Magnetic functionalization of ZnO nanoparticles surfaces via optically generated methyl radicals.

The combination of nuclear and electron magnetic resonance techniques, in pulse and continuous wave regimes, is used to unravel the nature and features of the light-induced magnetic state arising at the surface of chemically prepared zinc oxide nanoparticles (NPs) occurring under 120 K when subjected to a sub-bandgap (405 nm) laser excitation. It is shown that the four-line structure observed around g ∼ 2.00 in the as-grown samples (beside the usual core-defect signal at g ∼ 1.96) arises from surface-located methyl radicals (•CH3), originating from the acetate capped ZnO molecules. By functionalizing the as-grown zinc oxide NPs with deuterated sodium acetate, the •CH3 electron paramagnetic resonance (EPR) signal is replaced by trideuteromethyl (•CD3). For •CH3, •CD3, and core-defect signals, an electron spin echo is detected below ∼100 K, allowing for the spin-lattice and spin-spin relaxation-time measurements for each of them. Advanced pulse-EPR techniques reveal the proton or deuteron spin-echo modulation for both radicals and give access to small unresolved superhyperfine couplings between adjacent •CH3. In addition, electron double resonance techniques show that some correlations exist between the different EPR transitions of •CH3. These correlations are discussed as possibly arising from cross-relaxation phenomena between different rotational states of radicals.

The Project Appropriate Birth and a reduction in caesarean section rates: an analysis using the Robson classification system.

OBJECTIVE: The objective of this study was to assess caesarean section (CS) rates before and after the implementation of the Project Appropriate Birth (PPA), based on the Robson ten group classification system. DESIGN: A before-and-after study. SETTING: Maternity hospital in South Brazil. POPULATION: All pregnant women attending from April 2016 to April 2017 (period 1, pre-implementation of PPA) and from June 2017 to June 2018 (period 2, post-implementation of PPA). METHODS: Maternal and obstetric characteristics were evaluated, including Robson's classification, based on the characteristics of pregnancy and childbirth. A chi-square test and crude and adjusted relative rates were used to analyse the study variables. The significance level was set at 5%. MAIN OUTCOME MEASURES: The CS rate for each group, their contribution to the overall CS rate and the differences in these contributions before and after PPA implementation. RESULTS: The CS rates decreased from 62.4 to 55.6%, which represented a 10.9% reduction after the implementation of the PPA. Pregnant women in Robson classification groups 1-4 had a 21.4% reduction in CS rates, ranging from 49.1 to 38.6%. The greatest contributors to the overall CS rates were group 5 and group 2, accounting for more than 60% of the CS deliveries. CONCLUSION: The study results suggest that Project Appropriate Birth had an impact on the reduction of CS rates, especially in Robson classification groups 1 through 4, which indicates that providing mothers with evidence-based interventions for labour and childbirth assistance contributed to reduce CS rates. TWEETABLE ABSTRACT: The Project Appropriate Birth is an innovative project that has demonstrated promising results, suggesting that interventions based on scientific evidence can lead to real changes in childbirth care, contributing to reduce CS rates. The aim of the PPA is to promote activities to improve childbirth care and encourage vaginal delivery. In this study, 6238 pregnant women admitted to the hospital for delivery were included and classified into one of the Robson 10-group classification. Findings revealed a 10.9% reduction in the overall CS rate and a 21.4% reduction for pregnant women in Robson classification groups 1 through 4, after the implementation of the PPA.

[Epidemiology and clinical features of malignant melanoma. Analysis of 274 cases]. / Epidemiología y características anatomoclínicas del melanoma maligno en un instituto oncológico.

BACKGROUND: Malignant melanoma (MM) is the most fatal cutaneous neoplasm. Its incidence is increasing progressively, which cannot be explained only by early diagnosis. Chilean population, due to the geography of the country, has a very varied solar exposure. AIM: To know the incidence of MM in a Chilean population, according to the level of sun exposure and to describe its clinical and histopathological characteristics. MATERIAL AND METHODS: Two hundred seventy-four surgeries for malignant melanoma with histological confirmation, carried out between 2016 and 2018 in an oncological institute were included. RESULTS: The annualized incidence of MM was 13.83 cases per 100,000 people over 15 years of age in the 2016-2018 period. The geographical distribution of the incidence did not have a clear relationship with sun exposure. The most frequent locations of the primary lesions were trunk, head/neck and lower limb. Sixty-one per cent of cases were invasive MM; lesion thickness and presence of ulceration were associated with a higher risk of sentinel node involvement. CONCLUSIONS: No association between the level of sun exposure and the incidence of MM was observed in this study.

