Clinical features and prognosis of malignant small bowel tumors: Experience from a university hospital in Chile

BACKGROUND

Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America.

AIM

To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs.

METHODS

Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile.

RESULTS

A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, n=38), gastrointestinal stromal tumors (GIST) (21.8%, n=19), lymphoma (17.2%, n=15) and adenocarcinoma (AC) (11.5%, n=10). GIST was more frequent in duodenum (50%; n=12) and NET in the ileum (65.8%; n=25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC (p=0.035), as well as gastrointestinal bleeding in GIST (p=0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5-year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1-99.2), 82.2% (95%CI: 57.6-93.3), 40.0% (95%CI: 16.5-82.8) and 25.9% (95%CI: 4.5-55.7%), respectively. NET (HR 6.1; 95%CI: 2.1-17.2) and GIST (HR 24.4; 95%CI: 3.0-19.8) were independently associated with higher survival compared to AC, adjusted for age and sex.

CONCLUSIONS

Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes.

Are farmers motivated to select for heat tolerance? Linking attitudinal factors, perceived climate change impacts, and social trust to farmers' breeding desires

This study provides an understanding of dairy farmers' willingness to include heat tolerance in breeding goals and the modulating effect of sociopsychological factors and farm profile. A survey instrument including a choice experiment was designed to specifically address the trade-off between heat tolerance and milk production level. A total of 122 farmers across cattle, goat, and sheep farms were surveyed face-to-face. The results of the experiment show that most farmers perceive that heat stress and climate change are increasingly important problems, and that farming communities should invest more in generating knowledge and resources on mitigation strategies. However, we found limited initial support for selection for heat tolerance. This attitude changed when farmers were presented with objective information on the benefits and limitations of the different breeding choices, after which most farmers supported selection for heat tolerance, but only if doing so would compromise milk production gains to a small extent. Our results show that farmers' selection choices are driven by the interactions between heat stress risk perception, attitudes toward breeding tools, social trust, the species reared, and farm production level. In general, farmers willing to support selection of heat-tolerant animals are those with positive attitudes toward genetic values and genomic information and a strong perception of climate change and heat stress impacts on farms. On the contrary, negative support for selection for heat tolerance is found among farmers with high milk production levels; high trust in farming magazines, livestock farmers' associations, and veterinarians; and low trust in environmental and animalist groups.

Consistency between POLARS and LARS scores regarding the incidence of low anterior resection syndrome in a Chilean population undergoing rectal surgery secondary to cancer in a high-volume hospital

AIM

The aim of this work was to evaluate the concordance between the low anterior resection syndrome (LARS) and preoperative LARS (POLARS) scores regarding the incidence of LARS in a Chilean population undergoing rectal surgery for cancer in a high-volume hospital.

METHOD

The LARS score questionnaire, following telephone requests, was used to determine the presence and severity of LARS. The POLARS score was calculated based on variables described previously. Correlations and qualitative and quantitative concordance were evaluated using Spearman's correlation coefficient, the kappa coefficient and the Bland-Altman plot with Lin's concordance correlation coefficient.

RESULTS

A total of 120 patients met the inclusion criteria: 37.5% underwent neoadjuvant radiotherapy, 61% underwent total mesorectal excision (TME) and 51.6% underwent ostomy. A total of 49% of patients did not present with LARS, whereas 28% had major LARS. The correlation between scales was poor, with a fair qualitative concordance to determine the presence/absence of LARS and a slight qualitative concordance to determine the degree of the intensity. The quantitative concordance was poor.

CONCLUSION

In the Chilean population, concordance between the LARS and POLARS scores was qualitatively fair to determine the presence/absence of the disease and qualitatively slight to determine the degree of intensity. We do not suggest using the POLARS score in the perioperative period in the Chilean population deliberately, as the score may help to determine the presence/absence of LARS but cannot determine its degree of intensity. Additional evaluations are required to determine the factors contributing to the degree of agreement between the scales.

Risk factors for major complications after surgical treatment of primary ileocecal Crohn's disease. A multicentric Latin American experience

INTRODUCTION

Complications after ileocecal resection for Crohn's disease (CD) are frequent. The aim of this study was to analyze risk factors for postoperative complications after these procedures.

