Serotonin and aggressive behaviour in children and adolescents: a systematic review

OBJECTIVE

The role of serotonin (5-HT) in human aggression has been the subject of a large number of studies, mostly with adults. Meta-analyses indicate a small but significant inverse relationship between central nervous 5-HT availability and aggression, but genetically informed studies suggest two pathways: one to reactive aggression and the other to proactive aggression.

METHOD

We conducted a systemic review on central nervous 5-HT function in children and adolescents, with attention to the function of aggression.

RESULTS

In total, 675 articles were screened for relevance, with 45 reviewed. These included blood assays (e.g. plasma, 5-HIAA; platelet 5-HTR_2A ), epigenetic studies, retrospective PET studies and 5-HT challenge paradigms (e.g. tryptophan depletion). Overall, findings were mixed, with support both for negative and for positive associations of central nervous 5-HT function with aggression in children and adolescents.

CONCLUSION

We propose factors that may be blurring the picture, including problems in the conceptualization and measurement of aggression in young people, the lack of prospective designs and the bias towards clinical samples of boys. Research needs to account for variance in the both motivation for and implementation of aggression, and look to the behavioural economics literature to consider the roles of reward, vengeance and self-control more clearly.

Emergent Dirac Gullies and Gully-Symmetry-Breaking Quantum Hall States in ABA Trilayer Graphene

We report on quantum capacitance measurements of high quality, graphite and hexagonal boron nitride encapsulated Bernal stacked trilayer graphene devices. At zero applied magnetic field, we observe a number of electron density- and electrical displacement-tuned features in the electronic compressibility associated with changes in Fermi surface topology. At a high displacement field and low density, strong trigonal warping gives rise to three new emergent Dirac cones in each valley, which we term "gullies." The gullies are centered around the corners of a hexagonal Brillouin zone and related by threefold rotation symmetry. At low magnetic fields of B=1.25  T, the gullies manifest as a change in the degeneracy of the Landau levels from two to three. Weak incompressible states are also observed at integer filling within these triplet Landau levels, which a Hartree-Fock analysis indicates are associated with Coulomb-driven nematic phases that spontaneously break rotation symmetry.

Variability, drivers, and effects of atmospheric nitrogen inputs across an urban area: Emerging patterns among human activities, the atmosphere, and soils

Atmospheric deposition of nitrogen (N) is a major input of N to the biosphere and is elevated beyond preindustrial levels throughout many ecosystems. Deposition monitoring networks in the United States generally avoid urban areas in order to capture regional patterns of N deposition, and studies measuring N deposition in cities usually include only one or two urban sites in an urban-rural comparison or as an anchor along an urban-to-rural gradient. Describing patterns and drivers of atmospheric N inputs is crucial for understanding the effects of N deposition; however, little is known about the variability and drivers of atmospheric N inputs or their effects on soil biogeochemistry within urban ecosystems. We measured rates of canopy throughfall N as a measure of atmospheric N inputs, as well as soil net N mineralization and nitrification, soil solution N, and soil respiration at 15 sites across the greater Boston, Massachusetts area. Rates of throughfall N are 8.70±0.68kgNha^-1yr^-1, vary 3.5-fold across sites, and are positively correlated with rates of local vehicle N emissions. Ammonium (NH₄⁺) composes 69.9±2.2% of inorganic throughfall N inputs and is highest in late spring, suggesting a contribution from local fertilizer inputs. Soil solution NO₃^- is positively correlated with throughfall NO₃^- inputs. In contrast, soil solution NH₄⁺, net N mineralization, nitrification, and soil respiration are not correlated with rates of throughfall N inputs. Rather, these processes are correlated with soil properties such as soil organic matter. Our results demonstrate high variability in rates of urban throughfall N inputs, correlation of throughfall N inputs with local vehicle N emissions, and a decoupling of urban soil biogeochemistry and throughfall N inputs.

