Sleep quality in individuals with post-COVID-19 condition: Relation with emotional, cognitive and functional variables

The study aimed to assess sleep quality in PCC patients and its predictors by analysing its relationship with emotional, cognitive and functional variables, as well as possible differences based on COVID-19 severity. We included 368 individuals with PCC and 123 healthy controls (HCs) from the NAUTILUS Project (NCT05307549 and NCT05307575). We assessed sleep quality (Pittsburgh Sleep Quality Index, PSQI), anxiety (Generalized Anxiety Disorder, GAD-7), depression (Patient Health Questionnaire, PHQ-9), global cognition (Montreal Cognitive Assessment, MoCA), everyday memory failures (Memory Failures of Everyday Questionnaire, MFE-30), fatigue (Chadler Fatigue Questionnaire, CFQ), quality of life (European Quality of Life-5 Dimensions, EQ-5D), and physical activity levels (International Physical Activity Questionnaire, IPAQ). 203 were nonhospitalized, 83 were hospitalized and 82 were admitted to the intensive care unit (ICU). We found statistically significant differences in the PSQI total score between the PCC and HC groups (p < 0.0001), but there were no differences among the PCC groups. In the multiple linear regressions, the PHQ-9 score was a predictor of poor sleep quality for mild PCC patients (p = 0.003); GAD-7 (p = 0.032) and EQ-5D (p = 0.011) scores were predictors of poor sleep quality in the hospitalized PCC group; and GAD-7 (p = 0.045) and IPAQ (p = 0.005) scores were predictors of poor sleep quality in the group of ICU-PCC. These results indicate that worse sleep quality is related to higher levels of depression and anxiety, worse quality of life and less physical activity. Therapeutic strategies should focus on these factors to have a positive impact on the quality of sleep.

Severe conservation risks of roads on apex predators

The global expansion of road networks threatens apex predator conservation and ecosystem functioning. This occurs through wildlife-vehicle collisions, habitat loss and fragmentation, reduced genetic connectivity and increased poaching. We reviewed road impacts on 36 apex predator species and assessed their risk from current roads based on road exposure and species vulnerability. Our findings reveal all apex predators are exposed to road impacts. Eight of the ten species with the highest risk occur in Asia, although other high-risk species are present in the Americas, Africa and Europe. The sloth bear suffers the highest risk of all apex predators, followed by the tiger and dhole. Based on species risk from roads, we propose a widely applicable method to assess the potential impact of future roads on apex predators. We applied this method to proposed road developments in three areas: the Brazilian Amazon, Africa, and Nepal, to locate high-impact road segments. Roughly 500 protected areas will be intersected by these roads, threatening core apex predator habitats. We advocate the need for rigorous road development planning to apply effective mitigation measures as an urgent priority and to avoid construction in wilderness areas and predator strongholds.

P–415 Clinical and In Vitro Fertilization laboratory parameters that contribute to clinical miscarriage after single euploid embryo transfer

Study question

To investigate which factors, excluding embryo aneuploidies, are associated with miscarriage in patients who have undergone a single euploid blastocyst transfer.

Summary answer

Miscarriage was related to the body mass index (BMI), the type of cycle and the thickness of the endometrium.

What is known already

Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in-vitro fertilization (IVF) to select euploid embryos. Several studies have shown that embryo aneuploidy is the main contributing factor for IVF failure, reinforcing the relevance of PGT-A as a method to select chromosomally normal embryos.

A recent meta-analysis confirmed that patients undergoing PGT-A have a lower miscarriage rate than women that conceived naturally (9% vs 28%, respectively).

Even though most of the studies show that PGT-A significantly reduces miscarriage rate, still some women do lose their pregnancies. We investigated which other reasons may be related to this early pregnancy loss.

