Natural variation in learning ability in "Drosophila melanogaster"

Learning is the ability of an organism to adapt to the changes of its environment in response to its past experience. It is a widespread ability in the animal kingdom, but its evolutionary aspects are poorly known. Learning ability is supposedly advantageous under some conditions, when environmental conditions are not too stable - because in this case there is no need to learn to predict any event in the environment - and not changing too fast - otherwise environmental cues cannot be used because they are not reliable. Nevertheless, learning ability is also known to be costly in terms of energy needed for neuronal synthesis, memory formation, initial mistakes. During my PhD, I focused on the study of genetic variability of learning ability in natural populations. Genetic variability is the basis on which natural selection and genetic drift can act. How does learning ability vary in nature? What are the roles of additive genetic variation or maternal effects in this variation? Is it involved in evolutionary trade-offs with other fitness-related traits?¦I investigated a natural population of fruit fly, Drosophila melanogaster, as a model organism. Its learning ability is easy to measure with associative memory tests. I used two research tools: multiple inbred and isofemale lines derived from a natural population as a representative sample. My work was divided into three parts.¦First, I investigated the effects of inbreeding on aversive learning (avoidance of an odor previously associated with mechanical shock). While the inbred lines consistently showed reduced egg-to-adult viability by 28 %, the effects of inbreeding on learning performance was 18 % and varied among assays, with a trend to be most pronounced for intermediate conditioning intensity. Variation among inbred lines indicates that ample genetic variance for learning was segregating in the base population, and suggests that the inbreeding depression observed in learning performance was mostly due to dominance rather than overdominance. Across the inbred lines, learning performance was positively correlated with the egg-to-adult viability. This positive genetic correlation contradicts previous studies which observed a trade-off between learning ability and lifespan or larval competitive ability. It suggests that much of the genetic variation for learning is due to pleiotropic effects of genes affecting other functions related to survival. Together with the overall mild effects of inbreeding on learning performance, this suggests that genetic variation specifically affecting learning is either very low, or is due to alleles with mostly additive (semi-dominant) effects. It also suggests that alleles reducing learning performance are on average partially recessive, because their effect does not appear in the outbred base population. Moreover, overdominance seems unlikely as major cause of the inbreeding depression, because even if the overall mean of the inbred line is smaller than the outbred base population, some of the inbred lines show the same learning score as the outbred base population. If overdominance played an important part in inbreeding depression, then all the homozygous lines should show lower learning ability than¦outbred base population.¦In the second part of my project, I sampled the same natural population again and derived isofemale lines (F=0.25) which are less adapted to laboratory conditions and therefore are more representative of the variance of the natural population. They also showed some genetic variability for learning, and for three other fitness-related traits possibly related with learning: resistance to bacterial infection, egg-to-adult viability and developmental time. Nevertheless, the genetic variance of learning ability did not appear to be smaller than the variance of the other traits. The positive correlation previously observed between learning ability and egg- to-adult viability did not appear in isofemale lines (nor a negative correlation). It suggests that there was still genetic variability within isofemale lines and that they did not fix the highly deleterious pleiotropic alleles possibly responsible for the previous correlation.¦In order to investigate the relative amount of nuclear (additive and non-additive effects) and extra-nuclear (maternal and paternal effect) components of variance in learning ability and other fitness-related traits among the inbred lines tested in part one, I performed a diallel cross between them. The nuclear additive genetic variance was higher than other components for learning ability and survival to learning ability, but in contrast, maternal effects were more variable than other effects for developmental traits. This suggests that maternal effects, which reflects effects from mitochondrial DNA, epigenetic effects, or the amount of nutrients that are invested by the mother in the egg, are more important in the early stage of life, and less at the adult stage. There was no additive genetic correlation between learning ability and other traits, indicating that the correlation between learning ability and egg-to-adult viability observed in the first pat of my project was mostly due to recessive genes.¦Finally, my results showed that learning ability is genetically variable. The diallel experiment showed additive genetic variance was the most important component of the total variance. Moreover, every inbred or isofemale line showed some learning ability. This suggested that alleles impairing learning ability are eliminated by selection, and therefore that learning ability is under strong selection in natural populations of Drosophila. My results cannot alone explain the maintenance of the observed genetic variation. Even if I cannot eliminate the hypothesis of pleiotropy between learning ability and the other fitness-related traits I measured, there is no evidence for any trade-off between these traits and learning ability. This contradicts what has been observed between learning ability and other traits like lifespan and larval competitivity.