Wnt, Frizzled, and sFRP gene expression patterns during gastrulation in the starfish Patiria (Asterina) pectinifera

Publication date: Available online 23 June 2016
Source:Gene Expression Patterns
Author(s): Narudo Kawai, Ritsu Kuraishi, Hiroyuki Kaneko
By the initial phase of gastrulation, Wnt pathway regulation mediates endomesoderm specification and establishes the animal-vegetal axis, thereby leading to proper gastrulation in starfish. To provide insight into the ancestral mechanism regulating deuterostome gastrulation, we identified the gene expression patterns of Wnt, Frizzled (Fz), and secreted frizzled-related protein (sFRP) family genes, which play a role in the initial stage of the Wnt pathway, in starfish Patiria (Asterina) pectinifera embryos using whole mount in situ hybridization. We identified ten Wnt, four Fz, and two sFRP paralogues. From the hatching blastula to the late gastrula stage, the majority of the Wnt genes and both Fz5/8 and sFRP1/5 were expressed in the posterior and anterior half of the embryo, respectively. Wnt8, Fz1, and Fz4 showed restricted expression in the lateral ectoderm. On the other hand, several genes were expressed de novo in the restricted domain of the archenteron at the late gastrula stage. These results suggest that the canonical and/or non-canonical Wnt pathway might implicate endomesoderm specification, anterior-posterior axis establishment, anterior-posterior patterning, and archenteron morphogenesis in the developmental context of starfish embryos. From comparison with the expression patterns observed in Patria miniata, we consider that the Wnt pathway is conserved among starfishes.



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Analysis of anthocyanin biosynthesis genes expression profiles in contrasting cultivars of Japanese plum (Prunus salicina L.) during fruit development

Publication date: Available online 1 July 2016
Source:Gene Expression Patterns
Author(s): Máximo González, Erika Salazar, Soledad Cabrera, Pilar Olea, Basilio Carrasco
Flavonoids are responsible of different fruit sensorial properties. In Japanese plum (Prunus salicina L.) these compounds are variable in both type and quantity during the different stages of fruit growth and maturation. Here we present the first study which determines the expression profile of structural genes of the flavonoid pathway and accumulation profiles of total phenols, proanthocyanidins and anthocyanins during fruit development stages in contrasting cultivars in Japanese plum. The biosynthesis of these compounds is differentially regulated in different tissues and cultivars. Our result showed that all pigmented tissues increased the expression of the leucoanthocyanidin dioxygenase (LDOX) gene, while all tissues without anthocyanin accumulation presented a minimal expression of LDOX. In addition, the regulation of putative transcription factors PsMYB10 and PsMYB1 were correlated positively and negatively with the pigmented tissues respectively, suggesting a critical and coordinated mechanism involved in the change of the fruit color.



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N-linked glycosylation of Kv1.2 voltage-gated potassium channel facilitates cell surface expression and enhances stability of internalized channels

Abstract

Studies in cultured hippocampal neurons and the COS-7 cell line demonstrate important roles for N-linked glycosylation of Kv1.2 channels in forward trafficking and protein degradation. Kv1.2 channels can contain complex N-linked glycans, which facilitate cell surface expression of the channels. Additionally, the protein stability of cell surface-expressed Kv1.2 channels is affected by glycosylation via differences in degradation of internalized channels. This study reveals the importance of N-linked complex glycosylation in boosting Kv1.2 channel density. Notably, sialic acids at the terminal sugar branches play an important role in dampening degradation of Kv1.2 internalized from the cell membrane to promote its stability.

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Parallel processing of afferent olfactory sensory information

Abstract

Primary olfactory receptor neurons terminate in anatomically and functionally discrete cortical modules known as olfactory bulb glomeruli. The synaptic connectivity and postsynaptic responses of mitral and external tufted cells within the glomerulus may involve both direct and indirect components. For example, it has been suggested that sensory input to mitral cells is indirect through feedforward excitation from external tufted cells. We also observed feedforward excitation of mitral cells with weak stimulation of the olfactory nerve layer, however, focal stimulation of an axon bundle entering an individual glomeruli, revealed that mitral cells receive monosynaptic afferent inputs. Although external tufted cells had a 4.1 fold larger peak EPSC amplitude, integration of the evoked currents showed that the synaptic charge was 5 fold larger in mitral cells, reflecting the prolonged response in mitral cells. Presynaptic afferents onto mitral and external tufted cells had similar quantal amplitude and release probability, suggesting that the larger peak EPSC in external tufted cells resulted from more synaptic contacts. Our results indicate that the monosynaptic afferent input to mitral cells depends on the strength of odorant stimulation. The enhanced spiking we observed in response to brief afferent input provides a mechanism to amplify sensory information and contrasts with the transient response in external tufted cells. These parallel input paths may have discrete functions in processing olfactory sensory input.