Large cystic lympangioma of the pancreas: a case reportum

Lymphangioma of the pancreas is rare and presents as a large cystic mass in the retroperitoneum. The pancreatic origin can be confirmed by careful evaluation of cross sectional imaging. Preoperative differentiation from other pancreatic cystic neoplasms is difficult but possible. Large symptomatic lesions warrant surgery. The diagnosis is confirmed by typical features on histopathology and immunohistochemistry. Presented here is a case report of a pancreatic lymphangioma, discussed in the context of available literature.

Association of angiogenic cytokines (VEGF-A and VEGF-C) and clinical characteristic in women with unexplained recurrent miscarriage

INTRODUCTION

Recurrent miscarriage (RM) defined as 2 or more spontaneous miscarriage before 20 weeks of gestation, affects at least 1 % of couples trying to conceive. In over 50 % of cases, the cause of the loss of pregnancy remains unexplained. Reduced expression of Angiogenic factors such as: vascular endothelial growth factor (VEGF-A) and VEGF-C has been linked with spontaneous miscarriage, likely due to defective foetal and placental angiogenesis.

AIMS AND OBJECTIVES

To investigate the relationships between serum level of VEGF-A and VEGF-C with clinical characteristic in women with URM and compare to pregnant and healthy women.

MATERIALS AND METHODS

A case-control study, which was conducted between 90 non-pregnant women with history of RM, age-matched with 70 non-pregnant women without history of recurrent abortion with at least one child (controls) and 70 pregnant women without history of recurrent abortion with at least one child (controls). Those with unexplained RM were eligible. Demographic and Anthropometric data were retrieved by pre-test questionnaire and serum level of VEGF-A and VEGF-C measured by ELISA kit.

RESULTS

This study showeds that maternal levels of VEGF-A and VEGF-C were distinctly lower in RSA (189.87±88.1 vs 238.8±99.6) compared to healthy (239.1±99.7 vs 275.5±133.08) and pregnant (301.5±76.4 vs 402.5±128.6) women as control groups. Univariate analysis demonstrated that clinical characteristic factors were significantly associated with concentration of VEGF-A and VEGF-C in cases and controls.

CONCLUSIONS

Our findings suggest that these molecules could be used as potential predictive markers of miscarriage in these women presenting with URM (Tab. 4, Fig. 5, Ref. 40).

On the Impact of Granularity of Space-based Urban CO2 Emissions in Urban Atmospheric Inversions: A Case Study for Indianapolis, IN

Quantifying greenhouse gas (GHG) emissions from cities is a key challenge towards effective emissions management. An inversion analysis from the INdianapolis FLUX experiment (INFLUX) project, as the first of its kind, has achieved a top-down emission estimate for a single city using CO2 data collected by the dense tower network deployed across the city. However, city-level emission data, used as a priori emissions, are also a key component in the atmospheric inversion framework. Currently, fine-grained emission inventories (EIs) able to resolve GHG city emissions at high spatial resolution, are only available for few major cities across the globe. Following the INFLUX inversion case with a global 1×1 km ODIAC fossil fuel CO2 emission dataset, we further improved the ODIAC emission field and examined its utility as a prior for the city scale inversion. We disaggregated the 1×1 km ODIAC non-point source emissions using geospatial datasets such as the global road network data and satellite-data driven surface imperviousness data to a 30×30 m resolution. We assessed the impact of the improved emission field on the inversion result, relative to priors in previous studies (Hestia and ODIAC). The posterior total emission estimate (5.1 MtC/yr) remains statistically similar to the previous estimate with ODIAC (5.3 MtC/yr). However, the distribution of the flux corrections was very close to those of Hestia inversion and the model-observation mismatches were significantly reduced both in forward and inverse runs, even without hourly temporal changes in emissions. EIs reported by cities often do not have estimates of spatial extents. Thus, emission disaggregation is a required step when verifying those reported emissions using atmospheric models. Our approach offers gridded emission estimates for global cities that could serves as a prior for inversion, even without locally reported EIs in a systematic way to support city-level Measuring, Reporting and Verification (MRV) practice implementation.