¦L'apprentissage représente la capacité d'un organisme à s'adapter aux changement de son environnement au cours de sa vie, en réponse à son expérience passée. C'est une capacité très répandue dans le règne animal, y compris pour les animaux les plus petits et les plus simples, mais les aspects évolutifs de l'apprentissage sont encore mal connus. L'apprentissage est supposé avantageux dans certaines conditions, quand l'environnement n'est ni trop stable - dans ce cas, il n'y a rien à apprendre - ni trop variable - dans ce cas, les indices sur lesquels se reposer changent trop vite pour apprendre. D'un autre côté, l'apprentissage a aussi des coûts, en terme de synthèse neuronale, pour la formation de la mémoire, ou de coûts d'erreur initiale d'apprentissage. Pendant ma thèse, j'ai étudié la variabilité génétique naturelle des capacités d'apprentissage. Comment varient les capacités d'apprentissage dans la nature ? Quelle est la part de variation additive, l'impact des effets maternel ? Est-ce que l'apprentissage est impliqué dans des interactions, de type compromis évolutifs, avec d'autres traits liés à la fitness ?¦Afin de répondre à ces questions, je me suis intéressée à la mouche du vinaigre, ou drosophile, un organisme modèle. Ses capacités d'apprentissage sont facile à étudier avec un test de mémoire reposant sur l'association entre un choc mécanique et une odeur. Pour étudier ses capacités naturelles, j'ai dérivé de types de lignées d'une population naturelle: des lignées consanguines et des lignées isofemelles.¦Dans une première partie, je me suis intéressée aux effets de la consanguinité sur les capacités d'apprentissage, qui sont peu connues. Alors que les lignées consanguines ont montré une réduction de 28% de leur viabilité (proportion d'adultes émergeants d'un nombre d'oeufs donnés), leurs capacités d'apprentissage n'ont été réduites que de 18%, la plus forte diminution étant obtenue pour un conditionnement modéré. En outre, j'ai également observé que les capacités d'apprentissage était positivement corrélée à la viabilité entre les lignées. Cette corrélation est surprenante car elle est en contradiction avec les résultats obtenus par d'autres études, qui montrent l'existence de compromis évolutifs entre les capacités d'apprentissage et d'autres traits comme le vieillissement ou la compétitivité larvaire. Elle suggère que la variation génétique des capacités d'apprentissage est due aux effets pleiotropes de gènes récessifs affectant d'autres fonctions liées à la survie. Ces résultats indiquent que la variation pour les capacités d'apprentissage est réduite comparée à celle d'autres traits ou est due à des allèles principalement récessifs. L'hypothèse de superdominance semble peu vraisemblable, car certaines des lignées consanguines ont obtenu des scores d'apprentissage égaux à ceux de la population non consanguine, alors qu'en cas de superdominance, elles auraient toutes dû obtenir des scores inférieurs.¦Dans la deuxième partie de mon projet, j'ai mesuré les capacités d'apprentissage de lignées isofemelles issues de la même population initiale que les lignées consanguines. Ces lignées sont issues chacune d'un seul couple, ce qui leur donne un taux d'hétérozygosité supérieur et évite l'élimination de lignées par fixation d'allèles délétères rares. Elles sont ainsi plus représentatives de la variabilité naturelle. Leur variabilité génétique est significative pour les capacités d'apprentissage, et trois traits liés à la fois à la fitness et à l'apprentissage: la viabilité, la résistance à l'infection bactérienne et la vitesse de développement. Cependant, la variabilité des capacités d'apprentissage n'apparaît cette fois pas inférieure à celle des autres traits et aucune corrélation n'est constatée entre les capacité d'apprentissage et les autres traits. Ceci suggère que la corrélation observée auparavant était surtout due à la fixation d'allèles récessifs délétères également responsables de la dépression de consanguinité.¦Durant la troisième partie de mon projet, je me suis penchée sur la décomposition de la variance observée entre les lignées consanguines observée en partie 1. Quatre composants ont été examinés: la variance due à des effets nucléaires (additifs et non additifs), et due à des effets parentaux (maternels et paternels). J'ai réalisé un croisement diallèle de toutes les lignées. La variance additive nucléaire s'est révélée supérieure aux autres composants pour les capacités d'apprentissage et la résistance à l'infection bactérienne. Par contre, les effets maternels étaient plus importants que les autres composants pour les traits développementaux (viabilité et vitesse de développement). Ceci suggère que les effets maternels, dus à G ADN mitochondrial, à l'épistasie ou à la quantité de nutriments investis dans l'oeuf par la mère, sont plus importants dans les premiers stades de développement et que leur effet s'estompe à l'âge adulte. Il n'y a en revanche pas de corrélation statistiquement significative entre les effets additifs des capacités d'apprentissage et des autres traits, ce qui indique encore une fois que la corrélation observée entre les capacités d'apprentissage et la viabilité dans la première partie du projet était due à des effets d'allèles partiellement récessifs.¦Au, final, mes résultats montrent bien l'existence d'une variabilité génétique pour les capacités d'apprentissage, et l'expérience du diallèle montre que la variance additive de cette capacité est importante, ce qui permet une réponse à la sélection naturelle. Toutes les lignées, consanguines ou isofemelles, ont obtenu des scores d'apprentissage supérieurs à zéro. Ceci suggère que les allèles supprimant les capacités d'apprentissage sont fortement contre-sélectionnés dans la nature Néanmoins, mes résultats ne peuvent pas expliquer le maintien de cette variabilité génétique par eux-même. Même si l'hypothèse de pléiotropie entre les capacités d'apprentissage et l'un des traits liés à la fitness que j'ai mesuré ne peut être éliminée, il n'y a aucune preuve d'un compromis évolutif pouvant contribuer au maintien de la variabilité.

