslocation. Ultimately, the abnormal karyotype from the carrier parent were 46,XY,t(5;21)(q33.2;q21.2) for couple 1, 46,XY,t(6;16)(p22.3;q22.1) for couple 2 and 46,XY,t(2;6)(p25.1;p24.2) for couple 3. Finally, each couple performed a cryotransfer of a single normal balanced embryo. Two pregnancies are ongoing.

Limitations, reasons for caution

The main limitation of this approach is the NGS- PGT resolution. CNVs smaller than 5Mb could not be detected.

Wider implications of the findings: This study shows the value of PGT for unexplained RPL, followed by parental FISH to better characterize CNVs and identify couples in whom one partner carries a cryptic translocation. Accurate diagnosis of parental chromosome translocation can achieve with FISH only, but FISH would not be performed unless PGT showed CNVs.

Trial registration number

Not applicable

Social media and public perception as core aspect of public health: The cautionary case of @realdonaldtrump and COVID-19

The social media milieu in which we are enmeshed has substantive impacts on our beliefs and perceptions. Recent work has established that this can play a role in influencing understanding of, and reactions to, public health information. Twitter, in particular, appears to play a substantive role in the public health information ecosystem. From July 25th, 2020 to November 15th, 2020, we collected weekly tweets related to COVID19 keywords and assessed their networks, patterns and properties. Our analyses revealed the dominance of a handful of individual accounts as central structuring agents in the networks of tens of thousands of tweets and retweets, and thus millions of views, related to specific COVID19 keywords. These few individual accounts and the content of their tweets, mentions, and retweets are substantially overrepresented in terms of public exposure to, and thus interaction with, critical elements of public health information in the pandemic. Here we report on one particularly striking aspect of our dataset: the prominent position of @realdonaldtrump in Twitter networks related to four key terms of the COVID19 pandemic in 2020.

Do long-tailed macaques avoid large heterospecific carcasses?

This anecdotal observation details the response of long-tailed macaques (Macaca fascicularis) to a heterospecific carcass. The subgroup of macaques we were following abruptly changed their direction of travel upon reaching a tree line while displaying silent vigilance behaviour. We later discovered a dog carcass in the area and concluded their behaviour may have been in response to the smell of that carcass. The carcass was not visible from the response point at the tree line due to its distance from that point (approximately 30 meters) and the uneven and densely vegetated terrain between. The macaques were therefore most likely responding to scent cues from the carcass. We suggest the observed vigilance behaviour is excessive under a strictly pathogen-avoidance explanation and may be understood as a response to a cue of potential predation risk. We review alternative explanations and suggest future research on nonhuman primate heterospecific carcass avoidance is necessary to fully assess the potential relation to perceived risk of predation.

Biological anthropology's critical engagement with genomics, evolution, race/racism, and ourselves: Opportunities and challenges to making a difference in the academy and the world

Biological anthropology can, and should, matter in the Anthropocene. Biological anthropologists are interested in human biology and the human experience in a broader ecological, evolutionary, and phylogenetic context. We are interested in the material of the body, the history of the body, and interactions of diverse bodies, communities, ecologies, and evolutionary processes. However, the cultural realities of bodies, histories, communities, livelihoods, perceptions, and experiences are as central to the endeavor and inquiry of biological anthropology as are their material aspects. Biological anthropology is a constant dialectic between the cultural and the biological. In this essay, I argue that Biological Anthropology has much to offer, a history to contend with, and a future that matters. To illustrate this, I highlight theoretical and methodological issues in genomics, evolutionary theory and connect them to the study of Race and Racism to emphasize specific arenas where Biological Anthropology has a great capacity, and a strong obligation, to play a central role. However, Biological Anthropology also has substantive internal issues that hinder our ability to do the best possible science. If we are to live up to our potential and make a difference in the 21st century we need to ameliorate our structural shortcomings and expand our voice, and impact, in academic and public discourse. The goal of this perspective is to offer suggestions for moving us toward this goal.

Correction to: Review of GPS collar deployments and performance on nonhuman primates

In the original publication of the article, figure 1 was wrongly published as a duplication.

Dry eye is matched by increased intrasubject variability in tear osmolarity as confirmed by machine learning approach

OBJECTIVE

Because of high variability, tear film osmolarity measures have been questioned in dry eye assessment. Understanding the origin of such variability would aid data interpretation. This study aims to evaluate osmolarity variability in a clinical setting.

MATERIAL AND METHODS

Twenty dry eyes and 20 control patients were evaluated. Three consecutive osmolarity measurements per eye at 5min intervals were obtained. Variability was represented by the difference between both extreme readings per eye. Machine learning techniques were used to quantify discrimination capacity of tear osmolarity for dry eye.

RESULTS

Mean osmolarities in the control and dry eye groups were 295.1±7.3mOsm/L and 300.6±11.2mOsm/L, respectively (P=.004). Osmolarity variabilities were 7.5±3.6mOsm/L and 16.7±11.9mOsm/L, for the control and dry eye groups, respectively (P<.001). Based on osmolarity, a logistic classifier showed an 85% classification accuracy.

CONCLUSIONS

In the clinical setting, both mean osmolarity and osmolarity variability in the dry eye group were significantly higher than in the control group. Machine learning techniques showed good classification accuracy. It is concluded that higher variability of tear osmolarity is a dry eye feature.

Genetic variation and population structure of Diaphorina citri using cytochrome oxidase I sequencing

Citrus greening disease, or huanglongbing (HLB), is currently one of the most devastating diseases of citrus. The bacteria thought to be responsible for the disease, Candidatus Liberibacter asiaticus impact the majority of commercial citrus species worldwide. These bacteria are transmitted by the Asian citrus psyllid (ACP), Diaphorina citri Kuwayama, which is now found in most citrus growing regions. With no known cure, ACP-vectored HLB is responsible for significant economic losses to the global citrus industry. A better understanding of the global genetic diversity of D. citri would improve current and future pest management and mitigation programs. To assess the genetic diversity of D. citri in worldwide collections, a total of 1,108 sequences belonging to ACP gathered from 27 countries in the Americas, the Caribbean, Southeast and Southwest Asia were examined for the study. 883 D. citri came from 98 locations in 18 different countries, and were sequenced using a 678bp fragment of the mitochondrial cytochrome oxidase I (COI) gene. Additionally, 225 previously-reported D. citri COI sequences, were also included in our analysis. Analyses revealed 28 haplotypes and a low genetic diversity. This is in accordance with previous reports on the little diversity of D. citri in worldwide populations. Our analyses reveal population structure with 21 haplotypes showing geographic association, increasing the resolution for the source estimation of ACP. This study reveals the distribution of haplotypes observed in different geographic regions and likely geographic sources for D. citri introductions.