[Ophthalmological evaluation in children referred to a low-vision rehabilitation project of a social assistance agency]. / Evaluación oftalmológica en niños derivados a un proyecto de rehabilitación en baja visión de un organismo de apoyo social.

INTRODUCTION: A low-vision (LV) rehabilitated child can receive comprehensive education. Objec tive: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. PATIENTS AND METHOD: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. RESULTS: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. CONCLUSION: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

Preclinical validation of a targeted next generation sequencing-based comprehensive chromosome screening methodology in human blastocysts.

STUDY QUESTION: Can a novel targeted next generation sequencing (tNGS) platform accurately detect whole chromosome aneuploidy in a trophectoderm biopsy and provide additional information to improve testing? SUMMARY ANSWER: Karyotypes obtained by tNGS were concordant with other validated platforms and single nucleotide polymorphism genotyping information obtained can be used for improved detection and quality control. WHAT IS KNOWN ALREADY: qPCR-based whole chromosome aneuploidy screening is highly accurate in comparison to other common methods and has been shown to improve IVF success in two randomized clinical trials. With aneuploidy screening becoming standard of care in many IVF centres, there is a need to develop platforms with high throughput, low cost capabilities. STUDY DESIGN SIZE, DURATION: Twelve well-characterized cell lines were obtained from a commercial cell line repository and 31 discarded human blastocysts were obtained from 17 IVF patients who underwent comprehensive chromosome screening (CCS). PARTICIPANTS/MATERIAL, SETTING, METHODS: All samples were processed using a unique amplification strategy which directly incorporated sequencing library adapters and barcodes. Sequencing was performed on an Ion Torrent Proton. A custom bioinformatics pipeline was used to determine the karyotype for each sample. The consistency of tNGS diagnoses with either conventional karyotyping of cell lines or quantitative real-time PCR based CCS of blastocyst biopsies was evaluated. MAIN RESULTS AND THE ROLE OF CHANCE: Overall consistency per sample of tNGS based CCS in 5-cell samples from a variety of cell lines was 99.2%. In the blinded analysis of rebiopsies of aneuploid blastocysts, an overall targeted tNGS CCS consistency of 98.7% was observed per sample. These data demonstrate the ability of tNGS based CCS to provide an accurate and high throughput evaluation of aneuploidy in the human blastocyst. LARGE SCALE DATA: Not applicable. LIMITATIONS REASONS FOR CAUTION: This study is limited to whole chromosome aneuploidy, as mosaicism and segmental aneuploidy have not been investigated. WIDER IMPLICATIONS OF THE FINDINGS: These data show an accurate, high throughput method, and with the greater depth of each amplicon sequenced in comparison to commercial kits, there is greater application available for single nucleotide polymorphism based analysis for quality control. STUDY FUNDING/COMPETING INTERESTS: This study was funded through intramural research funds provided by the Foundation for Embryonic Competence. There are no competing interests.

Intensified blood glucose treatment in diabetic patients undergoing a liver transplant: impact on graft evolution at 3 months and at 5 years.

PURPOSE: The debate about the impact of intensified hyperglycemia treatment is still ranging. The main objective was to assess whether intensive glycemic control in hospitalized diabetic patients undergoing a liver transplant is associated with a lower rate of graft rejection at 3 months and at 5 years post-transplant. METHODS: Cross-sectional study comparing a cohort of patients undergoing liver transplant in 2010 and 2011, in whom an intensive insulin protocol was applied, with a retrospective group of patients undergoing a liver transplant in 2005 and 2006, in whom a conventional insulin protocol was applied. Both diabetics and non-diabetics were compared. As intensive insulin therapy is applied mainly in diabetic patients, it is expected that, when comparing both periods, the treatment would only benefit those patients. RESULTS: The logistic regression model showed a statistically significant interaction between the treatment group and the presence of diabetes for the rejection rate 3 months and 5 years post-transplant. At both time points, the intensive insulin treatment group had lower rejection rates in the case of diabetic patients, which did not occur in non-diabetic patients. CONCLUSIONS: Our study shows a decrease in the rate of liver graft rejection in diabetic patients undergoing intensive insulin treatment.

