Reproducibility analysis of two speckle tracking software for the antenatal semi-automated assessment of the fetal cardiac function.

Introduction Speckle tracking echocardiography (STE) is a non-Doppler modality allowing the semiautomated evaluation of the fetal cardiac function by tracking the speckles of the endocardial borders. Little evidence is available on the evaluation and comparison of different software for the functional assessment of the fetal heart by means of STE. The aim of this study is to evaluate the reproducibility and agreement of two different proprietary speckle tracking software for the prenatal semi-automated assessment of the fetal cardiac function. Methods Prospective study including non-anomalous fetuses referred for different indications at two tertiary academic units in Italy (University of Parma) and Spain (University of Barcelona). 2D clips of the four-chamber view of the fetal heart were acquired by two operators using high-end ultrasound machines with a frame rate higher than 60 Hz. The stored clips were pseudo-anonymized and shared between the collaborating Units. Functional echocardiographic analyses were independently performed using the two proprietary software (TomTec GmbH and FetalHQ®) by the same operators. Inter-software reproducibility of the endocardial global longitudinal strain (EndoGLS) and fractional area change (FAC) of the left (LV) and the right ventricles (RV) and ejection fraction (EF) of the LV were evaluated by the intraclass correlation coefficient (ICC). Results 48 fetuses were included at a median of 31+2 (21+6 - 40+3) gestational weeks. Moderate reproducibility was found for the functional parameters of the LV: EndoGLS (Pearson's correlation 0.456, p<0.01; ICC 0.446, 95%CI (0.189-0.647), p<0.01); EF (Pearson's correlation 0.435, p<0.01; ICC 0.419, 95%CI (0.156-0.627), p<0.01); FAC (Person's correlation 0.484, p<0.01; ICC 0.475, 95%CI (0.223-0.667), p<0.01). On the contrary, RV functional parameters showed poor reproducibility between the two software: EndoGLS (Pearson's correlation 0.383, p=0.01; ICC 0.377, 95%CI (0.107-0.596), p<0.01) and FAC (ICC 0.284, 95%CI (0.003-0.524), p=0.02). Conclusion Our results demonstrate a moderate reproducibility of the speckle tracking analysis of the LV using TomTec GmbH and FetalHQ®, with poor reproducibility for RV analysis.

Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines.

BACKGROUND: Pharmacological augmentation is a recommended strategy for patients with treatment-resistant depression. A range of guidelines provide advice on treatment selection, prescription, monitoring and discontinuation, but variation in the content and quality of guidelines may limit the provision of objective, evidence-based care. This is of importance given the side effect burden and poorer long-term outcomes associated with polypharmacy and treatment-resistant depression. This review provides a definitive overview of pharmacological augmentation recommendations by assessing the quality of guidelines for depression and comparing the recommendations made. METHODS: A systematic literature search identified current treatment guidelines for depression published in English. Guidelines were quality assessed using the Appraisal of Guidelines for Research and Evaluation II tool. Data relating to the prescription of pharmacological augmenters were extracted from those developed with sufficient rigor, and the included recommendations compared. RESULTS: Total of 1696 records were identified, 19 guidelines were assessed for quality, and 10 were included. Guidelines differed in their quality, the stage at which augmentation was recommended, the agents included, and the evidence base cited. Lithium and atypical antipsychotics were recommended by all 10, though the specific advice was not consistent. Of the 15 augmenters identified, no others were universally recommended. CONCLUSIONS: This review provides a comprehensive overview of current pharmacological augmentation recommendations for major depression and will support clinicians in selecting appropriate treatment guidance. Although some variation can be accounted for by date of guideline publication, and limited evidence from clinical trials, there is a clear need for greater consistency across guidelines to ensure patients receive consistent evidence-based care.

Determination of Antidepressants and Antipsychotics in Dried Blood Spots (DBSs) Collected from Post-Mortem Samples and Evaluation of the Stability over a Three-Month Period.