This article is protected by copyright. All rights reserved

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Secondary hyperalgesia is mediated by heat-insensitive A-fibre nociceptors

Abstract

Secondary hyperalgesia refers to the increase in sensitivity to mechanical nociceptive stimuli delivered outside the area of tissue injury. Previous studies suggested that secondary hyperalgesia is mediated by a specific class of myelinated nociceptors: slowly-adapting A-fibre mechano- and heat-sensitive (AMH) Type I nociceptors. Here, we tested this hypothesis by examining, whether long-lasting heat stimuli, which are known to activate AMH-type I nociceptors, elicit enhanced responses when delivered to the area of secondary hyperalgesia induced by high frequency electrical stimulation of the skin (HFS). Before and twenty minutes after HFS, sustained 30-s radiant heat stimuli were delivered to the area of increased mechanical pinprick sensitivity while participants continuously rated intensity of perception using an online visual-analogue scale (0-100 mm). After HFS, no significant enhancement of heat perception was observed in the area of increased pinprick sensitivity. To establish that myelinated nociceptors actually contribute to the perception of sustained heat, we conducted a second experiment in which sustained heat stimuli were presented before and during an A-fibre nerve conduction block, achieved by applying a rubber band with weights which compresses the superficial radial nerve against the radius. During the block, heat perception was significantly reduced 17–33 s after the onset of the heat stimulus (before: mean = 53 mm, during: mean = 31 mm; P = .03), matching the response profile of AMH-type I nociceptors. These results support the notion that AMH-type I nociceptors contribute to the perception of sustained heat, but also show that these afferents do not mediate secondary hyperalgesia.

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A new device for monitoring individual activity rhythms of honey bees reveals critical effects of the social environment on behavior

Abstract

Chronobiological studies of individual activity rhythms in social insects can be constrained by the artificial isolation of individuals from their social context. We present a new experimental set-up that simultaneously measures the temperature rhythm in a queen-less but brood raising mini colony and the walking activity rhythms of singly kept honey bees that have indirect social contact with it. Our approach enables monitoring of individual bees in the social context of a mini colony under controlled laboratory conditions. In a pilot experiment, we show that social contact with the mini colony improves the survival of monitored young individuals and affects locomotor activity patterns of young and old bees. When exposed to conflicting Zeitgebers consisting of a light–dark (LD) cycle that is phase-delayed with respect to the mini colony rhythm, rhythms of young and old bees are socially synchronized with the mini colony rhythm, whereas isolated bees synchronize to the LD cycle. We conclude that the social environment is a stronger Zeitgeber than the LD cycle and that our new experimental set-up is well suited for studying the mechanisms of social entrainment in honey bees.

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Does general anesthesia have a clinical impact on intraocular pressure in children?

Summary

Background

Reliable measurement of intraocular pressure (IOP) is crucial in pediatric patients with suspected glaucoma. General anesthesia (GA) is usually needed in infants to allow a thorough examination. However, anesthesia itself may influence IOP, depending on the type used and the depth of sedation. The purpose of this study was to evaluate the normal distribution of IOP during GA in healthy children and to analyze differences in IOP relative to the anesthetics used and the measurement time point.

Methods

Approval for this observational study was received from the local institutional review boards and written informed consent was obtained from the children's parents. A total of 100 pediatric patients with no history of glaucoma scheduled for nonintraocular surgery underwent general anesthesia, induced with sevoflurane (s) or propofol (p) and maintained with either sevoflurane with remifentanil (S) or propofol with remifentanil (P). The patients were grouped to one of four subgroups (sS, sP, pP, pS) depending on the anesthetics used during induction and maintenance. Hemodynamic parameters and IOP were measured in both eyes at four defined time points: before anesthesia induction (M1); in apnea immediately after induction and before insertion of a laryngeal mask airway (M2); in deep anesthesia during mechanical ventilation (M3); and after extubation (M4), using a handheld Perkins applanation tonometer. Differences in IOP in both eyes during the measurement periods were analyzed using multivariate repeated-measures analysis of variance and Tukey-HSD as a posthoc test with statistical significance set at P < 0.05. Pearson correlation coefficient was used to investigate further relationships between heart rate, systolic blood pressure, and IOP.

