Improving computerized decision support system interventions: a qualitative study combining the theoretical domains framework with the GUIDES Checklist

BACKGROUND

Computerized clinical decision support systems (CDSSs) can improve care by bridging knowledge to practice gaps. However, the real-world uptake of such systems in health care settings has been suboptimal. We sought to: (1) use the Theoretical Domains Framework (TDF) to identify determinants (barriers/enablers) of uptake of the Electronic Asthma Management System (eAMS) CDSS; (2) match identified TDF belief statements to elements in the Guideline Implementation with Decision Support (GUIDES) Checklist; and (3) explore the relationship between the TDF and GUIDES frameworks and the usefulness of this sequential approach for identifying opportunities to improve CDSS uptake.

METHODS

In Phase 1, we conducted semistructured interviews with primary care physicians in Toronto, Canada regarding the uptake of the eAMS CDSS. Using content analysis, two coders independently analyzed interview transcripts guided by the TDF to generate themes representing barriers and enablers to CDSS uptake. In Phase 2, the same reviewers independently mapped each belief statement to a GUIDES domain and factor. We calculated the proportion of TDF belief statements that linked to each GUIDES domain and the proportion of TDF domains that linked to GUIDES factors (and vice-versa) and domains.

RESULTS

We interviewed 10 participants before data saturation. In Phase 1, we identified 53 belief statements covering 12 TDF domains; 18 (34.0%) were barriers, and 35 (66.0%) were enablers. In Phase 2, 41 statements (77.4%) linked to at least one GUIDES factor, while 12 (22.6%) did not link to any specific factor. The GUIDES Context Domain was linked to the largest number of belief statements (19/53; 35.8%). Each TDF domain linked to one or more GUIDES factor, with 6 TDF domains linking to more than 1 factor and 8 TDF domains linking to more than 1 GUIDES domain.

CONCLUSIONS

The TDF provides unique insights into barriers and enablers to CDSS uptake, which can then be mapped to GUIDES domains and factors to identify required changes to CDSS context, content, and system. This can be followed by conventional mapping of TDF domains to behaviour change techniques to optimize CDSS implementation. This novel step-wise approach combines two established frameworks to optimize CDSS interventions, and requires prospective validation.

Supine vs upright exercise in patients with hepatopulmonary syndrome and orthodeoxia: study protocol for a randomized controlled crossover trial

BACKGROUND

The hepatopulmonary syndrome (HPS) is a pulmonary complication of liver disease found in 10 to 32% of patients with cirrhosis and is characterized by intrapulmonary vascular dilatations and abnormal oxygenation. Liver transplantation is the only effective therapy for this disease. Patients with HPS have significant exercise limitations, impacting their quality of life and associated with poor liver transplant outcomes. Many patients with HPS exhibit orthodeoxia-an improvement in oxygenation in the supine compared to the upright position. We hypothesize that exercise capacity will be superior in the supine compared to the upright position in such patients.

METHODS

We propose a randomized controlled crossover trial in patients with moderate HPS (PaO₂ < 80 mmHg) and orthodeoxia (supine to upright PaO₂ decrease > 4 mmHg) comparing the effect of supine vs upright position on exercise. Patients with pulmonary hypertension, FEV1/FVC ratio < 0.65, significant coronary artery disease, disorders preventing or contraindicating use of a cycle ergometer, and/or moderate or severe ascites will be excluded. Participants will be randomized to cycle ergometry in either the supine or upright position. After a short washout period (a minimum of 1 day to a maximum of 4 weeks), participants will crossover and perform an exercise in the alternate position. Exercise will be performed at a constant work rate of 70-85% of the predicted peak work rate until the "stopping time" is reached, defined by exhaustion, profound desaturation, or safety concerns (drop in systolic blood pressure or life-threatening arrhythmia). The primary outcome will be the difference in the stopping time between exercise positions, compared with a repeated measures analysis of variance method with a mixed effects model approach. The model will be adjusted for period effects. P < 0.05 will be considered statistically significant.

DISCUSSION

HPS patients have hypoxemia leading to significant exercise limitations. If our study is positive, a supine exercise regimen could become a routine prescription for patients with HPS and orthodeoxia, enabling them to exercise more effectively. Future studies could explore the corresponding effects of a supine exercise training regimen on physiologic variables such as long-term exercise capacity, quality of life, dyspnea, and liver transplantation outcomes.

TRIAL REGISTRATION

ClinicalTrials.gov Protocol Registration and Results System (PRS) NCT04004104 . Registered on 1 July 2019.

