Generation of a novel three-dimensional scaffold-based model of the bovine endometrium

Bovine in vitro endometrial models that resemble tissue function in vivo are needed to study infertility, long-term uterine alterations induced by pathogens and impact of endocrine disruptor chemicals on reproductive function and other reproductive system complications that cause high economic losses in livestock species. The present study aimed to generate an innovative, reproducible, and functional 3D scaffold-based model of the bovine endometrium structurally robust for long term-culture. We developed a multicellular model containing both endometrial epithelial and stromal cells. Epithelial cells organized to form a luminal-like epithelial layer on the surface of the scaffold. Stromal cells produced their own extracellular matrix forming a stable subepithelial compartment that physiologically resembles the normal endometrium. Both cell types released prostaglandin E2 and prostaglandin F2α following a treatment with oxytocin and arachidonic acid. Additionally signal pathways mediating oxytocin and arachidonic acid stimulation of prostaglandin synthesis were analyzed by real time PCR (RT-PCR). Oxytocin receptor (OXTR), prostaglandin E2 receptor 2 (EP2), prostaglandin E2 receptor 4 (EP4), prostaglandin F receptor (PTGFR), prostaglandin E synthase (PTGES), PGF-synthase (PGFS) and prostaglandin-endoperoxide synthase 2 (COX-2) expression was detected in both control and treatment groups, however, only significant changes in abundance of OXTR mRNA transcripts were found. The results obtained by this study are a step forward in bovine in vitro culture technology. This 3D scaffold-based model provides a platform to study regulatory mechanisms involved in endometrial physiology and can set the basis for a broader tool for designing and testing novel therapeutic strategies for recurrent uterine pathologies.

Trypanosoma cruzi Secreted Cyclophilin TcCyP19 as an Early Marker for Trypanocidal Treatment Efficiency

Cyclophilins (CyPs) are a family of enzymes involved in protein folding. Trypanosoma cruzi, the causative agent of Chagas disease, has a 19-kDa cyclophilin, TcCyP19, that was found to be secreted in parasite stages of the CL Brener clone and recognized by sera from T. cruzi-infected mice and patients. The levels of specific antibodies against TcCyP19 in T. cruzi-infected mice and subjects before and after drug treatment were measured by an in-house enzyme linked immunosorbent assay (ELISA). Mice in the acute and chronic phase of infection, with successful trypanocidal treatments, showed significantly lower anti-TcCyP19 antibody levels than untreated mice. In children and adults chronically infected with T. cruzi, a significant decrease in the anti-TcCyP19 titers was observed after 12 months of etiological treatment. This decrease was maintained in adult chronic patients followed-up 30-38 months post-treatment. These results encourage further studies on TcCyP19 as an early biomarker of trypanocidal treatment efficiency.

Midbrain and pons MRI shape analysis and its clinical and CSF correlates in degenerative parkinsonisms: a pilot study

OBJECTIVES

To conduct brainstem MRI shape analysis across neurodegenerative parkinsonisms and control subjects (CS), along with its association with clinical and cerebrospinal fluid (CSF) correlates.

METHODOLOGY

We collected demographic and clinical variables, performed planimetric and shape MRI analyses, and determined CSF neurofilament-light chain (NfL) levels in 84 participants: 11 CS, 12 with Parkinson's disease (PD), 26 with multiple system atrophy (MSA), 21 with progressive supranuclear palsy (PSP), and 14 with corticobasal degeneration (CBD).

RESULTS

MSA featured the most extensive and significant brainstem shape narrowing (that is, atrophy), mostly in the pons. CBD presented local atrophy in several small areas in the pons and midbrain compared to PD and CS. PSP presented local atrophy in small areas in the posterior and upper midbrain as well as the rostral pons compared to MSA. Our findings of planimetric MRI measurements and CSF NfL levels replicated those from previous literature. Brainstem shape atrophy correlated with worse motor state in all parkinsonisms and with higher NfL levels in MSA, PSP, and PD.

CONCLUSION

Atypical parkinsonisms present different brainstem shape patterns which correlate with clinical severity and neuronal degeneration. In MSA, shape analysis could be further explored as a potential diagnostic biomarker. By contrast, shape analysis appears to have a rather limited discriminant value in PSP.

KEY POINTS

• Atypical parkinsonisms present different brainstem shape patterns. • Shape patterns correlate with clinical severity and neuronal degeneration. • In MSA, shape analysis could be further explored as a potential diagnostic biomarker.

Expression of Inhibitory Receptors TIGIT, TIM-3, and LAG-3 on CD4+ T Cells from Patients with Different Clinical Forms of Chronic Chagas Disease

T cells are central to the adaptive immune response against Trypanosoma cruzi infection. In chronic Chagas disease (CCD), circulating parasite-specific memory T cells show reduced functionality and increased expression of inhibitory receptors as a result of persistent antigenic stimulation. This phenotype has been linked to progression of cardiac pathology, whereas the presence of polyfunctional T cells shows association with therapeutic success. In this study, we demonstrate that T. cruzi-specific human CD4+ T cells can be identified by their expression of OX40 and CD25 upon in vitro stimulation. We characterized the expression of the inhibitory receptors T cell immunoreceptor with Ig and ITIM domains (TIGIT), T cell Ig and mucin-domain containing-3 (TIM-3), and lymphocyte activation gene 3 (LAG-3) in CD4+ T cells from CCD patients with and without cardiac alterations. Our results show that, independently of their clinical stage, CCD patients present an increased frequency of CD4+ T cells expressing TIGIT in comparison with non-T. cruzi-infected donors. Exposure to parasite Ags increases the expression of TIM-3 in CD4+ T cells from CCD patients, especially in those with cardiac compromise. Upregulation of LAG-3 was also detected in CCD individuals without cardiac manifestations, predominantly within the subpopulation of cells that did not become activated upon stimulation. Further differences were found between groups in the coexpression of these receptors. Blockade of each individual receptor did not affect activation or the production of IFN-γ and IL-10 by CD4+ T cells in response to parasite Ags. Our results suggest a role for TIGIT, TIM-3, and LAG-3 in the modulation of inflammatory phenomena thought to ultimately lead to tissue damage and cardiac pathology.

