Laser-irradiating infrared attenuated total reflection spectroscopy of articular cartilage: Potential and challenges for diagnosing osteoarthritis

Objective

A prototype infrared attenuated total reflection (IR-ATR) laser spectroscopic system designed for in vivo classification of human cartilage tissue according to its histological health status during arthroscopic surgery is presented. Prior to real-world in vivo applications, this so-called osteoarthritis (OA) scanner has been tested at in vitro conditions revealing the challenges associated with complex sample matrices and the accordingly obtained sparse spectral datasets.

Methods

In vitro studies on human knee cartilage samples at different contact pressures (i.e., 0.2-0.5 ​MPa) allowed recording cartilage degeneration characteristic IR signatures comparable to in vivo conditions with high temporal resolution. Afterwards, the cartilage samples were assessed based on the clinically acknowledged osteoarthritis cartilage histopathology assessment (OARSI) system and correlated with the obtained sparse IR data.

Results

Amide and carbohydrate signal behavior was observed to be almost identical between the obtained sparse IR data and previously measured FTIR data used for sparse partial least squares discriminant analysis (SPLSDA) to identify the spectral regions relevant to cartilage condition. Contact pressures between 0.3 and 0.4 ​MPa seem to provide the best sparse IR spectra for cylindrical (d ​= ​3 ​mm) probe tips.

Conclusion

Laser-irradiating IR-ATR spectroscopy is a promising analytical technique for future arthroscopic applications to differentiate healthy and osteoarthritic cartilage tissue. However, this study also revealed that the flexible connection between the laser-based analyzer and the arthroscopic ATR-probe via IR-transparent fiberoptic cables may affect the robustness of the obtained IR data and requires further improvements.

Evaluating potential delays and outcomes of patients undergoing surgical resection for locally advanced and recurrent colorectal cancer during a pandemic

INTRODUCTION

The COVID-19 pandemic resulted in a significant disruption of colorectal cancer (CRC) care pathways. This study evaluates the management and outcomes of patients with primary locally advanced or recurrent CRC during the pandemic in a single tertiary referral centre.

METHODS

Patients undergoing elective surgery for advanced or recurrent CRC with curative intent between March 2020 and March 2021 were identified. Following first multidisciplinary team discussion patients were broadly classified into two groups: straight to surgery (n=22, 45%) or neoadjuvant therapy followed by surgery (n=27, 55%). Primary outcome was COVID-19-related complication rate.

RESULTS

Forty-nine patients with a median age of 66 years (interquartile range: 54-73) were included. No patients developed a COVID-19 infection or related complication during hospital admission. Significant delays were identified in the treatment pathway of patients in the straight to surgery group, mostly due to delays in referral from external centres. Nine of 22 patients in the straight to surgery group had evidence of tumour progression compared with 3 of 27 in the neoadjuvant group (p=0.015839). Seven of 27 patients in the neoadjuvant group showed evidence of tumour regression. During the study, surgical waiting times were reduced, and more operations were performed during the second wave of COVID-19.

CONCLUSION

This study suggests that it is possible to mitigate the risks of COVID-19-related complications in patients undergoing complex surgery for locally advanced and recurrent CRC. Delay in surgical intervention is associated with tumour progression, particularly in patients who may not have neoadjuvant therapy. Efforts should be made to prioritise resources for patients requiring time-sensitive surgery for advanced and recurrent CRC.

Wave chaos enhanced light trapping in optically thin solar cells

Enhancing the energy output of solar cells increases their competitiveness as a source of energy. Producing thinner solar cells is attractive, but a thin absorbing layer demands excellent light management in order to keep transmission- and reflection-related losses of incident photons at a minimum. We maximize absorption by trapping light rays to make the mean average path length in the absorber as long as possible. In chaotic scattering systems, there are ray trajectories with very long lifetimes. In this paper, we investigate the scattering dynamics of waves in a model system using principles from the field of quantum chaotic scattering. We quantitatively find that the transition from regular to chaotic scattering dynamics correlates with the enhancement of the absorption cross section and propose the use of an autocorrelation function to assess the average path length of rays as a possible way to verify the light-trapping efficiency experimentally.

The effect of mesenteric defect closure on internal hernias and small bowel obstruction in patients undergoing colorectal surgery: A systematic review and meta-analysis

Objective

Internal hernias (IH) are potentially severe complications after colorectal surgery and may lead to small bowel obstruction (SBO). However, the impact of mesenteric defect closure (MDC) on IH and SBO is currently unclear. The aim of this systematic review and meta-analysis was, therefore, to investigate the effect of MDC on IH and SBO in patients undergoing laparoscopic and open colorectal surgery.

Methods

Ovid Medline, PubMed, and Embase databases were searched. Studies reporting MDC in colorectal surgery were enclosed in the systematic review. Meta-analysis included studies that assessed the effect of MDC vs. non-closure (non-MDC) on IH and SBO. Meta-analysis was performed using a random effect model. Results of individual studies were summarized as ranges. Effect sizes were described as odds ratios (OR) with 95% confidence intervals (CI).

