Host space, not energy or symbiont size, constrains feather mite abundance across passerine bird species

Comprehending symbiont abundance among host species is a major ecological endeavour, and the metabolic theory of ecology has been proposed to understand what constrains symbiont populations. We parameterized metabolic theory equations to investigate how bird species' body size and the body size of their feather mites relate to mite abundance according to four potential energy (uropygial gland size) and space constraints (wing area, total length of barbs and number of feather barbs). Predictions were compared with the empirical scaling of feather mite abundance across 106 passerine bird species (26,604 individual birds sampled), using phylogenetic modelling and quantile regression. Feather mite abundance was strongly constrained by host space (number of feather barbs) but not by energy. Moreover, feather mite species' body size was unrelated to the body size of their host species. We discuss the implications of our results for our understanding of the bird-feather mite system and for symbiont abundance in general.

Prospective monitoring of adverse events following vaccination with Modified vaccinia Ankara - Bavarian Nordic (MVA-BN) administered to a Canadian population at risk of Mpox: A Canadian Immunization Research Network study

MVA-BN is an orthopoxvirus vaccine that provides protection against both smallpox and mpox. In June 2022, Canada launched a publicly-funded vaccination campaign to offer MVA-BN to at-risk populations including men who have sex with men (MSM) and sex workers. The safety of MVA-BN has not been assessed in this context. To address this, the Canadian National Vaccine Safety Network (CANVAS) conducted prospective safety surveillance during public health vaccination campaigns in Toronto, Ontario and in Vancouver, British Columbia. Vaccinated participants received a survey 7 and 30 days after each MVA-BN dose to elicit adverse health events. Unvaccinated individuals from a concurrent vaccine safety project evaluating COVID-19 vaccine safety were used as controls. Vaccinated and unvaccinated participants that reported a medically attended visit on their 7-day survey were interviewed. Vaccinated participants and unvaccinated controls were matched 1:1 based on age group, gender, sex and provincial study site. Overall, 1,173 vaccinated participants completed a 7-day survey, of whom 75 % (n = 878) also completed a 30-day survey. Mild to moderate injection site pain was reported by 60 % of vaccinated participants. Among vaccinated participants 8.4 % were HIV positive and when compared to HIV negative vaccinated individuals, local injection sites were less frequent in those with HIV (48 % vs 61 %, p = 0.021), but health events preventing work/school or requiring medical assessment were more frequent (7.1 % vs 3.1 %, p = 0.040). Health events interfering with work/school, or requiring medical assessment were less common in the vaccinated group than controls (3.3 % vs. 7.1 %, p < 0.010). No participants were hospitalized within 7 or 30 days of vaccination. No cases of severe neurological disease, skin disease, or myocarditis were identified. Our results demonstrate that the MVA-BN vaccine appears safe when used for mpox prevention, with a low frequency of severe adverse events and no hospitalizations observed.

Smart education system to improve the learning system with CBR based recommendation system using IoT

Over the last few years, the research fields of intelligent learning systems have been improving the process of learning systems. Smart Tutoring System-(STS) applications have been used in e-learning. The results signify the importance of the learner's engagement in customizing a model. The design outcomes of this IoT-based personalized learning system purely work on the audience's learning requirements, their keyword search, their learning experience levels, proficiency level of subjects, and the type of the course being taught. Students spent an average of 25.67 h accessing textual materials weekly, 27.4 h accessing video assets weekly, and similarly 6.5 h accessing visual learning materials. The research analysis part concludes participants' percentage of learning as per evaluations assessment, which increases whenever the outcome analysis comes with Case-Based Reasoning classifiers-CBR based search model. The findings displayed significant differences before and after learning case by case for every learner as per chosen topic and quiz assessments: 42.57% of the students responded before learning the first question assessments whereas 74.82%, of the students responded, after completion of learning from online resources based on their choice with CBR. Recommendation Model Analysis discussed root means square error-RMSE lies from 10% to 20% for 550 students group size. The RMSE result is 24% for a size of 1600, which is low performance compared to other group sizes. This study focuses on the STS recommendation model for the slow learner group to identify required learning from various online resources.

Cross-species transmission and PB2 mammalian adaptations of highly pathogenic avian influenza A/H5N1 viruses in Chile

H5N1 highly pathogenic avian influenza viruses (HPAIV) emerged in wild birds in Chile in December 2022 and spilled over into poultry, marine mammals, and one human. Between December 9, 2022 - March 14, 2023, a coordinated government/academic response detected HPAIV by real-time RT-PCR in 8.5% (412/4735) of samples from 23 avian and 3 mammal orders. Whole-genome sequences obtained from 77 birds and 8 marine mammals revealed that all Chilean H5N1 viruses belong to lineage 2.3.4.4b and cluster monophyletically with viruses from Peru, indicating a single introduction from North America into Peru/Chile. Mammalian adaptations were identified in the PB2 segment: D701N in two sea lions, one human, and one shorebird, and Q591K in the human and one sea lion. Minor variant analysis revealed that D701N was present in 52.9 - 70.9% of sequence reads, indicating the presence of both genotypes within hosts. Further surveillance of spillover events is warranted to assess the emergence and potential onward transmission of mammalian adapted H5N1 HPAIV in South America.