Carbon dioxide and methane measurements from the Los Angeles Megacity Carbon Project - Part 1: calibration, urban enhancements, and uncertainty estimates

We report continuous surface observations of carbon dioxide (CO₂) and methane (CH₄) from the Los Angeles (LA) Megacity Carbon Project during 2015. We devised a calibration strategy, methods for selection of background air masses, calculation of urban enhancements, and a detailed algorithm for estimating uncertainties in urban-scale CO₂ and CH₄ measurements. These methods are essential for understanding carbon fluxes from the LA megacity and other complex urban environments globally. We estimate background mole fractions entering LA using observations from four "extra-urban" sites including two "marine" sites located south of LA in La Jolla (LJO) and offshore on San Clemente Island (SCI), one "continental" site located in Victorville (VIC), in the high desert northeast of LA, and one "continental/mid-troposphere" site located on Mount Wilson (MWO) in the San Gabriel Mountains. We find that a local marine background can be established to within ~1 ppm CO₂ and ~10 ppb CH₄ using these local measurement sites. Overall, atmospheric carbon dioxide and methane levels are highly variable across Los Angeles. "Urban" and "suburban" sites show moderate to large CO₂ and CH₄ enhancements relative to a marine background estimate. The USC (University of Southern California) site near downtown LA exhibits median hourly enhancements of ~20 ppm CO₂ and ~150 ppb CH₄ during 2015 as well as ~15 ppm CO₂ and ~80 ppb CH₄ during mid-afternoon hours (12:00-16:00 LT, local time), which is the typical period of focus for flux inversions. The estimated measurement uncertainty is typically better than 0.1 ppm CO₂ and 1 ppb CH₄ based on the repeated standard gas measurements from the LA sites during the last 2 years, similar to Andrews et al. (2014). The largest component of the measurement uncertainty is due to the single-point calibration method; however, the uncertainty in the background mole fraction is much larger than the measurement uncertainty. The background uncertainty for the marine background estimate is ~10 and ~15 % of the median mid-afternoon enhancement near downtown LA for CO₂ and CH₄, respectively. Overall, analytical and background uncertainties are small relative to the local CO₂ and CH₄ enhancements; however, our results suggest that reducing the uncertainty to less than 5 % of the median mid-afternoon enhancement will require detailed assessment of the impact of meteorology on background conditions.

Carbon dioxide and methane measurements from the Los Angeles Megacity Carbon Project - Part 1: calibration, urban enhancements, and uncertainty estimates

We report continuous surface observations of carbon dioxide (CO2) and methane (CH4) from the Los Angeles (LA) Megacity Carbon Project during 2015. We devised a calibration strategy, methods for selection of background air masses, calculation of urban enhancements, and a detailed algorithm for estimating uncertainties in urban-scale CO2 and CH4 measurements. These methods are essential for understanding carbon fluxes from the LA megacity and other complex urban environments globally. We estimate background mole fractions entering LA using observations from four "extra-urban" sites including two "marine" sites located south of LA in La Jolla (LJO) and offshore on San Clemente Island (SCI), one "continental" site located in Victorville (VIC), in the high desert northeast of LA, and one "continental/mid-troposphere" site located on Mount Wilson (MWO) in the San Gabriel Mountains. We find that a local marine background can be established to within ~1 ppm CO2 and ~10 ppb CH4 using these local measurement sites. Overall, atmospheric carbon dioxide and methane levels are highly variable across Los Angeles. "Urban" and "suburban" sites show moderate to large CO2 and CH4 enhancements relative to a marine background estimate. The USC (University of Southern California) site near downtown LA exhibits median hourly enhancements of ~20 ppm CO2 and ~150 ppb CH4 during 2015 as well as ~15 ppm CO2 and ~80 ppb CH4 during mid-afternoon hours (12:00-16:00 LT, local time), which is the typical period of focus for flux inversions. The estimated measurement uncertainty is typically better than 0.1 ppm CO2 and 1 ppb CH4 based on the repeated standard gas measurements from the LA sites during the last 2 years, similar to Andrews et al. (2014). The largest component of the measurement uncertainty is due to the single-point calibration method; however, the uncertainty in the background mole fraction is much larger than the measurement uncertainty. The background uncertainty for the marine background estimate is ~10 and ~15 % of the median mid-afternoon enhancement near downtown LA for CO2 and CH4, respectively. Overall, analytical and background uncertainties are small relative to the local CO2 and CH4 enhancements; however, our results suggest that reducing the uncertainty to less than 5 % of the median mid-afternoon enhancement will require detailed assessment of the impact of meteorology on background conditions.

