Novel strain-level resolution of Crohn's disease mucosa-associated microbiota via an ex vivo combination of microbe culture and metagenomic sequencing.

The mucosa-associated microbiota is widely recognized as a potential trigger for Crohn's disease pathophysiology but remains largely uncharacterised beyond its taxonomic composition. Unlike stool microbiota, the functional characterisation of these communities using current DNA/RNA sequencing approaches remains constrained by the relatively small microbial density on tissue, and the overwhelming amount of human DNA recovered during sample preparation. Here, we have used a novel ex vivo approach that combines microbe culture from anaerobically preserved tissue with metagenome sequencing (MC-MGS) to reveal patient-specific and strain-level differences among these communities in post-operative Crohn's disease patients. The 16 S rRNA gene amplicon profiles showed these cultures provide a representative and holistic representation of the mucosa-associated microbiota, and MC-MGS produced both high quality metagenome-assembled genomes of recovered novel bacterial lineages. The MC-MGS approach also produced a strain-level resolution of key Enterobacteriacea and their associated virulence factors and revealed that urease activity underpins a key and diverse metabolic guild in these communities, which was confirmed by culture-based studies with axenic cultures. Collectively, these findings using MC-MGS show that the Crohn's disease mucosa-associated microbiota possesses taxonomic and functional attributes that are highly individualistic, borne at least in part by novel bacterial lineages not readily isolated or characterised from stool samples using current sequencing approaches.

[The efficacy of the systems training for emotional predictability and problem solving (STEPPS) in the treatment of borderline personality disorder. A randomized controlled trial]. / De effectiviteit van de vaardigheidstraining emotieregulatiestoornis (VERS) in de behandeling van de borderlinepersoonlijkheidsstoornis; een gerandomiseerd onderzoek.

BACKGROUND: The types of treatment for borderline personality disorder devised over the last few decades are often difficult to implement in therapy centres. stepps is a group treatment for this disorder which is easy to implement. AIM: To compare the efficacy of stepps supported by limited individual treatment with 'treatment as usual' (tau). METHOD: 79 patients with bpd were randomly assigned to stepps or to tau. Measurements were taken before and after the intervention and at one-year follow-up. Outcome measures were: borderline and general psychiatric symptomatology, suicide attempts, quality of life and use of care services. results stepps led to a larger reduction in symptoms than did tau, the difference being still significant at follow-up. 70% of patients treated with stepps showed improvement compared to 47% of patients treated with tau. In both treatment groups the percentage of patients who recovered was small. There was no difference in the number of suicide attempts in each group. stepps led to a greater improvement in quality of life than did tau, particularly at follow-up. Care service use seemed about equal. CONCLUSION: The efficacy of treatment for bpd can be improved by the introduction of stepps, which is relatively simple to implement.

Goal neglect and inhibitory limitations: dissociable causes of interference effects in conflict situations.

Interference effects on task performance in conflict situations might reflect real limitations in inhibitory capabilities or failures to fully or consistently utilize such capabilities in executive control of task performance. We propose that useful clues regarding the actual cause of interference effects may be obtained from examination of their robustness within and between experimental conditions. We illustrate this approach for two major types of interference effects that have commonly been attributed to fundamental inhibitory limitations: Stroop-type interference and residual switch costs. We present results that indicate that these effects may not be unavoidable consequences of fundamental inhibitory limitations but may stem from goal neglect, i.e., failures to fully or effectively deploy inhibitory capabilities. These results indicate that, in addition to mean performance levels, variability of task performance may provide a valuable source of evidence regarding the actual cause of performance limitations or deficits in conflict situations.