Activation-induced marker assays for identification of Trypanosoma cruzi-specific CD4 or CD8 T cells in chronic Chagas disease patients

Antigen-specific T cells are central to the adaptive immune response against T. cruzi infection and underpin the efficacy of on-going vaccine strategies. In this context, the present study focuses on T-cell assays that define the parasite-specificity on the basis of upregulation of TCR stimulation-induced surface markers. For this purpose, we tested different dual marker combinations (OX40, CD25, CD40L, CD137, CD69, PD-L1, CD11a, CD49d, HLA-DR, CD38) to reliably identify activated CD4⁺ and CD8⁺ T-cell populations from PBMCs of chronic Chagas disease (CCD) patients after 12 or 24 h of stimulation with T. cruzi lysate. Results demonstrated that activation-induced markers (AIM) assays combining the expression of OX40, CD25, CD40L, CD137, CD69 and/or PD-L1 surface markers are efficient at detecting T. cruzi-specific CD4⁺ T cells in CCD patients, in comparison to non-infected donors, after both stimulation times. For CD8⁺ T cells, only PD-L1/OX40 after 24 h of antigen exposure resulted to be useful to track a parasite-specific response. We also demonstrated that the agnostic activation is mediated by different T. cruzi strains, such as Dm28c, CL Brener or Sylvio. Additionally, we successfully used this approach to identify the phenotype of activated T lymphocytes based on the expression of CD45RA and CCR7. Overall, our results show that different combinations of AIM markers represent an effective and simple tool for the detection of T. cruzi-specific CD4⁺ and CD8⁺ T cells.

Recalculating the staff required to run a modern assisted reproductive technology laboratory

STUDY QUESTION

What number of staff is sufficient to perform increasingly complicated processes in today's modern ART laboratories?

SUMMARY ANSWER

The adequate number of personnel required for the efficient and safe operation of modern ART laboratories needs to be calculated.

WHAT IS KNOWN ALREADY

In today's modern ART laboratories, the amount of time required to perform increasingly complicated processes has more than doubled, with a downward trend in the amount of work an embryologist can do. Different workload unit values have been used to evaluate each workload task and efficiency in a particular ART laboratory, as well as to occasionally compare one laboratory with another.

STUDY DESIGN, SIZE, DURATION

Seven senior embryologists working at different IVF centers, three public and four private centers, participated in this multicenter study conducted between 2019 and 2020. We prepared a survey to create a calculator for staff using the average (of three attempts) time spent in every laboratory by each embryologist of the center to perform any ART process.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Different laboratory processes and activities related to quality control, time spent and conventional human double witnessing were included in the survey. To calculate the number of processes that each embryologist can perform per year, an embryologist was considered to be having a full-time contract and working 7 or 8 h/day. The times included in the calculation of each task were those corresponding to the 95th percentile. For the calculations, Microsoft® Office Excel® Professional Plus 2019 was used.

MAIN RESULTS AND THE ROLE OF CHANCE

The survey showed that the time needed per embryologist to perform the different processes necessary for a classic IVF cycle without time lapse (TL) was 8.11 h, and with TL, it was 10.27 h. The calculated time also considered the time spent in documentation handling, cycle preparation, database management and conventional human double witnessing verification. An ICSI without TL needed 8.55 h, and with TL, it needed 10.71 h. An ICSI-PGT without a TL cycle needed 11.75 h, and with TL, it needed 13.91 h. Furthermore, 1.81 h should be added for every vitrification support needed. The time needed to control more than 200 critical steps, including equipment control and culture parameters, was 30 min per day plus 3.9 min per device to control.The time spent in semen analysis (including documentation handling, cycle preparation and database management) or intrauterine insemination with a partner sperm was 2.7 h. For donor sperm, an additional hour was required for the management involved. The time required to perform a testicular biopsy and cryopreserve the sample was 4 h. Similarly, the time required to perform seminal cryopreservation was 3.7 h.

LIMITATIONS, REASONS FOR CAUTION

The study was conducted considering a full-time contract embryologist working 7 or 8 h/day, 5 days a week, with days off according to the Spanish regulations. However, our findings can be adapted to foreign regulations using the developed online calculation platform.

WIDER IMPLICATIONS OF THE FINDINGS

A new advanced staff calculator allows any IVF laboratory to estimate the minimum number of embryologists necessary without compromising the security or success of the results. Nevertheless, we recommend a minimum of two qualified embryologists in every laboratory, regardless of the workload.

STUDY FUNDING/COMPETING INTEREST(S)

This work was funded by the Asociación para el Estudio de la Biología de la Reproducción (ASEBIR). None of the authors has any conflict of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Loop-Mediated Isothermal Amplification of Trypanosoma cruzi DNA for Point-of-Care Follow-Up of Anti-Parasitic Treatment of Chagas Disease