Results

General anesthesia reduced IOP significantly. The mean IOP was normally distributed, with a mean of 7.4 ± 2.89 mmHg at M1. It decreased significantly to a minimum of 5.6 ± 3.04 mmHg (P < 0.01) at M2 and increased significantly to 7.2 ± 2.51 mmHg (P < 0.01) at M3 and again to 8.4 ± 3.72 mmHg (P = 0.03) at M4. All four subgroups (sS, sP, pP, pS) showed comparable decreases in IOP between M1 and M2. During deep anesthesia (M3) and during reversal (M4), the IOP increased again in all groups. During reversal (M4), however, the sS group had a significantly lower IOP than the pP group (P = 0.001) and sP group (P = 0.02). There were no correlations between changes in IOP and gender, age, or type of surgery.

Conclusions

Sevoflurane and propofol, both in combination with remifentanil, significantly lower IOP in children. Individual IOP levels rise and fall during anesthesia, depending on the time point of measurement. The lowest IOP can be measured immediately after induction of anesthesia. This needs to be taken into account when measuring IOP in children.

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The splanchnic anti-inflammatory pathway: Could it be the efferent arm of the inflammatory reflex?

Exposure to immune challenges results in the development of inflammation. An insufficient inflammatory response can be life-threatening, whereas an exaggerated response is also detrimental as it causes tissue damage and, in extreme cases, septic shock that can lead to death. Hence, inflammation must be finely regulated. It is generally accepted that the brain inhibits inflammation induced by an immune challenge in two main ways: humorally, by activating the hypothalamic-pituitary-adrenal axis to release glucocorticoids; and neurally, via a mechanism that has been termed the inflammatory reflex. The efferent arm of this reflex – the neural-to-immune link – was thought to be the 'cholinergic anti-inflammatory pathway'. Here we discuss data that support the hypothesis that the vagus nerves play no role in the control of inflammation in the endotoxemic animal model. We have shown and posit that it is the greater splanchnic nerves that are activated in response to the immune challenge and that in turn drive postganglionic sympathetic neurons to inhibit inflammation.

This article is protected by copyright. All rights reserved

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Prognostic significance of p53 expression in patients with esophageal cancer: A meta-analysis

BMC Cancer

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Ethnic differences in incidence of hepatitis B surface antigen seroclearance in a real-life multicenter clinical cohort of 4737 patients with chronic hepatitis B infection

Alimentary Pharmacology and Therapeutics

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Everolimus associated interstitial pneumonitis in a liver transplant patient

Respiratory Medicine Case Reports

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Randomized study of lafutidine vs lansoprazole in patients with mild gastroesophageal reflux disease

World Journal of Gastroenterology

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Recovery of brain structural abnormalities in morbidly obese patients after bariatric surgery

International Journal of Obesity

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The efficacy of levofloxacin triple therapy as the first- or second-line treatments of Helicobacter pylori infection

Alimentary Pharmacology and Therapeutics

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Prognosis of patients with esophageal squamous cell carcinoma who achieve major histopathological response after neoadjuvant chemoradiotherapy

European Journal of Surgical Oncology

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Isolated hepatitis B core antibody status is not associated with accelerated liver disease progression in HIV/hepatitis C coinfection

Journal of Acquired Immune Deficiency Syndromes

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Laparoscopic-assisted pull-through operation for Hirschsprung's disease: A systematic review and meta-analysis

Pediatric Surgery International

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Comparison of daily versus weekly recording of gastroesophageal reflux disease symptoms in patients with a partial response to proton pump inhibitor therapy

Value in Health

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A SMAD4 mutation indicative of juvenile polyposis syndrome in a family previously diagnosed with Menetrier's disease

Digestive and Liver Diseases

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Prevalence and clinical significance of IgA anti tissue transglutaminase antibodies in patients with chronic liver disease

Journal of Gastroenterology and Hepatology

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Paradoxical articular manifestations in patients with inflammatory bowel diseases treated with infliximab

European Journal of Gastroenterology & Hepatology

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Low testosterone in non-responsive coeliac disease: A case series, case-control study with comparisons to the National Health and Nutrition Examination Survey