Results

Literature search revealed a total of 344 abstracts. Of these, 16 studies met the inclusion criteria. Included studies comprised a total of 10,068 patients and were published between 2009 and 2019. The incidence of IH and SBO as a composite outcome ranged from 0.0 to 3.5%, whereas the incidence of IH and SBO as single outcomes ranged from 0.0 to 2.7% and 0.0 to 1.7%, respectively. If IH occurred, reoperation was required in 66-100% with additional bowel resections in 20-100% and stoma-formation in 17-50%. The complication rate after reoperations was 25-100% and mortality 0-25%. Meta-analysis including four studies revealed no statistically significant effect of MDC on the composite outcome of IH and SBO (OR 0.25, 95% CI 0.04-1.77) and SBO as a single outcome (three studies, OR 0.48, 95% CI 0.04-5.49). The risk for IH as a single outcome was significantly lower in the MDC group (three studies, OR 0.15, 95% CI 0.02-0.92). Heterogeneity of the studies included was low to moderate for the composite outcome, as well as for IH and SBO as single outcomes (I2 40.3%, 0.0%, and 45.7%, respectively).

Conclusion

In current meta-analysis, MDC was not significantly associated with the composite outcome of IH and SBO in patients undergoing colorectal surgery. However, MDC significantly reduced the risk for IH. Based on these results, the benefit of MDC in colorectal surgery remains unclear and needs to be addressed in further studies.

Chaos: A new mechanism for enhancing the optical generation rate in optically thin solar cells

The photogenerated current of solar cells can be enhanced by light management with surface structures. For solar cells with optically thin absorbing layers, it is especially important to take advantage of this fact through light trapping. The general idea behind light trapping is to use structures, either on the front surface or on the back, to scatter light rays to maximize their path length in the absorber. In this paper, we investigate the potential of chaotic scattering for light trapping. It is well known that the trajectories close to the invariant set of a chaotic scatterer spend a very long time inside of the scatterer before they leave. The invariant set, also called the chaotic repeller, contains all rays of infinite length that never enter or leave the region of the scatterer. If chaotic repellers exist in a system, a chaotic dynamics is present in the scatterer. As a model system, we investigate an elliptical dome structure placed on top of an optically thin absorbing film, a system inspired by the chaotic Bunimovich stadium. A classical ray-tracing program has been developed to classify the scattering dynamics and to evaluate the absorption efficiency, modeled with Beer-Lambert's law. We find that there is a strong correlation between the enhancement of absorption efficiency and the onset of chaotic scattering in such systems. The dynamics of the systems was shown to be chaotic by their positive Lyapunov exponents and the noninteger fractal dimension of their scattering fractals.

Observation of Mie ripples in the synchrotron Fourier transform infrared spectra of spheroidal pollen grains

Conceptually, biological cells are dielectric, photonic resonators that are expected to show a rich variety of shape resonances when exposed to electromagnetic radiation. For spheroidal cells, these shape resonances may be predicted and analyzed using the Mie theory of dielectric spheres, which predicts that a special class of resonances, i.e., whispering gallery modes (WGMs), causes ripples in the absorbance spectra of spheroidal cells. Indeed, the first tentative indication of the presence of Mie ripples in the synchrotron Fourier transform infrared (SFTIR) absorbance spectra of Juniperus chinensis pollen has already been reported [Analyst140, 3273 (2015)ANLYAG0365-488510.1039/C5AN00401B]. To show that this observation is no isolated incidence, but a generic spectral feature that can be expected to occur in all spheroidal biological cells, we measured and analyzed the SFTIR absorbance spectra of Cunninghamia lanceolata, Juniperus chinensis, Juniperus communis, and Juniperus excelsa. All four pollen species show Mie ripples. Since the WGMs causing the ripples are surface modes, we propose ripple spectroscopy as a powerful tool for studying the surface properties of spheroidal biological cells. In addition, our paper draws attention to the fact that shape resonances need to be taken into account when analyzing (S)FTIR spectra of isolated biological cells since shape resonances may distort the shape or mimic the presence of chemical absorption bands.

Regulatory networks underlying mycorrhizal development delineated by genome-wide expression profiling and functional analysis of the transcription factor repertoire of the plant symbiotic fungus Laccaria bicolor

BACKGROUND

Ectomycorrhizal (ECM) fungi develop a mutualistic symbiotic interaction with the roots of their host plants. During this process, they undergo a series of developmental transitions from the running hyphae in the rhizosphere to the coenocytic hyphae forming finger-like structures within the root apoplastic space. These transitions, which involve profound, symbiosis-associated metabolic changes, also entail a substantial transcriptome reprogramming with coordinated waves of differentially expressed genes. To date, little is known about the key transcriptional regulators driving these changes, and the aim of the present study was to delineate and functionally characterize the transcription factor (TF) repertoire of the model ECM fungus Laccaria bicolor.

RESULTS

We curated the L. bicolor gene models coding for transcription factors and assessed their expression and regulation in Poplar and Douglas fir ectomycorrhizae. We identified 285 TFs, 191 of which share a significant similarity with known transcriptional regulators. Expression profiling of the corresponding transcripts identified TF-encoding fungal genes differentially expressed in the ECM root tips of both host plants. The L. bicolor core set of differentially expressed TFs consists of 12 and 22 genes that are, respectively, upregulated and downregulated in symbiotic tissues. These TFs resemble known fungal regulators involved in the control of fungal invasive growth, fungal cell wall integrity, carbon and nitrogen metabolism, invasive stress response and fruiting-body development. However, this core set of mycorrhiza-regulated TFs seems to be characteristic of L. bicolor and our data suggest that each mycorrhizal fungus has evolved its own set of ECM development regulators. A subset of the above TFs was functionally validated with the use of a heterologous, transcription activation assay in yeast, which also allowed the identification of previously unknown, transcriptionally active yet secreted polypeptides designated as Secreted Transcriptional Activator Proteins (STAPs).

