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Selective treatment of clinical mastitis (STCM) potentially reduces antimicrobial use without negative implications on cow's milk production or health. However, this approach comes with additional costs. The aim of this study was to evaluate the net cash impact (NCI) of implementing STCM compared with blanket treatment of clinical mastitis (BTCM) under different diagnostic-test turnaround times (24 h, 14 h, and 8 h) using a stochastic partial budget analysis with Monte Carlo simulation. The target population was European commercial dairy herds; therefore, the model inputs were primarily from European sources. Additionally, variables associated with dairy management programs were obtained from USDA sources, worldwide multisite clinical trials, and expert opinion. The output was calculated by subtracting the cost of STCM from the cost of BTCM and it represented the expected NCI if a herd switched from BTCM to STCM. Depending on the time-to-treatment efficiency and diagnostic-test turnaround time, the expected mean NCI, assuming that STCM has no impact on the cow's future health or production, ranged from +8.7 to +12.4 per case with 72.4% to 84.8% of the iterations being ≥ 0. Moreover, using the numerically favorable health and production effects of STCM reported in the literature, the expected mean NCI ranged from +44.5 to +48.1 per case with 93.6% to 95.4% of the iterations being ≥ 0. The variables with the greatest contribution to NCI variance were proportion of gram-positive cases (39.2% of the variance) and days out of the tank for treated cows (22.0%). However, if future cow's health and production were accounted for, culling risk (24.6%), recurrence risk (19.4%), and milk yield (10.6%) would have the greatest contribution to NCI. The sensitivity analysis indicated that farms with high clinical mastitis incidence, low proportion of gram-positive cases, large number of days out of the tank for treated cows, higher milking frequency or using automatic milking systems, not using the highest priced diagnostic tests, and having high antimicrobial treatment costs are the best candidates for STCM. Improving time-to-treatment efficiency, for example, by using a rapid diagnostic test, leads to a favorable NCI, while high daily milk yield and milk price enhances the NCI in already positive scenarios. Finally, the cash flow entirely depends on future cow's health and milk yield. In conclusion, results indicate that overall, STCM is a practice that positively impacts the NCI of many herds.
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This study assesses affiliation bias in peer review of medical abstracts by a commonly used large language model.
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Idioma , Revisão por Pares , Viés de Publicação , Grupo Associado , Indexação e Redação de Resumos , Modelos TeóricosRESUMO
Maternal gatekeeping describes mothers' attempts to influence father involvement in child-rearing. While the effect of maternal gatekeeping on the father-child relationship has been explored, less is known about how fluctuations in the perception of maternal gatekeeping influences fathers' family outcomes and whether father's attachment might moderate these associations. Building on family systems theory, this study explores the within-person effect of negative maternal gatekeeping on father's weekly reports of romantic relationship quality and feelings of exclusion from the family and tests father attachment as a moderator of these associations. Two hundred seventy-seven Canadian and German fathers with children under the age of 6 took part in an 8-week online diary study. Data were analyzed using multilevel structural equation modeling. During weeks when fathers perceived more maternal gatekeeping than was typical, they reported lower positive romantic relationship quality, higher negative romantic relationship quality, and felt more excluded from the family system. Avoidant attachment moderated the within-person effect of perceived maternal gatekeeping on negative romantic relationship quality, such that within-person increases in perceived maternal gatekeeping were more strongly linked with higher than-average negative romantic relationship quality among more avoidant fathers. Our findings shed new light on the within-person effects of perceived maternal gatekeeping on fathers' feelings regarding the family system. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Pai , Mães , Masculino , Feminino , Criança , Humanos , Lactente , Pai/psicologia , Canadá , Mães/psicologia , Relações Pai-Filho , Educação Infantil , Poder Familiar/psicologiaRESUMO
Blue sharks, Prionace glauca, are cosmopolitan, extremely vagile sharks and the species among elasmobranchs for which most surveys containing tapeworm community data are available worldwide. In this study we report on the tapeworm fauna of three samples of blue sharks (n = 37) from two new regions (one sample from Galicia, north-east Atlantic, and two from Valencia, western Mediterranean), and compared it with previous studies, assessing the relative role of the ecological and evolutionary factors in structuring local tapeworm assemblages. Nine cestode taxa were identified, of which four included adult specimens, that is, Platybothrium auriculatum, Prosobothrium armigerum, Anthobothrium caseyi and Molicola horridus. The abundance of these species, and Brillouin's diversity index, differed significantly among samples without a clear geographical signal. A comparison with six previous surveys revealed that tapeworm assemblages were composed of the same 'core' taxa, with mean species richness typically ranging from two to four species. Global records of adult tapeworms in blue sharks included: 15 taxa identified at species level, of which only eight (generalist trypanorhynchs) were shared with other sympatric host species; five mostly with other carcharhinids; and three with large lamnid sharks sharing the blue sharks' habitat. The composition of tapeworm communities of blue sharks is thus highly constrained by strong host specificity, with composition and abundance varying across localities depending on idiosyncratic environmental conditions.