An LC-MS/MS method for the identification and quantification of antidepressants and antipsychotics was developed on dried blood spots (DBSs). Moreover, analyte stability on DBSs within a 3-month period was monitored. Aliquots of 85 µL of blood from autopsy cases were pipetted onto DBS cards, which were dried and stored at room temperature. DBSs were analyzed in triplicate immediately, within the following 3 weeks, and after 3 months. For each analysis, a whole blood stain was extracted in phosphate buffer and purified using Solid Phase Extraction (SPE) cartridges in order to avoid matrix effects and injected in the LC-MS/MS system. Thirty-nine molecules were screened. Limits of detection (LODs) ranged between 0.1 and 3.2 ng/mL (g) and 0.1 and 5.2 ng/mL (g) for antidepressants and antipsychotics, respectively. Limits of quantification (LOQs) varied from 5 to 10.0 ng/mL for both. Sixteen cases among the 60 analyzed resulted positive for 17 different analytes; for 14 of these the method was fully validated. A general good agreement between the concentrations on DBSs and those measured in conventional blood samples (collected concurrently and stored at -20 °C) was observed. The degradation/enhancement percentage for most of the substances was lower than 20% within the 3-month period. Our results, obtained from real post-mortem cases, suggest that DBSs can be used for routine sample storage.

Do school-aged children spontaneously use refreshing as maintenance strategy in working memory? Testing the effects of free time and motivation.

Working memory is the system responsible for maintaining information that is no longer available. Given the long-term impact of working memory in people's lives, it is fundamental to understand which mechanisms underlie it and how these develop with age. A recently proposed mechanism to explain working memory development is attentional refreshing. Refreshing is an attention-based maintenance mechanism that improves the accessibility of mental representations. It is assumed to operate serially, with attention cycling from one mental representation to the other, in order to reactivate all to-be-maintained items. Although it has been suggested that its efficiency increases in children between 7 and 14 years old, recent results contradict this notion. In this article, we modify several important task characteristics of a recently developed paradigm used to detect whether refreshing is spontaneously used in children and to examine whether evidence for spontaneous refreshing could be found. All participants were recruited in public schools in Geneva (Switzerland). In Experiment 1 (68 8-year-olds, 32 girls and 36 boys, and 62 12-year-olds, 35 girls and 27 boys) and Experiment 2 (26 8-year-olds, 11 girls and 15 boys, and 49 12-year-olds, 27 girls and 22 boys), we show that increasing children's motivation and providing more explicitly free time do not result in the spontaneous occurrence of refreshing in 8- and 12-year-olds. The absence of evidence for refreshing in a simple, commonly-used working memory task, despite theory-driven modifications aimed at encouraging it, casts some doubts on the notion that refreshing is crucially involved in children's working memory functioning and development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

First trimester ultrasound of the cerebral lateral ventricles in fetuses with open spina bifida: a retrospective cohort study.