Digestive and Liver Diseases

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Effects of different anesthetic methods on cellular immune and neuroendocrine functions in patients with hepatocellular carcinoma before and after surgery

Journal of Clinical Laboratory Analysis

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Baseline HBsAg and HBcrAg titres allow peginterferon-based precision medicine in HBeAg-negative chronic hepatitis B patients

Journal of Viral Hepatitis

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Patients with hepatocellular carcinoma have highest rates of wait-listing for liver transplantation among patients with end-stage liver disease

Clinical Gastroenterology and Hepatology

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Features of autoimmune hepatitis in patients with drug-induced liver injury

Clinical Gastroenterology and Hepatology

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The gut as an endocrine organ: Role in the regulation of food intake and body weight

Current Atherosclerosis Reports

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Recent improvements in the management of esophageal anastomotic leak after surgery for cancer

European Journal of Surgical Oncology

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A practical approach to ichthyoses with systemic manifestations

Abstract

Inherited ichthyoses are rare disorders in terms of patient numbers, but abundant in terms of clinical-genetic subtypes. These disorders are often associated with severe systemic manifestations, in addition to significant medical, cosmetic and social problems. There are 17 subtypes of syndromic ichthyosis identified so far and most patients with these syndromes are living in countries with high consanguinity rates. Frequently, clinicians cannot make a definitive diagnosis and patients are not managed properly owing to the rarity and complexity of these disorders. These difficulties make this group of ichthyosis and the patients living with them "orphan". After skin and skin appendages, nervous system is the most frequently involved system in ichthyosis syndromes. Thus, association of ichthyosis with neurological symptoms provides an important clue for diagnosis. In this paper, we aim to increase clinicians' comprehension of ichthyosis syndromes by providing a symptomatology-based approach based on this observation. Additionally, we provide a review of ichthyosis syndromes, with special emphasis on neurological symptoms, hoping to attract interest to this complicated field.

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Inadvertent administration of hypertonic saline during postoperative thoracic epidural patient-controlled epidural analgesia: A case report

No abstract available

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The efficacy of different doses of liquorice gargling for attenuating postoperative sore throat and cough after tracheal intubation

No abstract available

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‘Entrustable professional activities’: the way to go for competency-based curriculum?

No abstract available

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Peritonsillar morphine infiltration to prevent early postoperative pain after tonsillectomy: A randomised controlled trial

No abstract available

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Transforming the learning outcomes of anaesthesiology training into entrustable professional activities: A Delphi study

BACKGROUND: True competency-based medical education should produce graduates meeting fixed standards of competence. Current postgraduate programmes are usually based on a pre-determined length of time in training making them poorly suited for an individual approach. The concept of entrustable professional activities (EPAs) enables a more flexible, personalised and less time-dependent approach to training programmes. An EPA is a unit of professional practice, to be entrusted to a trainee to execute without supervision once they demonstrate sufficient competence. As EPAs relate competencies to clinical practice, they structure training and assessment more logically according to the way clinicians actually work. A first step in building an EPA-based curriculum is to identify the core EPAs of the profession. OBJECTIVES: The aim of this study was to identify EPAs for postgraduate training in anaesthesiology and to provide an example of how an existing curriculum can be transformed into an EPA-based curriculum. DESIGN: A modified Delphi method was used as a consensus approach applying three Delphi rounds. SETTING: Postgraduate specialty training in anaesthesiology in the Netherlands. PARTICIPANTS: All programme directors in anaesthesiology in the Netherlands except for a single programme director who was involved as a researcher in this study and could not participate. MAIN OUTCOME MEASURES: Agreement among participants on a list of EPAs. Agreement was specified as a consensus rate of more than 80%. RESULTS: In this study, 27 programme directors (69% overall response rate) reached consensus on a set of 45 EPAs that describe a curriculum in anaesthesiology for the Netherlands. CONCLUSION: This study is a first step toward a more contemporary curriculum in competency-based postgraduate anaesthesiology training.