CONCLUSIONS

Transcriptional regulators required for ECM symbiosis development in L. bicolor have been uncovered and classified through genome-wide analysis. This study also identifies the STAPs as a new class of potential ECM effectors, highly expressed in mycorrhizae, which may be involved in the control of the symbiotic root transcriptome.

Comparative genomics and expression levels of hydrophobins from eight mycorrhizal genomes

Hydrophobins are small secreted proteins that are present as several gene copies in most fungal genomes. Their properties are now well understood: they are amphiphilic and assemble at hydrophilic/hydrophobic interfaces. However, their physiological functions remain largely unexplored, especially within mycorrhizal fungi. In this study, we identified hydrophobin genes and analysed their distribution in eight mycorrhizal genomes. We then measured their expression levels in three different biological conditions (mycorrhizal tissue vs. free-living mycelium, organic vs. mineral growth medium and aerial vs. submerged growth). Results confirmed that the size of the hydrophobin repertoire increased in the terminal orders of the fungal evolutionary tree. Reconciliation analysis predicted that in 41% of the cases, hydrophobins evolved from duplication events. Whatever the treatment and the fungal species, the pattern of expression of hydrophobins followed a reciprocal function, with one gene much more expressed than others from the same repertoire. These most-expressed hydrophobin genes were also among the most expressed of the whole genome, which suggests that they play a role as structural proteins. The fine-tuning of the expression of hydrophobin genes in each condition appeared complex because it differed considerably between species, in a way that could not be explained by simple ecological traits. Hydrophobin gene regulation in mycorrhizal tissue as compared with free-living mycelium, however, was significantly associated with a calculated high exposure of hydrophilic residues.

Infrared refractive index dispersion of polymethyl methacrylate spheres from Mie ripples in Fourier-transform infrared microscopy extinction spectra

We performed high-resolution Fourier-transform infrared (FTIR) spectroscopy of a polymethyl methacrylate (PMMA) sphere of unknown size in the Mie scattering region. Apart from a slow, oscillatory structure (wiggles), which is due to an interference effect, the measured FTIR extinction spectrum exhibits a ripple structure, which is due to electromagnetic resonances. We fully characterize the underlying electromagnetic mode structure of the spectrum by assigning mode numbers to each of the ripples in the measured spectrum. We show that analyzing the ripple structure in the spectrum in the wavenumber region from about 3000  cm^-1 to 8000  cm^-1 allows us to determine both the unknown radius of the sphere and the PMMA index of refraction, which shows a strong frequency dependence in this infrared spectral region. While in this paper we focus on examining a PMMA sphere as an example, our method of determining the refractive index and its dispersion from infrared extinction spectra is generally applicable for the determination of the index of refraction of any transparent substance that can be shaped into micron-sized spheres.

Physiological and Structural Differences Between Enterococcus faecalis JH2-2 and Mutant Strains Resistant to (P)-Divercin RV41

The aim of this study was to show the differences that could exist at the physiological and structural levels between Enterococcus faecalis JH2-2 (wild type) and three mutant strains resistant to divercin RV41. These mutant strains were recently isolated and characterized for their intermediate resistance to recombinant DvnRV41; a subclass IIa bacteriocin produced by Escherichia coli. These mutant strains were named 35A1 (altered in gene coding phosphoesterase activity), 35H1 (altered in gene coding σ(54) factor) and 36H4 (altered in gene coding glycerophosphodiesterase). The growth and resistance of each strain were tested against lysozyme. The inhibitory substance did not show any cross-resistance but exhibited an additive effect ascribed to the combined action of lysozyme and (P)-DvnRV41. The use of Fourier transform infrared spectroscopy (FT-IR) allowed to unravelling differences at the structural levels between the aforementioned strains. Thus, mutants 35H1 and 36H4 showed clear differences from mutant 35A1 and wild-type strain. These differences were located, mainly in the fatty acid region and in the polysaccharide composition. This study contributes to understanding more the resistance/sensitivity of Ent. faecalis to (P)-DvnRV41, a subclass IIa bacteriocin.

The relationship between fatty acid profiles in milk identified by Fourier transform infrared spectroscopy and onset of luteal activity in Norwegian dairy cattle