BACKGROUND: Beyond 18 weeks of gestation an increased size of the fetal lateral ventricles is reported in the majority of fetuses with open spina bifida. At 1st trimester, the definition of ventriculomegaly is based on the ratio between the size of the choroid plexus and that of the ventricular space or of the entire fetal head. However, contrary to what is seen from midtrimester, in most fetuses with open spina bifida at 11-13 weeks the amount of fluid in the ventricular system seems to be reduced rather than increased. OBJECTIVE: To compare the biometry of the lateral ventricles at 11+0-13+6 weeks between normal fetuses and those with a confirmed open spina bifida. STUDY DESIGN: Retrospective cohort study including all cases of isolated open spina bifida detected at 11+0-13+6 weeks of gestation over a period of 5 years and a group of structurally normal fetuses attending at our Centre over a period of 1 year for the aneuploidies screening as controls. The transventricular axial views of the fetal brain obtained among cases and controls were extracted from the archive for post-hoc measurement of the cerebral ventricles. The ratios between choroid plexus and lateral ventricle lenghts (CPVLr) and areas (CPVAr), the ratio between the sum of both choroid plexus areas and fetal head area (CPHAr) and the ratio between the mean of choroid plexus lengths and occipito-frontal diameter (CPHLr) were calculated for both groups. Measurements obtained from the two groups were compared, and the association of each parameter with open spina bifida was investigated. RESULTS: Ten fetuses with open spina bifida were compared with 358 controls, showing significantly smaller size of the cerebral ventricles measurements as expressed by larger values of CPVAr (0.72 vs 0.49, p<0.001), CPVLr (0.79 vs 0.70, p<0.001), CPHAr (0.33 vs 0.28, p=0.006) and CPHLr (0.60 vs 0.52, p<0.001) compared with controls. CPVAr was found to be the most accurate predictor of OSB showing an area under the curve of 0.88 with a sensitivity of 90% and a specificity of 82%. CONCLUSIONS: At 11+0-13+6 weeks' gestation open spina bifida is consistently associated with a reduced amount of fluid in the lateral cerebral ventricles of the fetus, as witnessed by significantly increased CPVLr, CPVAr, CPHAr and CPHLr.

The "Preeclampsia and Hypertension Target Treatment" study: a multicenter prospective study to evaluate the effectiveness of the antihypertensive therapy based on maternal hemodynamic findings.

BACKGROUND: Despite major advances in the pharmacologic treatment of hypertension in the nonpregnant population, treatments for hypertension in pregnancy have remained largely unchanged over the years. There is recent evidence that a more adequate control of maternal blood pressure is achieved when the first given antihypertensive drug is able to correct the underlying hemodynamic disorder of the mother besides normalizing the blood pressure values. OBJECTIVE: This study aimed to compare the blood pressure control in women receiving an appropriate or inappropriate antihypertensive therapy following the baseline hemodynamic findings. STUDY DESIGN: This was a prospective multicenter study that included a population of women with de novo diagnosis of hypertensive disorders of pregnancy. A noninvasive assessment of the following maternal parameters was performed on hospital admission via Ultrasound Cardiac Output Monitor before any antihypertensive therapy was given: cardiac output, heart rate, systemic vascular resistance, and stroke volume. The clinician who prescribed the antihypertensive therapy was blinded to the hemodynamic evaluation and used as first-line treatment a vasodilator (nifedipine or alpha methyldopa) or a beta-blocker (labetalol) based on his preferences or on the local protocols. The first-line pharmacologic treatment was retrospectively considered hemodynamically appropriate in either of the following circumstances: (1) women with a hypodynamic profile (defined as low cardiac output [≤5 L/min] and/or high systemic vascular resistance [≥1300 dynes/second/cm2]) who were administered oral nifedipine or alpha methyldopa and (2) women with a hyperdynamic profile (defined as normal or high cardiac output [>5 L/min] and/or low systemic vascular resistances [<1300 dynes/second/cm2]) who were administered oral labetalol. The primary outcome of the study was to compare the occurrence of severe hypertension between women treated with a hemodynamically appropriate therapy and women treated with an inappropriate therapy. RESULTS: A total of 152 women with hypertensive disorders of pregnancy were included in the final analysis. Most women displayed a hypodynamic profile (114 [75.0%]) and received a hemodynamically appropriate treatment (116 [76.3%]). The occurrence of severe hypertension before delivery was significantly lower in the group receiving an appropriate therapy than in the group receiving an inappropriately treated (6.0% vs 19.4%, respectively; P=.02). Moreover, the number of women who achieved target values of blood pressure within 48 to 72 hours from the treatment start was higher in the group who received an appropriate treatment than in the group who received an inappropriate treatment (70.7% vs 50.0%, respectively; P=.02). CONCLUSION: In pregnant individuals with de novo hypertensive disorders of pregnancy, a lower occurrence of severe hypertension was observed when the first-line antihypertensive agent was tailored to the correct maternal hemodynamic profile.