MATERIALS AND METHODS

We conducted a retrospective analysis of patients treated surgically for Crohn's disease limited to the ileocecal region during an 8-year period at 10 medical centers specialized in inflammatory bowel disease (IBD) in Latin America. Patients were allocated into 2 groups: those who presented major postoperative complications (Clavien-Dindo > II), the "postoperative complication" (POC) group; and those who did not, the "no postoperative complication" (NPOC) group. Preoperative characteristics and intraoperative variables were analyzed to identify possible factors for POC.

RESULTS

In total, 337 patients were included, with 51 (15.13%) in the POC cohort. Smoking was more prevalent among the POC patients (31.37 vs. 17.83; P = .026), who presented more preoperative anemia (33.33 vs. 17.48%; P = .009), required more urgent care (37.25 vs. 22.38; P = .023), and had lower albumin levels. Complicated disease was associated with higher postoperative morbidity. POC patients had a longer operative time (188.77 vs. 143.86 min; P = .005), more intraoperative complications (17.65 vs. 4.55%; P < .001), and lower rates of primary anastomosis. In the multivariate analysis, both smoking and intraoperative complications were independently associated with the occurrence of major postoperative complications.

CONCLUSION

This study shows that risk factors for complications after primary ileocecal resections for Crohn's disease in Latin America are similar to those reported elsewhere. Future efforts in the region should be aimed at improving these outcomes by controlling some of the identified factors.

Social distancing enhanced automated optimal design of physical spaces in the wake of the COVID-19 pandemic

As the COVID-19 pandemic unfolds, manually enhanced ad-hoc solutions have helped the physical space designers and decision makers to cope with the dynamic nature of space planning. Due to the unpredictable nature by which the pandemic is unfolding, the standard operating procedures also change, and the protocols for physical interaction require continuous reconsideration. Consequently, the development of an appropriate technological solution to address the current challenge of reconfiguring common physical environments with prescribed physical distancing measures is much needed. To do this, we propose a design optimization methodology which takes the dimensions, as well as the constraints and other necessary requirements of a given physical space to yield optimal redesign solutions on the go. The methodology we propose here utilizes the solution to the well-known mathematical circle packing problem, which we define as a constrained mathematical optimization problem. The resulting optimization problem is solved subject to a given set of parameters and constraints - corresponding to the requirements on the social distancing criteria between people and the imposed constraints on the physical spaces such as the position of doors, windows, walkways and the variables related to the indoor airflow pattern. Thus, given the dimensions of a physical space and other essential requirements, the solution resulting from the automated optimization algorithm can suggest an optimal set of redesign solutions from which a user can pick the most feasible option. We demonstrate our automated optimal design methodology by way of a number of practical examples, and we discuss how this framework can be further taken forward as a design platform that can be implemented practically.

Swarm Intelligence Approach for Rational Global Approximation of Characteristic Curves for the Van der Waals Equation of State

The Van der Waals (VdW) equation of state is a popular generalization of the law of ideal gases proposed time ago. In many situations, it is convenient to compute the characteristic curves of the VdW equation of state, called binodal and spinodal curves. Typically, they are constructed through data fitting from a collection of data points represented in the two-dimensional pressure-volume plane. However, the resulting models are still limited and can be further enhanced. In this paper, we propose to extend this polynomial approach by using a rational function as a fitting function. In particular, we consider a rational free-form Bézier curve, which provides a global approximation to the shape of the curve. This rational approach is more flexible than the polynomial one owing to some extra parameters, the weights. Unfortunately, data fitting becomes more difficult as these new parameters have also to be computed. In this paper we address this problem through a powerful nature-inspired swarm intelligence method for continuous optimization called the bat algorithm. Our experimental results show that the method can reconstruct the characteristic curves with very good accuracy.