To investigate the feasibility of milk fatty acids as predictors of onset of luteal activity (OLA), 87 lactations taken from 73 healthy Norwegian Red cattle were surveyed over 2 winter housing seasons. The feasibility of using frozen milk samples for dry-film Fourier transform infrared (FTIR) determination of milk samples was also tested. Morning milk samples were collected thrice weekly (Monday, Wednesday, Friday) for the first 10 wk in milk (WIM). These samples had bronopol (2-bromo-2-nitropropane-1,3-diol) added to them before being frozen at -20°C, thawed, and analyzed by ELISA to determine progesterone concentration and the concentrations of the milk fatty acids C4:0, C14:0, C16:0, C18:0, and cis-9 C18:1 as a proportion of total milk fatty acid content using dry-film FTIR, and averaged by WIM. Onset of luteal activity was defined as the first day that milk progesterone concentrations were >3 ng/mL for 2 successive measurements; the study population was categorized as early (n=47) or late (n=40) OLA, using the median value of 21 DIM as the cutoff. Further milk samples were collected 6 times weekly, from morning and afternoon milkings, these were pooled by WIM, and one proportional sample was analyzed fresh for fat, protein, and lactose content by the dairy company Tine SA, using traditional FTIR spectrography in the wet phase of milk. Daily energy-balance calculations were performed in 42 lactations and averaged by WIM. Animals experiencing late OLA had a more negative energy balance in WIM 1, 3, 4, and 5, with the greatest differences been seen in WIM 3 and 4. A higher proportion of the fatty acids were medium chained, C14:0 and C16:0, in the early than in the late OLA group from WIM 1. In WIM 4, the proportion of total fatty acid content that was C16:0 predicted late OLA, with 74% sensitivity and 80% specificity. The long-chain proportion of the fatty acids C18:0 and cis-9 C18:1 were lower in the early than in the late OLA group. Differences were greatest in WIM 4 and 5. Differences in concentrations of cis-9 C18:1 were seen between the groups from WIM 1. No relationship was seen between OLA and milk concentrations of either protein or fat, or between OLA and the milk fat:protein ratio. The differences in milk fatty acid proportions between the 2 groups are most likely related to differences in energy balance. The study shows that frozen milk samples can be tested for fatty acids by FTIR spectroscopy and that FTIR spectroscopy of milk can be used to provide real-time information about cow reproductive function.

Recovery of absorbance spectra of micrometer-sized biological and inanimate particles

In this paper, we first provide an overview of the Mie type scattering at absorbing materials and existing correction methods, followed by a new method to obtain the pure absorbance spectra of biological systems with spherical symmetry. This method is a further development of the recently described iterative algorithm of van Dijk et al. The method is tested on FTIR synchrotron spectra of polymethyl methacrylate (PMMA) microspheres and pollen grains with approximately spherical shape. The imaginary part of the refractive index was successfully recovered for both systems. Good agreement was obtained between the pure absorbance spectra obtained by this method and the measured spectra.

Fish oil supplementation induces expression of genes related to cell cycle, endoplasmic reticulum stress and apoptosis in peripheral blood mononuclear cells: a transcriptomic approach

BACKGROUND

Fish oil supplementation has been shown to alter gene expression of mononuclear cells both in vitro and in vivo. However, little is known about the total transcriptome profile in healthy subjects after intake of fish oil. We therefore investigated the gene expression profile in peripheral blood mononuclear cells (PBMCs) after intake of fish oil for 7 weeks using transcriptome analyses.

DESIGN

In a 7-week, double-blinded, randomized, controlled, parallel-group study, healthy subjects received 8 g day(-1) fish oil (1.6 g day(-1) eicosapentaenoic acid + docosahexaenoic acid) (n = 17) or 8 g day(-1) high oleic sunflower oil (n = 19). Microarray analyses of RNA isolated from PBMCs were performed at baseline and after 7 weeks of intervention.

RESULTS

Cell cycle, DNA packaging and chromosome organization are biological processes found to be upregulated after intake of fish oil compared to high oleic sunflower oil using a moderated t-test. In addition, gene set enrichment analysis identified several enriched gene sets after intake of fish oil. The genes contributing to the significantly different gene sets in the subjects given fish oil compared with the control group are involved in cell cycle, endoplasmic reticulum (ER) stress and apoptosis. Gene transcripts with common motifs for 35 known transcription factors including E2F, TP53 and ATF4 were upregulated after intake of fish oil.

CONCLUSION

We have shown that intake of fish oil for 7 weeks modulates gene expression in PBMCs of healthy subjects. The increased expression of genes related to cell cycle, ER stress and apoptosis suggests that intake of fish oil may modulate basic cellular processes involved in normal cellular function.

[Recurrence after hernia surgery: complication or natural course?]

Recurrence after hernia surgery remains a relevant measure of surgical quality. In order to correctly assess the recurrence rate the surgeon needs to distinguish clinical relevant recurrence, clinically irrelevant recurrence and pseudo-recurrence. Current surgical techniques for inguinal hernia repair using mesh are associated with a low rate of recurrence. Thus, recurrence after inguinal hernia surgery is seen as a surgical complication. Conversely, the recurrence rate for large incisional hernias remains above 10 % and in rare cases a recurrence might represent the natural course. Recurrent hernia can depend on the indication, choice of operation and surgical technique. Therefore, postoperative hernia recurrence probably does not represent the natural course but rather a surgical complication that needs to be prevented by an optimized surgical technique.