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Especificidade de Hospedeiro , Tubarões , Animais , GeografiaRESUMO
In this work, the mechanical behaviour of hydrophilic and hydrophobic acrylates has been characterised by depth sensing indentation. Time-dependent behaviour has been studied using load-relaxation tests. Experiments have been simulated with a finite element software using a visco-hyperelastic material model. The parameters of this model have been determined using deep learning techniques. The developed material models have been used to mechanically simulate a standard compression test of a prototype intraocular lens.
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Acrilatos , Lentes Intraoculares , Interações Hidrofóbicas e HidrofílicasRESUMO
The interest in contaminants of emerging concern (CECs) has increased lately due to their continued emission and potential ecotoxicological hazards. Wastewater treatment plants (WWTPs) are generally not capable of eliminating them and are considered the main pathway for CECs to the aquatic environment. The number of CECs in WWTPs effluents is often so large that complementary approaches to the conventional target analysis need to be implemented. Within this context, multitarget quantitative analysis (162 compounds) and a suspect screening (>40,000 suspects) approaches were applied to characterize the CEC fingerprint in effluents of five WWTPs in the Henares River basin (central Spain) during two sampling campaigns (summer and autumn). The results indicated that 76% of the compounds quantified corresponded to pharmaceuticals, 21% to pesticides and 3% to industrial chemicals. Apart from the 82 compounds quantified, suspect screening increased the list to 297 annotated compounds. Significant differences in the CEC fingerprint were observed between summer and autumn campaigns and between the WWTPs, being those serving the city of Alcalá de Henares the ones with the largest number of compounds and concentrations. Finally, a risk prioritization approach was applied based on risk quotients (RQs) for algae, invertebrates, and fish. Azithromycin, diuron, chlortoluron, clarithromycin, sertraline and sulfamethoxazole were identified as having the largest risks to algae. As for invertebrates, the compounds having the largest RQs were carbendazim, fenoxycarb and eprosartan, and for fish acetaminophen, DEET, carbendazim, caffeine, fluconazole, and azithromycin. The two WWTPs showing higher calculated Risk Indexes had tertiary treatments, which points towards the need of increasing the removal efficiency in urban WWTPs. Furthermore, considering the complex mixtures emitted into the environment and the low dilution capacity of Mediterranean rivers, we recommend the development of detailed monitoring plans and stricter regulations to control the chemical burden created to freshwater ecosystems.