The role of defects in the persistent photoconductivity of BaSnO3thin films

Time-dependent photoconductivity (PC) and PC spectra have been studied in oxygen deficient BaSnO₃thin films grown on different substrates. X-ray spectroscopy measurements show that the films have epitaxially grown on MgO and SrTiO₃substrates. While on MgO the films are nearly unstrained, on SrTiO₃the resulting film is compressive strained in the plane. Electrical conductivity in dark is increased in one order of magnitude for the films on SrTiO₃in comparison to the one on MgO. This leads to an increase of PC in the latter film in at least one order of magnitude. PC spectra show a direct gap with a value ofEG=3.9eV for the film grown on MgO while on SrTiO₃EG=3.36eV. For both type of films, time-dependent PC curves show a persistent behavior after illumination is removed. These curves have been fitted employing an analytical procedure based on the frame of PC as a transmission phenomenon showing the relevant role of donor and acceptor defects as carrier traps and as a source of carriers. This model also suggests that in the BaSnO₃film on SrTiO₃more defects are created probably due to strain. This latter effect can also explain the different transition values obtained for both type of films.

Activity of Lepidium meyenii Walp (purple maca) in immunosuppressed Oryctolagus cuniculus (albino rabbits)

Various properties are attributed to “maca”, including immunomodulatory properties due to its secondary metabolites such as macamides, glucosinolates, isothiocyanates and flavonoids. Immunosuppression, hemolytic anemia, and thymic involution were induced with cyclophosphamide. Three concentrations of doses of dehydrated hydroalcoholic extract of purple maca (EHADM) were used for 30 days, the analysis of variance and Duncan’s multiple comparisons test the results are statistically significant (p&lt;.05) which shows immunostimulatory activity in the marrow bone (monocytes, lymphocytes and white blood cells) and antianemic (hematocrit 31%) compared to the negative control group (G-1). At 84 mg/kg and at 167 mg/kg, it shows immunomodulatory activity on the humoral response in 66.70% of the experimental animals (G-3 and G-4). It is concluded that the dehydrated hydroalcoholic extract of purple maca presents immunostimulating and immunomodulatory activity on the humoral response in 66.7% of the Oryctolagus cuniculus induced to immunodeficiency with cyclophosphamide.

Approach to the Fatigue and Cellular Behavior of Superficially Modified Porous Titanium Dental Implants

In this work, the fatigue and cellular performance of novel superficially treated porous titanium dental implants made up using conventional powder metallurgy and space-holder techniques (30 vol.% and 50 vol.%, both with a spacer size range of 100–200 µm) are evaluated. Before the sintering stage, a specific stage of CNC milling of the screw thread of the implant is used. After the consolidation processing, different surface modifications are performed: chemical etching and bioactive coatings (BG 45S5 and BG 1393). The results are discussed in terms of the effect of the porosity, as well as the surface roughness, chemical composition, and adherence of the coatings on the fatigue resistance and the osteoblast cells’ behavior for the proposed implants. Macro-pores are preferential sites of the nucleation of cracks and bone cell adhesion, and they increase the cellular activity of the implants, but decrease the fatigue life. In conclusion, SH 30 vol.% dental implant chemical etching presents the best bio-functional (in vitro osseointegration) and bio-mechanical (stiffness, yield strength and fatigue life) balance, which could ensure the required characteristics of cortical bone tissue.

Analysis of the Reformulated Source to Drain Tunneling Probability for Improving the Accuracy of a Multisubband Ensemble Monte Carlo Simulator

As an attempt to improve the description of the tunneling current that arises in ultrascaled nanoelectronic devices when charge carriers succeed in traversing the potential barrier between source and drain, an alternative and more accurate non-local formulation of the tunneling probability was suggested. This improvement of the probability computation might result of particular interest in the context of Monte Carlo simulations where the utilization of the conventional Wentzel-Kramers-Brillouin (WKB) approximation tends to overestimate the number of particles experiencing this type of direct tunneling. However, in light of the reformulated expression for the tunneling probability, it becomes of paramount importance to assess the type of potentials for which it behaves adequately. We demonstrate that, for ensuring boundedness, the top of the potential barrier cannot feature a plateau, but rather has to behave quadratically as one approaches its maximum. Moreover, we show that monotonicity of the reformulated tunneling probability is not guaranteed by boundedness and requires an additional constraint regarding the derivative of the prefactor that modifies the traditional WKB tunneling probability.

A Review of Sharp-Switching Band-Modulation Devices

This paper reviews the recently-developed class of band-modulation devices, born from the recent progress in fully-depleted silicon-on-insulator (FD-SOI) and other ultrathin-body technologies, which have enabled the concept of gate-controlled electrostatic doping. In a lateral PIN diode, two additional gates can construct a reconfigurable PNPN structure with unrivalled sharp-switching capability. We describe the implementation, operation, and various applications of these band-modulation devices. Physical and compact models are presented to explain the output and transfer characteristics in both steady-state and transient modes. Not only can band-modulation devices be used for quasi-vertical current switching, but they also show promise for compact capacitorless memories, electrostatic discharge (ESD) protection, sensing, and reconfigurable circuits, while retaining full compatibility with modern silicon processing and standard room-temperature low-voltage operation.

Hysteresis in As-Synthesized MoS2 Transistors: Origin and Sensing Perspectives

Two-dimensional materials, including molybdenum disulfide (MoS2), present promising sensing and detecting capabilities thanks to their extreme sensitivity to changes in the environment. Their reduced thickness also facilitates the electrostatic control of the channel and opens the door to flexible electronic applications. However, these materials still exhibit integration difficulties with complementary-MOS standardized processes and methods. The device reliability is compromised by gate insulator selection and the quality of the metal/semiconductor and semiconductor/insulator interfaces. Despite some improvements regarding mobility, hysteresis and Schottky barriers having been reported thanks to metal engineering, vertically stacked heterostructures with compatible thin-layers (such as hexagonal boron nitride or device encapsulation) variability is still an important constraint to sensor performance. In this work, we fabricated and extensively characterized the reliability of as-synthesized back-gated MoS2 transistors. Under atmospheric and room-temperature conditions, these devices present a wide electrical hysteresis (up to 5 volts) in their transfer characteristics. However, their performance is highly influenced by the temperature, light and pressure conditions. The singular signature in the time response of the devices points to adsorbates and contaminants inducing mobile charges and trapping/detrapping carrier phenomena as the mechanisms responsible for time-dependent current degradation. Far from being only a reliability issue, we demonstrated a method to exploit this device response to perform light, temperature and/or pressure sensors in as-synthesized devices. Two orders of magnitude drain current level differences were demonstrated by comparing device operation under light and dark conditions while a factor up to 105 is observed at vacuum versus atmospheric pressure environments.