Individual vocal signatures in barn owl nestlings: does individual recognition have an adaptive role in sibling vocal competition?

To compete over limited parental resources, young animals communicate with their parents and siblings by producing honest vocal signals of need. Components of begging calls that are sensitive to food deprivation may honestly signal need, whereas other components may be associated with individual-specific attributes that do not change with time such as identity, sex, absolute age and hierarchy. In a sib-sib communication system where barn owl (Tyto alba) nestlings vocally negotiate priority access to food resources, we show that calls have individual signatures that are used by nestlings to recognize which siblings are motivated to compete, even if most vocalization features vary with hunger level. Nestlings were more identifiable when food-deprived than food-satiated, suggesting that vocal identity is emphasized when the benefit of winning a vocal contest is higher. In broods where siblings interact iteratively, we speculate that individual-specific signature permits siblings to verify that the most vocal individual in the absence of parents is the one that indeed perceived the food brought by parents. Individual recognition may also allow nestlings to associate identity with individual-specific characteristics such as position in the within-brood dominance hierarchy. Calls indeed revealed age hierarchy and to a lower extent sex and absolute age. Using a cross-fostering experimental design, we show that most acoustic features were related to the nest of origin (but not the nest of rearing), suggesting a genetic or an early developmental effect on the ontogeny of vocal signatures. To conclude, our study suggests that sibling competition has promoted the evolution of vocal behaviours that signal not only hunger level but also intrinsic individual characteristics such as identity, family, sex and age.

Effect of vitamin D on Epstein-Barr (EBV)-specific CD8+T cells in patients with early multiple sclerosis (MS)