A loop-mediated isothermal amplification assay was evaluated as a surrogate marker of treatment failure in Chagas disease (CD). A convenience series of 18 acute or reactivated CD patients who received anti-parasitic treatment with benznidazole was selected-namely, nine orally infected patients: three people living with HIV and CD reactivation, five chronic CD recipients with reactivation after organ transplantation and one seronegative recipient of a kidney and liver transplant from a CD donor. Fifty-four archival samples (venous blood treated with EDTA or guanidinium hydrochloride-EDTA buffer and cerebrospinal fluid) were extracted using a Spin-column manual kit and tested by T. cruzi Loopamp kit (Tc-LAMP, index test) and standardized real-time PCR (qPCR, comparator test). Of them, 23 samples were also extracted using a novel repurposed 3D printer designed for point-of-care DNA extraction (PrintrLab). The agreement between methods was estimated by Cohen's kappa index and Bland-Altman plot analysis. The T. cruzi Loopamp kit was as sensitive as qPCR for detecting parasite DNA in samples with parasite loads higher than 0.5 parasite equivalents/mL and infected with different discrete typing units. The agreement between qPCR and Tc-LAMP (Spin-column) or Tc-LAMP (PrintrLab) was excellent, with a mean difference of 0.02 [CI = -0.58-0.62] and -0.04 [CI = -0.45-0.37] and a Cohen's kappa coefficient of 0.78 [CI = 0.60-0.96] and 0.90 [CI = 0.71 to 1.00], respectively. These findings encourage prospective field studies to validate the use of LAMP as a surrogate marker of treatment failure in CD.

IgE antibodies against Trypanosoma cruzi arginine kinase in patients with chronic Chagas disease

Arginine kinase (AK) is an enzyme present in various invertebrates, as well as in some trypanosomatids such as T. cruzi, the etiological agent that causes Chagas disease. In invertebrates, this protein acts as an allergen inducing an IgE-type humoral immune response. Since AK is a highly conserved protein, we decided to study whether patients with chronic Chagas disease (CCD) produce specific antibodies against T. cruzi AK (TcAK). Plasma from patients with CCD, with and without cardiac alterations and non-infected individuals were evaluated for the presence of anti-TcAK IgG and IgE antibodies by ELISA, including detection of specific IgG subclasses. Our results showed that the levels of specific anti-TcAK IgG and IgE were different between infected and non-infected individuals, but comparable between those with different clinical manifestations. Interestingly, anti-TcAK IgG4 antibodies associated with IgE-mediated allergenic processes were also increased in CCD patients. Finally, we found that several of the predicted B cell epitopes in TcAK matched allergenic peptides previously described for its homologues in other organisms. Our results revealed for the first time a parasite's specific IgE antibody target and suggest that TcAK could contribute to delineate an inefficient B cell response by prompting a bias towards a Th2 profile. These findings also shed light on a potential allergenic response in the context of T. cruzi infection.

Trypanosoma cruzi Induces Regulatory B Cell Alterations in Patients With Chronic Chagas Disease

The clinical evolution of patients with chronic Chagas disease (CCD) is mainly associated with an excessive inflammation and a defective immunomodulatory profile caused by the interaction between T. cruzi and the host. Regulatory B (Breg) cells exert immune suppression mostly through IL-10 production (B10 cells), but also through IL-10-independent mechanisms. Previously, we demonstrated that CCD patients with cardiomyopathy show changes in the ex vivo Breg cell phenotypic distribution although maintain IL-10 production capacity. Here, we sought to identify potential alterations on Breg cells upon in vitro stimulation. Isolated B cells from CCD patients with or without cardiomyopathy and non-infected (NI) donors were stimulated with T. cruzi lysate or CpG + CD40L, and characterized by flow cytometry based on the expression of CD24, CD27, CD38, and the regulatory molecules IL-10 and PD-L1. IL-10 and IL-17 secretion in the supernatant of B cells was evaluated by ELISA. Data showed that T. cruzi stimulation diminished the expression of CD24 and CD38 on CD27- B cells while reducing the percentage of CD24high inside CD27+ B cells. Furthermore, T. cruzi induced a regulatory B cell phenotype by increasing B10 cells and IL-10 secretion in all the groups. The innate-like B10 cells expansion observed in patients with cardiomyopathy would be associated with CD27- B10 cell subsets, while no predominant phenotype was found in the other groups. Patients with cardiomyopathy also displayed higher IL-17 secretion levels in T. cruzi-activated B cells. CpG + CD40L stimulation revealed that B cells from CCD patients and NI donors had the same ability to differentiate into B10 cells and secrete IL-10 in vitro. Additionally, CCD patients showed an increased frequency of CD24-CD27- B cells and a reduction in the percentage of CD24highCD27+ Breg cells, which appeared to be inversely correlated with the presence of T. cruzi DNA in blood. Finally, CCD patients exhibited a higher frequency of PD-L1+ B cells in T. cruzi-stimulated samples, suggesting that IL-10-independent mechanisms could also be tangled in the control of inflammation. Altogether, our results provide evidence about the potential role of Breg cells in the immune response developed against T. cruzi and its contribution to chronic Chagas cardiomyopathy.

P–161 Is enough the staff in your lab?

Study question

Must be all the activity made in in vitro fertilization (IVF) laboratories keep in mind to size its staff?

Summary answer

To create a staff calculator based on number of cycles carry on, assisted reproduction techniques, quality controls, administration management, weekend duties, labour regulations and holidays.

What is known already

In a bibliographic search about staff in human reproduction labs there is no mention about de number of embryologists recommended for every cycle done. Only that it will be according to the workload. Other guidelines establish that every embryologist could assume 150 IVF cycles/year. However, here is a downward tendency in the work that an embryologist can assume. Alikani established a maximum of 100 cycles/year for every embryologist (Alikani et al, 2014).

Study design, size, duration

Seven senior embryologists working in different IVF centres, three public and 4 privates, take part lead in this Multicentre study during 2019 and 2020. We made a survey to create a calculator for staff using the mean time spent in every lab by each embryologist of the centre to do any IVF procedure and measured three times each one.

Participants/materials, setting, methods

Different lab procedures and activities related with quality control, time spent to do them, and witnessing were included in the survey. For the calculations it was considered an embryologist with a full-time contract working 1744 hours / year according to current labour agreement in Spain.

The times included in the calculations for each task were those corresponding to the 95th percentile. For the calculation, the program used was Microsoft Office Excel.