Stuck on the Last: The Last-Presented Benefit as an Index of Attentional Refreshing in Adolescents.

Working memory is a limited-capacity system responsible for maintaining information that is known to dramatically develop throughout childhood and adolescence. Different maintenance mechanisms are proposed to support working memory development, among which is attentional refreshing. Attentional refreshing is assumed to improve the accessibility of working-memory representations by cycling attention from one mental representation to the other, serially. It has been suggested that the efficiency of refreshing increases between the ages of 7 and 14 years old, thereby supporting working memory development. Yet, there is not much research about refreshing in adolescence. Here, we investigate the occurrence of refreshing in 15-year-olds by using a recently-developed index, i.e., the last-presented benefit. Adolescents had to remember a list of four letters and judge whether a subsequent probe letter was present or not in the list. Reaction times to the probe were used to assess the spontaneous occurrence of refreshing. We found that, unlike young adults, 15-year-olds showed consistent speeded responses to probes matching the last-presented memory item, indicating that, in this task, adolescents did not refocus their attention away from the last memory item to initiate refreshing. Implications for working memory functioning and development are discussed.

Going wild: ecology and genomics are crucial to understand yeast evolution.

Improved and more accessible genome-sequencing approaches have allowed the analysis of large sets of natural yeast isolates. As a consequence, this unprecedented level of description of yeast-genome characteristics and variations in natural environments has provided crucial insights on yeast ecology and evolution. Here, we review some of the most relevant and intriguing aspects of yeast evolution pointed out, thanks to the combination of yeast ecology and genomics, and critically examine the resulting improvement of our knowledge on this field. Only integrated approaches, taking into consideration not only the characteristics of the microbe but also those of the hosting environment, will significantly move forward the exploration of yeast diversity, ecology, and evolution.

Forests influence yeast populations vectored by insects into vineyards.

Introduction: In the vineyard, yeast communities impact the ripening and fermentation of grapes and are influenced by geographical location, climate, and soil characteristics. Despite the great advancement in our knowledge of the vineyard mycobiota, a key step of the process leading to the definition of the vineyard yeast community is still poorly understood: if geography, climate, and soil influence the mycobiota, potentially through selection, where do the yeast originate from, and how can they reach the vineyard? In this perspective, it is currently acknowledged that forests host several yeast species and that insects, particularly social wasps, can vector and maintain the yeasts known to populate the vineyard. Alas, the conveyance, fostered by insects, of yeasts from the forest to the vineyard has not been proven yet. In this study, we aimed to assess the existence of links between a potential natural source of yeasts (woods), the vectors (social wasps), and the composition of the vineyard mycobiota. Methods: For this purpose, the mycobiota of wasps caught in six Italian vineyards were analyzed over 2 years through culturomics approaches. Results: The results clearly indicate that the presence of wooded areas close to vineyards is associated with particular features of the mycobiota vectored by social wasps. Wasps caught in vineyards near wooded areas bear a higher number of yeast cells and higher biodiversity than insects caught in vineyards far from woods. Furthermore, insects caught in vineyards close to woods bear distinctive yeast populations, encompassing species such as Saccharomyces cerevisiae. Discussion: Overall, our work provides fundamental insights into the ecology of the vineyard mycobiota and highlights the need to maintain a vineyard-woodland mosaic landscape, thus preserving the suitable habitat for yeast species relevant to wine-making.

Lexical access speed and the development of phonological recoding during immediate serial recall.