Diagnostic accuracy of combining C-Reactive protein and Alvarado Score among 2-to-20-year-old patients with acute appendicitis suspected presenting to Emergency Departments

OBJECTIVE

Main objective was whether the combination of C-Reactive Protein (CRP) and Alvarado Score (AS) increase the diagnosis accuracy of AS among 2-to-20-year-old patients with suspected acute appendicitis presenting to Emergency Departments.

METHODS

This is a secondary analysis of prospective cohort study consecutively including all patients from 2 to 20 years of age attended for suspected acute appendicitis in 4 Spanish Emergency Departments during 6-month period. We collected demographic, clinical, analytic and radiographic, and surgical data. AS categories were retrospectively calculated as low (0-4 points), intermediate (5-6 points) or high (7-10 points). The cut-off levels were >0.5 mg/dl for CRP. The outcome was diagnosis of acute appendicitis within 14 days of the index visit.

RESULTS

A total of 331 patients with suspected of acute appendicitis (mean age 11.8 (SD 3.8) years; 52.9% males) were recruited. According to AS, 108 (32.6%) were at low risk, 76 at (23.0%) intermediate risk and 147 (44.4%) at high risk of acute appendicitis. One hundred and sixteen (35.0%) cases had confirmed histopathological diagnosis of acute appendicitis. The AUCs of ROC were 0.76 (0.70-0.81) for AS and 0.79 (95% CI 0.75-0.84) for CRP-AS being the difference statistically significant (p=0.003). The CRP for diagnosis acute appendicitis in low risk AS group had negative predictive value of 95.8% (95%CI 87.3-98.9) and likelihood ratio negative of 0.4 (95%CI 0.2-1.0)..

CONCLUSIONS

CRP-AS has shown to increase the diagnostic accuracy of AS for acute appendicitis. This approach may be useful to rule out the diagnosis of acute appendicitis in paediatric patients attended for abdominal pain suggestive of acute appendicitis.

Oncological outcomes of lipofilling in breast reconstruction: a matched cohort study with 250 patients

Background

Fat grafting is a procedure commonly used in breast reconstruction nowadays. Nevertheless, its oncological safety remains controversial. The potential risk that progenitor cells included in fat graft tissue may contribute to disease progression in patients with breast cancer is still debatable. We have designed a matching-cohort study with 250 patients with history of breast cancer trying to elucidate an answer for this question.

Methods

We selected 250 patients with a history of breast cancer in our hospital, between 2011 and 2019. A total of 125 patients (cases) had a history of breast cancer reconstructed with fat grafting. The additional 125 patients are matched controls. We analyzed the distribution of eight different variables within the cases and their matched controls: date of first oncological surgery, age, type of oncological surgery, histological subtype, Her-2 status, pN, smoking habit and diabetes mellitus. The objective of this study was to analyze the influence of fat grafting over breast cancer recurrence.

Results

There are not statistically significant differences in breast cancer locoregional recurrences (P=0.183), distant metastases (P=0.200) or total recurrences (P=0.065) amongst the two groups (cancer cases and matched controls).

Conclusions

Our study adds more information over the oncological safety of fat grafting. These findings should encourage long-term prospective trials to provide surgeons with accurate information regarding the role of lipofilling on breast neoplasms.

Antibodies elicited by the CaniLeish® vaccine: long-term clinical follow-up study of dogs in Spain

The prevention of canine leishmaniosis in healthy dogs requires a multimodal approach combining repellents with an effective vaccine. A vaccine that modulates the cell-mediated immune response against the protozoan has been available in Europe since 2012 (CaniLeish®, Virbac, France). The aim of the present study was to monitor dogs vaccinated with CaniLeish® to examine the kinetics of the antibody response and the safety and tolerance of CaniLeish®. Dogs vaccinated with CaniLeish® were monitored for 12 months. In follow-up visits at baseline (primovaccination or annual booster) (Visit 1, V1), and 1 (V2), 4 (V3), 8 (V4) and 12 (V5) months later, we examined antibody response kinetics using two serology techniques (IFAT and Speed Leish K™). Tolerance to CaniLeish® and its safety were also monitored. Anti-L. infantum IgG antibodies were determined in 242 dogs (125 dogs after primovaccination (Group P) and 117 dogs after booster vaccination (Group B). In addition, 46, 22 and 19 dogs were followed for 2, 3 and 4 years, respectively. At baseline, 100% of dogs in Group P returned negative IFAT and Speed Leish K™ test results while 9.4% (11/117) in Group B tested IFAT positive though Speed Leish K™ negative. In subsequent visits, seropositivity was detected by IFAT in 31.2% (Group P) and 41% (Group B) of the dogs in V2; 16.8% (Group P) and 10.2% (Group B) in V3; 6.4% (Group P) and 8.5% (Group B) in V4; and 3.2% (Group P) and 5.9% (Group B) in V5. All dogs tested Speed Leish K™ negative except two, in which it was later confirmed by molecular testing that they were not infected. Adverse events that could be associated with the vaccine were detected in 20 out of 314 dogs (6.4%). The good clinical status of all dogs was confirmed in an exhaustive clinical exam and haemato-biochemical profile. The Canileish® vaccine was well-tolerated with exceptions that did not appear to be related to age, sex, race or size of vaccinated dogs. Anti-L. infantum antibodies were detected by IFAT in 31.9-40.3% of the dogs 1 month after vaccination, and these antibodies could still be detected in 3.2% of the dogs 1 year later. This means that veterinarians need to use other tools (eg. PCR) to correctly diagnose seropositive dogs.