Background: Infection with EBV and a lack in vitamin D may be important environmental triggers of MS. 1,25-(OH)2D3 mediates a shift of antigen presenting cells (APC) and CD4+ T cells to a less inflammatory profile. Although CD8+ T cells do express the vitamin D receptor, a direct effect of 1,25(OH)2D3 on these cells has not been demonstrated until now. Since CD8+ T cells are important immune mediators of the inflammatory response in MS, we examined whether vitamin D directly affects the CD8+ T cell response, and more specifically if it modulates the EBV-specific CD8+ T cell response. Material and Methods: To explore whether the vitamin D status may influence the pattern of the EBV-specific CD8+ T cell response, PBMC of 10 patients with early MS and 10 healthy controls (HC) were stimulated with a pool of immunodominant 8-10 mer peptide epitopes known to elicit CD8+ T cell responses. PBMC were stimulated with this EBV CD8 peptide pool, medium (negative control) or anti- CD3/anti-CD28 beads (positive control). The following assays were performed: ELISPOT to assess the secretion of IFN-gamma by T cells in general; cytometric beads array (CBA) and ELISA to determine whichcytokines were released by EBV-specific CD8+ T cells after six days of culture; and intracellular cytokine staining assay to determine by which subtype of T cells secreted given cytokines. To examine whether vitamin D could directly modulate CD8+ T cell immune responses, we depleted CD4+ T cells using negative selection. Results: We found that pre-treatment of vitamin D had an antiinflammatory action on both EBV-specific CD8+ T cells and on CD3/ CD28-stimulated T cells: secretion of pro-inflammatory cytokines (IFNgamma and TNF-alpha) was decreased, whereas secretion of antiinflammatory cytokines (IL-5 and TGF-beta) was increased. At baseline, CD8+ T cells of early MS patients showed a higher secretion of TNFalpha and lower secretion of IL-5. Addition of vitamin D did not restore the same levels of both cytokines as compared to HC. Vitamin D-pretreated CD8+T cells exhibited a decreased secretion of IFN-gamma and TNF-alpha, even after depletion of CD4+ T cells from culture. Conclusion: Vitamin D has a direct anti-inflammatory effect on CD8+ T cells independently from CD4+ T cells. CD8+ T cells of patients with earlyMS are less responsive to the inflammatory effect of vitamin D than HC, pointing toward an intrinsic dysregulation of CD8+ T cells. The modulation of EBV-specific CD8+T cells by vitaminDsuggests that there may be interplay between these twomajor environmental factors of MS. This study was supported by a grant from the Swiss National Foundation (PP00P3-124893), and by an unrestricted research grant from Bayer to RDP.

Vitamin D has a direct immunomodulatory effect on CD8+ T cells of patients with early multiple sclerosis and healthy control subjects.

Little is known on a putative effect of vitamin D on CD8+ T cells. Yet, these cells are involved in the immmunopathogenesis of MS. We assessed the cytokine profile of EBV-specific CD8+ T cells of 10 early MS patients and 10 healthy control subjects with or without 1,25(OH)(2)D(3) and found that, with 1,25(OH)(2)D(3), these cells secreted less IFN-γ and TNF-α and more IL-5 and TGF-β. CD4+ T cell depletion or even culture with CD8+ T cells only did not abolish the immunomodulatory effect of 1,25(OH)(2)D(3) on CD8+ T cells, suggesting that 1,25(OH)(2)D(3) can act directly on CD8+ T cells.

Effect of controlled co-delivery of synergistic neurotrophic factors on early nerve regeneration in rats.

Present interventions to repair severed peripheral nerves provide slow and poor early axonal regeneration, which may cause unsatisfactory functional reinnervation. To improve early axonal regeneration in a 10 mm rat sciatic nerve gap model, we developed collagen nerve conduits loaded with the synergistically acting glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF). For controlling the concomitant GDNF and NGF release, the collagen tubes were cross-linked by a dehydro-thermal treatment (110 degrees C; 20 mbar; 5 days) prior to impregnating the tubes with GDNF and NGF and by coating drug-loaded tubes with layers of poly(lactide-co-glycolide). The conduits made of cross-linked collagen released low initial amounts of GDNF and NGF (2% of both during first 3 days) and enhanced significantly the early (2 weeks) nerve regeneration in terms of axonal outgrowth and Schwann cell migration in a 10 mm rat sciatic nerve gap model, as compared to the conduits made of non-cross-linked collagen releasing higher initial amounts of GDNF and NGF (12-16% within 3 days), or those releasing GDNF alone. The enhancement of early axonal regeneration using controlled co-delivery of multiple synergistic neurotrophic factors is an important requisite for eventually establishing functional connections with the target organ.

Modelling the effect of minor orthopaedic day surgery on patient mood at the early post-operative period: a prospective population-based cohort study.

OBJECTIVE: The effect of minor orthopaedic day surgery (MiODS) on patient's mood. METHODS: A prospective population-based cohort study of 148 consecutive patients with age above 18 and less than 65, an American Society of Anaesthesiology (ASA) score of 1, and the requirement of general anaesthesia (GA) were included. The Medical Outcomes Study - Short Form 36 (SF-36), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used pre- and post-operatively. RESULTS: The mean physical component score of SF-36 before surgery was 45.3 (SD=+/-10.1) and 8 weeks following surgery was 44.9 (SD=+/-11.04) [n=148, p=0.51, 95% CI=(-1.03 to 1.52)]. For the measurement of the changes in mood using BDI, BAI and SF-36, latent construct modelling was employed to increase validity. The covariance between mood pre- and post-operatively (cov=69.44) corresponded to a correlation coefficient, r=0.88 indicating that patients suffering a greater number of mood symptoms before surgery continue to have a greater number of symptoms following surgery. When the latent mood constructs were permitted to have different means the model fitted well with chi(2) (df=1)=0.86 for which p=0.77, thus the null hypothesis that MiODS has no effect on patient mood was rejected. CONCLUSIONS: MiODS affects patient mood which deteriorates at 8 weeks post-operatively regardless of the pre-operative patient mood state. More importantly patients suffering a greater number of mood symptoms before MiODS continue to have a greater number of symptoms following surgery.