Adapting viticulture to climate change in the Mediterranean region: Evaluations accounting for spatial differences in the producers-climate interactions

Effective adaptation of viticulture to climate change requires impact and response scenarios. Although climate and production impact scenarios are based on the evaluation of a spatially heterogeneous system, conventional response scenarios do not take into account the variation of the producers-climate interactions. These interactions are often extremely heterogeneous and unevenly distributed in space, leading to errors in the needs and adaptation plans, especially in large areas. Here we develop a novel framework for adaptation that considers the heterogeneity of the responses given by producers to climate, and applies the concept to adaptation of viticulture to climate change in the Mediterranean region. We use future climate scenarios at 0.5 ∘ resolution to estimate the adaptation of viticulture by the end of the 21st century. Results suggest that most of the Mediterranean region may urgently need adaptation plans, leading to potential opportunities. By incorporating spatially explicit information on the diversity of viticulture systems, management practices, and climate vulnerability, this approach may contribute to adaptation policy.

A novel anaerobic filter membrane bioreactor: prototype start-up and filtration assays

Anaerobic digestion allows efficient treatment of high loaded wastewater, and membrane technology allows obtaining high quality effluents with complete biomass retention. However, high biomass concentration interferes with membrane fouling. In the present work, a new bioreactor that integrates an attached biomass anaerobic culture on a fixed bed and a submerged membrane has been started up. The recirculation between the digestion and filtration chambers is coupled to the gas-lift effect of the bubbling employed for the scouring of the membranes, avoiding the use or electromechanical pumps that damage the suspended biomass. The support material retains the biomass in the digestion tank despite the downwards flow, avoiding the submerged membrane contacting with a high concentrated suspension. This novel system, called an anaerobic filter membrane bioreactor was immediately started up, achieving chemical oxygen demand (COD) removal efficiencies of 96% at an organic loading rate (OLR) of 7 kg COD/m³·d. In order to select filtration flux, specific gas demand and filtration cycle duration, the results of 15 short term assays, eight hours for each one, is presented for fluxes between 15.7 and 17.7 L/m²·h, cycle duration between 10 and 30 minutes, and three levels of scouring. It was checked that reversible and irreversible fouling were directly related when dTMP/dt > 2.5 mbar/min.

Contribuição de fatores não-genéticos para o desempenho reprodutivo de vacas Mirandesa

Conhecer as características reprodutivas da raça bovina Mirandesa é fundamental para o melhoramento e conservação desta raça de carne, sobretudo pela sua baixa diversidade genética. A depressão por consanguinidade acompanha-se frequentemente de desempenhos individuais e maternais mais fracos, que podem agravar os efeitos ambientais. Neste trabalho utilizaram-se 7386 registos do Livro Genealógico para caracterizar alguns indicadores reprodutivos: a idade ao primeiro parto (AFC), a duração da gestação (PL), o intervalo entre partos (CI), a distribuição partos no ano (CD) e a longevidade produtiva (PLf). Testaram-se ainda efeitos não genéticos na sua expressão, através de métodos não-paramétricos, por não estarem cumpridos os pressupostos de normalidade. A mediana para a AFC aproximou-se dos 32 meses, variando com o sistema de produção, a exploração, e o ano e estação de nascimento. A média de PL (287±8.9 dias) foi afetada pela paridade e sexo da cria. A mediana do CI foi de 378 dias, e variou apenas com o programa de reprodução, paridade, ano e estação. Os partos, irregularmente distribuídos ao longo do ano, mostraram padrões distintos segundo o sistema de produção. A longevidade produtiva desta raça foi de 6,45 anos, e 20% da população apresentou uma PLf superior a dez anos. Este trabalho sugere serem a estratégia do agricultor e a nutrição os principais efeitos não genéticos limitando o desempenho reprodutivo nesta raça, a considerar para aumentar o número de vitelos produzidos anualmente em paralelo com uma cuidada seleção de reprodutores para reduzir o inbreeding da raça.