Main results and the role of chance

In the IVF laboratory many gametes and embryos from different couples are manipulated daily. The maintenance of traceability could be affected by not having the right staff and lead to dramatic consequences for the patients and the centre.

Workload or overload caused by non-suitable staff number also affects the embryologist having a direct impact on his health.

The results of the survey carried out showed the time needed by embryologist to perform the different procedures necessary for an IVF treatment, being a classic IVF cycle (8.11 hours), also taking into account the time spent in managing documentation, preparing the cycle and databases. An ICSI with Time lapse needs 10.27 hours and an ICSI-PGD cycle 13.91 hours. To all off this, 1.81 hours should be added for every vitrification support needed and the time to control more than 200 critical steps, including equipment control and culture parameters.

The time spent in semen analysis (including managing documentation, cycle preparation and databases) or intrauterine insemination with a partner sperm was 2.7 hours. For donor sperm an additional hour for the management involved is required. The time required to perform and cryopreserve a testicular biopsy and seminal cryopreservation was 4 and 3.7 hours, respectively.

Limitations, reasons for caution

The study was made taking account of Spanish regulations, quality standards and recommendations and should be adapted to the foreigner’s regulations. Wider implications of the findings: New advance staff calculator allows laboratories estimate minimum number of embryologist necessary for a particular public or private laboratory without compromise neither security nor success in their results. Nevertheless, we recommended a minimum of two qualified embryologists in every lab, whatever it was the workload.

Trial registration number

none

On the generation of periodic discrete structures with identical two-point correlation

Strategies for the generation of periodic discrete structures with identical two-point correlation-called 2PC-equivalent-are developed. It is shown that starting from a set of 2PC-equivalent root structures, 2PC-equivalent child structures of arbitrary resolution and number of phases (e.g. material phases) can be generated based on phase extension through trivial embeddings, kernel-based extension and phase coalescence. Proofs are provided by means of discrete Fourier transform theory. A Python 3 implementation is offered for reproduction of examples and future applications.

Trypanosoma cruzi loop-mediated isothermal amplification (Trypanosoma cruzi Loopamp) kit for detection of congenital, acute and Chagas disease reactivation

A Trypanosoma cruzi Loopamp kit was recently developed as a ready-to-use diagnostic method requiring minimal laboratory facilities. We evaluated its diagnostic accuracy for detection of acute Chagas disease (CD) in different epidemiological and clinical scenarios. In this retrospective study, a convenience series of clinical samples (venous blood treated with EDTA or different stabilizer agents, heel-prick blood in filter paper or cerebrospinal fluid samples (CSF)) from 30 infants born to seropositive mothers (13 with congenital CD and 17 noninfected), four recipients of organs from CD donors, six orally-infected cases after consumption of contaminated guava juice and six CD patients coinfected with HIV at risk of CD reactivation (N = 46 patients, 46 blood samples and 1 CSF sample) were tested by T. cruzi Loopamp kit (Tc LAMP) and standardized quantitative real-time PCR (qPCR). T. cruzi Loopamp accuracy was estimated using the case definition in the different groups as a reference. Cohen's kappa coefficient (κ) was applied to measure the agreement between Tc LAMP (index test) and qPCR (reference test). Sensitivity and specificity of T. cruzi Loopamp kit in blood samples from the pooled clinical groups was 93% (95% CI: 77-99) and 100% (95% CI: 80-100) respectively. The agreement between Tc LAMP and qPCR was almost perfect (κ = 0.92, 95% CI: 0.62-1.00). The T. cruzi Loopamp kit was sensitive and specific for detection of T. cruzi infection. It was carried out from DNA extracted from peripheral blood samples (via frozen EDTA blood, guanidine hydrochloride-EDTA blood, DNAgard blood and dried blood spots), as well as in CSF specimens infected with TcI or TcII/V/VI parasite populations. The T. cruzi Loopamp kit appears potentially useful for rapid detection of T. cruzi infection in congenital, acute and CD reactivation due to HIV infection.

Genetic Deletion of Galectin-3 Alters the Temporal Evolution of Macrophage Infiltration and Healing Affecting the Cardiac Remodeling and Function after Myocardial Infarction in Mice

We studied the role of galectin-3 (Gal-3) in the expression of alternative activation markers (M2) on macrophage, cytokines, and fibrosis through the temporal evolution of healing, ventricular remodeling, and function after myocardial infarction (MI). C57BL/6J and Gal-3 knockout mice (Lgals3^-/-) were subjected to permanent coronary ligation or sham. We studied i) mortality, ii) macrophage infiltration and expression of markers of alternative activation, iii) cytokine, iv) matrix metalloproteinase-2 activity, v) fibrosis, and vi) cardiac function and remodeling. At 1 week post-MI, lack of Gal-3 markedly attenuated F4/80+ macrophage infiltration and significantly increased the expression of Mrc1 and Chil1, markers of M2 macrophages at the MI zone. Levels of IL-10, IL-6, and matrix metalloproteinase-2 were significantly increased, whereas tumor necrosis factor-α, transforming growth factor-β, and fibrosis were remarkably attenuated at the infarct zone. In Gal-3 knockout mice, scar thinning ratio, expansion, and cardiac remodeling and function were severely affected from the onset of MI. At 4 weeks post-MI, the natural evolution of fibrosis in Gal-3 knockout mice was also affected. Our results suggest that Gal-3 is essential for wound healing because it regulates the dynamics of macrophage infiltration, proinflammatory and anti-inflammatory cytokine expression, and fibrosis along the temporal evolution of MI in mice. The deficit of Gal-3 affected the dynamics of wound healing, thus aggravating the evolution of remodeling and function.

Suppressive antibiotic therapy in prosthetic joint infections: a multicentre cohort study

OBJECTIVES

The aim was to describe the effectiveness of suppressive antibiotic treatment (SAT) in routine clinical practice when used in situations in which removal of a prosthetic implant is considered essential for the eradication of an infection, and it cannot be performed.