Environmental prenatal stress eliminates brain and maternal behavioral sex differences and alters hormone levels in female rats

Environmental prenatal stress (EPS) has effects on fetuses that are long-lasting, altering their hormone levels, brain morphology and behavior when they reach maturity. In previous research, we demonstrated that EPS affects the expression of induced maternal behavior (MB), the neuroendocrine system, and morphology of the sexually dimorphic accessory olfactory bulb (AOB) involved in reproductive behavior patterns. The bed nucleus of the accessory olfactory tract (BAOT) is another vomeronasal (VN) structure that plays an inhibitory role in rats in the expression of induced maternal behavior in female and male virgins. In the present study, we have ascertained whether the behavioral, neuroendocrine, and neuromorphological alterations of the AOB found after EPS also appear in the BAOT. After applying EPS to pregnant rats during the late gestational period, in their female offspring at maturity we tested induced maternal behavior, BAOT morphology and plasma levels of testosterone (T), estradiol (E2), progesterone (P), adrenocorticotropic hormone (ACTH) and corticosterone (Cpd B). EPS: a) affected the induction of MB, showed a male-like pattern of care for pups, b) elevated plasma levels of Cpd B and reduced E2 in comparison with the controls, and c) significantly increased the number of BAOT neurons compared to the control females and comparable to the control male group. These findings provide further evidence that stress applied to pregnant rats produces long-lasting behavioral, endocrine and neuroanatomical alterations in the female offspring that are evident when they become mature.

Maternal care interacts with prenatal stress in altering sexual dimorphism in male rats

The present study analyzes the interaction between prenatal stress and mother's behavior on brain, hormonal, and behavioral development of male offspring in rats. It extends to males our previous findings, in females, that maternal care can alter behavioral dimorphism that becomes evident in the neonates when they mature. Experiment 1 compares the maternal behavior of foster mothers toward cross-fostered pups versus mothers rearing their own litters. Experiment 2 ascertains the induced "maternal" behavior of the male pups, derived from Experiment 1 when they reached maturity. The most striking effect was that the males non-exposed to the stress as fetuses and raised by stressed foster mothers showed the highest levels of "maternal" behavior of all the groups (i.e., induction of maternal behavior and retrieving behavior), not differing from the control, unstressed, female groups. Furthermore, those males showed significantly fewer olfactory bulb mitral cells than the control males that were non-stressed as fetuses and raised by their own non-stressed mothers. They also presented the lowest levels of plasma testosterone of all the male groups. The present findings provide evidence that prenatal environmental stress can "demasculinize" the behavior, brain anatomy and hormone secretion in the male fetuses expressed when they reach maturity. Moreover, the nature of the maternal care received by neonates can affect the behavior and physiology that they express at maturity.

Bicuculline infusion into the accessory olfactory bulb facilitates the induction of maternal behavior in rats

The GABAA antagonist bicuculline, intracranially infused into the accessory olfactory bulb (AOB), facilitated the expression of maternal behavior (MB) in virgin Wistar female rats. Behavioral effects were observed 24 hours after infusion and were injection dependent. Pheromonal stimuli, generated by the pups, are thought to exert an inhibitory effect on vomeronasal nuclei involved in MB in virgin rats. The present study investigated the possibility that a decrement in AOB output, resulting from long-term compensatory synaptic changes to chronic bicuculline infusion, would facilitate the expression of MB. The implications of our findings for the mechanisms involved in the induction of MB and the maternal experience effect are discussed.

The development of sex differences in the locus coeruleus of the rat

Development of sex differences in the locus coeruleus (LC) is investigated. The LC is a sexually dimorphic structure in which the female manifests a larger volume and greater number of neurons than do males. Male and female Wistar rats were sacrificed on prenatal days (E) 16 and 20 and postnatally (P) on days 1, 3, 7, 15, 35, 45, 60, and 90. Male and female rats show a continuous increase in the number of neurons after birth that stops in the males by P45 and in females by P60. These findings point out the existence of different patterns of development in male and female rats and may suggest that sex differences could be established because of the existence of a differential period of neurogenesis in both sexes in the postpubertal period.

[Quality control in Medicine. Position of the Chilean Academy of Medicine]

In the last two decades, important changes in medical training and care have occurred in Chile. The number of medical schools has been doubled, exceeding the national availability of professors and qualified training fields. The quality assessment and accreditation of medical training and care is insufficient in Chile. A National Autonomous Corporation of Certification of Medical Specialties, has certified more than 4,000 physicians in 44 specialties. The Chilean Association of Faculties of Medicine has accredited training centers during the last four decades. The National Commission of Undergraduate Training Accreditation, has developed a voluntary system for medical school accreditation. The Academy supports these strategies and considers that accreditation does not threaten institutions or individuals. It is rather a mechanism that identifies strengths and weaknesses of institutions and programs. This will finally result in better quality in medical training and patient care.

Estradiol masculinizes the posteromedial cortical nucleus of the amygdala in the rat

It has been demonstrated that the posteromedial cortical amygdaloid nucleus (PMCo), is sexually dimorphic. It is shown (Experiment 1) that male orchidectomy on the day of birth (D1) decreases the volume and number of neurons of the PMCo, while a single injection of propionate testosterone to the female on D1 masculinizes the PMCo in this gender. Since male gonadectomy on D1 (Experiment 2) is counteracted by a single injection of estradiol benzoate in males it has been suggested that the masculinization of the PMCo is due to the aromatization of testosterone to estradiol in this structure. These findings support the hypothesis that the development of sex differences in structures that belong to the vomeronasal system are due to the aromatization of testosterone to estradiol shortly after birth.