Genetic and environmental information in goat milk Fourier transform infrared spectra

Fourier transform infrared (FTIR) spectroscopy is often used in prediction of major milk components in genetic evaluation of dairy animals. Until now genetic variability of goat milk FTIR spectra has only been known indirectly through their contribution to the major milk components. In this study, genetic and environmental components of goat milk FTIR spectra were examined directly. A data set containing 83,858 milk FTIR spectral observations belonging to 29,320 Norwegian dairy goats of 271 herds was used for the study. Principal components analysis was applied on both unprocessed and preprocessed spectral data, and new traits (latent traits) were defined because a multitrait analysis of all spectral variables for variance components could not be done. Eight and 7 latent variables, explaining approximately 99% of the total unprocessed and preprocessed spectral variation, respectively, were kept from the principal components analysis for genetic analysis. Genetic and environmental variance components were estimated for the latent traits using restricted maximum likelihood. Genetic-to-total phenotypic variance ratios (heritabilities) of the latent traits were between 0.011 and 0.285 for the unprocessed spectra and between 0.135 and 0.262 for the preprocessed spectra. The estimated variance components for the latent traits were back transformed to the spectral variables. Heritabilities of these spectral variables ranged from 0.018 to 0.408 and variance ratios of the permanent environmental effects of goats were between 0.002 and 0.184 of the phenotypic spectral variation. High-to-moderate heritabilities were observed in particular in spectral regions related to major milk components (fat, lactose, and protein): between 1,030 and 1,300 cm(-1), 1,500 and 1,600 cm(-1), 1,700 and 1,800 cm(-1), and 2,800 and 3,000 cm(-1). Our results confirmed that a substantial amount of genetic variation exists in goat milk FTIR spectra. Not all spectral variations are of genetic origin; some FTIR regions are highly influenced by herd test-day variation. The study also pointed out the possibility of using FTIR spectra as a monitoring tool in herd management.

Fetal reduction of triplet pregnancy: one or two?

OBJECTIVE

To review outcomes following reductions in trichorionic triplet pregnancies at our institution.

METHOD

Retrospective analysis of the outcome of trichorionic triamniotic triplets reduced to singletons (group I, n = 44) or twins (group II, n = 136) at 10 and 12 weeks of gestation.

RESULTS

Reduction to one or two was based on parent's preference, hence unrelated to any specific obstetrical or maternal issue. Early fetal loss rate (e.g. <24 weeks) was 9.1% in group I versus 5.1% in group II (p = 0.83). In group I, the take-home baby rate was 86.4% versus 91.9% in group II (p = 0.8). In group I, 17.5% of the women gave birth between 33 and 36(+6) weeks of gestation versus 40.6% in group II (p = 0.026). Delivery beyond 37 weeks was 72.5% in group I and 46.9% in group II (p = 0.01). Intrauterine growth restriction rate was 27.0% in group I versus 45.0% in group II (p = 0.049).

CONCLUSION

Reduction to one rather than two fetuses led to significantly higher term delivery rate without significant differences in fetal loss rate or take-home baby rate.

The transcriptome of the arbuscular mycorrhizal fungus Glomus intraradices (DAOM 197198) reveals functional tradeoffs in an obligate symbiont

• The arbuscular mycorrhizal symbiosis is arguably the most ecologically important eukaryotic symbiosis, yet it is poorly understood at the molecular level. To provide novel insights into the molecular basis of symbiosis-associated traits, we report the first genome-wide analysis of the transcriptome from Glomus intraradices DAOM 197198. • We generated a set of 25,906 nonredundant virtual transcripts (NRVTs) transcribed in germinated spores, extraradical mycelium and symbiotic roots using Sanger and 454 sequencing. NRVTs were used to construct an oligoarray for investigating gene expression. • We identified transcripts coding for the meiotic recombination machinery, as well as meiosis-specific proteins, suggesting that the lack of a known sexual cycle in G. intraradices is not a result of major deletions of genes essential for sexual reproduction and meiosis. Induced expression of genes encoding membrane transporters and small secreted proteins in intraradical mycelium, together with the lack of expression of hydrolytic enzymes acting on plant cell wall polysaccharides, are all features of G. intraradices that are shared with ectomycorrhizal symbionts and obligate biotrophic pathogens. • Our results illuminate the genetic basis of symbiosis-related traits of the most ancient lineage of plant biotrophs, advancing future research on these agriculturally and ecologically important symbionts.

[Fetoscopic laser coagulation in 100 consecutive monochorionic pregnancies with severe twin-to-twin transfusion syndrome]

OBJECTIVES

To report pre- and post-surgical datas of large series of severe twin-to-twin transfusion syndrome (TTTS) managed with laser ablation surgery in our centre, to evaluate the incidence of complications, perinatal outcome and to compare with other cohorts.

PATIENTS AND METHODS

Observational study of 100 cases of TTTS consecutively treated with fetoscopic laser coagulation between January 2004 and April 2010 in CMCO-SIHCUS of Schiltigheim.

RESULTS

There are nine stage I, 49 stage II, 38 stage III and four stage 4. Median gestation at time of laser is 20.6 weeks (14-29) whereas median gestation at delivery is 32.6 weeks (16.3-39). Overall perinatal survival rate is 68.5% (137 children over 200). Eighty-five percent have one or more surviving twins. The survival rate is the same for donors and for recipients. Preterm premature rupture of the membranes are observed in 17% of cases and the median gestational age for this complication is 30 weeks (20-34). Cerebral abnormalities are present in 7% of newborns.

CONCLUSION

Our results for the management of severe TTTS are comparable to the other reported series. There are still many questions remaining concerning the optimal management of TTTS.