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Transcutaneous vocal cord ultrasonography after oral and maxillofacial surgery requiring intermaxillary fixation: A technical report

No abstract available

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Simulation-based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: A before and after intervention study

BACKGROUND: Multimodal educational interventions have been shown to improve short-term competency in, and knowledge of central venous catheter (CVC) insertion. OBJECTIVE: To evaluate the effectiveness of simulation-based medical education training in improving short and long-term competency in, and knowledge of CVC insertion. DESIGN: Before and after intervention study. SETTING: University Geneva Hospital, Geneva, Switzerland, between May 2008 and January 2012. PARTICIPANTS: Residents in anaesthesiology aware of the Seldinger technique for vascular puncture. INTERVENTION: Participants attended a half-day course on CVC insertion. Learning objectives included work organization, aseptic technique and prevention of CVC complications. CVC insertion competency was tested pretraining, posttraining and then more than 2 years after training (sustainability phase). MAIN OUTCOME MEASURES: The primary study outcome was competency as measured by a global rating scale of technical skills, a hand hygiene compliance score and a checklist compliance score. Secondary outcome was knowledge as measured by a standardised pretraining and posttraining multiple-choice questionnaire. Statistical analyses were performed using paired Student's t test or Wilcoxon signed-rank test. RESULTS: Thirty-seven residents were included; 18 were tested in the sustainability phase (on average 34 months after training). The average global rating of skills was 23.4 points (±SD 4.08) before training, 32.2 (±4.51) after training (P 

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Are transdermal opioids contraindicated in patients at risk of suicide?: An underappreciated problem

No abstract available

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Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: A randomised controlled single-blinded manikin trial

BACKGROUND: High-quality cardiopulmonary resuscitation (CPR) by laypersons is a key determinant of both outcome and survival for out-of-hospital cardiac arrest. Dispatcher-assisted CPR (telephone-CPR, T-CPR) increases the frequency and correctness of bystander-CPR but results in prolonged time to first chest compressions. However, it remains unclear whether instructions for rescue ventilation and/or chest compressions should be recommended for dispatcher-assisted CPR. OBJECTIVE: The aim of this study was to evaluate both principles of T-CPR with respect to CPR quality. DESIGN: Randomised controlled single-blinded manikin trial. SETTING: University Hospital of Cologne, Germany, 1 July 2012 to 30 September 2012. PARTICIPANTS: Sixty laypersons between 18 and 65 years. Medically educated individuals, medical professionals and pregnant women were excluded. Participants were asked to resuscitate a manikin and were randomised into three groups: not dispatcher-assisted (uninstructed) CPR (group 1; U-CPR; n = 20), dispatcher-assisted compression-only CPR (group 2; DACO-CPR; n = 19) and full dispatcher-assisted CPR with rescue ventilation (group 3; DAF-CPR; n = 19). MAIN OUTCOME MEASURES: Specific parameters of CPR quality [i.e. no-flow-time (NFT) as well as compression and ventilation parameters] were analysed. To compare different groups we used Student's t test and P less than 0.05 was considered significant. RESULTS: Initial NFT was lowest in the DACO-CPR group (mean 21.3 ± 14.4%), followed by dispatcher-assisted full CPR (mean 49.1 ± 8.5%) and by unassisted CPR (mean 55.0 ± 12.9%). Initial NFT covering the time of instruction was lower in DACO-CPR (12.1 ± 5.4%) as compared to dispatcher-assisted full CPR (20.7 ± 8.1%). Compression depth was similar in all three groups: 40.6 ± 13.0 mm (unassisted CPR), 41.0 ± 12.2 mm (DACO-CPR) and 38.8 ± 15.8 mm (dispatcher-assisted full CPR). Average compression frequency was highest in the DACO-CPR group (65.2 ± 22.4 min−1) compared with the unassisted CPR group (35.6 ± 24.2 min−1) and the dispatcher-assisted full CPR group (44.5 ± 10.8 min−1). Correct rescue ventilation was given in 3.1 ± 11.1% (unassisted CPR) and 1.6 ± 16.1% (dispatcher-assisted full CPR) of all ventilation attempts. CONCLUSION: Best quality of CPR was achieved by DACO-CPR because of superior compression frequencies and reduced NFT. In contrast, the full dispatcher-assisted CPR with a longer initial instructing phase (initial NFT) did not result in enhanced CPR quality or an optimised compression depth.