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Poluentes Químicos da Água , Purificação da Água , Animais , Ecossistema , Monitoramento Ambiental , Rios , Espanha , Águas Residuárias/análise , Poluentes Químicos da Água/análiseAssuntos
Condromatose Sinovial , Corpos Livres Articulares , Artroscopia , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Humanos , Corpos Livres Articulares/diagnóstico por imagem , Corpos Livres Articulares/cirurgia , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgiaRESUMO
Bacterial urinary tract infection (UTI) is a common clinical concern in dogs. However, incidence of feline UTI is much lower than in dogs although an increasing prevalence has been registered. The main objective of the present study was to describe and characterize the prevalence of urinary tract pathogens in urine samples of dogs and cats with urinary clinical signs throughout different Spanish provinces. Secondary aims were to determine if there were differences in urine sample characterizations based on species (i.e., dog and cat) or season. Dogs were found to have a higher rate of positive urinary cultures than cats (39.3% and 24.7% of the cultures submitted, respectively). The bacterial genera most commonly isolated in dogs were Escherichia spp. (45.3%), Proteus spp. (13.2%), Staphylococcus spp. (11%), and Enterococcus spp. (8.6%). Whereas in the feline population, Escherichia spp. (42.7%), Enterococcus spp. (22.2%), and Staphyloccoccus spp. (15.2%) were the most frequently isolated bacteria. The highest rates of positive urine cultures were registered in Melilla (70%), Zamora (66.7%), Teruel (64.3%), and Guadalajara (60%). Moreover, the proportion of positive urine cultures was not homogeneously distributed across provinces. Finally, some seasonality was found among most isolated bacterias. Enterococcus spp. was significantly more prevalent in summer, whereas Escherichia spp. and Proteus spp. were more commonly isolated in spring and Pseudomonas spp. in autumn.
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Doenças do Gato , Doenças do Cão , Infecções Urinárias , Animais , Doenças do Gato/epidemiologia , Gatos , Doenças do Cão/epidemiologia , Cães , Prevalência , Espanha/epidemiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/veterináriaRESUMO
INTRODUCTION: There is an argument about inbreeding as a risk factor in the development of major mental illnesses like bipolar disorder or schizophrenia. The genealogical trees of European royal dynasties represent an opportunity to study this relationship. Felipe V was the first Bourbon king to rule in Spain, who was thought to have possibly suffered a severe mental disorder. Felipe's son Fernando VI, also had a mental disease. Nevertheless Carlos III, Felipe V's son born from a different, unrelated mother, apparently showed no trace of such disorder. We hypothesize that consanguinity or inbreeding could explain the tendency in the acquiring of severe mental disorders. SUBJECTS AND METHODS: Biographies of three Spanish Bourbon kings (Felipe V, Fernando VI and Carlos III) were analysed in order to evaluate if they were likely to have suffered from some mental disorder, according to DSM-5 and ICD-11 criteria. An inbreeding coefficient was determined with the PedPro Program. RESULTS: Felipe V and Fernando VI could have been diagnosed with bipolar disorder, whereas Carlos III could have been diagnosed with a mild personality disorder. Both Felipe V and Fernando VI had a high inbreeding coefficient (0.091109 and 0.095023, respectively), while Carlos III had a lower one (0.038264). The inbreeding coefficient of siblings of couples of first grade cousins is 0.0625. CONCLUSIONS: A high inbreeding coefficient is a risk factor in developing bipolar disorder. Felipe V and Fernando VI suffered from bipolar disorder. The analysis of genetic trees by the inbreeding coefficient is a valuable tool in the study of heredability of bipolar disorder. Endogamy accumulates pathogenic alleles and increases risk to suffer it. These kings had a high consanguinity which was an important risk factor to the illness. High consanguinity is a risk factor to suffer bipolar disorder.