Effect of early antiretroviral therapy during primary HIV-1 infection on cell-associated HIV-1 DNA and plasma HIV-1 RNA.

Background: Early initiation of combination antiretroviral therapy (ART) during primary HIV-1 infection may prevent the establishment of large viral reservoirs, possibly resulting in improved control of plasma viraemia rebound after ART cessation.Methods: Levels of cell-associated HIV-1 DNA and plasma HIV-1 RNA were measured longitudinally in 32 acutely and recently infected patients, who started ART <= 120 days after the estimated date of infection, and interrupted ART after 18 months (median) of continuous therapy. Averages of HIV-1 DNA and RNA concentrations present in blood 30-365 days after therapy interruption (median duration 300 days, range 195-358) were compared between patients who started ART <= 60 days after the estimated date of infection (early starters), those who started between 61 and 120 days (later starters), and, for HIV-1 RNA only, with 89 untreated participants of the Swiss HIV Cohort Study with documented sero-conversion and longitudinal measurements collected 90-455 days after the first positive HIV test.Results: In early ART starters, average levels of plasma HIV-1 RNA and cell-associated HIV-1 DNA after treatment interruption were 1 log(10) (P=0.008) and 0.4 log(10) (P=0.03) lower compared with later starters. Average post-treatment plasma HIV-1 RNA levels in early starters were significantly lower, respectively, compared with untreated controls (-1.2 log(10); P<0.0004).Conclusions: Early treatment initiation within 2 months after HIV infection compared with later therapy initiation resulted in reduced levels of plasma viraemia and proviral HIV-1 DNA for >= 1 year after subsequent ART cessation. Plasma HIV-1 RNA levels in early starters were also significantly lower than in untreated controls.

Dramatic effect of early clopidogrel administration in reducing mortality and MACE rates in ACS patients. Data from the Swiss registry AMIS-Plus.

BACKGROUND: Patients who have acute coronary syndromes with or without ST-segment elevation have high rates of major vascular events. We evaluated the efficacy of early clopidogrel administration (300 mg) (<24 hours) when given with aspirin in such patients. METHODS: We included 30,243 patients who had an acute coronary syndrome with or without ST segment elevation. Data on early clopidogrel administration were available for 24,463 (81%). Some 15,525 (51%) of the total cohort were administrated clopidogrel within 24h of admission. RESULTS: In-hospital death occurred in 2.9% of the patients in the early clopidogrel group treated with primary PCI and in 11.4% of the patients in the other group without primary percutaneous coronary intervention (PCI) and no early clopidogrel. The unadjusted clopidogrel odds ratio (OR) for mortality was 0.31 (95% confidence interval 0.27-0.34; p <0.001). Incidence of major adverse cardiac death (MACE) was 4.1% in the early clopidogrel group treated with 1°PCI and 13.5% in the other group without primary PCI and no early clopidogrel (OR 0.35, confidence interval 0.32-0.39, p <0.001). Early clopidogrel administration and PCI were the only treatment lowering mortality as shown by mutlivariate analysis. CONCLUSIONS: The early administration of the anti-platelet agent clopidogrel in patients with acute coronary syndromes with or without ST-segment elevation has a beneficial effect on mortality and major adverse cardiac events. The lower mortality rate and incidence of MACE emerged with a combination of primary PCI and early clopidogrel administration.