Diagnostic exome sequencing in children: A survey of parental understanding, experience and psychological impact

Clinical exome sequencing (CES) is increasingly being used as an effective diagnostic tool in the field of pediatric genetics. We sought to evaluate the parental experience, understanding and psychological impact of CES by conducting a survey study of English-speaking parents of children who had diagnostic CES. Parents of 192 unique patients participated. The parent's interpretation of the child's result agreed with the clinician's interpretation in 79% of cases, with more frequent discordance when the clinician's interpretation was uncertain. The majority (79%) reported no regret with the decision to have CES. Most (65%) reported complete satisfaction with the genetic counseling experience, and satisfaction was positively associated with years of genetic counselor (GC) experience. The psychological impact of CES was greatest for parents of children with positive results and for parents with anxiety or depression. The results of this study are important for helping clinicians to prepare families for the possible results and variable psychological impact of CES. The frequency of parental misinterpretation of test results indicates the need for additional clarity in the communication of results. Finally, while the majority of patients were satisfied with their genetic counseling, satisfaction was lower for new GCs, suggesting a need for targeted GC training for genomic testing.

Feed3: A Strategy for a 3-Direction Connection Among AT Consumers and Developers

The Feed3 strategy aims to provide AT consumers, developers and manufacturers with Feedback, Feedforwards and FeedPeer mechanisms to collaborate in the development of novel accessible solutions. This strategy was developed as part of the GPII and it is currently adopted by the Unified Listing and DeveloperSpace infrastructure components.

Características de la canal de terneros de la Denominación de Origen Protegida Mirandesa

El objetivo de este trabajo fue evaluar las características de la canal de la raza Mirandesa. Para llevar a cabo este estudio, un total de 20 animales de la raza Mirandesa fueron sacrificados a los 315 días. 24 horas tras el sacrificio, se determinó el peso canal y rendimiento canal, se realizaron las medidas morfométricas (longitud de la canal, longitud de la pierna, espesor de la pierna, profundidad interna del pecho y perímetro máximo de la pierna), se calcularon los siguientes índices: índice de compacidad de la canal e índice longitudinal transversal de la pierna y se realizó el despiece de los principales cortes comerciales. Los animales de la raza Mirandesa presentaron un peso vivo de 293,7 kg, un peso canal de 152 kg y un rendimiento canal de 60,5 %. En relación a las medidas morfométricas, la raza Mirandesa mostró una longitud de canal de 110 cm, una longitud de pierna de 69 cm y un perímetro de pierna de 89,8 cm. Los valores para el índice de compacidad de la canal y el índice longitudinal transversal de la pierna fueron de 1,4 y 3,7, respectivamente. Con respecto al quinto cuarto, la piel presentó los mayores porcentajes seguida de la cabeza y pies. Finalmente, la composición de las canales de la raza Mirandesa fue: 74,9 % de carne, 18,1 % de hueso y 7,0 % de grasa.

Fossil forests in the Austral Basin (Argentina) marking a Cenomanian heterogeneous forced regressive surface

The mid-Cretaceous greenhouse period in the southern Patagonia Argentina (Austral Basin) is represented by the Mata Amarilla Formation. It is composed of three informal sections which were deposited in littoral and continental environments. The boundary between the lower and middle sections of the Mata Amarilla Formation shows a drastic reduction in accommodation/sediment supply (A/S) ratio, interpreted as a forced regressive surface. This surface is characterized by a well-developed palaeosol, associated with the extensive preservation of a podocarp-dominated fossil forest over a vast area (more than 5400 km(2) ). Sedimentological and palaeopedological analyses, in conjunction with forest structure, tree density and growth ring analyses, indicate that the mid-Cenomanian forced regression can be distinguished as a non-uniform surface developed over a short period of time. This sequence boundary is recognized through a heterogeneous regional surface, delimited in the western part of the study area by an erosional surface generated by a large lateral channel migration recorded by sheet-like channel deposits with transported logs. By comparison, towards the eastern part of the study area, it appears as a paraconformity bounded by a very mature vertic Alfisol, which may have taken 40-100 ky to develop, and the preservation of a fossil forest in life position with a minimum age of 337 years. It is concluded that the extensive presence of these fossil forests at the same stratigraphic level in a vast region respond to changes in A/S ratio in a forced regressive surface at basin scale.