Functional sex differences in the accessory olfactory bulb of the rat

The aim of this study is to determine whether sex-related differences exist in the biosynthetic activity of the mitral cells within the mitral layer of the AOB. Possible functional changes over the estrus cycle and the potential effects of castration and androgenization are assessed. Biosynthetic activity was measured using silver staining of the argyrophilic proteins associated with the nucleolar organizer regions (Ag-NOR). Assisted by stereological methods, the following parameters were studied: mean number, percentage and mean area of Ag-NOR in estrus and diestrus females, intact males, castrated and androgenizated rats. We detected sex differences in a histochemical marker related to synthetic activity, an estrus cycle effect and changes resulting from the perinatal treatments. We conclude that this structurally dimorphic region is also functionally dimorphic.

The development of brain sex differences: a multisignaling process

In order to account for the development of sex differences in the brain, we took, as an integrative model, the vomeronasal pathway, which is involved in the control of reproductive physiology and behavior. The fact that brain sex differences take place in complex neural networks will help to develop a motivational theory of sex differences in reproductive behaviors. We also address the classic genomic actions in which three agents (the hormone, the intracellular receptor, and the transcription function) play an important role in brain differentiation, but we also point out refinements that such a theory requires if we want to account of the existence of two morphological patterns of sex differences in the brain, one in which males show greater morphological measures (neuron numbers and/or volume) than females and the opposite. Moreover, we also consider very important processes closely related to neuronal afferent input and membrane excitability for the developing of sex differences. Neurotransmission associated to metabotropic and ionotropic receptors, neurotrophic factors, neuroactive steroids that alter membrane excitability, cross-talk (and/or by-pass) phenomena, and second messenger pathways appear to be involved in the development of brain sex differences. The sexual differentiation of the brain and reproductive behavior is regarded as a cellular multisignaling process.

Expression of intracellular progesterone receptors in rat brain during different reproductive states, and involvement in maternal behavior

Progesterone is one of a complex of hormones which influences the occurrence of maternal behavior in rats. The present study provides information on progesterone's mechanism and possible neural site(s) of action with respect to maternal responsiveness. Progesterone can exert cellular effects by acting on membrane receptors or by acting on intracellular receptors. In the first experiment we show that RU 486 can antagonize progesterone's inhibitory effect on maternal behavior. Since RU 486 acts as an antagonist to progesterone's action at its intracellular receptor, these results support the involvement of that receptor in maternal behavior control. The second experiment employs immunocytochemical techniques to detect the number of cells in various forebrain regions which contain intracellular progesterone receptors during different reproductive states. The number of cells which contained progesterone receptors was higher toward the end of pregnancy (progesterone is presumably exerting its effects on maternal behavior at this time) when compared to either early pregnancy or lactation in the following forebrain regions: anteroventral periventricular nucleus of the preoptic area; medial preoptic area; ventral part of the bed nucleus of stria terminalis; ventrolateral division of the ventromedial nucleus; arcuate nucleus; anterior paraventricular nucleus of the hypothalamus; and medial amygdala. The possible involvement of these regions as a site or sites where progesterone might exert its effects on maternal behavior is discussed.

Sex differences in the posteromedial cortical nucleus of the amygdala in the rat

It has been hypothesized that the vomeronasal system (VNS), a complex neural network implicated in the control of reproductive behaviors, is sexually dimorphic. The posteromedial cortical amygdaloid nucleus (PMCo) belongs to the group of amygdaloid structures that receive direct olfactory input from the accessory olfactory bulb. In the present study we looked for sex differences in this nucleus in male and female adult rats and we found that the males had larger volumes and more neurons than the females. These results support the hypothesis that the VNS is a sexually dimorphic system.

Development of sex differences in the bed nucleus of the accessory olfactory tract in the rat

In the present study, we investigate the development of sex differences in the bed nucleus of the accessory olfactory tract (BAOT), a sexually dimorphic structure in which masculinization of male rats depends on the level of postnatal estradiol. Male and female Wistar rats were sacrificed postnatally when they were 1, 3, 7, 15, 45 and 60 days old, and stereological methods were used to estimate the volume and number of neurons in the BAOT of the subjects. With respect to volume, sex differences were established from P15. In relation to the number of neurons, the males acquire their adult morphological parameter by P15, while females show a decrease (P3), increase (from P3 to P15) and later decrease (from P15 to P45). Sex differences from P3 to P7 might be related to greater cell death in the BAOT of the females. These results support the hypothesis that both male and female rats reach their adult morphological pattern within this sexually dimorphic nucleus in an active manner.