METHODS

This was a descriptive retrospective and multicentre cohort study of prosthetic joint infection (PJI) cases managed with SAT. SAT was considered to have failed if a fistula appeared or persisted, if debridement was necessary, if the prosthesis was removed due to persistence of the infection or if uncontrolled symptoms were present.

RESULTS

In total, 302 patients were analysed. Two hundred and three of these patients (67.2%) received monotherapy. The most commonly used drugs were tetracyclines (39.7% of patients) (120/302) and cotrimoxazole (35.4% of patients) (107/302). SAT was considered successful in 58.6% (177/302) of the patients (median time administered, 36.5 months; IQR 20.75-59.25). Infection was controlled in 50% of patients at 5 years according to Kaplan-Meier analysis. Resistance development was documented in 15 of 65 (23.1%) of the microbiologically documented cases. SAT failure was associated with age <70 years (sub-hazard ratio (SHR) 1.61, 95% CI 1.1-2.33), aetiology other than Gram-positive cocci (SHR 1.56, 95% CI 1.09-2.27) and location of the prosthesis in the upper limb (SHR 2.4, 95% CI 1.5-3.84). SAT suspension was necessary due to adverse effects in 17 of 302 patients (5.6%).

CONCLUSIONS

SAT offers acceptable results for patients with PJI when surgical treatment is not performed or when it fails to eradicate the infection.

In Silico Guided Discovery of Novel Class I and II Trypanosoma cruzi Epitopes Recognized by T Cells from Chagas' Disease Patients

T cell-mediated immune response plays a crucial role in controlling Trypanosoma cruzi infection and parasite burden, but it is also involved in the clinical onset and progression of chronic Chagas' disease. Therefore, the study of T cells is central to the understanding of the immune response against the parasite and its implications for the infected organism. The complexity of the parasite-host interactions hampers the identification and characterization of T cell-activating epitopes. We approached this issue by combining in silico and in vitro methods to interrogate patients' T cells specificity. Fifty T. cruzi peptides predicted to bind a broad range of class I and II HLA molecules were selected for in vitro screening against PBMC samples from a cohort of chronic Chagas' disease patients, using IFN-γ secretion as a readout. Seven of these peptides were shown to activate this type of T cell response, and four out of these contain class I and II epitopes that, to our knowledge, are first described in this study. The remaining three contain sequences that had been previously demonstrated to induce CD8⁺ T cell response in Chagas' disease patients, or bind HLA-A*02:01, but are, in this study, demonstrated to engage CD4⁺ T cells. We also assessed the degree of differentiation of activated T cells and looked into the HLA variants that might restrict the recognition of these peptides in the context of human T. cruzi infection.

Prevalence of eosinophilic esophagitis: A multicenter study on a pediatric population evaluated at thirty-six Latin American gastroenterology centers

INTRODUCTION AND OBJECTIVE

Eosinophilic esophagitis is a chronic, immune-mediated disease described in case series and publications worldwide. Over the past twenty years, the authors of different studies have attempted to evaluate its incidence and prevalence. The objetive of the present study was to estimate the prevalence of eosinophilic esophagitis in a group of children seen at 36 pediatric gastroenterology centers in ten Latin American countries.

MATERIALS AND METHODS

A multicenter, observational, and cross-sectional study was conducted that estimated the period prevalence of eosinophilic esophagitis in children seen at outpatient consultation and that underwent diagnostic upper gastrointestinal endoscopy for any indication at 36 centers in 10 Latin American countries, within a 3-month time frame.

RESULTS

Between April and June 2016, 108 cases of eosinophilic esophagitis were evaluated. Likewise, an average of 29,253 outpatient consultations and 4,152 diagnostic upper gastrointestinal endoscopies were carried out at the 36 participating centers. The period prevalence of eosinophilic esophagitis in the population studied (n=29,253) was 3.69 cases×1,000 (95% CI: 3.04 to 4.44), and among the children that underwent routine upper gastrointestinal endoscopy (n=4,152), it was 26x1,000 (95% CI: 22.6 to 29.4).

CONCLUSIONS

The general period prevalence of eosinophilic esophagitis in a group of children evaluated at 36 Latin American pediatric gastroenterology centers was 3.69×1,000, and in the children that underwent endoscopy, it was 26×1,000. There was important prevalence variability between the participating countries and centers. The present analysis is the first study conducted on the prevalence of pediatric eosinophilic esophagitis in Latin America.

A giant exoplanet orbiting a very-low-mass star challenges planet formation models

Surveys have shown that super-Earth and Neptune-mass exoplanets are more frequent than gas giants around low-mass stars, as predicted by the core accretion theory of planet formation. We report the discovery of a giant planet around the very-low-mass star GJ 3512, as determined by optical and near-infrared radial-velocity observations. The planet has a minimum mass of 0.46 Jupiter masses, very high for such a small host star, and an eccentric 204-day orbit. Dynamical models show that the high eccentricity is most likely due to planet-planet interactions. We use simulations to demonstrate that the GJ 3512 planetary system challenges generally accepted formation theories, and that it puts constraints on the planet accretion and migration rates. Disk instabilities may be more efficient in forming planets than previously thought.

Scalp eschar and neck lymphadenopathy after tick bite in Argentina

Scalp eschar and neck lymphadenopathy after a tick bite (SENLAT) is an emerging non-pathogen-specific syndrome characterized by scalp eschar and occipital and/or cervical lymph node enlargement following a tick bite. We report a case of SENLAT syndrome in an Argentinian patient after exposure to ticks during outdoor work in the Paraná River Delta region.