TITLE: Consanguinidad y enfermedad mental grave en los primeros Borbones españoles.Introducción. Se discute si la consanguinidad es un factor de riesgo para sufrir trastorno bipolar o esquizofrenia. Los árboles genealógicos de las casas reales son una oportunidad para estudiarlo. Felipe V posiblemente sufrió un trastorno mental grave, como también su hijo Fernando VI. Sin embargo, Carlos III, también hijo de Felipe V, pero fruto de otro matrimonio, aparentemente no. Se mantiene la hipótesis de que la consanguinidad podría haber sido un factor de riesgo para ello. Sujetos y métodos. Se analizan las biografías de estos tres reyes para detectar si sufrieron algún trastorno mental de acuerdo con el DSM-5 y la CIE-11. Se estudia su coeficiente de consanguinidad mediante el programa PedPro con una base de datos de 25.776 individuos. Resultados. Felipe V y Fernando VI podrían haber sido diagnosticados de trastorno bipolar, mientras que Carlos III podría haberlo sido de un leve trastorno de la personalidad. Felipe V y Fernando VI tenían un coeficiente de consanguinidad elevado (0,091109 y 0,095023, respectivamente), mientras que en Carlos III era sólo de 0,038264. El coeficiente de los dos primeros es mayor que el de los hijos de primos hermanos (0,0625). Conclusiones. Felipe V y Fernando VI sufrieron un trastorno bipolar. El análisis de los árboles genéticos mediante el coeficiente de consanguinidad es una valiosa herramienta para el estudio de la heredabilidad del trastorno bipolar. La endogamia acumula alelos patógenos y el riesgo de sufrirlo. En estos sujetos, la alta consanguinidad fue un importante factor etiopatogénico de la enfermedad que sufrieron. Una elevada consanguinidad supone un factor de riesgo de sufrir trastorno bipolar.
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Consanguinidade , Pessoas Famosas , Transtornos Mentais/história , Transtorno Bipolar/genética , Transtorno Bipolar/história , História do Século XVIII , Humanos , Masculino , Transtornos Mentais/genética , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/história , Linhagem , EspanhaRESUMO
O objetivo deste trabalho foi mapear e descrever a ocorrência de roedores e seus ectoparasitas nas regiões norte do departamento de La Paz, Bolívia. De abril a maio e julho a agosto de 2017, 80 indivíduos da espécie Oligoryzomys microtis foram capturados em armadilhas vivas. Uma amostra aleatória de 36 indivíduos foi analisada quanto à presença de ectoparasitas, encontrando um total de 458 ectoparasitas. Os roedores foram capturados em dois tipos de ambientes: floresta secundária e áreas cultivadas, sendo a área cultivada a área com maior captação de roedores. Dos ectoparasitas, Laelaps sp. foi o gênero com maior abundância e Mysolaelaps sp. o mais prevalente; o gênero Polygenis sp. é aparentemente descrito pela primeira vez na selva amazônica, exigindo estudos adicionais para entender melhor os patógenos que são transmitidos no parasitismo desta pulga em roedores devido à sua importância no ecossistema e para a saúde pública.(AU)
The objective of this work was to map and describe the occurrence of rodents and their ectoparasites in regions to the North of the department of La Paz in Bolivia. From April to May and July to August 2017, 80 Oligoryzomys microtis rodents were captured and 36 random samples of their ectoparasites were analyzed, totaling 458 ectoparasites. Rodents were captured in two types of environments: secondary forest and crops areas, being the second one with greater amount of capture of rodents. Among the ectoparasites, Laelaps sp was the genus with the highest abundance and Mysolaelaps sp with the highest prevalence; the genus Polygenis sp is apparently described for the first time in the Amazon rainforest, requiring more studies to better understand the pathogens transmitted in the parasitism of this flea in rodents due to their importance in the ecosystem and public health.(AU)
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Animais , Parasitos , Roedores/parasitologia , Ectoparasitoses/veterinária , BolíviaRESUMO
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.
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Antibacterianos/uso terapêutico , Bactérias/efeitos dos fármacos , Infecções Relacionadas à Prótese/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/microbiologia , Desbridamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/microbiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
In 1993, the US Food and Drug Administration (FDA) approved the first drug specifically for treating multiple sclerosis (MS). More than two decades later, a dozen such treatments are now available. Of these, four are considered second-line treatments for use in escalation strategies and two new drugs are currently undergoing accreditation procedures. Soon, they will provide clinicians with a range of six effective disease-modifying treatments (DMTs) to thwart the inflammatory processes in MS patients with active disease. However, while such a large number of DMTs for MS can help to control early inflammation, any decisions to be made by clinicians have also been made substantially more complex. This complexity is increased by the lack of head-to-head studies comparing these second-line therapies and the benefit-risk profiles for each of these drugs, which are likely to vary among patients. Ultimately, good awareness of the benefits and, more important, the risks of each MS DMT is crucial for the effective management of inflammation in MS.