Canine Distemper Outbreak by Natural Infection in a Group of Vaccinated Maned Wolves in Captivity

Canine distemper virus (CDV) is one of the most significant infectious disease threats to the health and conservation of free-ranging and captive wild carnivores. CDV vaccination using recombinant canarypox-based vaccines has been recommended for maned wolf (Chrysocyon brachyurus) after the failure of modified live vaccines that induced disease in vaccinated animals. Here, we report a CDV outbreak in a captive population of maned wolves that were previously vaccinated. Five juveniles and one adult from a group of seven maned wolves housed in an outdoor exhibit died in April–May 2013 in a zoo in the Metropolitan Region, Chile. Clinical signs ranged from lethargy to digestive and respiratory signs. Diagnosis of CDV was confirmed by histopathology, antibody assays, and viral molecular detection and characterization. The phylogenetic analyses of the nucleotide sequence of the H gene of the CDV genome identified in the two positive samples suggest a close relation with the lineage Europe 1, commonly found in South America and Chile. CDV infections in maned wolves have not been previously characterized. To the authors’ best knowledge, this is the first report of the clinical presentation of CDV in a canine species previously immunized with a recombinant vaccine.

The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study

PURPOSE

To investigate the impact of a 3-month course of intracortical injections of autologous platelet-rich plasma (PRP) upon ovarian reserve markers versus no intervention in women with low ovarian reserve prior to undergoing assisted reproductive technology (ART).

METHODS

Prospective controlled, non-randomized comparative study conducted in a private fertility clinic, in Venezuela. Women with abnormal ovarian reserve markers (FSH, AMH and AFC) who declined oocyte donation were allocated to one of the following groups according to patient choice: monthly intracortical ovarian PRP injections for three cycles, or no intervention. Primary outcomes were the change in FSH, AMH and AFC pre- and post-treatment. Secondary outcomes included the number of oocytes collected and fertilized, biochemical/clinical pregnancy rates and miscarriage and live birth rates.

RESULTS

Eighty-three women were included, of which 46 received PRP treatment and 37 underwent no intervention. Overall median age was 41 years (IQR 39-44). There were no demographic differences between the study groups. At the 3-month follow-up, women treated with PRP experienced a significant improvement in FSH, AMH and AFC, whereas there was no change in the control group. Furthermore, overall rates of biochemical (26.1% versus 5.4%, P = 0.02) and clinical pregnancy (23.9% versus 5.4%, P = 0.03) were higher in the PRP group, while there was no difference in the rates of first trimester miscarriage and live birth between groups.

CONCLUSION

PRP injections are effective and safe to improve markers of low ovarian reserve prior to ART, although further evidence is required to evaluate the impact of PRP on pregnancy outcomes.

Congenital syphilis: A prospective study of 22 cases diagnosed by PCR

Congenital syphilis (CS) is caused by Treponema pallidum infection in utero. There is a need to develop new tools to diagnose CS: the diagnostic value of PCR is difficult to assess. The aim of this study was to describe the clinical and laboratory characteristics of mothers and infants with CS as diagnosed by PCR tests on various maternal and neonatal samples.

PATIENTS AND METHODS

We included all infants epidemiologically linked to a mother diagnosed with syphilis whose samples were referred to the Syphilis Reference Center, and for whom at least one positive PCR result was obtained.

RESULTS

Twenty-two mother-infant pairs (8.3%) with assay performed on samples from one to four different anatomic sites were included between February 2011 and April 2018. Seven mothers (31.8%) were born abroad, fifteen (68.2%) presented psychological and/or social problems, eight (36.4%) had not been screened for syphilis prior to delivery, and eleven (50%) were referred from French overseas departments or territories, or from the Paris region. Six infants (27.3%) were stillborn and six were born preterm, while fifteen infants (68.2%) presented clinical features of CS. All infants born preterm were symptomatic. Infant VDRL/RPR titer was no greater than four times that in the mother's serum, except in two cases.

DISCUSSION

Lack of antenatal care, social disadvantage and psychological issues were common. There is a need for enhanced surveillance both in the French overseas departments/territories and in the Paris region. A larger study is required to assess the sensitivity and specificity of PCR. The best site for sampling has yet to be established. We recommend the collection of as many samples as possible to avoid underdiagnosis of CS.

Mercury levels in blood, urine and hair in a nation-wide sample of Spanish adults

Mercury (Hg) is among the top 10 environmental chemicals of major public health concern (WHO). The Minamata Convention on Mercury (United Nations Environment Program, 2017), commits signing countries to control anthropogenic mercury emissions and reduce human exposure. Human biomonitoring (HBM) programs, are the most straight-forward approaches to get information on the actual exposure levels in the population and assess over time. We report here the results of a HBM study in a nationwide cross-section of Spanish adults (18-65y) as baseline values obtained before the Minamata Convention entered into force. Subsequent follow-ups will show if the Convention has been successful. The study includes 1880 blood samples, 1704 urine samples and 577 hair samples from all Spanish regions collected and analysed under a strictly quality controlled and quality assured protocol. The EU-DEMOCOPHES project demonstrated that fish and seafood are the major sources of mercury exposure and that the Spanish as well as the Portuguese populations have higher levels than other European countries. The data from the present study confirms this pattern at national level and that inhabitants in coastal regions have higher values than from inland regions. The geometric mean (GM) for blood is 6.35 μg Hg/l, in urine is 1.11 μg Hg/l and for hair is 1.91 μg Hg/g. In an international comparison these values are not exceptional. Spanish concentrations fall into the group of Easter Mediterranean populations. Although information on gender, age, occupational sector, geographical area, sampling period and frequency of fish consumption is reported in the tables, the purpose of this paper has not been to analyse the determinants of exposure in detail but to provide baseline data for future assessments and for regional authorities.