Deep RNA sequencing improved the structural annotation of the Tuber melanosporum transcriptome

• The functional complexity of the Tuber melanosporum transcriptome has not yet been fully elucidated. Here, we applied high-throughput Illumina RNA-sequencing (RNA-Seq) to the transcriptome of T. melanosporum at different major developmental stages, that is free-living mycelium, fruiting body and ectomycorrhiza. • Sequencing of cDNA libraries generated a total of c. 24 million sequence reads representing > 882 Mb of sequence data. To construct a coverage signal profile across the genome, all reads were then aligned to the reference genome assembly of T. melanosporum Mel28. • We were able to identify a substantial number of novel transcripts, antisense transcripts, new exons, untranslated regions (UTRs), alternative upstream initiation codons and upstream open reading frames. • This RNA-Seq analysis allowed us to improve the genome annotation. It also provided us with a genome-wide view of the transcriptional and post-transcriptional mechanisms generating an increased number of transcript isoforms during major developmental transitions in T. melanosporum.

Genomic profiling of carbohydrate metabolism in the ectomycorrhizal fungus Tuber melanosporum

• Primary carbohydrate metabolism plays a special role related to carbon/nitrogen exchange, as well as metabolic support of fruiting body development, in ectomycorrhizal macrofungi. In this study, we used information retrieved from the recently sequenced Tuber melanosporum genome, together with transcriptome analysis data and targeted validation experiments, to construct the first genome-wide catalogue of the proteins supporting carbohydrate metabolism in a plant-symbiotic ascomycete. • More than 100 genes coding for enzymes of the glycolysis, pentose phosphate, tricarboxylic acid, glyoxylate and methylcitrate pathways, glycogen, trehalose and mannitol metabolism and cell wall precursor were annotated. Transcriptional regulation of these pathways in different stages of the T. melanosporum lifecycle was investigated using whole-genome oligoarray expression data together with real-time reverse transcription-polymerase chain reaction analysis of selected genes. • The most significant results were the identification of methylcitrate cycle genes and of an acid invertase, the first enzyme of this kind to be described in a plant-symbiotic filamentous fungus. • A subset of transcripts coding for trehalose, glyoxylate and methylcitrate enzymes was up-regulated in fruiting bodies, whereas genes involved in mannitol and glycogen metabolism were preferentially expressed in mycelia and ectomycorrhizas, respectively. These data indicate a high degree of lifecycle stage specialization for particular branches of carbohydrate metabolism in T. melanosporum.

Effect of poplar genotypes on mycorrhizal infection and secreted enzyme activities in mycorrhizal and non-mycorrhizal roots

The impact of ectomycorrhiza formation on the secretion of exoenzymes by the host plant and the symbiont is unknown. Thirty-eight F(1) individuals from an interspecific Populus deltoides (Bartr.)×Populus trichocarpa (Torr. & A. Gray) controlled cross were inoculated with the ectomycorrhizal fungus Laccaria bicolor. The colonization of poplar roots by L. bicolor dramatically modified their ability to secrete enzymes involved in organic matter breakdown or organic phosphorus mobilization, such as N-acetylglucosaminidase, β-glucuronidase, cellobiohydrolase, β-glucosidase, β-xylosidase, laccase, and acid phosphatase. The expression of genes coding for laccase, N-acetylglucosaminidase, and acid phosphatase was studied in mycorrhizal and non-mycorrhizal root tips. Depending on the genes, their expression was regulated upon symbiosis development. Moreover, it appears that poplar laccases or phosphatases contribute poorly to ectomycorrhiza metabolic activity. Enzymes secreted by poplar roots were added to or substituted by enzymes secreted by L. bicolor. The enzymatic activities expressed in mycorrhizal roots differed significantly between the two parents, while it did not differ in non-mycorrhizal roots. Significant differences were found between poplar genotypes for all enzymatic activities measured on ectomycorrhizas except for laccases activity. In contrast, no significant differences were found between poplar genotypes for enzymatic activities of non-mycorrhizal root tips except for acid phosphatase activity. The level of enzymes secreted by the ectomycorrhizal root tips is under the genetic control of the host. Moreover, poplar heterosis was expressed through the enzymatic activities of the fungal partner.

[First trimester screening for Down syndrome: five years prospective experience]

First trimester screening for Down syndrome is yet to become the first intention strategy in France. This screening program at 11-14 weeks of gestation using maternal age, fetal nuchal translucency, maternal serum free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A has already been validated for a long time by many international studies. It seems to improve detection rate and decrease false positive rates. We report here five years prospective experience.

[Experience with an automated dispensing system in department of pharmacy]

Nominative drug dispensation significantly reduces the incidence of medication errors. Computerized automated unit dose drug distribution system could be a safest hospital drug distribution system and allows an improvement of drug distribution in clinical ward. In 2005, at the Vinatier Hospital, an automated ward dispensing device was acquired. This report describes the implementation of this system and the experience of the pharmacy department. The implementation of an automated unit dose system includes expanding computerized order entry system, physicians' training and nurses to use the software, pharmaceutic staff's training to use the new dispensing system and setting under quality assurance the dispensation process.