Study design, size, duration

Retrospective, observational, and multicenter study of 6910 patients undergoing single euploid blastocyst transfer after PGT-A from January 2017 to December 2019 in our institution. Several laboratory and clinic variables were analyzed to study the effect of these variables on the miscarriage rate

Participants/materials, setting, methods

Indications for PGT-A were advanced maternal age, implantation failure, recurrent pregnancy loss and male factor. Embryos were cultured 5% O2 concentration and 6.5% CO2 concentration. Trophectoderm biopsy was performed on day 5/6 of development and analyzed through Next Generation Sequencing (NGS); embryos were vitrified until transfer was performed. Single euploid embryo transfer was performed in all cases.

We performed a multivariate regression analysis to compare the different variables and search for there are significant differences.

Main results and the role of chance

We studied a total of 6910 patients undergoing PGT-A to describe which factors, excluding embryo aneuploidies, were correlated with miscarriage in patients who underwent single thawed euploid embryo transfer.

When considering embryo morphology (embryo grading, quality of inner cell and quality of trophectoderm), we did not find differences in miscarriage rate among groups (high quality= 15.9%; normal quality= 14.3%; low quality= 15.0%; poor quality= 14.8%) p = 0.833.

BMI was significantly associated with miscarriage rate (odds ratio [OD] 1.04; 95% confidence interval [CI], 1.012–1–076 p = 0.006) and miscarriage rate.

We observed a weak association between endometrial thickness and miscarriage rate ([OD] 0.65; 95%, 0.528–0.778 p = 0.04) and also between type of endometrial preparation (natural cycle or hormone replacement cycle) ([OD] 0.77; 95%, 0.528–0.778) p = 0.04.

Body mass index, according to our findings, was the main variable correlated with miscarriage rate. We did not find any association with the other variables studied (biopsy day, maternal age, male age, duration infertility, cycle length, previous miscarriage, previous live birth, previous cycles IVF, endometrial pattern and diagnosis).

Limitations, reasons for caution

The retrospective study design limits the generalization of our results but offers a good insight to be validated in prospective trials.

Wider implications of the findings: According to our findings, BMI, endometrial thickness the day of the embryo transfer, and the type of endometrial preparation should be considered when transferring an euploid blastocyst.

Trial registration number

NO APLICA

Conceptual and empirical advances in Neotropical biodiversity research

The unparalleled biodiversity found in the American tropics (the Neotropics) has attracted the attention of naturalists for centuries. Despite major advances in recent years in our understanding of the origin and diversification of many Neotropical taxa and biotic regions, many questions remain to be answered. Additional biological and geological data are still needed, as well as methodological advances that are capable of bridging these research fields. In this review, aimed primarily at advanced students and early-career scientists, we introduce the concept of "trans-disciplinary biogeography," which refers to the integration of data from multiple areas of research in biology (e.g., community ecology, phylogeography, systematics, historical biogeography) and Earth and the physical sciences (e.g., geology, climatology, palaeontology), as a means to reconstruct the giant puzzle of Neotropical biodiversity and evolution in space and time. We caution against extrapolating results derived from the study of one or a few taxa to convey general scenarios of Neotropical evolution and landscape formation. We urge more coordination and integration of data and ideas among disciplines, transcending their traditional boundaries, as a basis for advancing tomorrow's ground-breaking research. Our review highlights the great opportunities for studying the Neotropical biota to understand the evolution of life.

Polimorfismos de los genes CAPN1, CAST, DES, PRKAG3 Y RYR1 asociados a la capacidad de retención de agua en crudo y cocinado en carne de bovino en cruces Bos indicus y Bos taurus en Colombia

