Blood and CSF anti-neuronal antibodies testing in psychotic syndromes: a retrospective analysis from a tertiary psychiatric hospital.

A Consensus of Psychoimmunology Experts (Pollak et al., 2019) established a set of red flags and proposed diagnostic criteria for psychosis of autoimmune origin (AIP). Previous studies on AIP are limited by the scarcity of CSF analysis, preventing the valorization of blood anti-neuronal antibodies (Ab). The aims of this study are to determine the relative frequency and characterize AIP in a cohort of psychotic patients that underwent CSF workup. This work is a retrospective study in a tertiary psychiatric hospital. Clinical and paraclinical data were collected from medical records, and patients were classified according to Pollak et al. (2019) criteria. From 68 patients, ten (14.7%) had positive anti-neuronal antibodies (Ab): n = 5 in CSF and blood (n = 4 anti-NMDAr, n = 1 -GAD65), and n = 5 in blood only (n = 1 anti-GABAb, n = 1 -GAD65, n = 1 -SOX1, n = 1 -NMDAr, n = 1 -zic4). After 5- (2-10)-year follow-up, n = 6/68 (8.8%) had AIP diagnosis in context of autoimmune encephalitis (AE), and the remaining (n = 4/10, blood-only Ab) alternative diagnoses (n = 2 dementia, n = 1 schizophrenia, n = 1 intellectual disability). Ten of the 13 patients that fulfilled criteria for possible AIP were mimics, and only three AE had criteria for probable AIP. All AIP developed neurological manifestations (mostly cognitive dysfunction); EEG was usually abnormal (66.7%), and all had normal MRI. We found statistically significant associations between AIP/AE and systemic autoimmune disease, presentation with seizures and EEG abnormalities. All AE developed neurological symptoms alongside psychosis. Ab positivity occurred predominantly in AE but also in other neuropsychiatric disorders. Clinical suspicion based on the knowledge of the described presentations of established Ab is crucial in the psychotic patient approach.

Adopting distributed pair programming as an effective team learning activity: a systematic review.

As online learning has become an inevitable trend in the post-peak era of the COVID-19 pandemic, distributed pair programming (DPP) is gaining momentum in both education and industry. DDP serves as a collaborative programming approach and also benefits the development of computational thinking, a fundamental skill in today's world. This study conducted a systematic review of studies on DPP published after 2010 to understand the themes and factors that impact the team effectiveness of DPP and thus inform future research and practices on how to better leverage this approach for teaching and learning. The results showed that individual characteristics attracted major investigations in the selected 23 studies, including prior programming experience, actual skill, perceived skill, gender, personality, time management, confidence, and self-esteem, with pair compatibility identified as a critical team design factor that significantly affects programmers' satisfaction. Although the feel-good factor in the team process was investigated, no significant impact was found. Under the team environment theme, we compared different opinions on the orientation (e.g., scripted roles) and the use of technology (e.g., integrated development environment tools). Future research should investigate how task structure influences team effectiveness of DPP and relates to computational thinking education. Additionally, because most studies were conducted in higher education contexts, more research in primary and secondary educational contexts is also needed.

Sentinel node total tumour load as a predictive factor for non-sentinel node status in early breast cancer patients - The porttle study.

OSNA is a molecular assay for the detection of sentinel node metastasis. TTL emerged as a concept that seems to accurately predict the status of the NSN. Authors tried to confirm this motion. This is a retrospective and multicentric study that analyzed 2164 patients, 579 of whom had positive SN and completion AD. Logistic regression models were performed in order to identify a suitable cutoff to identify patients who benefit from AD. Univariate and multivariate regression analysis showed a relationship between TTL>30000 and the presence of NSN metastasis (OR 2.84, CI 1.99-4.08, p < 0.001). Logistic regression indicated that the cutoff of 30000 copies/µL better discriminates patients with NSN positivity and allows wide use of these criteria. This cutoff value may safely assist clinicians and patients to decide to proceed or not with an AD.

Lessons Learned from ToxMSDT: A Pilot Innovative Toxicology Research Education Pipeline Program Targeting Underrepresented Undergraduate Students to the Field of Toxicology.