Sex differences in the vomeronasal system

In the early eighties we found sex differences in the vomeronasal organ (VNO) and hypothesized that the vomeronasal system (VNS), a complex neural network involved in the control of reproductive behavior, might be sexually dimorphic. At that time sex differences had already been described for some structures that receive VNO input, such as the medial amygdala, the medial preoptic area, the ventromedial hypothalamic nucleus, and the ventral region of the premammillary nucleus. Since then, we have shown sex differences in the accessory olfactory bulb (AOB), the bed nucleus of the accessory olfactory tract (BAOT), and the bed nucleus of the stria terminalis (BST). When new VNS connections were found, all of them ended in nuclei that present sex differences. In general, sex differences in the olfactory system show two morphological patterns: one in which males present greater morphological measures than females, and just the opposite. To explain the morphometric measures of males in the latter, it has been hypothesized that androgens serve as inhibitors. Our work on the involvement of the GABA(A) receptor in the development of AOB and maternal behavior sex differences also suggests that neonatal changes in neuronal membrane permeability to the ion Cl- differences. This might be the first animal model to help us to understand the situation in which human genetic and gonadal sex do not agree with brain and behavioral sex. Finally, we stress that sex differences in the VNS constitute a neurofunctional model for understanding sex differences in reproductive behaviors.

Estradiol masculinizes the number of accessory olfactory bulb mitral cells in the rat

Orchidectomized males injected with a single dose of estradiol benzoate on the day of birth (D1) showed mitral cell numbers in the accessory olfactory bulb similar to those of control males. However, orchidectomized males that received no additional estradiol benzoate treatment and those orchidectomized and given a single dose of dihydrotestosterone on D1 showed decreases in the number of accessory olfactory bulb mitral cells compared with control males. These results support the notion that the presence of estradiol immediately after birth induces the masculinization of mitral cells number in the accessory olfactory bulb.

Searching for sex differences in the vomeronasal pathway

The sexual differentiation of brain and behavior is reviewed from the findings of sex differences in the vomeronasal pathway. A motivational approach to sex differences in reproductive behavior is stressed by taking into account that sex differences are present in neural networks: from the receptor organ (the vomeronasal organ) to effector nuclei. Sex differences in the brain appear in two morphological patterns. In one, the male presents greater morphological measurements than the female; in the other, the opposite occurs. These two morphological patterns are actively differentiated by gonadal steroids. The functional significance of these two morphological patterns is addressed. Moreover, since the GABA(A) receptor is involved in the organization of sex differences in vomeronasal structures such as the accessory olfactory bulb and in maternal behavior, the role of membrane mechanisms, 5alpha reduced hormones, and neurosteroids in the sexual differentiation process is discussed.

Role of GABAA receptors in the organization of brain and behavioural sex differences

Sex differences in GABA neurotransmitter have been described. We have studied the involvement of the GABAA receptor in sex differences in the brain and reproductive behaviour. Neonatal administration of the GABAA agonist diazepam to male rats facilitated the induction of maternal behaviour in adults, while the antagonist picrotoxin disrupted it in females. Sex differences in the accessory olfactory bulb were also reversed, but gonadal function remained unaltered in both sexes. This suggests that neonatal changes in neuronal membrane permeability to Cl- ions may play a role in the organization of sex differences. Our study constitutes a new model for understanding the early neurobiological organization of sex differences.

Lesions in the medial posterior region of the BST impair sexual behavior in sexually experienced and inexperienced male rats

Previous studies have showed that lesions in the bed nucleus of the stria terminalis of experienced male rats impair some parameters of sexual behavior. The aim of this study was to examine the contribution of the medial posterior region of the bed nucleus of the stria terminalis (BSTMP), a sexually dimorphic region of this nucleus that pertains to the vomeronasal system, to the modulation of sexual behavior of the male rat. Small electrolytic bilateral lesions in the BSTMP were made in male heterosexual experienced and inexperienced rats. Sham lesioned animals were also tested as a control of the effects of the general surgical procedures. Behavioral tests were then performed to obtain standard measures of masculine sexual behavior. Our results indicate that the sexually experienced male rats with lesioned BSTMPs showed increases in the number of mounts and the number of intromissions and, consequently, in ejaculation latency. In contrast, the sexually naive male rats showed increases in first mount and intromission latencies and in ejaculation latency, but the latter occurred due to increases in the interintromission intervals. This group also showed low correlations between olfactory investigation of the anogenital area of the female and initiation and maintenance of copulatory behavior. The results suggest that sexual experience obtained in the very artificial conditions of laboratory tests could supply some of the cues provided by the BSTMP in the process of sensorial integration, which we hypothesize modulates the initiation and pacing of copulation. However, sexual experience does not apparently supply any other kinds of cues provided or processed in the BSTMP that are involved in modulating the elicitation of intromissions and ejaculations.