Unmasking of primary hyperparathyroidism by Vitamin D therapy

A 38-year-old female on Vitamin D therapy presented with hypercalcemia induced acute kidney injury. Evaluation revealed primary hyperparathyroidism (PHPT) and iatrogenic hypervitaminosis D. After medical stabilization, she underwent surgical removal of the parathyroid adenoma, and made a full recovery. This case highlights unmasking of subclinical hyperparathyroidism by vitamin D therapy leading to severe hypercalcemia.

MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility

OBJECTIVE

To evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner.

MATERIALS AND METHODS

This is a retrospective study of 16 consecutive patients (8 male, 8 female; mean age 74 years) who underwent MRI-guided core needle biopsy of a mediastinal mass between February 2010 and January 2014. Size and location of lesion, approach taken, time for needle placement, overall duration of procedure, and post-procedural complications were evaluated. Technical success rates and correlation with surgical pathology (where available) were assessed.

RESULTS

Target lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6-11 cm). Average time for needle placement was 9.4 min (range 3-18 min); average duration of entire procedure was 42 min (range 27-62 min). 2-5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100%, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5%, respectively.

CONCLUSION

MRI-guided mediastinal biopsy is a safe procedure with high diagnostic accuracy, which may offer a non-ionizing alternative to CT guidance.

Prevalence of Hepatitis A virus (HAV) and Hepatitis E virus (HEV) in the patients presenting with acute viral hepatitis

BACKGROUND

Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are both enterically transmitted, resulting in acute viral hepatitis (AVH) in developing countries. They pose major health problems in our country. This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients.

MATERIALS AND METHODS

A cross-sectional study of 2-years duration was conducted in the Department of Microbiology, KMC, Mangalore. A non-random sampling of 958 patients presenting with AVH was considered in the study. On the basis of history, serum samples were analysed for IgM anti-HAV and IgM anti-HEV for the detection of HAV and HEV, respectively using commercially available ELISA kits. Data collected was analysed by using Statistical Package for the Social Sciences (SPSS) version 11.5.

RESULTS

The seroprevalence of HAV- and HEV-positive patients were 19.31% and 10.54%, respectively. The seroprevalence of both HAV and HEV in patients with acute viral hepatitis was 11.5%. The prevalence of HAV and HEV among males (68% and 31%) was higher than in females (31% and 20%) and was predominantly seen among young adults. These infections were predominantly seen during end of monsoons and beginning of winter.

CONCLUSION

Though the prevalence of HAV is much higher than that of HEV, co-infection rate of 11.5% mandates the screening for HEV which will be of immense importance in pregnant women and improving levels of personal hygiene among higher socio-economic population. These data will be essential for planning of future vaccination strategies and for better sanitation programme in this part of the country.

Aspergillus infection in urinary tract post-ureteric stenting

Fungal infections of the urinary tract are usually encountered following prolonged antibiotic use, instrumentation and indwelling urinary catheters. These type of infections are mostly seen in immuno-compromised patients. Candida is the most common among the fungal infections of urinary tract followed by Aspergillus infection. Here is a case report of a 26 year old diabetic female who presented with abdominal pain, fever, nausea and vomiting. She had undergone double-J stenting 15-20 days back. The cause of the symptoms was not detected till the patient underwent C.T Scan-KUB with excretory urography which showed the displaced D-J stent. Then on performing replacement of D-J stent, cystoscopy was done and the tissue sample was sent for microbiological and histopathological examination. On Microbiological examination, Aspergillus flavus was isolated from the tissue, which was culprit behind the disease. Patient was then treated with anti-fungal drugs, following which she gradually improved.