Management of agricultural soils for greenhouse gas mitigation: Learning from a case study in NE Spain

A portfolio of agricultural practices is now available that can contribute to reaching European mitigation targets. Among them, the management of agricultural soils has a large potential for reducing GHG emissions or sequestering carbon. Many of the practices are based on well tested agronomic and technical know-how, with proven benefits for farmers and the environment. A suite of practices has to be used since none of the practices can provide a unique solution. However, there are limitations in the process of policy development: (a) agricultural activities are based on biological processes and thus, these practices are location specific and climate, soils and crops determine their agronomic potential; (b) since agriculture sustains rural communities, the costs and potential for implementation have also to be regionally evaluated and (c) the aggregated regional potential of the combination of practices has to be defined in order to inform abatement targets. We believe that, when implementing mitigation practices, three questions are important: Are they cost-effective for farmers? Do they reduce GHG emissions? What policies favour their implementation? This study addressed these questions in three sequential steps. First, mapping the use of representative soil management practices in the European regions to provide a spatial context to upscale the local results. Second, using a Marginal Abatement Cost Curve (MACC) in a Mediterranean case study (NE Spain) for ranking soil management practices in terms of their cost-effectiveness. Finally, using a wedge approach of the practices as a complementary tool to link science to mitigation policy. A set of soil management practices was found to be financially attractive for Mediterranean farmers, which in turn could achieve significant abatements (e.g., 1.34 MtCO2e in the case study region). The quantitative analysis was completed by a discussion of potential farming and policy choices to shape realistic mitigation policy at European regional level.

Newborn screening for X-linked adrenoleukodystrophy in New York State: diagnostic protocol, surveillance protocol and treatment guidelines

PURPOSE

To describe a diagnostic protocol, surveillance and treatment guidelines, genetic counseling considerations and long-term follow-up data elements developed in preparation for X-linked adrenoleukodystrophy (X-ALD) newborn screening in New York State.

METHODS

A group including the director from each regional NYS inherited metabolic disorder center, personnel from the NYS Newborn Screening Program, and others prepared a follow-up plan for X-ALD NBS. Over the months preceding the start of screening, a series of conference calls took place to develop and refine a complete newborn screening system from initial positive screen results to long-term follow-up.

RESULTS

A diagnostic protocol was developed to determine for each newborn with a positive screen whether the final diagnosis is X-ALD, carrier of X-ALD, Zellweger spectrum disorder, acyl CoA oxidase deficiency or D-bifunctional protein deficiency. For asymptomatic males with X-ALD, surveillance protocols were developed for use at the time of diagnosis, during childhood and during adulthood. Considerations for timing of treatment of adrenal and cerebral disease were developed.

CONCLUSION

Because New York was the first newborn screening laboratory to include X-ALD on its panel, and symptoms may not develop for years, long-term follow-up is needed to evaluate the presented guidelines.

Single fraction volumetric modulated arc radiosurgery of brain metastases

PURPOSE

To show the clinical results of the treatment of brain metastases via radiosurgery using Volumetric Modulated Arc Therapy (VMAT).

MATERIALS AND METHODS

52 patients having lung (62 %), breast (17 %), colorectal (8 %) and other cancers (13 %) with one to three brain metastases were treated with 5 non-coplanar VMAT arcs. The treatment dose varied from 12 to 20 Gy, administered in one single session. The volume of metastases ranged from 0.04 to 24.92 cc. Radiosurgery alone was used for 54 % of cases, while 19 % received whole brain radiotherapy due to relapse. Patients were classified according to the Disease-specific graded prognostic assessment (DS-GPA) index and survival was assessed via the Kaplan-Meier model.

RESULTS

The median survival time was 7.2 months from the date of radiosurgery. The Karnofsky and DS-GPA indices were the most significant with regard to survival. Patients with a Karnofsky performance status (KPS) over 70 had a longer survival time of 9.2 months, as opposed to those with a KPS below 70 of 3.5 months. No significant differences were found with regard to the type of cancer or the number of lesions. Local tumour control was achieved for 42 metastases (82 %), of which a complete response was achieved for 7 lesions, a partial response for 21; 15 lesions were stabilized. Local progression was observed in 8 lesions (15 %). The median treatment time per patient was 29 min.