Effect of l-theanine tablets in reducing stress-related emotional signs in cats: an open-label field study

Background

L-theanine is an aminoacid found in tea leaves which has relaxing effects in humans and animals. It is a structural analogue of glutamate which can bind glutamate receptors. Although the relaxing action of L-theanine has been shown in humans, laboratory animals and dogs, it has never been published in cats. The goal of this open-label, multicentre and prospective trial was to determine whether an L-theanine based oral supplement (Anxitane®, Virbac, France) could attenuate manifestations of stress in cats under field conditions.

Case presentation

Thirty-three privately owned cats presenting signs associated with stress or fear (inappropriate urination/defecation, fear-induced aggressiveness, hypervigilance/tenseness or physical/functional manifestations of stress) for at least 1 month, were included in the study. They were given L-theanine (Anxitane®, 25 mg twice a day) for 30 days and 20 stress-related parameters were scored at Days 0, 15 and 30. The evolution of some parameters was also rated relative to Day 0. All median scores of the 20 parameters were significantly reduced at D30, and 30/33 cats (91%) had a reduced global score at the end of the study, including 21/33 with ≥50% score reduction. The median (IQR) global scores went from 18 (13-23) at D0 to 11 (8-13) at D15 and 5 (3-12) at D30 (p < 0.0001; Friedman test; significant reduction starting from D15). All the stress-related signs were significantly improved compared to D0, according to the owners, especially inappropriate elimination. Tablet palatability was judged good or very good in 94% of cases with spontaneous intake by cats when given by hand or in food. Tolerance was satisfactory as well, and no side effects were reported, so that most owners (27/33; 82%) were satisfied with the product.

Conclusions

Despite the lack of a placebo group, it can be concluded that L-theanine (Anxitane®) helped to improve the undesirable manifestations of stress in cats in as soon as 15 days, though better results could be seen after 30 days of administration. These encouraging results show that L-theanine can help manage stress-related behaviour, but additional trials with a placebo group should be run to confirm this effect.

On the time required to freeze water

By using the seeding technique the nucleation rate for the formation of ice at room pressure will be estimated for the TIP4P/ICE model using longer runs and a smaller grid of temperatures than in the previous work. The growth rate of ice will be determined for TIP4P/ICE and for the mW model of water. Although TIP4P/ICE and mW have a similar melting point and melting enthalpy, they differ significantly in the dynamics of freezing. The nucleation rate of mW is lower than that of TIP4P/ICE due to its higher interfacial free energy. Experimental results for the nucleation rate of ice are between the predictions of these two models when obtained from the seeding technique, although closer to the predictions of TIP4P/ICE. The growth rate of ice for the mW model is four orders of magnitude larger than for TIP4P/ICE. Avrami's expression is used to estimate the crystallization time from the values of the nucleation and growth rates. For mW the minimum in the crystallization time is found at approximately 85 K below the melting point and its value is of about a few ns, in agreement with the results obtained from brute force simulations by Moore and Molinero. For the TIP4P/ICE the minimum is found at about 55 K below the melting point, but its value is about ten microseconds. This value is compatible with the minimum cooling rate required to avoid the formation of ice and obtaining a glass phase. The crossover from the nucleation controlled crystallization to the growth controlled crystallization will be discussed for systems of finite size. This crossover could explain the apparent discrepancy between the values of J obtained by different experimental groups for temperatures below 230 K and should be considered as an alternative hypothesis to the two previously suggested: internal pressure and/or surface freezing effects. A maximum in the compressibility was found for the TIP4P/ICE model in supercooled water. The relaxation time is much smaller than the crystallization time at the temperature at which this maximum occurs, so this maximum is a real thermodynamic feature of the model. At the temperature of minimum crystallization time, the crystallization time is larger than the relaxation time by just two orders of magnitude.

Left Ventricular Noncompaction Associated with Wolf-Parkinson-White Syndrome and Acute Heart Failure in Two Adult Patients

Left ventricular noncompaction is a relatively newly defined disorder of the endomyocardium characterized by prominent ventricular trabeculations and deep intertrabecular recesses. It is important that clinician can recognise and differentiate this condition from other forms of cardiomyopathy as treatment and prognosis may differ significantly. We report two cases of left ventricular non-compaction in the emergency department with different forms of presentations. (Hong Kong j.emerg.med. 2015;22:108-112)

Pharmacodynamics and Tolerance of Two Nadroparin Formulations (10,250 and 20,500 Anti Xa IU·ml-1) Delivered for 10 Days at Therapeutic Dose