Assessment of the effect of grape seed cake inclusion in the diet of healthy fattening-finishing pigs.

Modulatory capacity of bioactive compounds from different wastes has been scarcely investigated in pigs. This study aimed to evaluate the effects of dietary inclusion of grape seed cakes (GS diet) on performance and plasma biochemistry parameters as health indicators, as well as on several markers related to inflammation and antioxidant defence in the liver of fattening-finishing pigs. Twelve cross-bred pigs (TOPIG) were randomly assigned to one of two experimental diets: control and 5% grape seed cake diet during finishing period (24 days). No effect of GS diet on pig performance and blood biochemistry was observed. However, GS diet decreased significantly (-9.05%, p < .05) the cholesterol concentration (85.71 ± 0.94 mg/dl vs 94.24 ± 2.16 mg/dl) and increased IgA level (+49.90%, p < .05) in plasma (5.04 ± 0.5 mg/ml vs 3.36 ± 0.7 mg/ml). GS cakes decreased the inflammatory response in the liver of pigs fed with GS diet by lowering the Gene expression and protein concentration of pro-inflammatory cytokines (IL-1ß, IL-8, TNF-α and IFN-γ) as well as the mRNA abundances of NF-κB signalling molecules. The antioxidant status was not increased by GS diet. The gene expression and activity of catalase decreased significantly. The gene expression of Nrf2, superoxide dismutase, glutathione peroxidase and heat-shock protein decreased, and no effect on their activity was observed with the exception of catalase activity which decreased. However, TBARS was reduced significantly. GS diet showed a modulatory effect on antioxidative status as well as anti-inflammatory and hypocholesterolic properties without effect on pig performance.

Negative latent tuberculosis at time of incarceration: identifying a very high-risk group for infection.

The main aim was to measure the incidence of latent tuberculosis infection (LTBI) and identify risk factors associated with infection. In addition, we determined the number needed to screen (NNS) to identify LTBI and active tuberculosis. We followed 129 prisoners for 2 years following a negative two-step tuberculin skin test (TST). The cumulative incidence of TST conversion over 2 years was 29·5% (38/129), among the new TST converters, nine developed active TB. Among persons with no evidence of LTBI, the NNS to identify a LTBI case was 3·4 and an active TB case was 14·3. The adjusted risk factors for LTBI conversion were incarceration in prison number 1, being formerly incarcerated, and overweight. In conclusion, prisoners have higher risk of LTBI acquisition compared with high-risk groups, such as HIV-infected individuals and children for whom LTBI testing should be performed according to World Health Organization guidance. The high conversion rate is associated with high incidence of active TB disease, and therefore we recommend mandatory LTBI screening at the time of prison entry. Individuals with a negative TST at the time of entry to prison are at high risk of acquiring infection, and should therefore be followed in order to detect convertors and offer LTBI treatment. This approach has a very low NNS for each identified case, and it can be utilized to decrease development of active TB disease and transmission.

Symptomatic BK Virus Infection Is Associated With Kidney Function Decline and Poor Overall Survival in Allogeneic Hematopoietic Stem Cell Recipients.

Nephropathy due to BK virus (BKV) infection is an evolving challenge in patients undergoing hematopoietic stem cell transplantation (HSCT). We hypothesized that BKV infection was a marker of kidney function decline and a poor prognostic factor in HSCT recipients who experience this complication. In this retrospective study, we analyzed all patients who underwent their first allogeneic HSCT at our institution between 2004 and 2012. We evaluated the incidence of persistent kidney function decline, which was defined as a confirmed reduction in estimated glomerular filtration rate of at least 25% from baseline using the Chronic Kidney Disease Epidemiology equation. Cox proportional hazard regression was used to model the cause-specific hazard of kidney function decline, and the Fine-Gray method was used to account for the competing risks of death. Among 2477 recipients of a first allogeneic HSCT, BK viruria was detected in 25% (n = 629) and kidney function decline in 944 (38.1%). On multivariate analysis, after adjusting for age, sex, acute graft-versus-host disease (GVHD), chronic GVHD, preparative conditioning regimen, and graft source, BK viruria remained a significant risk factor for kidney function decline (p < 0.001). In addition, patients with BKV infection and kidney function decline experienced worse overall survival. After allogeneic HSCT, BKV infection was strongly and independently associated with subsequent kidney function decline and worse patient survival after HSCT.