Early postnatal diazepam exposure facilitates maternal behavior in virgin female rats

Virgin female rats do not display maternal behavior if they are not exposed to the pups during several days. This exposure is called induction. In this work we have studied the effects of early postnatal (PO-P16) diazepam (DZ) administration (1 and 2.5 mg/kg, SC) on the display of maternal behavior of virgin female rats when adults. Although we did not find statistically significant differences between P0-P16 DZ treated and control females with respect to the latency of retrieval, P0-P16 DZ administration resulted in a statistically significant increase of the percentage of female rats that became maternal, showing retrieval behavior. This early postnatal treatment with DZ also increased other variables that are currently measured in maternal behavior tests, such as: time of physical contacts, grooming, crouching, and nest building quality. No statistically significant differences were found in the body weight of treated versus control animals during development, nor during adulthood. Our results provide further evidence that the GABAA-BDZ-Cl- receptor complex is implicated in the development of maternal behavior in female rats.

MBR: a computer program to record and analyze parental behavior in rodents

The Maternal Behavior Recorder (MBR) is a microcomputer program designed to record and analyze data from research on parental behavior of rats and other rodents. It is used to record the specific, characteristic patterns of maternal care in rodents: nest building, grooming, licking, crouching, and retrieval of pups. Moreover, it analyzes these events in terms of frequency and duration, allowing any events erroneously recorded to be corrected. The MBR can also simultaneously control observations made by one or two experimenters, and it calculates a set of reliability measures between them.

Perinatal administration of diazepam alters sexual dimorphism in the rat accessory olfactory bulb

The present study examines the effects of pre and/or early postnatal administration of diazepam on the mitral cell and on the light and dark granule cell populations in the sexually dimorphic accessory olfactory bulb of the rat. Quantitative differences related to sex were observed in the numbers of the three types of neurons, with vehicle males showing greater numbers of cells than vehicle females. The number of mitral cells in males decreased to the levels shown by female rats following prenatal and pre-postnatal diazepam treatments, whereas the DZ treatments did not affect the females. In addition, the diazepam administration during the prenatal, postnatal and pre-postnatal periods decreased the numbers of both light and dark granule cells in males, while these two granule cell subpopulations were not affected in diazepam treated females. These results indicate that perinatal administration of diazepam can alter the sexual dimorphism in the accessory olfactory bulb and that the GABAA/benzodiazepine receptor complex is involved in the sexual differentiation this part of the brain.

Effects of estradiol on the development of sexual dimorphism in the bed nucleus of the accessory olfactory tract in the rat

Orchidectomized males injected with a single dose of estradiol benzoate (EB) on the day of birth (D1) showed a volume and neuron number in the nucleus of the accessory olfactory tract (BAOT) similar to that of control males. However, orchidectomized males and those orchidectomized and given a single dose of DHT on D1 showed a decrease in BAOT volume and neuron number with respect to control males. These results support the notion that estradiol induces the morphological masculinization of this structure. The inability of DHT in counteracting the effect of orchidectomy is addressed taking into account the inhibitory action of androgens.

Effects of perinatal diazepam exposure on the sexually dimorphic rat locus coeruleus

Diazepam (DZ) administration over prenatal, postnatal, and pre plus postnatal periods altered the normal expression of the morphological sex differences of the LC. Males were affected only by the prenatal exposure and the effect of this exposure produced an increase in the volume and neuron number of male's LC. By contrast, females were affected by both pre and postnatal treatments and the effect of this exposure resulted in a decrease in the volume and neuron number of female's LC. However, pre plus postnatal treatment did not affect female's LC.

Sexual dimorphism in the vomeronasal pathway and sex differences in reproductive behaviors

Several years ago we hypothesized that the vomeronasal system (VNS), a complex neural network involved in the control of reproductive behavior, might be sexually dimorphic. This hypothesis sprung from several facts; (a) the existence of steroid receptors in the VNS; (b) sexual dimorphism was already described in some structures that receive vomeronasal input, such as the medial preoptic area, the ventromedial hypothalamic nucleus, the ventral region of the premammillary nucleus and the medial amygdaloid nucleus; and (c) the vomeronasal organ, which is the receptor organ of the VNS, was also sexually dimorphic. After that point, the accessory olfactory bulb (AOB), the bed nucleus of the accessory olfactory tract (BAOT) and the bed nucleus of the stria terminalis were found to be sexually dimorphic. The aim of the present review is to show the experimental facts that confirm our earlier hypothesis and, consequently, to present the existence of a sexually dimorphic multisynaptic pathway for the first time in mammals. Sexual dimorphism in the VNS might provide a comprehensive approach to understanding the neural bases of sexually dimorphic reproductive behavior and it is suggested here that the greater number of neurons which male rats present in relation to females in most VNS structures might contribute to the inhibition of the expression of feminine copulatory behavior (lordosis) and maternal behavior in males. In addition, the mechanisms that control the development of sexual dimorphism in the VNS are discussed. The discussion takes into account the two patterns of sexual dimorphism found in the rat brain. Estrogens seem to promote the development of sexual dimorphism in both male and female rats. However, an inhibitory role of androgens might be necessary to hypothesize when males or females present a lower number of neurons and/or volume than the opposite sex. There are experimental data supporting this hypothesis in the female, since dihydrotestosterone seems to facilitate neuronal death in VNS structures, such as the AOB and the BAOT, in which females present a lower number of neurons and volume than male rats. Finally, since the lateral division of the bed nucleus of the stria terminalis, which belongs to the main olfactory system (MOS), is sexually dimorphic and presents anatomical relationships with some VNS structures the MOS might be sexually dimorphic.