Venous thromboembolism may be efficiently treated by once-a-day (o.d.) administration of a high dose of low molecular weight heparin (LMWH) instead of administration of the same total dose in two injections a day (b.i. d.). To reduce the volume of the subcutaneous (s.c.) injection, a more concentrated form of the drug is advisable. This study was designed to compare the bioavailability of 2 formulations of nadroparin containing 10,250 and 20,500 anti-Xa IU·ml-1 respectively. This was an open, randomized, cross-over study where 12 healthy volunteers (age 18-35) were enrolled. They received either 90 anti-Xa IU·kg-1 b.i. d. of the 10,250 IU preparation (treatment A), or 180 anti-Xa IU·kg-1 o.d. of the 20,500 IU preparation (treatment B) for 10 days. On day 1, the subjects were sampled between 0 and 12 h (treatment A) or between 0 and 24 h (treatment B). On day 10, they were sampled between 0 and 12 h and between 12 and 24 h (treatment A) or between 0 and 24 h (treatment B). Anti-Xa and anti-IIa activities were determined by specific chromogenic assays. The main result of the study was that the bioavailability of the anti-Xa activity of the 2 nadroparin formulations was equivalent, as shown by the comparison of the AUC0-12 h plus AUC12-24 h (treatment A) and the AUC0-24 h (treatment B), calculated on day 10. This study also allowed a number of interesting observations to be made. 1) Between day 1 and day 10, there was an accumulation of the anti-Xa activity for treatment A but not for treatment B (accumulation factors: 1.6 and 1.1 respectively); 2) On day 10, the AUC0-12 h were slightly but significantly lower than the AUC12-24 h suggesting a circadian effect for anti-Xa and anti-IIa activities; 3) the clearance of the anti-Xa activity was comparable at the 2-dose regimens, while that of the anti-IIa activity was lower in treatment B than in treatment A, indicating a significant dose effect for the pharmacodynamics of the longer heparin chains; 4) On average, the clearance of the anti-IIa activity was twice as high as that of the anti-Xa activity; 5) For treatment B, significant APTT prolongations were noticed at Tmax (prolongation factor: 1.7 ± 0.25), in relation with the anti-IIa activity (0.3 ± 0.1 IU·ml–1).

Aging and Venous Thromboembolism Influence the Pharmacodynamics of the Anti-Factor Xa and Anti-thrombin Activities of a Low Molecular Weight Heparin (Nadroparin)

Venous thromboembolism may be efficiently treated by one single daily administration of a high dose of low molecular weight heparin (LMWH). The present study investigates if the physiological deterioration of renal function associated with normal aging or the presence of an acute venous thromboembolism influences the pharmacodynamic pattern of the anti-factor Xa and anti-thrombin activities. Three groups of 12 subjects were investigated. The first 2 groups were composed of healthy volunteers differing by age (25 ± 4 and 65 ± 3 yrs) and creati-nine clearance (114 ± 15 and 62 ± 6 ml · min –1). The third group was composed of patients hospitalized for deep vein thrombosis, having a mean age of 65 ± 11 yrs and creatinine clearance of 76 ± 8 ml · min –1. Nadroparin was administered subcutaneously once daily at the dose of 180 anti-factor Xa IU.kg–1 for 6 to 10 days. Serial sampling on day 1 and on the last day of administration (day n) allowed the pharmacodynamic parameters of the anti-factor Xa and anti-thrombin activities to be compared at the begining and at the end of the treatment. The main findings were the following: (1) After repeated administration, a significant accumulation of the anti-factor Xa activity was observed in the healthy elderly and in the patients but not in the healthy young subjects (accumulation factor: 1.3). There was no evidence of accumulation of anti-thrombin activity; (2) There were significant correlations between the clearance of creatinine and the clearance of the anti-factor Xa activity but not with that of the anti-thrombin activity; (3) In the patients, the clearance of the anti-factor Xa and of the anti-thrombin activities were 1.4 and 2 times higher respectively than those calculated in the healthy elderly; (4) The mean ratio of the of anti-factor Xa and anti-thrombin clearances was close to 2 in the healthy subjects but equal to 5.4 in the patients. These results suggest that the mechanisms involved in the clearance of polysaccharide chains which support the anti-thrombin activity are different from those of the anti-factor Xa activity and that the enhanced binding properties of plasma proteins to unfractionated heparin reported in patients presenting an acute venous thromboembolism also exists for LMWH, predominantly for the anti-thrombin activity.

Dialog Organization and Functional Communication in a Medical Assistance Task by Phone

This study is based on a corpus of 110 dialogs recorded in a medical assistance telephonist's workstation. Given the nature of the task, we have considered five main variables in dialog (topics) as well as their order of occurrence (sequences). These data were analyzed with a lexical analysis program. Results show a great difference between Operator/Specialist dialog and Operator/Nonspecialist dialog. Dialog “script” is very strong in the first case in which the operator merely plays a feedback role (routine procedures). If the caller is a private individual, the situation is often an indefinite problem, and the operator may have to adapt to the person (weak script) to obtain relevant information as quickly as possible (problem-solving procedures). This provides confirmation of the operator's twofold competence (efficient decision-making, dialog management).

Implementation and evaluation of a transit dosimetry system for treatment verification

PURPOSE

To evaluate a formalism for transit dosimetry using a phantom study and prospectively evaluate the protocol on a patient population undergoing 3D conformal radiotherapy.

METHODS

Amorphous silicon EPIDs were calibrated for dose and used to acquire images of delivered fields. The measured EPID dose map was back-projected using the planning CT images to calculate dose at pre-specified points within the patient using commercially available software, EPIgray (DOSIsoft, France). This software compared computed back-projected dose with treatment planning system dose. A series of tests were performed on solid water phantoms (linearity, field size effects, off-axis effects). 37 patients were enrolled in the prospective study.

RESULTS

The EPID dose response was stable and linear with dose. For all tested field sizes the agreement was good between EPID-derived and treatment planning system dose in the central axis, with performance stability up to a measured depth of 18cm (agreement within -0.5% at 10cm depth on the central axis and within -1.4% at 2cm off-axis). 126 transit images were analysed of 37 3D-conformal patients. Patient results demonstrated the potential of EPIgray with 91% of all delivered fields achieved the initial set tolerance level of ΔD of 0±5-cGy or %ΔD of 0±5%.