La capacidad de retención de agua (CRA) es uno de los parámetros de calidad de la carne más importante, dado que posee asociación con la percepción de jugosidad y la pérdida de peso de la pieza cárnica durante procedimientos como la maduración, la cocción y otro tipo de procesamiento tecnológico. La CRA en crudo y cocinado (CRAr y CRAc respectivamente) fue evaluada en 164 machos castrados cruzados, en los cuales se realizó la genotipificación de 23 regiones genómicas de los genes CAPN1, CAST, DES, PRKAG3 y RYR1. El marcador CAST2959 presentó asociación con el parámetro CRAr en el músculo Longissimus dorsi (LD) siendo el genotipo AA el de mejor comportamiento. El marcador RYR1-11195 se encontró asociado con el parámetro CRAc en LD, siendo la carne de animales con los genotipos GG y GA, la de mayor pérdida de peso, si son comparados con carne proveniente de animales con genotipo AA. Lo anterior permite establecer estos marcadores como posibles polimorfismos de importancia en procesos de selección y mejoramiento animal de este parámetro de calidad cárnica (CRAr y CRAc) en bovinos, posterior a un proceso de validación.

Efecto del tipo genético y la maduración sobre la retención de agua en carne de toros castrados

La capacidad de retención de agua en crudo (CRAr) y en cocinado (CRAc) fue determinada en carne madurada a 7, 14 y 21 días post mórtem. Los músculos Longissimus dorsi (LD) y Semitendi-nosus (ST) de 164 machos castrados provenientes del cruce de machos de las razas Simmental, Normanda, Blanco Orejinegro, Braunvieh, Guzerat, Brahman Blanco, Brahman Rojo, Limousin y Romosinuano con hembras Brahman blanco. Para el parámetro CRAr en LD se presentó significancia de los factores tipo genético y maduración y en ST del factor maduración. Para el parámetro de CRAc en LD fue significativo el factor tipo genético y para ST ninguno de los dos factores fue significativo. No existieron interacciones significativas de los dos factores evaluados. Lo ideal es someter a tiempos cortos de maduración ambos músculos y tener en cuenta el tipo genético al cual pertenece el individuo con el fin de minimizar las pérdidas de exudado.

Sperm DNA fragmentation index does not correlate with the sperm or embryo aneuploidy rate in recurrent miscarriage or implantation failure patients

BACKGROUND

The aneuploidy rate is higher in poor-quality sperm samples, which also have higher DNA fragmentation index values. The aim of this study was to assess the relationship between sperm DNA fragmentation in samples from infertile men belonging to couples with recurrent miscarriage or implantation failure and the aneuploidy rate in spermatozoa as well as in embryos from patients.

METHODS

This prospective study evaluated DNA damage and the aneuploidy rate in fresh and processed (density gradient centrifugation) ejaculated sperm as well as the aneuploidy rate in biopsied embryos from fertility cycles. Fluorescence in situ hybridization was used for the aneuploidy analysis. Results were compared using linear regression and analysis of variance.

RESULTS

A total of 154 embryos were evaluated from 38 patients undergoing PGD cycles; 35.2% of the embryos were chromosomally normal. Analysis of the same sperm samples showed an increased DNA fragmentation after sperm preparation in 76% of the patients. There was no correlation between DNA fragmentation and the aneuploidy rate in embryos or in fresh or processed sperm samples.

CONCLUSIONS

Sperm DNA fragmentation is not related to chromosomal anomalies in embryos from patients with recurrent miscarriage or implantation failure. However, we cannot rule out the possibility that a relationship between DNA fragmentation and aneuploidy exists for other causes of infertility. Furthermore, the different methods used to evaluate DNA fragmentation may produce different results.

Influence of APOE polymorphism on cognitive and behavioural outcome in moderate and severe traumatic brain injury

AIM

To analyse the influence of apolipoprotein (APOE) epsilon4 status on the cognitive and behavioural functions usually impaired after moderate and severe traumatic brain injury (TBI).

METHODS

In all, 77 patients with TBI selected from 140 consecutive admissions were genotyped for APOE. Each patient was subjected to neuropsychological and neurobehavioural assessment at least 6 months after injury.