Precocious pubertal events in Chilean children: ethnic disparities

PURPOSE

Puberty onset exhibits remarkable inter-individual and ethnic differences. 5% of Chileans are indigenous but puberty ethnic disparities have not been studied. We aim for evaluating precocious puberty prevalence in children with Mapuche ancestry vs non-indigenous Chilean children (according to their surnames).

METHODS

Longitudinal cohort study: 1003 children (50.2% girls) participating in the Growth and Obesity Chilean Cohort Study (GOCS) were studied. Annual anthropometry was measured since 4-7 years. Subsequently, Tanner staging and anthropometry were measured every 6 months. In girls, Tanner stage was assessed by breast palpation and in boys by testicular volume measurements. The cohort was stratified in three groups depending on Mapuche surname numbers as follows: (A) no indigenous surnames (n = 811), (B) one to two indigenous surnames (n = 147), and (C) three or more indigenous surnames (n = 45). We evaluated the prevalence of precocious thelarche, pubarche, menarche and gonadarche (testicular volume ≥ 4 ml-G2), using a cutoff age of 8 years in girls and 9 years in boys while controlling for socioeconomic status, body mass index, waist circumference, IGF-1 and DHEAS at 7 years.

RESULTS

In girls, no significant differences were observed. On the contrary, in boys, precocious gonadarche prevalence was higher in group C (29.2%) vs group A (6.0%) and vs group B (10.5%) (p =0.001, p = 0.004, respectively). Increased precocious gonadarche and pubarche risks in group C were observed even after adjustment [OR 7.31; 95% IC (2.32-23.51); p = 0.001] and [OR 6.17, 95% CI (1.62-23.49); p = 0.008], respectively.

CONCLUSION

Indigenous origin in Chile is an independent risk factor for precocious gonadarche and pubarche in boys but not in girls.

Randomized controlled trial of cognitive-motivational therapy program (PIPE) for the initial phase of schizophrenia: Maintenance of efficacy at 5-year follow up✰

AIM

The main goal of this study was to evaluate the effectiveness of a cognitive motivational treatment program.

METHOD

A randomized, controlled, single-blind clinical trial was carried out. A total of 104 patients were recruited to take part in the trial, of whom ultimately 62 patients were allocated into two groups and finished the study. An initial assessment was carried out before patients were randomly placed in one of two groups for the clinical trial: (a) PIPE program plus routine care; and (b) routine care only. Clinical assessments were performed at baseline at 6 months, 1 year and follow-ups, at 18 months and 5 years).

RESULTS

MANCOVA analysis of tests repeated 18 months after the start of the intervention detected significant differences between the two groups in terms of clinical variables, everyday functioning and relapses. These differences remained upon follow-up measurements taken five years after the start of the trial.

CONCLUSIONS

The present study offers scientific evidence for cognitive-motivational therapy's effectiveness as a treatment for clinical symptoms in the early stages of psychosis. PIPE intervention may contribute to long-term clinical improvement and stability.

Effect of milking frequency and α-tocopherol plus selenium supplementation on sheep milk lipid composition and oxidative stability

The aim of this research was to study the effect of milking frequency [once-daily milking (ODM) vs. twice-daily milking (TDM)] and antioxidant (AOX) supplementation on fatty acid (FA) profile and oxidative stability in sheep milk. Sixteen Assaf ewes were used; 8 did not receive any vitamin-mineral supplement (control), and the other 8 received an oral dose of 1,000 IU of α-tocopherol and 0.4 mg of Se daily. The experiment consisted of 2 consecutive periods; the first was 3 wk with TDM of both mammary glands. The second period was 8 wk and consisted of ODM of one mammary gland and TDM of the other gland. All ewes were fed ad libitum the same total mixed ration from lambing and throughout the experiment. There were no differences in plasma or milk Se concentrations between control and AOX ewes. However, plasma and milk α-tocopherol concentrations and AOX capacity were increased in ewes receiving the AOX supplement. Milk FA profile was practically unaffected after 21 d of AOX supplementation. However, after 77 d, AOX supplementation increased the relative percentage of C16:0 and cis-9 C18:1 and reduced the proportions of some saturated FA with less than 16 carbons and cis-9 C12:1. Antioxidant supplementation had no effect on the proportions of conjugated linoleic acid or total polyunsaturated FA (PUFA) but decreased the proportion of trans-7,cis-9 C18:2 and increased that of n-6 C20:3. Once-daily milking did not affect α-tocopherol, Se, or fat resistance to oxidation in milk. Total monounsaturated FA, cis-9 C16:1, and several cis and trans isomers of C18:1 were increased and total saturated FA were decreased in milk from ODM glands. Compared with TDM, ODM increased the proportions of cis-9,cis-12 C18:2 and several isomers of C18:2 and reduced those of cis-9,cis-12,cis-15 C18:3 and some PUFA of 20 and 22 carbons, but total proportion of PUFA was unaffected. Once-daily milking and AOX supplementation modified milk FA profile, but the effects of ODM could be considered of little biological relevance for consumer health. Supplementing ewes with α-tocopherol plus Se could be considered an effective strategy to improve plasma AOX status and reduce milk fat oxidation without substantial changes in the milk FA profile.

QTL mapping of melon fruit quality traits using a high-density GBS-based genetic map

BACKGROUND

Melon shows a broad diversity in fruit morphology and quality, which is still underexploited in breeding programs. The knowledge of the genetic basis of fruit quality traits is important for identifying new alleles that may be introduced in elite material by highly efficient molecular breeding tools.