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Don’t forget to ventilate during cardiopulmonary resuscitation with mechanical chest compression devices

No abstract available

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Impact of disruptions on anaesthetic workflow during anaesthesia induction and patient positioning: A prospective study

BACKGROUND: Work disruption in operating rooms hinders flow of patients and increases chances of error. Previous studies have largely considered the types of disruption occurring in operating rooms, but have not analysed systematically the objective impact of disruption. OBJECTIVE: The objective was to evaluate the impact of disruption on time efficiency in preoperative anaesthetic work in the operating room and to link disruption to failures in co-ordination of care. DESIGN: Prospective, cross-sectional and observational study. SETTING: Disruptions were evaluated in operating rooms of five hospitals across three countries: Australia (one community hospital, one teaching hospital); Thailand (two community hospitals); China (one teaching hospital). PARTICIPANTS: The preoperative phase of anaesthesia induction/patient positioning of 64 surgical patients across specialities was prospectively evaluated (Australia = 33; Thailand = 12; China = 10). Further, interviews were carried out with 16 consultant anaesthetists and surgeons and 13 senior operating room nurses involved in the care of these patients. MAIN OUTCOME MEASURES: Disruptions were identified by trained observers in real time during the preoperative phase; four types of care co-ordination problems were identified from the interviews with senior anaesthetists, surgeons and nurses, and linked to the disruptions. Descriptive analyses of time efficiency were performed. RESULTS: Complete data were available from 55 cases. Good inter-observer agreement was obtained across measurements (range 74 to 92%). An average of three disruptions per case during the preoperative phase, were observed (range 2 to 9). 'Disruption types': disruptive staff activities were associated with most timewasting (median = 1 min per case, range 0 min 0 s to 4 min 45 s per case). 'Care co-ordination problems': co-ordination lapses within the operating room team, and between them and the preoperative team were associated with most timewasting (median = 1 min per case, range 0 min 0 s to 5 min 0 s per case). CONCLUSION: The study quantifies time inefficiencies affecting anaesthetic work during the preoperative phase. Work disruption wastes time and is preventable.

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Acromio-axillo-suprasternal notch index: a new screening test to predict difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

No abstract available

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Gender difference in career advancement and job satisfaction in anaesthesia: A cross-sectional study

No abstract available

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Regional haemodynamic changes after selective block of the four principal nerves in the arm: A double-blind randomised controlled study

No abstract available

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Clinical pertinence and diagnostic accuracy of an evidence-based monitoring system: Custos

No abstract available

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The vertical obturator nerve block: A randomised controlled double-blind pilot trial

No abstract available

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Comparing airway topical anaesthesia techniques for awake fibreoptic intubation

No abstract available

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Effects of a single-dose preemptive pregabalin on acute and chronic pain after inguinal hernia repair with mesh under spinal anaesthesia: A randomised controlled trial

No abstract available

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Upper airway trauma during general anaesthesia for major surgery: incidence and trends: A retrospective study

No abstract available

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Graphic Anaesthesia

No abstract available

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Startle amplitude during unpleasant pictures is greater in veterans with a history of multiple-suicide attempts and predicts a future suicide attempt

Abstract

Recent studies demonstrate that veterans exhibit higher suicide risk compared with the general U.S. population. A prior suicide attempt is a well-documented predictor of suicide death. Despite increased attention to clinical risk factors of suicide and efforts to develop psychosocial interventions to reduce suicide risk, the underlying biological factors that confer this risk are not well understood. This study examined affect-modulated startle (AMS) during a series of intermixed unpleasant, neutral, and pleasant pictures in a sample of 108 demographically-matched veterans at low (passive ideators: n = 26) and high risk (active ideators: n = 29; single attempters: n = 28; and multiple attempters: n = 25) for suicide based on the Columbia Suicide Severity Rating Scale. An exploratory aim involved a longitudinal component in a subset of the high-risk sample that went on to participate in a randomized 6-month clinical trial. We investigated whether baseline AMS predicts a subsequent suicide attempt at 12-month follow-up. Compared with the other three groups, multiple attempters showed greater startle potentiation during unpleasant pictures and deficient overall startle habituation from early to later trials. The groups did not differ in startle during neutral or pleasant pictures, or self-reported picture valence. Greater startle during unpleasant pictures was associated with greater emotion dysregulation as measured by the Difficulties in Emotion Regulation Scale and a future suicide attempt assessed prospectively at 12-month follow-up. These findings suggest that startle potentiation during unpleasant pictures in multiple-suicide attempters is a promising psychophysiological biomarker of suicide risk and underscore the clinical importance of targeting emotion dysregulation in the treatment of patients at-risk for suicide.

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