RESULTS

Performance of participants carrying the epsilon4 allele was notably worse on verbal memory (Auditory Verbal Learning Test), motor speed, fine motor coordination, visual scanning, attention and mental flexibility (Grooved Pegboard, Symbol Digit Modalities Test and part B of the Trail Making Test) and showed considerably more neurobehavioural disturbances (Neurobehavioral Rating Scale-Revised) than the group without the epsilon4 allele.

CONCLUSIONS

In particular, performance on neuropsychological tasks that are presumed to be related to temporal lobe, frontal lobe and white matter integrity is worse in patients with the APOE epsilon4 allele than in those without it. More neurobehavioural disturbances are observed in APOE epsilon4 carriers than in APOE epsilon2 and epsilon3 carriers.

Neuropsychological outcome in relation to the traumatic coma data bank classification of computed tomography imaging

The Traumatic Coma Data Bank (TCDB) classification of CT (computed tomography) scan has been related to the general outcome and intracranial pressure evolution. Our aim was to analyse the relationship of this classification with neuropsychological outcome and late indices of ventricular dilatation. Fifty-seven patients with a moderate or severe head injury (mean admission Glasgow Coma Scale Score, 7.7) were studied from 122 consecutive cases. There were 49 males and 8 females (mean age, 27.7 years). Subjects were classified into TCDB categories on the basis of their most serious acute CT scan finding. From the last control CT scan image, performed at a mean of 6.12 months postinjury, several measures of ventricular dilatation were calculated. Neuropsychological assessment at 6-month included tests of verbal and visual memory, visuoconstructive functions, fine motor speed, and frontal lobe functions. Patients with diffuse injury type I showed better neuropsychological outcome than patients with more severe diffuse injuries and those with mass lesions. Within the diffuse injury groups, the degree of diffuse damage was related to measures of verbal memory and attention and cognitive flexibility. Ventricular enlargement was more evident in patients with mass lesions and it decreased in the remaining groups as the severity of diffuse injury diminished. These results show that there is a relationship between acute intracranial lesion diagnosis according to TCDB classification and neuropsychological results and ventricular dilatation indices at 6 months postinjury.

A successful pregnancy outcome in treated vulval rhabdomyosarcoma

A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery.

Latin American Registry of dialysis and renal transplantation: 1993 annual dialysis data report

BACKGROUND

The Latin American Registry of Dialysis and Transplantation was created in October 1991 and comprises the National Societies of Nephrology from 21 countries with a total population of 468.56 million inhabitants.

METHODS

This report includes data from 21,181 patients from Argentina, Brazil, Chile, El Salvador, Panama, Paraguay, Peru, Puerto Rico, Uruguay, and Venezuela who were receiving chronic dialysis treatment during 1993. Data was collected by individual patient questionnaires except from Chile and Brazil where the data was obtained from a local centre questionnaire.

RESULTS

The prevalence rate averaged 131.1 per million population. The mean age of the 8972 incident patients was 50.5 years, with 58.2% males. The more frequent causes of renal failure were glomerulopathies (22.6%), vascular nephropathy (20.9%) and diabetes (16.9%). Haemodialysis was the most used treatment (88.3%). Gross mortality was 21.1% and the more frequent causes of death were cardiac complications and infections. The analysis of mortality risk factors using a logistic regression model showed that diabetics patients older than 65 years had the highest probability of death (43.0%) and patients with glomerulonephritis, younger than 65 years had the lowest (8.0%). The adjusted mortality rate was 241 deaths/1000 patient-years at risk when the USRDS 1987-1989 white mortality rate by age groups and primary diseases was used as standard.

CONCLUSION

In spite of the economic difficulties, very important efforts have been made to treat ESRD patients and gross mortality statistics in some countries are similar to those reported by other regional registries.