RESULTS

In order to identify QTLs controlling fruit quality, a recombinant inbred line population was developed using two commercial cultivars as parental lines: "Védrantais", from the cantalupensis group, and "Piel de Sapo", from the inodorus group. Both have desirable quality traits for the market, but their fruits differ in traits such as rind and flesh color, sugar content, ripening behavior, size and shape. We used a genotyping-by-sequencing strategy to construct a dense genetic map, which included around five thousand variants distributed in 824 bins. The RIL population was phenotyped for quality and morphology traits, and we mapped 33 stable QTLs involved in sugar and carotenoid content, fruit and seed morphology and major loci controlling external color of immature fruit and mottled rind. The median confidence interval of the QTLs was 942 kb, suggesting that the high density of the genetic map helped in increasing the mapping resolution. Some of these intervals contained less than a hundred annotated genes, and an integrative strategy combining gene expression and resequencing data enabled identification of candidate genes for some of these traits.

CONCLUSION

Several QTLs controlling fruit quality traits in melon were identified and delimited to narrow genomic intervals, using a RIL population and a GBS-based genetic map.

Comparing genetic diversity and demographic history in co-distributed wild South American camelids

Vicuñas and guanacos are two species of wild South American camelids that are key ruminants in the ecosystems where they occur. Although closely related, these species feature differing ecologies and life history characters, which are expected to influence both their genetic diversity and population differentiation at different spatial scales. Here, using mitochondrial and microsatellite genetic markers, we show that vicuña display lower genetic diversity within populations than guanaco but exhibit more structure across their Peruvian range, which may reflect a combination of natural genetic differentiation linked to geographic isolation and recent anthropogenic population declines. Coalescent-based demographic analyses indicate that both species have passed through a strong bottleneck, reducing their effective population sizes from over 20,000 to less than 1000 individuals. For vicuña, this bottleneck is inferred to have taken place ~3300 years ago, but to have occurred more recently for guanaco at ~2000 years ago. These inferred dates are considerably later than the onset of domestication (when the alpaca was domesticated from the vicuña while the llama was domesticated from the guanaco), coinciding instead with a major human population expansion following the mid-Holocene cold period. As importantly, they imply earlier declines than the well-documented Spanish conquest, where major mass mortality events were recorded for Andean human and camelid populations. We argue that underlying species' differences and recent demographic perturbations have influenced genetic diversity in modern vicuña and guanaco populations, and these processes should be carefully evaluated in the development and implementation of management strategies for these important genetic resources.

[Risk of falls and consumption of medicines in an elderly population]

OBJECTIVES

To describe the risk factors and the effect of medication use on the risk of falls in a population of 65 years or older.

MATERIAL AND METHODS

Descriptive study of falls in the elderly population. The risk factors and consequences of the fall were recorded. Hypnotic and sedative risk drugs, opioids, and the simultaneous consumption of six or more drugs were considered. Diuretics were also included. The cumulative incidence for each group and the corresponding relative risks of falls were analysed from the cases registered between June and November 2016.

RESULTS

During the study period, 60 falls were reported, of which 66% were by women and 34% by men. The cumulative incidence of falls was 3 per thousand women (95% CI: 2.22-4.08), and 2 per thousand men (95% CI: 1.44-3.41). The majority (71%) had consumed risk medication. Six or more medications were taken by 40% of the men and 62.5% of the women, and 97.6% was risk medication. The relative risk of falls in people using hypnotics, sedatives and opioids compared to non-users was 8.7 in men and 7.1 in women. In people who took diuretics, the relative risk was 4.6 for both genders. In women on multiple medications the relative risk was 3.7 compared to 1.7 in men.

CONCLUSIONS

Polypharmacy and the use of hypnotic and sedative drugs and opioids and diuretics are an important public health problem, due to being risk factors for falls in this population, with a greater impact for women.

Tutoría académica: otra forma de enseñanza

RESUMEN Presentamos un dispositivo pedagógico denominado “tutoría académica” implementado como propuesta de enseñanza en las asignaturas Pedagogía del Centro Regional Universitario-Universidad Nacional del Comahue-Argentina. Centrado en el trabajo en torno al conocimiento del campo pedagógico, se enmarca en una línea de investigación que venimos desarrollando sobre formación docente universitaria, focalizada en la indagación de prácticas pedagógicas cotidianas en tanto variable intrainstitucional que impacta en las trayectorias formativas. Constituye una estructura de andamiaje académico y una instancia de formación sistemática. En este sentido procuramos habilitar espacios de experiencia formativa y generar mejores intervenciones docentes que propicien trayectorias estudiantiles más democráticas.

Ovine Toxoplasmosis: A New Look at its Pathogenesis

Conditions causing reproductive failure are a significant concern in the livestock industry, and amongst these, ovine toxoplasmosis is one of the most important. Despite decades of research, there remain gaps in knowledge about this disease, especially regarding the pathogenesis of abortion in sheep. As for other diseases causing ovine abortion, such as chlamydial abortion or border disease, the consequences of infection with Toxoplasma gondii depend largely on the stage of gestation, but the mechanisms involved are not well understood. Immunological modulation occurring during gestation has been proposed as the main mechanism accounting for this clinical variation. However, the extent and effect of such modulation has not yet been identified clearly in sheep and the involvement of other unknown factors has been proposed. Recent experimental studies have defined an unacknowledged clinical presentation of ovine toxoplasmosis, where abortions occur during the acute phase of infection, resulting in as high as 100% fetal loss in susceptible sheep. The pathogenesis of this clinical form differs from that of classically described ovine toxoplasmosis, and its pathological features resemble those of the perinatal syndrome known as cerebral palsy in man. A range of variables, including individual susceptibility, isolate virulence and infective dose, have been proposed as key factors in the development of one or the other of these clinical forms and warrants further investigation in this important disease.