A recent Registered Replication Report (RRR) of the development of verbal rehearsal during serial recall (Elliott et al., 2021) revealed that children verbalized at younger ages than previously thought (Flavell et al., 1966), but did not identify sources of individual differences. Here we use mediation analysis to reanalyze data from the 934 children ranging from 5 to 10 years old from the RRR for that purpose. From ages 5 to 7, the time taken for a child to label pictures (i.e. isolated naming speed) predicted the child's spontaneous use of labels during a visually-presented serial reconstruction task, despite no need for spoken responses. For 6- and 7-year-olds, isolated naming speed also predicted recall. The degree to which verbalization mediated the relation between isolated naming speed and recall changed across development. All relations dissipated by age 10. The same general pattern was observed in an exploratory analysis of delayed recall for which greater demands are placed on rehearsal for item maintenance. Overall, our findings suggest that spontaneous phonological recoding during a standard short-term memory task emerges around age 5, increases in efficiency during the early elementary school years, and is sufficiently automatic by age 10 to support immediate serial recall in most children. Moreover, the findings highlight the need to distinguish between phonological recoding and rehearsal in developmental studies of short-term memory.

The Time-Course of the Last-Presented Benefit in Working Memory: Shifts in the Content of the Focus of Attention.

Working memory is a cognitive system responsible for maintaining information. It is often assumed to contain different states of accessibility of information, which is highest for an item held in the focus of attention. Evidence for this heightened accessibility usually comes from item-recognition tasks, in which a memory list is followed by a probe to be judged as being present in or absent from the list. Probes corresponding to the last-presented list item are usually recognized faster than probes corresponding to any other list item (i.e., the last-presented benefit), an effect that is often explained by the last-presented item being in the focus of attention. The last-presented benefit usually disappears when a long retention interval is inserted between the presentation of the list items and the probe. This raises the question of how long the last-presented item remains in the focus of attention. The present study gradually manipulates the retention interval between the presentation of the list of items and the probe in an item-recognition task in order to pinpoint when the focus of attention switches away from the last-presented list item. The results show that the last-presented benefit decreases over time when the retention interval is gradually extended from 0 ms to 200 ms, 400 ms and 500 ms, and completely disappears as of 750 ms. The cognitive mechanisms that may be involved in the time course of the last-presented benefit are discussed.

Electrophysiological evidence for cross-language interference in foreign-language attrition.

Foreign language attrition (FLA) appears to be driven by interference from other, more recently-used languages (Mickan et al., 2020). Here we tracked these interference dynamics electrophysiologically to further our understanding of the underlying processes. Twenty-seven Dutch native speakers learned 70 new Italian words over two days. On a third day, EEG was recorded as they performed naming tasks on half of these words in English and, finally, as their memory for all the Italian words was tested in a picture-naming task. Replicating Mickan et al. recall was slower and tended to be less complete for Italian words that were interfered with (i.e., named in English) than for words that were not. These behavioral interference effects were accompanied by an enhanced frontal N2 and a decreased late positivity (LPC) for interfered compared to not-interfered items. Moreover, interfered items elicited more theta power. We also found an increased N2 during the interference phase for items that participants were later slower to retrieve in Italian. We interpret the N2 and theta effects as markers of interference, in line with the idea that Italian retrieval at final test is hampered by competition from recently practiced English translations. The LPC, in turn, reflects the consequences of interference: the reduced accessibility of interfered Italian labels. Finally, that retrieval ease at final test was related to the degree of interference during previous English retrieval shows that FLA is already set in motion during the interference phase, and hence can be the direct consequence of using other languages.

Online mood monitoring in treatment-resistant depression: qualitative study of patients' perspectives in the NHS.

AIMS AND METHOD: True Colours is an automated symptom monitoring programme used by National Health Service psychiatric services. This study explored whether patients with unipolar treatment-resistant depression (TRD) found this a useful addition to their treatment regimes. Semi-structured qualitative interviews were conducted with 21 patients with TRD, who had engaged in True Colours monitoring as part of the Lithium versus Quetiapine in Depression study. A thematic analysis was used to assess participant experiences of the system. RESULTS: Six main themes emerged from the data, the most notable indicating that mood monitoring increased patients' insight into their disorder, but that subsequent behaviour change was absent. CLINICAL IMPLICATIONS: Patients with TRD can benefit from mood monitoring via True Colours, making it a worthwhile addition to treatment. Further development of such systems and additional support may be required for patients with TRD to experience further benefits as reported by other patient groups.