The first case of acute unilateral pan-ureteritis caused by BK polyomavirus in an allogeneic stem cell transplant patient.

Several cases of ureteral obstruction have been reported in stem cell transplant (SCT) patients; however, they were bilateral and concomitant with or preceded by hemorrhagic cystitis. We describe, to our knowledge, a first case of acute unilateral pan-ureteritis caused by BK polyomavirus (BKPyV) in an SCT patient. This case may represent an early phase of BKPyV reactivation. BKPyV infection should be considered as a potential cause of acute unilateral ureteritis even among SCT recipients.

Adaptation and validation of the Spanish self-report version of the Spinal Cord Independence Measure (SCIM III).

STUDY DESIGN: This is a cross-sectional validation study. OBJECTIVE: The objective of this study was to adapt and validate a self-report version of the Spinal Cord Independence Measure (SCIM III) for the Spanish population. METHODS: A cross-cultural adaptation of the self-report version of the SCIM III for the Spanish population was performed on the basis of international guidelines. A total of 100 patients with spinal cord injury (SCI) were recruited. A team of healthcare professionals administered the SCIM III by observation. In addition, the patients completed the Spanish self-report version (eSCIM-SR). Data from both questionnaires were analysed jointly. RESULTS: A high correlation was observed between SCIM III and eSCIM-SR. Lin's concordance correlation coefficient for the global score was 0.998 (95% confidence interval: 0.997, 0.998), and the subscale scores were 0.988 (0.982, 0.992) for self-care, 0.992 (0.988, 0.995) for respiration and sphincter management and 0.997 (0.995, 0.998) for Mobility. Bland-Altman plots showed a small bias of -0.32 (95% limits of agreement: -3.01, 2.37). The estimated bias was low in all three domains, with values of -0.22 (-2.12, 1.68), -0.1 (-2.02, 1.82) and -0.03 (-1.69, 1.63) for the self-care, respiration and sphincter management and mobility subscales, respectively. CONCLUSION: Our study validates the eSCIM-SR as a tool for the functional assessment of patients with SCI, principally in the outpatient setting.

[NONINVASIVE VENTILATION IN THE POSTOPERATIVE PERIOD].

Acute respiratory failure is relatively common postoperative complication, occurs frequently in patients with preexisting compromised respiratory function and/or undergoing major thoracoabdominal procedures. Although endotracheal intubation and mechanical ventilation is still considered the cornerstone for the treatment of patients with acute respiratory failure, literature data have shown that mortality of these patients is closely associated to complications of intubation and mechanical ventilation. Therefore, the goal is to prevent complications and if possible to avoid endotracheal intubation. Noninvasive ventilation (NIV) is a form of mechanical support that does not require endotracheal intubation and is nowadays often used in prophylactic and therapeutic purposes in surgical patients with acute respiratory failure. In this article we give a brief overview of the indications and limitations of non-invasive ventilation in perioperative period.

Giant thoraco-abdominal tumor -- a surgical challenge. Case report.

BACKGROUND: During the last three decades, several improvements in surgical and anesthetic techniques have allowed a better management of primary and secondary tumors of the chest wall. OBJECTIVES: Chest wall tumors, regardless of their location,anterior, posterior or lateral, have always been a challenge for the thoracic surgeon through technical and tactical problems they entail. The most common techniques to reconstruct a full thickness defect are by the use of alloplastic material and filling the soft tissue defect with myocutaneous flap. METHOD: We present the unusual case of a 45 years old patient with a giant right thoraco-abdominal tumor, developing for the last 22 years. The tumor occupied the lower half of the right hemithorax and the right hemi abdomen, down to the right iliac crest. The tumor also developed inside the thoracic cavity, with the invasion of the last 3 ribs, of the diaphragm(partial) and with intra-abdominal invasion of a liver section and the right kidney. RESULTS: The surgery team had special problems related to:providing training and logistics, in-block tumor resection in oncological limits, followed by complex thoraco-abdominal reconstruction. The results were very good, with a favorable postoperative evolution, without any complications, the patient being discharged with the recommendation to come for follow-up on his condition. CONCLUSIONS: A complex surgical intervention proved to be the only solution for saving the patient, for which the life due to the tumor's size became almost unbearable.