Early postpartum administration of equine chorionic gonadotropin to dairy cows calved during the hot season: Effects on fertility after first artificial insemination

Heat stress reduces fertility of high-producing dairy cows, and early administration of equine chorionic gonadotropin (eCG) may improve it. Here, 401 heat-stressed, high-producing dairy cows on a single commercial farm were given eCG (500 UI, n = 214) or saline (n = 187) on days 11-17 after calving, and the effects on fertility after the first artificial insemination (AI) were assessed. On post-partum day 96.34 ± 9.88, all cows were inseminated after a "double short Cosynch" synchronization protocol. Ovarian activity and uterine status were checked by ultrasound on the day of eCG administration and every 7 days thereafter for a total of 3 weeks; checks were also performed during synchronization, and 7 days after AI. On post-partum day 30, cytobrush uterine cytology was performed to check for subclinical endometritis. Pregnancy status was checked on days 30 and 60 after AI. The eCG and control groups did not differ significantly in terms of average lactations per cow (2.33 ± 1.34), days in milk at first AI (96.33 ± 9.88), average milk yield at AI (41.38 ± 7.74 L), or the particular inseminator or bull used for AI. The eCG and control groups showed increasing ovarian activity with time, with approximately 75% of cows in both groups showing a corpus luteum at the beginning of the synchronization protocol. On post-partum day 30, 17.4% of eCG cows and 22.9% of control cows showed subclinical endometritis. Cows treated with eCG showed a tendency toward lower hyperecogenic intraluminal content (16.8 vs. 21.4%, P = 0.15), but ovarian activity during the synchronization protocol was similar between eCG and control groups, with 91% of animals in both groups showing luteolysis after prostaglandin application and 88% showing ovulation after the last administration of gonadotropin-releasing hormone. Fertility was similar between the two groups at both time points after AI (30 days, 34.9 vs. 31.8%; 60 days, 30.6 vs. 28.5%; P > 0.2). These results suggest that early postpartum eCG administration does not improve fertility of heat-stressed dairy cows as long as 60 days after AI. Other strategies may be more effective at mitigating the ability of post-partum heat stress to reduce fertility of high-producing dairy cows.

Effects of a silver nanomaterial on cellular organelles and time course of oxidative stress in a fish cell line (PLHC-1)

Among the nanomaterials currently in commercial products, those based on silver are the most used, and so there is a high probability that silver nanoparticles (AgNPs) will be released into aquatic environments where they could adversely affect aquatic organisms, including fish. Taking this into account, the aim of the present work was to characterize in depth the mechanisms underlying the toxic action of AgNPs using fish cell lines, determining specifically the contribution of alterations in cellular structures and oxidative stress time course to the cytotoxicity of AgNPs. Since liver plays a key role in detoxification, the hepatoma cell line PLHC-1 was used. Exposure to AgNPs (NM-300K, obtained from the Joint Research Centre Repository) caused alterations at the lysosomal and mitochondrial levels at lower concentrations than those that disrupted plasma membrane (evaluated by means of neutral red, alamarBlue, and 5-carboxyfluorescein diacetate, acetoxymethyl ester assays respectively). AgNO₃, used as a control Ag⁺ ion source, produced similar cytotoxic effects but at lower concentrations than AgNPs. Both silver forms caused oxidative disruption but the initial response was delayed in AgNPs until 6h of exposure. Transmission electron microscopy analysis also evidenced the disruption of mitochondrial structures in cells exposed to cytotoxic concentrations of both forms of silver. At non-cytotoxic concentrations, AgNPs were detected inside the nucleoli and mitochondria, thereby pointing to long-term effects. The present work evidences the mutual interaction between the induction of oxidative stress and the alterations of cellular structures, particularly mitochondria, as cytotoxicity mechanisms not exclusively associated to NPs.

Características de la raza bovina Monchina y de su programa de recuperación

La raza bovina Monchina es una raza autóctona de la Comunidad Autónoma de Cantabria, reconocida como raza en peligro de extinción. La utilización de información molecular mostró una raza dividida en tres ecotipos, con una elevada contribución a la diversidad genética del conjunto de razas bovinas de la Península Ibérica, situándola genéticamente próxima a las razas Tudanca, Lidia, Betizú y Pirenaica. Por otro lado, la información genealógica, todavía con un reducido nivel de completitud, con un valor medio del número equivalente al de generaciones completas de 1,13, mostró una raza con un censo efectivo inferior al considerado por la FAO para poder garantizar la sostenibilidad de la diversidad genética a medio plazo (50 años).

Efecto del uso combinado de la Pronasa E y de un extracto fúngico (Mucor racemosus forma sphaerosporus) en la maduración de embutidos crudos curados / Effect of the combined use of Pronase E and a fungal extract (Mucor racemosus forma sphaerosporus) on the ripening of dry fermented sausages

The effect of the addition of 600 units of Pronase E/kg of sausage mixture and/or a fungal extract ( Mucor racemosus forma sphaerosporus) at two different concentrations (1.75 and 17.5 mg protein/kg sausage mixture) on dry fermented sausages was evaluated. The only addition of protease to sau sages led to an increase in the content of free amino acids and biogenic amines. When the protease and the fungal extract were added together at high concentration (17.5 mg protein/kg sausage mix ture), a decrease in the free amino acid content and a slight increase in the ammonia content were observed, together with a clear increase in the concentration of several volatile compounds, such as 2- and 3-methylbutanal, 2-methylpropanal and 2- and 3-methyl-1-butanol. The addition of the fungal extract only at high concentration (17.5 mg protein/kg sausage mixture) or the combined protease and fungal extract at low concentration (1.75 mg protein/kg sausage mixture), produced slight physi cochemical modifications compared with the corresponding controls. All sausages with Pronase E showed a clear modification of texture, with a marked decrease of hardness, adhesiveness, springi ness, cohesiveness, gumminess, chewiness, cutting force and cutting work. Sensory analysis of the different batches of sausages showed that the combined addition of Pronase E (600 units/kg of sau sage mixture) and the Mucor racemosus forma sphaerosporus extract at high concentration (17.5 mg protein/kg of sausage mixture) improved the odor, taste, texture and, in consequence, the global acceptability in relation to the control batch.