CONCLUSIONS

The VMAT technique proves to be safe and effective for treating brain metastases via radiosurgery.

[Allergology in the public health service of the Community of Madrid: current situation and opportunities in the XXI century public health system]

The high prevalence of allergic diseases and the use of more complex diagnostic techniques and therapeutic options require allergists to be highly trained professionals and health-care organizations to be knowledgeable about available structural and human resources. Updated information is lacking in Spain, and current activity indicators do not reflect complexity. The present article analyzes the situation of allergology in Madrid and proposes improvements where necessary. The heads of the allergy departments of public hospitals in Madrid voluntarily completed a purpose-designed survey. Data on care activity (2010) and on teaching and research activity (2009-2010) were provided. A SWOT analysis was performed, and strategic lines and proposals for improvement were designed. One hundred and seventeen allergists (41% with a PhD) worked in 24 hospitals with an allergology department (4.6 physicians/center; ≤3 in 10 hospitals). All the institutions had an outpatient clinic (4,000 first consultations/hospital/year, 36% high-resolution rate; 6200 successive visits/hospital/year) performing complex diagnostic and therapeutic procedures, most of which were not taken into account by activity indicators. Two hospitals had their own hospitalization facilities and 10 were accredited teaching hospitals (2.78 medical residents/year). The survey revealed that, twice yearly, a typical allergology service participated in 4 research projects, 2 clinical trials, 16 publications and 17 communications at scientific meetings, with notable differences between hospitals. Allergists in Madrid are well prepared. The allergology care structure is adequate, although possibly insufficient. Quality and efficiency can be improved with new tools for recording activity and by increasing coordination and taking advantage of new technologies and geographical proximity.

Systemic bile acid sensing by G protein-coupled bile acid receptor 1 (GPBAR1) promotes PYY and GLP-1 release

BACKGROUND AND PURPOSE

Nutrient sensing in the gut is believed to be accomplished through activation of GPCRs expressed on enteroendocrine cells. In particular, L-cells located predominantly in distal regions of the gut secrete glucagon-like peptide 1 (GLP-1) and peptide tyrosine-tyrosine (PYY) upon stimulation by nutrients and bile acids (BA). The study was designed to address the mechanism of hormone secretion in L-cells stimulated by the BA receptor G protein-coupled bile acid receptor 1 (GPBAR1).

EXPERIMENTAL APPROACH

A novel, selective, orally bioavailable, and potent GPBAR1 agonist, RO5527239, was synthesized in order to investigate L-cell secretion in vitro and in vivo in mice and monkey. In analogy to BA, RO5527239 was conjugated with taurine to reduce p.o. bioavailability yet retaining its potency. Using RO5527239 and tauro-RO5527239, the acute secretion effects on L-cells were addressed via different routes of administration.

KEY RESULTS

GPBAR1 signalling triggers the co-secretion of PYY and GLP-1, and leads to improved glucose tolerance. The strong correlation of plasma drug exposure and plasma PYY levels suggests activation of GPBAR1 from systemically accessible compartments. In contrast to the orally bioavailable agonist RO5527239, we show that tauro-RO5527239 triggers PYY release only when applied intravenously. Compared to mice, a slower and more sustained PYY secretion was observed in monkeys.

CONCLUSION AND IMPLICATIONS

Selective GPBAR1 activation elicits a strong secretagogue effect on L-cells, which primarily requires systemic exposure. We suggest that GPBAR1 is a key player in the intestinal proximal-distal loop that mediates the early phase of nutrient-evoked L-cell secretion effects.