CONCLUSIONS

The in vivo dose verification method was simple to implement, with very few commissioning measurements needed. The system required no extra dose to the patient, and importantly was able to detect patient position errors that impacted on dose delivery in two of cases.

Bioequivalence study between two formulations of ciclosporin A (Cyclavance® oral solution and Atopica® soft capsules) following a single oral administration to dogs

Background

Ciclosporin is a selective immunomodulator used for the treatment of atopic dermatitis in dogs. A new 100 mg/ml oral solution formulation (Cyclavance®, Virbac) was developed as a pharmaceutical equivalent to the marketed capsule formulations (Atopica®, Novartis Animal Health) containing 25, 50 mg, or 100 mg of ciclosporin A. The aim of this study was to assess and compare the pharmacokinetic profiles and bioequivalence of the two formulations following a single oral administration to dogs. This randomised, two-period, two-sequence, crossover bioequivalence study was conducted in 40 healthy dogs under fasting conditions. Each dog received either one 50 mg capsule of Atopica® or 0.5 ml of Cyclavance®. After dosing, blood samples were collected during a 48-h time period at 0, 0.5, 1, 2, 4, 6, 12, 24, 36 and 48 h. Blood ciclosporin A concentrations were measured by using an HPLC-MS/MS method. Cmax, Tmax, t1/2, AUC0-t, AUC0-∞ and Kel were determined for the two ciclosporin formulations. Bioequivalence was to be concluded if the 90 % confidence intervals were within the range of 80 % to 125 % for Cmax and AUC0-t. Dogs were monitored once daily throughout the study period for adverse effects.

Results

The 90 % confidence intervals for Cyclavance®/Atopica® mean ratios of the log-transformed pharmacokinetic variables Cmax and AUC0-t were within the conventional bioequivalence range of 80 % to 125 % (Point estimate: 101.2 % and 101.4 % respectively). Except for salivation reported after administration of both products, or vomiting and diarrhoea reported after Atopica® administration, both formulations were well tolerated in the 40 healthy dogs over the 48-h study period.

Conclusions

The two ciclosporin oral formulations demonstrated similar pharmacokinetic profiles and were found to be bioequivalent, and therefore, interchangeable.

Mutational spectrum of Duchenne muscular dystrophy in Spain: Study of 284 cases

INTRODUCTION

Duchenne muscular dystrophy (DMD) is a severe X-linked recessive neuromuscular disease that affects one in 3500 live-born males. The total absence of dystrophin observed in DMD patients is generally caused by mutations that disrupt the reading frame of the DMD gene, and about 80% of cases harbour deletions or duplications of one or more exons.

METHODS

We reviewed 284 cases of males with a genetic diagnosis of DMD between 2007 and 2014. These patients were selected from 8 Spanish reference hospitals representing most areas of Spain. Multiplex PCR, MLPA, and sequencing were performed to identify mutations.

RESULTS

Most of these DMD patients present large deletions (46.1%) or large duplications (19.7%) in the dystrophin gene. The remaining 34.2% correspond to point mutations, and half of these correspond to nonsense mutations. In this study we identified 23 new mutations in DMD: 7 large deletions and 16 point mutations.

CONCLUSIONS

The algorithm for genetic diagnosis applied by the participating centres is the most appropriate for genotyping patients with DMD. The genetic specificity of different therapies currently being developed emphasises the importance of identifying the mutation appearing in each patient; 38.7% of the cases in this series are eligible to participate in current clinical trials.

Drug screening on Hutchinson Gilford progeria pluripotent stem cells reveals aminopyrimidines as new modulators of farnesylation

Hutchinson-Gilford progeria syndrome (HGPS) is a rare genetic disorder characterized by a dramatic appearance of premature aging. HGPS is due to a single-base substitution in exon 11 of the LMNA gene (c.1824C>T) leading to the production of a toxic form of the prelamin A protein called progerin. Because farnesylation process had been shown to control progerin toxicity, in this study we have developed a screening method permitting to identify new pharmacological inhibitors of farnesylation. For this, we have used the unique potential of pluripotent stem cells to have access to an unlimited and relevant biological resource and test 21,608 small molecules. This study identified several compounds, called monoaminopyrimidines, which target two key enzymes of the farnesylation process, farnesyl pyrophosphate synthase and farnesyl transferase, and rescue in vitro phenotypes associated with HGPS. Our results opens up new therapeutic possibilities for the treatment of HGPS by identifying a new family of protein farnesylation inhibitors, and which may also be applicable to cancers and diseases associated with mutations that involve farnesylated proteins.

Survival for oesophageal, stomach and small intestine cancers in Europe 1999-2007: Results from EUROCARE-5

BACKGROUND

European regional variation in cancer survival was reported in the EUROCARE-4 study for patients diagnosed in 1995-1999. Relative survival (RS) estimates are here updated for patients diagnosed with cancer of the oesophagus, stomach and small intestine from 2000 to 2007. Trends in RS from 1999-2001 to 2005-2007 are presented to monitor and discuss improvements in patient survival in Europe.

MATERIALS AND METHODS

EUROCARE-5 data from 29 countries (87 cancer registries) were used to investigate 1- and 5-year RS. Using registry-specific life-tables stratified by age, gender and calendar year, age-standardised 'complete analysis' RS estimates by country and region were calculated for Northern, Southern, Eastern and Central Europe, and for Ireland and United Kingdom (UK). Survival trends of patients in periods 1999-2001, 2002-2004 and 2005-2007 were investigated using the 'period' RS approach. We computed the 5-year RS conditional on surviving the first year (5-year conditional survival), as the ratio of age-standardised 5-year RS to 1-year RS.