Maternal behavior induced in male rats by bilateral lesions of the bed nucleus of the accessory olfactory tract

In the present study, we investigate the effect of bilateral electrolytic lesions of the bed nucleus of the accessory olfactory tract (BAOT) in male Wistar rats that did not have care-pups experience, using a test of induced maternal behavior. Consistent with our previous findings in virgin female rats (10), there was a significantly shorter sensitization (3 days) and retrieval (2 days) latencies in the BAOT-lesioned group than in the sham-lesioned and intact-control male groups (12 days for both). Based on these findings, we propose that BAOT, a sexually dimorphic nucleus of the vomeronasal system, exerts an inhibitory modulation in the expression of parental behavior in male and female virgin rats. It may do so by maintaining an olfactory-based tonic inhibition of maternal behavior, thereby resulting in the adults' tonic avoidance of the pups until this inhibition is abolished by lesion, or reduced or overridden by appropriate hormonal and/or sensory influences.

Postnatal administration of dihydrotestosterone to the male rat abolishes sexual dimorphism in the accessory olfactory bulb: a volumetric study

The regulatory action of the non-aromatizable androgen dihydrotestosterone (DHT) on sexual differentiation of the volume of the rat accessory olfactory bulb (AOB) was studied. Postnatal treatment with DHT (180 micrograms/day) carried out daily between days 6 and 20 produced a drastic reduction in overall AOB size and that of its constituent neural layers in genetic males with respect to intact and control males. The volumetric measures found in DHT-treated males did not differ from those shown by the intact females. These results, which indicate a demasculinization and a feminization of the AOB volume in gonadally intact male rats induced by DHT, are discussed in relation to the presumably regulatory role of DHT on neuron populations during the sexual organizational process of the brain.

Sexual dimorphism of the dopamine-beta-hydroxylase-immunoreactive neurons in the rat locus ceruleus

Sex differences in the noradrenaline synthesizing neurons of the locus ceruleus (LC) in rat brain were investigated immunocytochemically using an antibody to dopamine-beta-hydroxylase. Female adult rats contained a greater structural volume and average somatic area in the anterior intermediate region of the nucleus compared with males. Whether this difference is related to the endocrine status of the animals, and consequently a functionally distinct population of neurons, is yet to be determined.

Effects of early postnatal sex steroids on acquisition and extinction of a continuously reinforced lever-pressing response

The effects of early postnatal dihydrotestosterone (DHT) and estradiol on the sexually dimorphic continuously reinforced lever-pressing response were investigated. 90-day-old male rats postnatally treated (during the first eight days of postnatal life) with cyproterone acetate (CA), tamoxifen (TX) or vehicle, and 90-day-old females treated with estradiol benzoate (EB), DHT or vehicle in the same postnatal period, were studied during the acquisition and extinction of the continuously reinforced lever-pressing response using a free-operant procedure. During acquisition, the control males made more responses per minute than the control females, and also reached the extinction criterion significantly sooner than the females. CA treatment impaired the male's performance at the levels of that shown by females, whereas TX treatment affected neither acquisition nor extinction. Inversely, in both experimental phases females treated with DHT performed like control females, whereas the acquisition and extinction performances of the EB-females were similar to those obtained in the control or TX male groups.

Female's DHT controls sex differences in the rat bed nucleus of the accessory olfactory tract

In the present study the regulatory action of the non-aromatic androgen dihydrotestoterone (DHT) on the volume of the sexually dimorphic bed nucleus of the accessory olfactory tract (BAOT) was investigated. Postnatal treatment with DHT (180 micrograms day-1) between days 6 and 20 (D6-D20) induced, in gonadally intact male rats, a drastic reduction in the overall volume to levels typical in control females. Conversely, the postnatal administration of the anti-androgen cyproterone acetate (CA) to the females from D6-D20 produced an increment in the BAOT volume not dissimilar to that found in control males. These findings reveal that sexual organization in this vomeronasal structure is dependent on the presence of DHT in females during postnatal development.

Bilateral lesions of the bed nucleus of the accessory olfactory tract facilitate maternal behavior in virgin female rats

In this study the effects of electrolytic lesions of the bed nucleus of the accessory olfactory tract (BAOT) on the induction of maternal behavior in virgin female Wistar rats was investigated. Results demonstrate a functional role of the BOAT in the neural control of maternal behavior in virgin female rats since bilaterally BOAT lesioned (BL) animals showed significantly shorter sensitization latencies (BL = 6 days) than sham lesioned (SH = 12 days) and intact control (C = 12 days) female rats. At the same time, statistically significant differences were observed in retrieval latency between BL (5.5 days) and C (10 days) groups, but not in the SH group (8 days). In physical contact frequency, the BL group reached higher scores than SH or C group. However, bilateral BAOT lesions failed to affect other maternal patterns such as nest building quality. Thus these results indicate that the BOAT, a vomeronasal system structure, is involved in the control of maternal behavior and that BL electrolytic lesions facilitate the onset of this behavior in virgin female Wistar rats.