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Anti-Inflamatórios/administração & dosagem , Imunossupressores/administração & dosagem , Esclerose Múltipla/tratamento farmacológico , Neurologia/tendências , Anti-Inflamatórios/efeitos adversos , Esquema de Medicação , Humanos , Imunossupressores/efeitos adversos , Neurologia/métodos , Resultado do Tratamento , Estados UnidosRESUMO
OBJECTIVES: As longer times from the first symptom to diagnosis and treatment of oral cancers have been linked to poorer outcomes, this study investigates the contribution of the specialist to this time (STI). SUBJECTS AND METHODS: A series of 228 oral/oropharyngeal squamous cell carcinoma patients were retrospectively studied to determine the STI and its related factors. RESULTS: Patients were mostly males (n = 170; 74.5%), (50.7% stages I-II), mean age = 61.4 ± 12.5 years. The STI median was 6 days (X±SD:6.8 ± 5.6 days). Time first symptom to diagnosis was 64 days (X±SD:91.0 ± 84.6 days). Univariate regression unveiled a significant association between STI and TNM stage, which was confirmed by multivariate regression. CONCLUSIONS: Specialist time interval is a short time interval in oral cancer diagnosis, imposing a limited time burden in the context of the whole interval until diagnosis. However, there seems to be room for improvement and a possible target for future interventions to shorten STI particularly for patients at early stages after their disease has been disclosed.
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Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/patologia , Especialização , Cirurgia Bucal , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Tardio , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Tempo para o TratamentoRESUMO
The field of gene therapy has recently witnessed a number of major conceptual changes. Besides the traditional thinking that comprises the use of viral vectors for the delivery of a given therapeutic gene, a number of original approaches have been recently envisaged, focused on using vectors carrying genes to further modify basal ganglia circuits of interest. It is expected that these approaches will ultimately induce a therapeutic potential being sustained by gene-induced changes in brain circuits. Among others, at present, it is technically feasible to use viral vectors to (1) achieve a controlled release of neurotrophic factors, (2) conduct either a transient or permanent silencing of any given basal ganglia circuit of interest, (3) perform an in vivo cellular reprogramming by promoting the conversion of resident cells into dopaminergic-like neurons, and (4) improving levodopa efficacy over time by targeting aromatic L-amino acid decarboxylase. Furthermore, extensive research efforts based on viral vectors are currently ongoing in an attempt to better replicate the dopaminergic neurodegeneration phenomena inherent to the progressive intraneuronal aggregation of alpha-synuclein. Finally, a number of incoming strategies will soon emerge over the horizon, these being sustained by the underlying goal of promoting alpha-synuclein clearance, such as, for instance, gene therapy initiatives based on increasing the activity of glucocerebrosidase. To provide adequate proof-of-concept on safety and efficacy and to push forward true translational initiatives based on these different types of gene therapies before entering into clinical trials, the use of non-human primate models undoubtedly plays an instrumental role.
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Terapia Genética , Vetores Genéticos , Doença de Parkinson/terapia , alfa-Sinucleína/genética , Animais , Modelos Animais de Doenças , Doença de Parkinson/genética , PrimatasRESUMO
INTRODUCTION: Intracranial haemorrhages (ICH) represent a severe and frequently lethal complication in patients treated with vitamin K antagonists (VKA). The purpose of our study is to describe the factors and clinical features associated with mortality in these patients. METHODS: We conducted an observational, retrospective, multi-centre study based on prospective stroke registries in Spain. We included all patients admitted to neurology departments during a one-year period who met the following inclusion criteria: being 18 or older, having a diagnosis of ICH, and receiving VKA. Clinical and radiological parameters and 3-month outcomes were analysed. RESULTS: A total of 235 patients from 21 hospitals were included. Mortality rate at 90 days was 42.6%. Bivariate analysis showed a significant association between death and the following factors: median NIHSS score at admission (5 [IQR = 9] vs 17 [IQR = 14] points, P<.01) and presence of an extensive hemispheric haemorrhage (4.9% vs 35%, P < .01; χ2). Extensive hemispheric haemorrhages, in addition to being the most lethal type, were associated with a shorter time to death (mean of 16.5 days; 95% CI: 7.1-26). A logistic regression model showed that only baseline NIHSS scores independently predicted death (odds ratio=1.13 [95% CI: 1.08-1.17] for each point in the scale). CONCLUSION: ICH in patients treated with VKA is associated with high mortality rates; mortality in these patients is mainly and independently associated with the clinical situation at stroke onset.