A family with a milder form of adult dominant polycystic kidney disease not linked to the PKD1 (16p) or PKD2 (4q) genes

Autosomal dominant polycystic kidney disease (ADPKD) is a genetically heterogeneous disease. Most families show positive linkage to polymorphic markers around the PKD1 (16p13.3) or PKD2 (4q21-23) loci. The PKD1 and PKD2 genes have been cloned and mutations defined in a number of patients. Several clinical studies have described a milder phenotype for PKD2 patients. More recently, evidence for a third genetic locus has been found in one Portuguese, one French-Canadian, and one Italian family. We identified a Spanish family with negative linkage to the PKD1 and the PKD2 loci. This family showed a very mild clinical phenotype compared to the other forms of ADPKD, including the non-PKD1/non-PKD2 families previously described.

[Evaluation of Mycobacterium fortuitum acyltrehaloses in the serologic diagnosis of pulmonary tuberculosis]

BACKGROUND

Several glycolipids of Mycobacterium tuberculosis are antigenic and their use in the serodiagnosis of pulmonary tuberculosis has been postulated. Acyltrehaloses (SL-IV) are among the strongest antigenic glycolipids of M. tuberculosis; similar compounds have been found in M. fortuitum. The aim of the present study was to evaluate the usefulness of the acyltrehaloses of M. fortuitum in the serodiagnosis of pulmonary tuberculosis.

METHODS

Two glycolipids, identified as triacyl- (TAT-MF) and diacyl- (DAT-MF) trehaloses, were studied by an ELISA method. Two independent analyses were carried out. In the first one, IgG and IgM were determined in sera from patients with pulmonary tuberculosis (84-24 bacteriologically not confirmed--), healthy individuals (46) and patients with respiratory pathologies other than pulmonary tuberculosis (38), using TAT-MF. In the second one, IgG was determined in sera from pulmonary tuberculosis patients (34) and from healthy individuals (20), using DAT-MF.

RESULTS

The sensitivity of the IgG ELISA using TAT-MF varied, according to the cut-off point, between 79.8 and 39.3%; the specificity values ranged between 83.3 and 98.8%. In sera from bacteriologically not confirmed pulmonary tuberculosis patients the sensitivity was 87.5-45.8%. The sensitivity for IgM was very low using TAM-MF (10.7-2.3%), with specificity values ranging from 77.4 to 100%. The sensitivity and specificity values of IgG using DAT-MF were, respectively, 34.3-9.3% and 90-100%.

CONCLUSIONS

The IgG ELISA using TAT-MF has similar values of sensitivity and specificity to those reported for the acyltrehaloses of M. tuberculosis, although this antigen, by itself, can not be used in the serodiagnosis of pulmonary tuberculosis. DAT-MF has no value in the serodiagnosis of pulmonary tuberculosis.

Blood lactate and mixed venous-arterial PCO2 gradient as indices of poor peripheral perfusion following cardiopulmonary bypass surgery

Conventional indices of tissue perfusion after surgery involving cardiopulmonary bypass (CPB) may not accurately reflect disordered cell metabolism. Venous hypercarbia leading to an increased veno-arterial difference in CO2 tensions (V-aCO2 gradient) has been shown to reflect critical reductions in systemic and pulmonary blood flow that occur during cardiorespiratory arrest and septic shock. We therefore measured plasma lactate levels and V-aCO2 gradients in 10 patients (mean age 57.2 years) following CPB and compared them with conventional indices of tissue perfusion. Plasma lactate levels, cardiac index (CI) and oxygen uptake (VO2) all increased significantly (p less than 0.05 vs baseline levels) up to 3 h following surgery. Oxygen delivery (DO2) did not change. Plasma lactate levels correlated significantly with CI (r = 0.47, p less than 0.01). V-aCO2 fell significantly with time (p less than 0.01 vs baseline). There was an inverse relationship between V-aCO2 and cardiac index and V-aCO2 and lactate (r = -0.37, p less than 0.05; r = -0.3, p less than 0.05 respectively). We conclude that blood lactate, CI and VO2 increase progressively following CPB. An increase in lactate was associated with a decrease in V-aCO2. An increase in V-aCO2 was not therefore associated with evidence of inadequate tissue perfusion as indicated by an increased blood lactate concentration.