Toxicology, as a profession, lacks diversity. Undergraduate students, and especially underrepresented students, are not commonly introduced to toxicology at US colleges and universities. The Toxicology Mentoring and Skills Development Training Program (ToxMSDT) seeks to acquaint underrepresented undergraduates enrolled in STEM fields with toxicology fundamentals and skills to aid their entry into graduate programs and, ultimately, careers in toxicology. ToxMSDT is a collaboration among three universities. It is a year-long holistic training and mentoring program comprised of web resources accessible 24/7 and extensive one-to-one mentor-mentee interactions throughout the year. Evaluation of the two-year pilot program shows that students expressed a significant increase in knowledge about toxicology careers, networking with people involved in the field of toxicology, feelings of being part of the toxicology community, and seeing themselves as someone who will study toxicology, compared with their feelings prior to their participation in the ToxMSDT program. Thirty students have completed the ToxMSDT program and all 10 (100%) of those who have graduated have joined graduate school in toxicology or toxicology-related STEM fields. Of the 20 (66.6%) program alumni still enrolled as undergraduates, five (25%) are in the process of applying to graduate programs and medical schools as of August 2019.

Genetic and biochemical markers in patients with Alzheimer's disease support a concerted systemic iron homeostasis dysregulation.

Alzheimer's disease (AD) is the most common form of dementia in the elderly individuals, resulting from a complex interaction between environmental and genetic factors. Impaired brain iron homeostasis has been recognized as an important mechanism underlying the pathogenesis of this disease. Nevertheless, the knowledge gathered so far at the systemic level is clearly insufficient. Herein, we used an integrative approach to study iron metabolism in the periphery, at both genotypic and phenotypic levels, in a sample of 116 patients with AD and 89 healthy control subjects. To assess the potential impact of iron metabolism on the risk of developing AD, genetic analyses were performed along with the evaluation of the iron status profile in peripheral blood by biochemical and gene expression studies. The results obtained showed a significant decrease of serum iron, ferritin, and transferrin concentrations in patients compared with the control subjects. Also, a significant decrease of ferroportin (SLC40A1) and both transferrin receptors TFRC and TFR2 transcripts was found in peripheral blood mononuclear cells from patients. At the genetic level, significant associations with AD were found for single nucleotide polymorphisms in TF, TFR2, ACO1, and SLC40A1 genes. Apolipoprotein E gene, a well-known risk factor for AD, was also found significantly associated with the disease in this study. Taken together, we hypothesize that the alterations on systemic iron status observed in patients could reflect an iron homeostasis dysregulation, particularly in cellular iron efflux. The intracellular iron accumulation would lead to a rise in oxidative damage, contributing to AD pathophysiology.

CAT53 and HFE alleles in Alzheimer's disease: a putative protective role of the C282Y HFE mutation.

Alzheimer's disease (AD) is a complex disorder, resulting from an interaction between environmental and genetic factors. Several studies addressed the association of AD with MHC class-I polymorphisms without definite conclusions. Considering the remarkable linkage disequilibrium at the MHC region, it is not possible to assume if the reported associations result from a direct effect of the respective genes or result from associations with other closely linked genes transmitted in an extended conserved haplotype. Recent evidence pointed to CAT53, a newly described gene located at the MHC class-I region in the vicinity of HLA-C, as a candidate modifier gene in AD. CAT53 encodes a phosphatase 1 nuclear inhibitor protein and is strongly expressed in brain regions involved in memory and AD. Here we tested the potential association of CAT53 with the risk of developing AD and searched for potential haplotypic associations of CAT53 with two common mutations (H63D, C282Y) in the HFE gene, also located at chromosome 6p21.3. The allele frequencies of these mutations in AD patients were compared to the expected frequencies previously established in the normal Portuguese population. We detected only one polymorphism (G>A) in CAT53, at position 8232, in intron 17. Screening of this polymorphism in 113 AD patients and 82 controls did not show any evidence of association, therefore excluding the hypothetical role of the CAT53 polymorphism as modifier in AD. In contrast, we found a significant negative association of the C282Y HFE mutation with AD, thus supporting a putative protective role of this protein variant in neurodegeneration.