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Anticoagulantes/efeitos adversos , Hemorragia Cerebral/induzido quimicamente , Hemorragia Cerebral/mortalidade , Vitamina K/antagonistas & inibidores , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Causas de Morte , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Espanha/epidemiologia , Acidente Vascular Cerebral/complicações , Adulto JovemRESUMO
Rivers extend in space and time under the influence of their catchment area. Our perception largely relies on discrete spatial and temporal observations carried out at certain sites located throughout the catchment (monitoring networks, MN). However, MNs are constrained by (a) the distribution of sampling sites, (b) the dynamics of the variable considered and (c) the river hydrological conditions. In this study, all three aspects were captured and quantified by applying a spatial autocorrelation modeling approach. We exemplarily studied its application to 235 emerging contaminants (pesticides, pharmaceuticals, and personal care products [PPCP], industrial and miscellaneous) measured at 55 sampling sites in the Danube River. 22 out of the 235 compounds monitored were present at all sites and 125 were found in at least 50%.We first calculated the Moran Index (MI) to characterize the spatial autocorrelation of the compound set. 59 compounds showed MI≤0, which can be interpreted as 'no spatial correlation'. Next, spatial autocorrelation models were set for each compound. From the autocorrelation parameter ρ, catchment average correlation lengths were derived for each compound. MN optimality was examined and compounds were classified into three groups: (a) those with ρ≤0 [25%]; (b) those with ρ>0 and correl. length
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OBJECTIVE: In early multiple sclerosis, although brain T2 lesions accrual are hallmark of the disease, only weak correlations were found between T2 lesions accrual and EDSS progression, the disability scale commonly used in multiple sclerosis studies. This may be related to the very poor sensitivity of EDSS to cognitive dysfunctions that may occur and progress from the first stage of the disease. In the present study, we aimed to demonstrate that cognitive deficits progress during the first ten years of MS and are significantly impacted by new T2 lesions. METHODS: EDSS and extensive neuropsychological battery (22 measures) exploring memory, attention/speed of information processing and executive functions were assessed at baseline, Year 1 and Year 10 in 26 patients enrolled after their first clinical attack. To limit the bias of test-retest effect, only measures obtained at Year 1 and Year 10 were reported in the analysis. Raw scores of patients were transformed into z-scores using published normative data when available or scores of matched controls. Lesion probability mapping was used to assess the potential relationships between T2 lesions accumulation, cognitive decline and EDSS progression (P<0.05, FWE-corrected). RESULTS: At Year 1, 27% of patients showed attention/speed of information processing deficits, 11.5% executive dysfunction and 11.5% memory impairment. During the follow-up, frequency and severity of executive dysfunction increased (from 11.5% of patients at Year 1 to 42% at Year 10, p<0.01) while no significant changes were evidenced for the other cognitive domains. Median EDSS increased from 0.5 [range: 0-3] at Year 1 to 2.5 [range: 0-6.5] at Year 10 (p<0.001). During the ten-year follow-up, lesions accumulation in the left cerebellum and semi-ovale centers was associated with EDSS progression. In contrast, most lesions accumulation in the frontal, parietal and temporal lobes were associated with cognitive decline but had no effect on EDSS progression. CONCLUSION: The present study provides strong evidence that clinically silent T2 lesions impact cognition in early MS. In daily practice, early prevention of T2 lesions accrual may be useful to limit cognitive decline.