RESULTS

Oesophageal cancer 1- and 5-year RS (40% and 12%, respectively) remained poor in Europe. Patient survival was worst in Eastern (8%), Northern (11%) and Southern Europe (10%). Europe-wide, there was a 3% improvement in oesophageal cancer 5-year survival by 2005-2007, with Ireland and the UK (3%), and Central Europe (4%) showing large improvements. Europe-wide, stomach cancer 5-year RS was 25%. Ireland and UK (17%) and Eastern Europe (19%) had the poorest 5-year patient survival. Southern Europe had the best 5-year survival (30%), though only showing an improvement of 2% by 2005-2007. Small intestine cancer 5-year RS for Europe was 48%, with Central Europe having the best (54%), and Ireland and UK the poorest (37%). Five-year patient survival improvement for Europe was 8% by 2005-2007, with Central, Southern and Eastern Europe showing the greatest increases (⩾9%).

CONCLUSIONS

Survival for these cancer sites, particularly oesophageal cancer, remains poor in Europe with wide variation. Further investigation into the wide variation, including analysis by histology and anatomical sub-site, will yield insights to better monitor and explain the improvements in survival observed over time.

Survival in patients with primary liver cancer, gallbladder and extrahepatic biliary tract cancer and pancreatic cancer in Europe 1999-2007: Results of EUROCARE-5

BACKGROUND

The EUROCARE study collects and analyses survival data from population-based cancer registries (CRs) in Europe in order to provide data on between-country differences in survival and time trends in survival.

METHODS

This study analyses data on liver cancer, gallbladder and extrahepatic biliary tract cancers ("biliary tract cancers"), and pancreatic cancer diagnosed in 2000-2007 from 88 CRs in 29 countries. Relative survival (RS) was estimated overall, by region, sex, age and period of diagnosis using the complete approach. Time trends in 5-year RS over 1999-2007 were also analysed using the period approach.

RESULTS

The prognosis of the studied cancers was poor. Age-standardised 5-year RS was 12% for liver cancer, 17% for biliary tract cancers and 7% for pancreatic cancer. There were some between-country differences in survival. In general, RS was low in Eastern Europe and high in Central and Southern Europe. For all sites, 5-year RS was similar in men and women and decreased with advancing age. No substantial changes in survival were reported for pancreatic cancer over the period 1999-2007. On average, there was a crude increase in 5-year RS of 3 percentage points between the periods 1999-2001 and 2005-2007 for liver cancer and biliary tract cancers.

CONCLUSIONS

The major changes in imaging techniques over the study period for the diagnosis of the three studied cancers did not result in an improvement in the prognosis of these cancers. In the near future, new innovative treatments might be the best way to improve the prognosis in these cancers.

Descriptive epidemiology of Kaposi sarcoma in Europe. Report from the RARECARE project

Kaposi sarcoma (KS) is a virus-related malignancy which most frequently arises in skin, though visceral sites can also be involved. Infection with Kaposi sarcoma herpes virus (KSHV or HHV-8) is required for development of KS. Nowadays, most cases worldwide occur in persons who are immunosuppressed, usually because of HIV infection or as a result of therapy to combat rejection of a transplanted organ, but classic Kaposi sarcoma is predominantly a disease of the elderly without apparent immunosuppression. We analyzed 2667 KS incident cases diagnosed during 1995-2002 and registered by 75 population-based European cancer registries contributing to the RARECARE project. Total crude and age-standardized incidence rate was 0.3 per 100,000 per year with an estimated 1642 new cases per year in the EU27 countries. Age-standardized incidence rate was 0.8 per 100,000 in Southern Europe but below 0.3 per 100,000 in all other regions. The elevated rate in southern Europe was attributable to a combination of classic Kaposi sarcoma in some Mediterranean countries and the relatively high incidence of AIDS in several countries. Five-year relative survival for 2000-2002 by the period method was 75%. More than 10,000 persons were estimated to be alive in Europe at the beginning of 2008 with a past diagnosis of KS. The aetiological link with suppressed immunity means that many people alive following diagnosis of KS suffer comorbidity from a pre-existing condition. While KS is a rare cancer, it has a relatively good prognosis and so the number of people affected by it is quite large. Thus it provides a notable example of the importance of networking in diagnosis, therapy and research for rare cancers.

Repeatability of feather mite prevalence and intensity in passerine birds

Understanding why host species differ so much in symbiont loads and how this depends on ecological host and symbiont traits is a major issue in the ecology of symbiosis. A first step in this inquiry is to know whether observed differences among host species are species-specific traits or more related with host-symbiont environmental conditions. Here we analysed the repeatability (R) of the intensity and the prevalence of feather mites to partition within- and among-host species variance components. We compiled the largest dataset so far available: 119 Paleartic passerine bird species, 75,944 individual birds, ca. 1.8 million mites, seven countries, 23 study years. Several analyses and approaches were made to estimate R and adjusted repeatability (R(adj)) after controlling for potential confounding factors (breeding period, weather, habitat, spatial autocorrelation and researcher identity). The prevalence of feather mites was moderately repeatable (R = 0.26-0.53; R(adj) = 0.32-0.57); smaller values were found for intensity (R = 0.19-0.30; R(adj )= 0.18-0.30). These moderate repeatabilities show that prevalence and intensity of feather mites differ among species, but also that the high variation within species leads to considerable overlap among bird species. Differences in the prevalence and intensity of feather mites within bird species were small among habitats, suggesting that local factors are playing a secondary role. However, effects of local climatic conditions were partially observed for intensity.