Effect of vitamin D on EBV-specific CD8+T cells in patients with early multiple sclerosis

Introduction: Infection with Epstein-Barr Virus (EBV) and a lack invitamin D are emerging as the twomost significant environmental triggersof multiple sclerosis (MS). Sincewe and others have shown that CD8+T cells are important immune mediatorsof the inflammatory response inMS, we examined whether vitamin Ddirectly affects the CD8+ T cell response.We also explored if vitaminDmodulates the EBV-specific CD8+ Tcell response. Methods: PBMC of 10patients with early MS and 10 healthycontrols (HC) were stimulated eitherwith a pool of EBVimmunodominantpeptides or anti-CD3/anti-CD28 beads.Cytokine secretion was assessed witha Cytometric Beads Array (CBA),ELISA and intracellular cytokinestaining. To examine whether vitaminD could directly modulate CD8+ Tcell immune responses, we depletedCD4+ T cells using a negative selection.Results: We found that vitaminD-treated PBMC stimulated eitherwith the EBV peptide pool or anti-CD3/anti-CD28 beads adopted ananti-inflammatory profile: significantdecrease in IFN-and TNF secretion,contrasting with a significant increasein IL-5 and TGF-secretion. At baseline,but also after vitamin D stimulation,IL-5 was significantly less producedby stimulated CD8+ T cells ofearly MS than HC. Finally, using depletionof CD4+ T cells, we couldshow that vitaminDcan directlymodulateCD8+ T cells. Discussion: Ourdata suggest that vitaminDconfers ananti-inflammatory profile to CD8+ Tcells, without the help of CD4+ Tcells. Even if vitamin D has a significanteffect on CD8+ T cells of earlyMS patients, this "rescuing" effect isof smaller magnitude than in HC subjects.Finally, vitamin D does influencethe CD8+ T cell response toEBV in early MS patients, suggestingthat there is an interplay betweenthese two major environmental factorsof MS.

Representation of Sound Objects within Early-Stage Auditory Areas: A Repetition Effect Study Using 7T fMRI.

Environmental sounds are highly complex stimuli whose recognition depends on the interaction of top-down and bottom-up processes in the brain. Their semantic representations were shown to yield repetition suppression effects, i. e. a decrease in activity during exposure to a sound that is perceived as belonging to the same source as a preceding sound. Making use of the high spatial resolution of 7T fMRI we have investigated the representations of sound objects within early-stage auditory areas on the supratemporal plane. The primary auditory cortex was identified by means of tonotopic mapping and the non-primary areas by comparison with previous histological studies. Repeated presentations of different exemplars of the same sound source, as compared to the presentation of different sound sources, yielded significant repetition suppression effects within a subset of early-stage areas. This effect was found within the right hemisphere in primary areas A1 and R as well as two non-primary areas on the antero-medial part of the planum temporale, and within the left hemisphere in A1 and a non-primary area on the medial part of Heschl's gyrus. Thus, several, but not all early-stage auditory areas encode the meaning of environmental sounds.

Early Recurrence and Cerebral Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation: effect of Anticoagulation and Its Timing: the RAF Study.

BACKGROUND AND PURPOSE: The best time for administering anticoagulation therapy in acute cardioembolic stroke remains unclear. This prospective cohort study of patients with acute stroke and atrial fibrillation, evaluated (1) the risk of recurrent ischemic event and severe bleeding; (2) the risk factors for recurrence and bleeding; and (3) the risks of recurrence and bleeding associated with anticoagulant therapy and its starting time after the acute stroke. METHODS: The primary outcome of this multicenter study was the composite of stroke, transient ischemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding within 90 days from acute stroke. RESULTS: Of the 1029 patients enrolled, 123 had 128 events (12.6%): 77 (7.6%) ischemic stroke or transient ischemic attack or systemic embolism, 37 (3.6%) symptomatic cerebral bleeding, and 14 (1.4%) major extracranial bleeding. At 90 days, 50% of the patients were either deceased or disabled (modified Rankin score ≥3), and 10.9% were deceased. High CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesion and type of anticoagulant were predictive factors for primary study outcome. At adjusted Cox regression analysis, initiating anticoagulants 4 to 14 days from stroke onset was associated with a significant reduction in primary study outcome, compared with initiating treatment before 4 or after 14 days: hazard ratio 0.53 (95% confidence interval 0.30-0.93). About 7% of the patients treated with oral anticoagulants alone had an outcome event compared with 16.8% and 12.3% of the patients treated with low molecular weight heparins alone or followed by oral anticoagulants, respectively (P=0.003). CONCLUSIONS: Acute stroke in atrial fibrillation patients is associated with high rates of ischemic recurrence and major bleeding at 90 days. This study has observed that high CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesions, and type of anticoagulant administered each independently led to a greater risk of recurrence and bleedings. Also, data showed that the best time for initiating anticoagulation treatment for secondary stroke prevention is 4 to 14 days from stroke onset. Moreover, patients treated with oral anticoagulants alone had better outcomes compared with patients treated with low molecular weight heparins alone or before oral anticoagulants.