Sequenom MassARRAY approach in the arrhythmogenic right ventricular cardiomyopathy post-mortem setting: clinical and forensic implications

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disease characterized by myocardial fibrofatty replacement, which can lead to sudden death. Previous studies have described a reduction of plakoglobin (PKG) protein at the level of intercalated disks as the hallmark of ARVC. The main objective of this study was to investigate the involvement of desmosome mutations in the histological phenotype of ARVC. We performed a genetic analysis of ARVC cases, and histological characterization of ARVC heart tissue samples. We genetically analyzed 48 ARVC cases distributed into two groups: 42 human tissue heart samples with conclusive diagnoses of ARVC after post-mortem examination; and six DNA samples from peripheral blood of living patients who were clinically diagnosed. Sequenom MassARRAY analysis revealed three ARVC-associated variants in three patients in 42 tissue samples (7.14 %). Three individuals carried one single pathogenic mutation, p.R811S _PKP2, p.S824L_DSC2, and p.T526M_PKP2 in postmortem samples. In the living patients group, Sequenom MassARRAY revealed no mutation, however, later Sanger sequencing analysis identified three ARVC mutations in 2/6 patients not included in the Sequenom design. In post-mortem tissue samples we performed immunohistochemical labeling for desmosomal proteins and Connexin 43. This study revealed that PKP2 carriers present either absent or clearly reduced PKG immunolabeling, while the DSC2 carrier showed PKG immunolabeling similar to control samples. Immunolabeling for Cx43 did not show any differences compared to controls. The present Sequenom MassARRAY design is a useful tool for post-mortem genetic diagnosis of ARVC. Plakoglobin reduction occurs at intercalated disks, while other desmosome proteins and Cx43 remain unaltered.

Towards light-mediated sensing of bacterial comfort

Bacterial comfort is central to biotechnological applications. Here, we report the characterization of different sensoring systems, the first step within a broader synthetic biology-inspired light-mediated strategy to determine Escherichia coli perception of environmental factors critical to bacterial performance. We did so by directly 'asking' bacterial cultures with light-encoded questions corresponding to the excitation wavelength of fluorescent proteins placed under the control of environment-sensitive promoters. We built four genetic constructions with fluorescent proteins responding to glucose, temperature, oxygen and nitrogen; and a fifth construction allowing UV-induced expression of heterologous genes. Our engineered strains proved able to give feedback in response to key environmental factors and to express heterologous proteins upon light induction. This light-based dialoguing strategy reported here is the first effort towards developing a human-bacteria interphase with both fundamental and applied implications.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results we present here are at the core of a larger synthetic biology research effort aiming at establishing a dialogue with bacteria. The framework is to convert the human voice into electric pulses, these into light pulses exciting bacterial fluorescent proteins, and convert light-emission back into electric pulses, which will be finally transformed into synthetic voice messages. We report here the first results of the project, in the form of light-based determination of key parameters for bacterial comfort. The ultimate goal of this strategy is to combine different engineered populations to have a combined feedback from the pool.

A computational knowledge-based model for emulating human performance in the Iowa Gambling Task

A new computational knowledge-based model for emulating human performance in decision making tasks is proposed. This model is mainly based on the knowledge acquired through past experience, the knowledge extracted from the environment and the relationships between the concepts that represent these two kinds of knowledge. The proposed model divides the decision making process into two phases. The first phase lies in the estimation of the decision outcomes using a net of concepts. In the second phase, the proposed model uses a value function to score each possible alternative. The design of the model focuses on some psychological and neurophysiological evidence from current research. In order to validate the model, it is compared with other widely used models that implement different theories of decision making under risk and uncertainty. The model comparison is centered on a well defined task, the Iowa Gambling Task, used in several psychological experiments. The comparison applies an evaluation method based on the optimization of each model in order to emulate human performance individually starting both the participant and the model from the same environmentally available information. The results show that the performance of the proposed model is quantitatively better than the other compared models. Besides, using relevant concepts extracted from interviews with the participants increases the performance of the proposed model.