Clinical and placental characteristics in four new cases of twin anemia-polycythemia sequence

We report and analyze four new cases of spontaneous twin anemia-polycythemia sequence (TAPS) and discuss antenatal management by fetoscopic laser coagulation for this uncommon form of chronic intertwin transfusion. The clinical course and placental characteristics of four pairs of monochorionic-diamniotic (MCDA) twins with spontaneous TAPS, of which one was treated with fetoscopic laser surgery, are described. For the three cases that did not undergo intrauterine intervention, serial Doppler measurement revealed a gradual increase in the middle cerebral artery peak systolic velocity (MCA-PSV) in the donor and a concomitant decrease in the recipient. These twins were born at between 32 and 34 weeks' gestation by Cesarean section. At birth, the donor twins were severely anemic and the recipient twins were polycythemic. Placental injection studies revealed a few small arteriovenous (AV) and venoarterial anastomoses. In the fourth case, because of the high suspicion of TAPS on MCA-PSV data at 24 weeks' gestation, fetoscopic laser coagulation of three small AV anastomoses was successfully performed. No hematological abnormalities were detected at birth. TAPS is a newly described form of chronic twin-to-twin transfusion associated with chronic anemia in the donor and polycythemia in the recipient, without twin oligo-polyhydramnios sequence (TOPS). The monitoring of MCDA pregnancies should include measurement of MCA-PSV in both fetuses even in the absence of intertwin discordance in amniotic fluid volume. Early detection of TAPS could indicate fetoscopic laser coagulation of AV anastomoses.

Nuchal translucency and cystic hygroma colli in screening for fetal major congenital heart defects in a series of 12,910 euploid pregnancies

OBJECTIVE

Many studies have shown that an increased nuchal translucency (NT) may be a good marker of fetal heart malformation, but the extent to which NT is suitable for identifying the population at risk remains unclear. We aimed to determine the value of NT measurement and of the presence of cystic hygroma colli in the screening of euploid fetuses for congenital heart defects (CHD).

METHODS

We carried out a retrospective analysis of 12 910 euploid pregnancies examined between January 1995 and August 2007 at our institution. The screening performance of NT measurements in identifying fetuses with CHD was assessed, with comparison between the use of cut-offs defined as absolute values, multiples of the median (MoM) and percentiles. The presence of cystic hygroma colli was also assessed in the prediction of CHD.

RESULTS

The incidence of major CHD was 3.4 per thousand (44/12 910). The sensitivity of NT measurement in screening for major CHD was 54.5% if the threshold was set at the 95(th) percentile, 45.4% if it was set at 3 mm, 27.3% for 3.5 mm, 50.0% for 1.5 MoM and 45.5% for 1.75 MoM. The false-positive rates for these thresholds were 8.4, 6.6, 1.7, 8.9 and 6.3%, respectively. The incidence of major CHD was 1.2% (10/813) in cases of thick NT (> 95(th) centile) and 4.3% (13/304) in cases of hygroma colli.

CONCLUSIONS

NT measurement during the first trimester is potentially useful for screening for fetal major CHD. Screening performance is consistent whether NT values are expressed as MoMs, percentiles or absolute values. The incidence of major CHD seems to be higher in cases of cystic hygroma colli.

Sources, nature, and fate of heavy metal-bearing particles in the sewer system

A preliminary insight into metal cycling within the urban sewer was obtained by determining both the heavy metal concentrations (Cu, Zn, Pb, Cd, Ni, Cr) in sewage and sediments, and the nature of metal-bearing particles using TEM-EDX, SEM-EDX and XRD. Particles collected from tap water, sump-pit deposits, and washbasin siphons, were also examined to trace back the origin of some mineral species. The results show that the total levels in Cu, Pb, Zn, Ni, and Cr in sewage are similar to that reported in the literature, thus suggesting that a time-averaged heavy metal fingerprint of domestic sewage can be defined for most developed cities at the urban catchment scale. Household activities represent the main source of Zn and Pb, the water supply system is a significant source of Cu, and in our case, groundwater infiltration in the sewer system provides a supplementary source of Ni and Cd. Concentrations in heavy metals were much higher in sewer sediments than in sewage suspended solids, the enrichment being due to the preferential settling of metal-bearing particles of high density and/or the precipitation of neoformed mineral phases. TEM and SEM-EDX analyses indicated that suspended solids, biofilms, and sewer sediments contained similar heavy metal-bearing particles including alloys and metal fragments, oxidized metals and sulfides. Copper fragments, metal carbonates (Cu, Zn, Pb), and oxidized soldering materials are released from the erosion of domestic plumbing, whereas the precipitation of sulfides and the sulfurization of metal phases occur primarily within the household connections to the sewer trunk. Close examination of sulfide phases also revealed in most cases a complex growth history recorded in the texture of particles, which likely reflects changes in physicochemical conditions associated with successive resuspension and settling of particles within the sewer system.

Use of Z-scores to select a fetal biometric reference curve

OBJECTIVE

Fetal biometric data are a major part of prenatal ultrasound screening in the general population. The aim of this study was to analyze the effect of choice of reference curve on the quality of screening for growth abnormalities, using a statistical tool based on Z-scores.