Early postnatal diazepam exposure alters sex differences in the rat brain

The volume and neuron number of the sexually dimorphic accessory olfactory bulb and locus coeruleus are altered by early postnatal exposure (from the day of birth to postnatal day 16) to diazepam. After diazepam treatment, both volume and neuron number were decreased in the male accessory olfactory bulb and in the female locus coeruleus. These results indicate that early postnatal diazepam administration can bear gender-dependent teratogenic effects upon sexually dimorphic nuclei and suggest that endogenous benzodiazepines may be involved in the sexual differentiation of the brain.

Sexual dimorphism in accessory olfactory bulb mitral cells: a quantitative Golgi study

The purpose of the present study was to identify the existence of sexual dimorphism in the dendritic field of accessory olfactory bulb mitral cells in rats and to investigate the effects of male orchidectomy and female androgenization on the day of birth upon this dendritic field. The rapid Golgi method was used to conduct a quantitative study of various characteristics of the dendritic field of accessory olfactory bulb mitral cells. The results indicated greater values for males than females for the following characteristics: (i) somatic area; (ii) degree of branching in the dendritic field; (iii) total dendritic length; and (iv) dendritic density around the neuronal soma. Orchidectomy of males, as well as androgenization of females, on the day of birth inverted these differences.

Effects of perinatal diazepam administration on two sexually dimorphic nonreproductive behaviors

The effects of prenatal and/or early postnatal diazepam (DZ) administration on open field activity and continuously reinforced lever-pressing response were studied. Rat pups of both sexes were prenatally (during the last week of pregnancy) and/or postnatally (from the day of birth to day 16) daily exposed to a 2.5 mg/kg dose of DZ. At the age of 60 days all groups were tested in the open field for 5 consecutive days and thirty days later they were studied in a continuously reinforced lever-pressing situation during four consecutive days. In the open field test, females showed greater activity than males and prenatal and/or early postnatal DZ treatments did not alter this sexual dimorphism, although all treatments decreased the open field activity in both male and female 60-day-old rats. In the Skinner box, 90-day-old males presented higher rates of lever-pressing response than females, and only the early postnatal DZ treatment was effective in altering this sexual dimorphism, by decreasing the male's but not female's rates of response. These results are discussed in regard to the possible interaction between DZ and gonadal hormones during the early sexual differentiation period.

Sexual dimorphism in the bed nucleus of the accessory olfactory tract in the rat

This work investigates the existence of sex differences in the volume and number of neurons and glial cells in the bed nucleus of the accessory olfactory tract (BAOT). Males showed larger volume and number of cells than female rats. Early postnatal (day 1 after birth) orchidectomy in males, and androgenization in females, reversed these differences. No sex differences were found in BAOT glial cells. The sexual dimorphism found in the neuron/glial cell ratio reflects sex differences in neuron number. The existence of sexual dimorphism in the BAOT supports our earlier hypothesis which states that the vomeronasal system (VNS) is sexually dimorphic.

SBR: a computer program to record and analyse sexual behavior in rodents

SBR (Sexual Behavior Recorder) is a program designed to record and analyse data from research on the sexual behavior of rats and other animals with similar patterns of sexual behavior. SBR allows the user to record the characteristic events of both the male and female's sexual behavior: mounts, intromissions, ejaculations and lordosis. It also allows the user to record two other types of events, and analyse them in terms of frequency and duration, using two user-defined keys. The program allows the correction of any event erroneously recorded. SBR can simultaneously control observations made by one or two observers, and on one or two experiment boxes. In the case that two observers record from the same experiment box, the program calculates a set of measures of reliability between the observers. At the end of each observation, SBR conducts a descriptive analysis of the recorded events, including the parameters normally used in scientific literature on the subject, and writes this analysis to disk files. As well as the default calculation parameters, it is possible to calculate any other, or to use the program as a record of general purpose events using the file which contains all the recorded events in sequential order and the exact time at which they were recorded. SBR was written using the compiler Turbobasic 1.1 from Borland International Inc. (1987).

Sexual dimorphism in the parastrial nucleus of the rat preoptic area

This work investigates the possible existence of sex differences in the volume of the parastrial nucleus (PSN), a component of the preoptic area in the rat. The effects of postnatal (on day 1 after birth) male orchidectomy and female androgenization on this nucleus were studied. The volume of the PSN was greater in the control females than in the control males and postnatal treatments reversed this sexual dimorphism.