A Rare Anastomosis Between the Internal and the External Jugular Veins: A Case Report.

Usually, the external jugular vein (EJV) is located superficially over the sternocleidomastoid muscle and joins the subclavian vein or the venous angle. The internal jugular vein (IJV) lies deeply in close relation with the common carotid artery and vagus nerve, enveloped by the carotid sheath. Normally, there is no direct connection between those vessels. During a routine neck dissection, we found a rare anastomosis between IJV and EJV. The anastomosis was localized on the level of the cricoid cartilage. It was approximately 1 cm long, with the diameter of the lumen being 0.3 cm. There was no obstruction along the length of the vessel. The direction was oblique and followed the blood flow from IJV to EJV. The observed variation has high clinical importance related to numerous procedures executed in the neck region, such as placement of hemodialysis catheter in patients with renal failure, insertion of central venous line in the care of critically ill patients, and radical neck dissections.

Minimally invasive repair for pectus excavatum -- aesthetic and/or functional?

INTRODUCTION: Pectus excavatum is the most frequent anterior thoracic wall congenital malformation. This malformation is increasing its effects with the aging process and has its peak during teenage, when the clinical symptoms become more acute and psychological effects are really important. Across the course of time many treatment techniques have been proposed, among which conservative or surgical correction techniques. The minimally invasive repair of pectus excavatum, "Nuss technique", developed after 1987, is the most frequently performed technique world wide. MATERIAL AND METHOD: This article analyzes 52 patients, admitted to the University Emergency Military Hospital "Carol Davila" - Thoracic Surgery Department, diagnosed, investigated and surgically treated according to Nuss procedure. Therapeutic and diagnostic protocols will be presented and analyzed: clinical and paraclinical evaluation, indications and contraindications of Nuss procedure, as well as possible intraoperative and postoperative complications. RESULTS AND CONCLUSIONS: Nuss procedure's benefits will be presented, as well as improvements of functional and aesthetic parameters. Nuss procedure has a series of advantages: minimally invasive surgical procedure reduced operative time, minimal blood loss and fast socio-professional reinstatement.

Potential for automatic detection of calving in beef cows grazing on rangelands from Global Navigate Satellite System collar data.

Dystocia is one of the main causes of calf death around calving. In addition, peripartum deaths may occur due to other factors, such as weather or predators, especially in the case of grazing animals. Precision Livestock Farming (PLF) tools aimed at the automatic detection of calving may be useful for farmers, allowing cow assistance in case of dystocia or checking the condition of the cow-calf pair after calving. Such PLF systems are commercially available for dairy cows, but these tools are not suitable for rangelands, mainly due to power and connectivity constraints. Thus, since most commercial PLF tools for rangelands are based on Global Navigate Satellite System (GNSS) technology, the objective of this study was to design and evaluate several indicators built from data gathered with GNSS collars to characterise their potential for the detection of calving on rangelands. Location data from 57 cows, 42 of which calved during the study, were curated and analysed following a standardised procedure. Several indicators were calculated using two different strategies. The first approach consisted of having indicators that could be computed using the data of a single GNSS collar (cow indicators). The second strategy involved the use of data from several animals (herd indicators), which requires more animals to be monitored, but may allow the characterisation of social behaviour. Several indicators, such as the length of the daily trajectory or the sinuosity of cow path, showed significant differences between the pre- and postpartum periods, but no clear differences between calving day and previous days. Herd indicators, such as the distance to herd centroid or to the nearest peer were superior in terms of the detection of calving day, as cows showed isolation behaviour from 24 hours before calving. Relative indicators, i.e., the value of cow or herd indicators for the calving cow in relation to the average value of the same indicators for its herdmates, provided additional information on cow behaviour. For instance, according to the relative indicator for the change in daily trajectory, pregnant cows had a differential exploratory behaviour up to 14 days before calving. In conclusion, data from commercial GNSS collars proved to be useful for the computation of several indicators related to the occurrence of calving on rangelands. Some of those indicators showed changes from baseline values on the day before calving, which could serve to predict the onset of parturition.