METHODS

The biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were measured in 9699 ultrasound scans during the second trimester (20-24 weeks of gestation) and 8100 scans during the third trimester (30-34 weeks of gestation). These biometric data were all transformed retrospectively into Z-scores, calculated using five reference curves: those published by Snijders and Nicolaides (1994), Chitty et al. (1994), Kurmanavicius et al. (1999) and Salomon et al. (2006), and curves used at our ultrasound unit generated from a sample of the local population. The Z-score distribution was compared with the expected normal distribution by calculation of the mean and SD, and using the Kolmogorov-Smirnov test. The sensitivity and specificity of each reference curve were calculated to determine the capacity of these curves to identify fetuses with measurements < 5(th) percentile or > 95(th) percentile for each parameter.

RESULTS

Most of the distribution curves determined from the Z-scores of the measurements taken differed significantly from a non-skewed standard normal curve (mean of 0 and SD of 1). In our population, the Chitty reference curves gave the best results for identifying fetuses with abnormal (< 5(th) percentile or > 95(th) percentile) BPD (sensitivity, 100%; specificity, 97.24%), HC (sensitivity, 96.07%; specificity, 98.89%) and FL (sensitivity, 96.46%; specificity, 98.80%). The best reference for AC was the Salomon curve (sensitivity, 72.25%; specificity, 99.64%).

CONCLUSIONS

Checking for good concordance between the study population and chosen reference data is a key initial step in quality control. Z-scores are a simple tool for evaluating the performance of each reference curve for a given population in order to optimize the sensitivity and specificity of screening for fetal growth abnormalities.

Reducing inter-replicate variation in fourier transform infrared spectroscopy by extended multiplicative signal correction

Fourier transform infrared (FT-IR) spectroscopy is a powerful tool for characterizing biological tissues and organisms, but it is plagued by replicate variation of various sources. Here, a method for estimating and correcting unwanted replicate variation in multivariate measurement signals, based on extended multiplicative signal correction (EMSC), is presented. Systematic patterns of unwanted methodological variations are estimated from replicate spectra, modeled by a linear subspace model, and implemented into EMSC. The method is applied to FT-IR spectra of two different sets of microorganisms (different double gene knockout strains of Saccharomyces cerevisiae and different species of Listeria) and compared to other preprocessing methods used in FT-IR absorption spectroscopy of microorganisms. The EMSC replicate correction turns out to perform best among the compared methods.

Phylogenetic analysis, genomic organization, and expression analysis of multi-copper oxidases in the ectomycorrhizal basidiomycete Laccaria bicolor

In forest soils, ectomycorrhizal and saprotrophic Agaricales differ in their strategies for carbon acquisition, but share common gene families encoding multi-copper oxidases (MCOs). These enzymes are involved in the oxidation of a variety of soil organic compounds. The MCO gene family of the ectomycorrhizal fungus Laccaria bicolor is composed of 11 genes divided into two distinct subfamilies corresponding to laccases (lcc) sensu stricto (lcc1 to lcc9), sharing a high sequence homology with the coprophilic Coprinopsis cinerea laccase genes, and to ferroxidases (lcc10 and lcc11) that are not present in C. cinerea. The fet3-like ferroxidase genes lcc10 and lcc11 in L. bicolor are each arranged in a mirrored tandem orientation with an ftr gene coding for an iron permease. Unlike C. cinerea, L. bicolor has no sid1/sidA gene for siderophore biosynthesis. Transcript profiling using whole-genome expression arrays and quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) revealed that some transcripts were very abundant in ectomycorrhizas (lcc3 and lcc8), in fruiting bodies (lcc7) or in the free-living mycelium grown on agar medium (lcc9 and lcc10), suggesting a specific function of these MCOs. The amino acid composition of the MCO substrate binding sites suggests that L. bicolor MCOs interact with substrates different from those of saprotrophic fungi.

A spatio-temporal interaction on the apparent motion trace

During the perception of apparent motion, activity along the apparent motion trace has been found in the primary visual cortex. It has been hypothesized that this activity interferes with stimuli presented on the apparent motion trace ("motion masking"). We investigated whether this perceptual interference varies with regard to the trajectory of a moving object token in a detection task. We found a general decrease of detectability of targets presented on the trace. Surprisingly, targets presented in time with the trajectory were detected significantly more often than targets which appeared out of time. We relate this finding to a spatio-temporally specific prediction of visual events along the apparent motion trace.

Estimating and correcting mie scattering in synchrotron-based microscopic fourier transform infrared spectra by extended multiplicative signal correction

We present an approach for estimating and correcting Mie scattering occurring in infrared spectra of single cells, at diffraction limited probe size, as in synchrotron based microscopy. The Mie scattering is modeled by extended multiplicative signal correction (EMSC) and subtracted from the vibrational absorption. Because the Mie scattering depends non-linearly on alpha, the product of the radius and the refractive index of the medium/sphere causing it, a new method was developed for estimating the Mie scattering by EMSC for unknown radius and refractive index of the Mie scatterer. The theoretically expected Mie contributions for a range of different alpha values were computed according to the formulae developed by Van de Hulst (1957). The many simulated spectra were then summarized by a six-dimensional subspace model by principal component analysis (PCA). This subspace model was used in EMSC to estimate and correct for Mie scattering, as well as other additive and multiplicative interference effects. The approach was applied to a set of Fourier transform infrared (FT-IR) absorbance spectra measured for individual lung cancer cells in order to remove unwanted interferences and to estimate ranges of important alpha values for each spectrum. The results indicate that several cell components may contribute to the Mie scattering.