Multicenter performance evaluation of a second generation cortisol assay

Background: Untreated disorders of the adrenocortical system, such as Cushing's or Addison's disease, can be fatal, and accurate quantification of a patient's cortisol levels is vital for diagnosis. The objective of this study was to assess the analytical performance of a new fully-automated Elecsys (R) Cortisol II assay (second generation) to measure cortisol levels in serum and saliva. Methods: Four European investigational sites assessed the intermediate precision and reproducibility of the Cortisol II assay (Roche Diagnostics) under routine conditions. Method comparisons of the Cortisol II assay vs. liquid chromatography-tandem mass spectrometry (LC-MS/MS), the gold standard for cortisol measurement, were performed. Cortisol reference ranges from three US sites were determined using samples from self-reported healthy individuals. Results: The coefficients of variation (CVs) for repeatability, intermediate precision, and reproducibility for serum samples were <= 2.6%, <= 5.8%, and <= 9.5%, respectively, and for saliva were <= 4.4% and <= 10.9%, and <= 11.4%, respectively. Agreement between the Cortisol II assay and LC-MS/MS in serum samples was close, with a slope of 1.02 and an intercept of 4.473 nmol/L. Reference range samples were collected from healthy individuals (n = 300) and serum morning cortisol concentrations (5-95th percentile) were 166.1-507 nmol/L and afternoon concentrations were 73.8-291 nmol/L. Morning, afternoon, and midnight saliva concentrations (95th percentile) were 20.3, 6.94, and 7.56 nmol/L, respectively. Conclusions: The Cortisol II assay had good precision over the entire measuring range and had excellent agreement with LC-MS/MS. This test was found suitable for routine diagnostic application and will be valuable for the diagnosis of adrenocortical diseases

Discrepancies between dimensions of interoception in autism: implications for emotion and anxiety

Emotions and affective feelings are influenced by one's internal state of bodily arousal via interoception. Autism Spectrum Conditions (ASC) are associated with difficulties in recognising others' emotions, and in regulating own emotions. We tested the hypothesis that, in people with ASC, such affective differences may arise from abnormalities in interoceptive processing. We demonstrated that individuals with ASC have reduced interoceptive accuracy (quantified using heartbeat detection tests) and exaggerated interoceptive sensibility (subjective sensitivity to internal sensations on self-report questionnaires), reflecting an impaired ability to objectively detect bodily signals alongside an over-inflated subjective perception of bodily sensations. The divergence of these two interoceptive axes can be computed as a trait prediction error. This error correlated with deficits in emotion sensitivity and occurrence of anxiety symptoms. Our results indicate an origin of emotion deficits and affective symptoms in ASC at the interface between body and mind, specifically in expectancy-driven interpretation of interoceptive information

Eocene-Oligocene transition in the Southern Ocean: History of water mass circulation and biological productivity

High-resolution records of carbon and oxygen isotopes and benthic foraminiferal accumulation rates for the Eocene-Oligocene section at Ocean Drilling Program Site 689(Maud Rise, Weddell Sea; paleodepth about 1500 m) were used to infer variations in paleoproductivity in relation to changes in climate and ventilation of the deeper-water column. The benthic foraminiferal abundance and isotope records show short-term fluctuations at periodicities of 100 and 400 ka, implying orbitally driven climatic variations. Both records suggest that intermediate-depth water chemistry and primary productivity changed in response to climate. During the Eocene, productivity increased during cold periods and during cold-to-warm transitions, possibly as a result of increased upwelling of nutrient-rich waters. In the Oligocene, in contrast, productivity maxima occurred during intervals of low d18O values (presumably warmer periods), when a proto–polar front moved to the south of the location of Site 689. This profound transition in climate-productivity patterns occurred around 37 Ma, coeval with rapid changes toward increasing variability of the oxygen and carbon isotope and benthic abundance records and toward larger-amplitude d18O fluctuations. Therefore, we infer that, at this time, temperature fluctuations increased and a proto–polar front formed in conjunction with the first distinct pulsations in size of the Antarctic ice sheet. We speculate that this major change might have resulted from an initial opening of the Drake Passage at 37 Ma, at least for surface- and intermediate-water circulation