Associations between Macronutrients Intake and Bone Mineral Density: A Longitudinal Analysis of the Health Workers Cohort Study Participants.

OBJECTIVE: This study aimed to evaluate the association between macronutrient intake and bone mineral density (BMD) using non-substitution and substitution statistical approaches. DESIGN: Longitudinal analysis. SETTINGS AND PARTICIPANTS: 1,317 adults in the Health Worker Cohort Study in Mexico. MEASUREMENTS: These participants were assessed at baseline (2004-2006) and follow-up (2010-2012). Dietary intakes were assessed using validated food frequency questionnaires. BMD at the different sites was performed by dual-energy X-ray absorptiometry (DXA). Hybrid-mixed effects regression models were performed to evaluate the associations of interest. RESULTS: Cross-sectional associations were found between fiber intake and higher total hip and femoral neck BMD in women and longitudinal associations with loss of femoral neck BMD in men. An increase in 5% energy intake from carbohydrate was associated with a BMD loss at several site in women and total hip and femoral neck in men. In both sexes, an increase in 5% energy intake of animal protein or fat was associated with a site-specific BMD gain after six years. Substitution analysis showed that the energy intake replacement from fat or carbohydrate by protein had an increase in BMD at different sites in women; while in men, it was only significant when replacing carbohydrate. Substitution of protein or fat by carbohydrates was associated with lower BMD in women, and only protein replacement by carbohydrates in men. CONCLUSION: Our findings suggest that carbohydrate intake was associated with loss of BMD, while animal protein and fat intake was associated with gain of BMD among the Mexican population. Macronutrient substitutions resulted in significant associations; however, additional studies are needed to confirm these findings.

Anterior thoracic wall giant tumor--special surgical procedure.

We describe the case of a 39 years old male known with an anterior thoracic traumatism in 1993 who observed ananterior thoracic wall tumor since 2000. After one and half year of empiric treatment the tumor starts growing very fast, reaching 30/40/35 cm by the date of his hospital admission (march 2003). Due to this accelerate growth and the size of the tumor the patient is proposed for a particular surgical procedure removing the tumor along with the anterior thoracic wall and the reconstruction using "spider web" technique, Thoratex reinforced mesh and muscle flaps. Thisprocedure had agood result, the patient returned to his anterior lifestyle few months after. The patient did not come for follow-up, although he was recommended to come every tree months. Four years after surgery (2007) the patient came back with local recurrence of the tumor. In 2007 the patient underwent another surgical intervention, removing the tumor recurrence. Chest wall tumors are complex surgical conditions requiring complex treatment. The empiric treatment and the fact that the patient did not come as planned for follow-up, prolonged his sufferance, leading to a second surgical intervention.

Genome-wide DNA methylation profiling in anorexia nervosa discordant identical twins.

Up until now, no study has looked specifically at epigenomic landscapes throughout twin samples, discordant for Anorexia nervosa (AN). Our goal was to find evidence to confirm the hypothesis that epigenetic variations play a key role in the aetiology of AN. In this study, we quantified genome-wide patterns of DNA methylation using the Infinium Human DNA Methylation EPIC BeadChip array ("850 K") in DNA samples isolated from whole blood collected from a group of 7 monozygotic twin pairs discordant for AN. Results were then validated performing a genome-wide DNA methylation profiling using DNA extracted from whole blood of a group of non-family-related AN patients and a group of healthy controls. Our first analysis using the twin sample revealed 9 CpGs associated to a gene. The validation analysis showed two statistically significant CpGs with the rank regression method related to two genes associated to metabolic traits, PPP2R2C and CHST1. When doing beta regression, 6 of them showed statistically significant differences, including 3 CpGs associated to genes JAM3, UBAP2L and SYNJ2. Finally, the overall pattern of results shows genetic links to phenotypes which the literature has constantly related to AN, including metabolic and psychological traits. The genes PPP2R2C and CHST1 have both been linked to the metabolic traits type 2 diabetes through GWAS studies. The genes UBAP2L and SYNJ2 have been related to other psychiatric comorbidity.