Genetic testing of candidate genes in arrhythmogenic right ventricular cardiomyopathy/dysplasia

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a rare cardiac genetic disease characterized by the presence of structural alterations in the right ventricle which may cause ventricular arrhythmias and may induce sudden cardiac death. ARVC/D has been associated with mutations in genes encoding myocyte adhesion proteins. However, only 30%-50% of patients have mutations in these genes. Genetic testing is useful in obtaining a diagnosis, particularly in individuals who do not completely fulfill clinical criteria, thereby also enabling the undertaking of preventive strategies in family members. The main goal of this study was to identify mutations in candidate genes associated with intercalate disks that could be potentially involved in ARVC/D pathogenesis. We analyze a cohort of 14 Spanish unrelated patients clinically diagnosed with ARVC/D without any genetic alteration in all previously known responsible genes. Thus, a genetic screening has been performed in 7 additional potential candidate genes (ACTC1 -actin alpha cardiac muscle 1-, CDHN -cadherin 2 type 1 or N-cadherin-, CTNNA1 -catenin alpha 1-, Cx43 or GJA1 -gap junction protein alpha 1-, MVCL -Metavinculin-, MYL2 -myosin light chain 2- and MYL3 -myosin light chain 3-) by direct sequencing analysis. Our genetic analysis did not identify any disease-causing mutation. Thirty single nucleotides polymorphisms were found, six of them novel. In conclusion, our ARVC/D Spanish cohort has not shown any mutations in the analyzed candidate genes despite their involvement in formation and maintenance of the intercalated disk.

Contact angioedema and rhinoconjunctivitis caused by Dendrobaena species and Sarcophaga carnaria used as fishing bait

The flesh fly Sarcophaga carnaria is commonly used as fishing bait. Immunoglobulin (Ig) E-mediated reactions caused by the handling of this bait have been reported. The earthworm Dendrobaena species is increasingly being used as fishing bait but there have been no reported cases of allergy to this species to date. We studied a 26-year-old amateur angler who presented rhinoconjunctivitis, urticaria, and angioedema on handling S carnaria. He started to use Dendrobaena species instead but developed the same symptoms. The aim of this study was to identify the allergens involved in the patient's clinical reactions. The study was performed using immunoglobulin (Ig) E immunoblotting and immunoblotting inhibition assays.The patient's serum detected allergens from Dendrobaena species (of an apparent molecular weight of approximately 150, 60, 37, 24, 21 and 19 kDa) and S. carnaria (approximately 70 kDa and a smear ranging from 50 to 40 kDa). The patient was diagnosed with allergy to both Dendrobaena species and 5 carnaria. This is the first case describing Dendrobaena species as an allergic agent.

Morphological traits in Portuguese Bordaleira de Entre Douro e Minho sheep: divergence of the breed

Production of the autochthonous Portuguese sheep breed Bordaleira de Entre Douro e Minho (BEDM) is directly associated with the concept of sustainable agriculture. This concept focuses on the adaptation of animal populations to adverse environmental conditions, high biological efficiency and traditional management. Native BEDM sheep can be divided into the following two types on the basis of their geographic location in Portugal and how they are managed: the Várzea, which is found mainly in the lower Entre Douro e Minho region, and the Mountain type, which traditionally prefers common areas. In the present work, we analysed records of liveweight, 15 body measurements and eight indexes of the BEDM sheep, to explore the ability to distinguish different characteristics between BEDM sheep populations. The records that were obtained and analysed by principal component analysis for 412 BEDM sheep (68 males and 344 females) included the following: heights at withers (HW), at back (HB), at rump (HR) and at chest (HC); lengths of trunk (LT), of rump (LR), of head (LH) and of perineum (LP); widths of head (WH), of chest (WC), of biiliac (WBIIL) and of biischiatic (WBIIS); perimeters of the shin (PS), thorax (PT), and abdomen (PA); and finally indexes such as cephalic index (CI), thoracic index (TI), pelvic index (PI), body index (BI), relative chest depth index (RDCI), lateral corporal index (LCI), relative shin thickness index (RTSI) and dactyl–thoracic index (DTI). The Várzea BEDM was morphologically superior to the Mountain variety, with this superiority more evident in females. Height measurements, especially HW in adult females, provided an excellent measurement reference for biometrical breed studies. Functional index values confirmed the BEDM Mountain variety’s appropriateness for mountainous regions. Relationships among body measurements suggested that the breed standard needed to be updated. The research presented here was used by the Portuguese Ministery to split BEDM into two new breeds; the traditional variety called Várzea now represents the new BEDM breed, whereas the Mountain variety represents the new Churra do Minho breed.