Ectodysplasin A1 promotes placodal cell fate during early morphogenesis of ectodermal appendages.

Organs developing as appendages of the ectoderm are initiated from epithelial thickenings called placodes. Their formation is regulated by interactions between the ectoderm and underlying mesenchyme, and several signalling molecules have been implicated as activators or inhibitors of placode formation. Ectodysplasin (Eda) is a unique signalling molecule in the tumour necrosis factor family that, together with its receptor Edar, is necessary for normal development of ectodermal organs both in humans and mice. We have shown previously that overexpression of the Eda-A1 isoform in transgenic mice stimulates the formation of several ectodermal organs. In the present study, we have analysed the formation and morphology of placodes using in vivo and in vitro models in which both the timing and amount of Eda-A1 applied could be varied. The hair and tooth placodes of K14-Eda-A1 transgenic embryos were enlarged, and extra placodes developed from the dental lamina and mammary line. Exposure of embryonic skin to Eda-A1 recombinant protein in vitro stimulated the growth and fusion of placodes. However, it did not accelerate the initiation of the first wave of hair follicles giving rise to the guard hairs. Hence, the function of Eda-A1 appears to be downstream of the primary inductive signal required for placode initiation during skin patterning. Analysis of BrdU incorporation indicated that the formation of the epithelial thickening in early placodes does not involve increased cell proliferation and also that the positive effect of Eda-A1 on placode expansion is not a result of increased cell proliferation. Taken together, our results suggest that Eda-A1 signalling promotes placodal cell fate during early development of ectodermal organs.

Differential effect of long versus short wavelength light exposure on pupillary re-dilation in patients with outer retinal disease.

BACKGROUND: In patients with outer retinal degeneration, a differential pupil response to long wavelength (red) versus short wavelength (blue) light stimulation has been previously observed. The goal of this study was to quantify differences in the pupillary re-dilation following exposure to red versus blue light in patients with outer retinal disease and compare them with patients with optic neuropathy and with healthy subjects. DESIGN: Prospective comparative cohort study. PARTICIPANTS: Twenty-three patients with outer retinal disease, 13 patients with optic neuropathy and 14 normal subjects. METHODS: Subjects were tested using continuous red and blue light stimulation at three intensities (1, 10 and 100 cd/m2) for 13 s per intensity. Pupillary re-dilation dynamics following the brightest intensity was analysed and compared between the three groups. MAIN OUTCOME MEASURES: The parameters of pupil re-dilation used in this study were: time to recover 90% of baseline size; mean pupil size at early and late phases of re-dilation; and differential re-dilation time for blue versus red light. RESULTS: Patients with outer retinal disease showed a pupil that tended to stay smaller after light termination and thus had a longer time to recovery. The differential re-dilation time was significantly greater in patients with outer retinal disease (median = 28.0 s, P < 0.0001) compared with controls and patients with optic neuropathy. CONCLUSIONS: A differential response of pupil re-dilation following red versus blue light stimulation is present in patients with outer retinal disease but is not found in normal eyes or among patients with visual loss from optic neuropathy.

Large-scale imatinib dose-concentration-effect study in CML patients under routine care conditions.

This observational study analyzed imatinib pharmacokinetics and response in 2478 chronic myeloid leukemia (CML) patients. Data were obtained through centralized therapeutic drug monitoring (TDM) at median treatment duration of ≥2 years. First, individual initial trough concentrations under 400mg/day imatinib starting dose were estimated. Second, their correlation (C^min(400mg)) with reported treatment response was verified. Low imatinib levels were predicted in young male patients and those receiving P-gp/CYP3A4 inducers. These patients had also lower response rates (7% lower 18-months MMR in male, 17% lower 1-year CCyR in young patients, Kaplan-Meier estimates). Time-point independent multivariate regression confirmed a correlation of individual C^min(400mg) with response and adverse events. Possibly due to confounding factors (e.g. dose modifications, patient selection bias), the relationship seemed however flatter than previously reported from prospective controlled studies. Nonetheless, these observational results strongly suggest that a subgroup of patients could benefit from early dosage optimization assisted by TDM, because of lower imatinib concentrations and lower response rates.