Learned immobility explains the behavior of rats in the forced swimming test

The rat forced-swimming test (FST) is widely used for screening substances with a potential antidepressant effect. The rat immobility shown in the FST has been interpreted as "behavioral despair" and has been suggested as an animal model of human depression. In the following series of experiments it is shown that measuring rat mobility by an automatic recording device is more accurate than measuring immobility time by direct observation (Experiment 1 and 5). The automatic recording procedure was tested with imipramine and mianserin showing similar results to those reported in the literature using a direct observation procedure by the researcher (Experiment 2). In Experiment 3 it was demonstrated that: (a) rat mobility decreased with experience, (b) switching water depth on Day 2 of the test increased mobility and (c) anisomycin acts as a false positive. In Experiment 4 the possible state dependent effect of imipramine in the FST was studied. The effect of imipramine on rat behavior in the FST is not state dependent. The imipramine-saline group shows greater mobility than the saline-saline group and does not differentiate from the imipramine-imipramine group. Thus, it was suggested that imipramine could interfere with the acquisition and/or consolidation processes. In Experiment 5, it is shown that a single dose of 25 mg/kg of imipramine, administered before or immediately after training on Day 1, increases rat's mobility on Day 2, thus suggesting that imipramine alters the consolidation process. From these results it is suggested that the behavioral process involved in the FST is "learning to be immobile" instead of "behavioral despair" as previously suggested in the literature.

Early effects of gonadal steroids on the neuron number in the medial posterior region and the lateral division of the bed nucleus of the stria terminalis in the rat

This work investigates the possible existence of sex differences in the number of neurons in the medial posterior region (BNSTMp) and the lateral division (BNSTL) of the bed nucleus of the stria terminalis in the rat. These two zones of the bed nucleus of the stria terminalis belong, respectively, to the vomeronasal system (VNS), and to the main olfactory system (MOS). In the BNSTMp, males showed a greater number of neurons than females. Early postnatal (Day 1 after birth) orchidectomy in males, and androgenization in females, eliminated and reversed these differences. In the BNSTL, sexual dimorphism was restricted to its anterior region (BNSTLa). Females showed there a greater number of neurons than males. Male orchidectomy on Day 1 after birth increased the number of neurons, while female androgenization produced the opposite effect. The results obtained in this study support the hypothesis that the VNS is sexodimorphic, and suggest that sex differences exist in MOS, and that these differences are controlled by gonadal steroids during the perinatal period.

The distribution of glial fibrillary acidic protein in the adult rat brain is influenced by the neonatal levels of sex steroids

Sex steroids during the perinatal period are able to modify the postnatal development of neurons within steroid-sensitive areas in the rat brain. This study was designed to test the possible influence of the early postnatal levels of sex steroids on the morphology of the astrocytes. The experimental manipulation of the neonatal levels of sex steroids was performed by the androgenization of females with a single injection of testosterone propionate and by the orchidectomy of males on the day of birth. Control females received a single injection of vehicle and control males were sham operated. All the animals were sacrificed at 3 months of age postnatally. The immunohistochemical distribution of the glial fibrillary acidic protein (GFAP), a marker of astrocytic filaments, was studied on coronal sections of the dorsal hippocampus, the globus pallidus and the hypothalamic arcuate nucleus. The number of GFAP immunoreactive cells, the number of GFAP immunoreactive primary processes per cell and the surface density of the GFAP immunoreactive material were evaluated. This morphometric evaluation revealed a decreased surface density of GFAP immunoreactive material in the hippocampus, globus pallidus and the ventral part of the arcuate nucleus of orchidectomized males when compared to control males. Sex differences in the distribution of GFAP immunoreactivity were detected in the hippocampus and globus pallidus. These differences were abolished by the androgenization of females. The number of GFAP immunoreactive cells was similar in all the experimental groups, indicating that the differences in surface density represent an effect of sex steroids on the growth of astrocytic processes rather than on the proliferation of astrocytes.

Effects of sex steroids on the development of the locus coeruleus in the rat

The effects of postnatal (on day 1 (D1) after birth) male orchidectomy and female androgenization on the locus coeruleus (LC) are studied. Normal adult female rats show greater LC volume and cell number than males. Testosterone treatment of females on D1 eliminates these differences. However, D1 male orchidectomy does not affect either the volume or the number of cells.

Effects of early postnatal gonadal steroids on acquisition and extinction of a single alternation response in discrete-trials lever pressing

The present report studies the effect of sex on the acquisition and extinction of a single alternation schedule of reinforced (R) and nonreinforced (N) trials in a Skinner box. In addition to the investigation of the basic sex differences in Experiment 1, the effects of early gonadal steroids treatment and postpubertal gonadectomy of male and female rats were examined in Experiments 2 and 3, respectively. Both acquisition and extinction performances were evaluated by means of latency. In Experiment 1, males showed higher latencies on N trials and extinguished faster than female rats. In Experiment 2, female androgenization and male orchidectomy on day one after birth reversed the direction of the sex differences found in the previous experiment. However, postpubertal gonadectomy (Experiment 3) does not affect the performance of male and female rats.