Further understanding the interaction between dark energy and dark matter: current status and future directions

The interaction between dark matter and dark energy (DE) can be incorporated into field theory models of DE that have proved successful in alleviating the coincidence problem. We review recent advances in this field, including new models and constraints from different astronomical data sets. We show that interactions are allowed by observations and can reduce the current tensions among different measurements of cosmological parameters. We extend our discussion to include constraints from non-linear effects and results from cosmological simulations. Finally, we discuss forthcoming multi-messenger data from current and future observational facilities that will help to improve our understanding of the interactions within the dark sector.

Novel genetic parameters for genetic residual feed intake in dairy cattle using time series data from multiple parities and countries in North America and Europe

Residual feed intake is viewed as an important trait in breeding programs that could be used to enhance genetic progress in feed efficiency. In particular, improving feed efficiency could improve both economic and environmental sustainability in the dairy cattle industry. However, data remain sparse, limiting the development of reliable genomic evaluations across lactation and parity for residual feed intake. Here, we estimated novel genetic parameters for genetic residual feed intake (gRFI) across the first, second, and third parity, using a random regression model. Research data on the measured feed intake, milk production, and body weight of 7,379 cows (271,080 records) from 6 countries in 2 continents were shared through the Horizon 2020 project Genomic Management Tools to Optimise Resilience and Efficiency, and the Resilient Dairy Genome Project. The countries included Canada (1,053 cows with 47,130 weekly records), Denmark (1,045 cows with 72,760 weekly records), France (329 cows with 16,888 weekly records), Germany (938 cows with 32,614 weekly records), the Netherlands (2,051 cows with 57,830 weekly records), and United States (1,963 cows with 43,858 weekly records). Each trait had variance components estimated from first to third parity, using a random regression model across countries. Genetic residual feed intake was found to be heritable in all 3 parities, with first parity being predominant (range: 22-34%). Genetic residual feed intake was highly correlated across parities for mid- to late lactation; however, genetic correlation across parities was lower during early lactation, especially when comparing first and third parity. We estimated a genetic correlation of 0.77 ± 0.37 between North America and Europe for dry matter intake at first parity. Published literature on genetic correlations between high input countries/continents for dry matter intake support a high genetic correlation for dry matter intake. In conclusion, our results demonstrate the feasibility of estimating variance components for gRFI across parities, and the value of sharing data on scarce phenotypes across countries. These results can potentially be implemented in genetic evaluations for gRFI in dairy cattle.

Peri-anal infiltration versus caudal block for multimodal analgesia in paediatric patients with Hirschsprung's disease undergoing transanal endorectal pull-through procedure: A randomised trial

Background and Aims

Transanal endorectal pull-through (TERPT) is a standard procedure for managing paediatric patients with Hirschsprung's disease (HD). This study aimed to evaluate peri-anal infiltration versus caudal block as a part of multimodal analgesia for paediatric patients with HD undergoing the TERPT procedure.

Methods

This randomised trial included 60 patients of both genders, aged 6 to 18 months who underwent the TERPT procedure under general anaesthesia. The patients were randomly assigned into two groups to receive either peri-anal infiltration or caudal block with 1 ml/kg bupivacaine 0.25% and dexmedetomidine 1 µg/kg in 0.5 ml normal saline. The primary outcome was the time to the first rescue analgesia. The secondary outcomes were the total consumption, the frequency of nalbuphine administration as rescue analgesia within 24 hours and the level of postoperative sedation.

Results

The time to first rescue analgesia was significantly shorter in the peri-anal infiltration group versus the caudal block group (median [interquartile range] 10 [7.5-12.5] h versus 16 [13.5-18.5] h, respectively, P = 0.008). The frequency of administration and the total dose of nalbuphine was significantly higher in the peri-anal infiltration group (P = 0.003 and 0.013, respectively). The sedation score was significantly higher in the caudal block group postoperatively.

Conclusion

For paediatric patients undergoing the TERPT procedure, peri-anal infiltration was less effective than caudal block in terms of the duration of postoperative analgesia. However, both techniques were comparable during the first 6 hours postoperatively.

Managing adult patients with infectious diseases in emergency departments: international ID-IRI study

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

Dark matter and dark energy interactions: theoretical challenges, cosmological implications and observational signatures

Models where dark matter and dark energy interact with each other have been proposed to solve the coincidence problem. We review the motivations underlying the need to introduce such interaction, its influence on the background dynamics and how it modifies the evolution of linear perturbations. We test models using the most recent observational data and we find that the interaction is compatible with the current astronomical and cosmological data. Finally, we describe the forthcoming data sets from current and future facilities that are being constructed or designed that will allow a clearer understanding of the physics of the dark sector.

NOTES total mesorectal excision (TME) for patients with rectal neoplasia: a preliminary experience

BACKGROUND

Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy are emerging, minimally invasive techniques. Total mesorectal excision (TME), the gold standard treatment for patients with resectable distal rectal tumors, is usually performed in an "up-to-down" approach, either laparoscopically or via open techniques. A transanal, "down-to-up" TME has already been reported. Our NOTES variant of TME (NOTESTME) is based on a transperineal approach without any form of abdominal assistance. The aim was to reduce further the invasiveness of the procedure while optimizing the anatomical definition of the distal mesorectum. This approach may lead to reduced postoperative pain, decreased hernia formation and improved cosmesis when compared to standard laparoscopy.

METHODS

NOTESTME was attempted in 16 patients with distal rectal neoplasia (i.e., distal edge of the tumor lower than the pouch of Douglas, between 0 and 12 cm from the dentate line). Additional inclusion criteria consisted of an ASA status ≤III and the absence of previous abdominal surgery.

RESULTS

NOTESTME was completed in all patients. Additional abdominal, single-incision laparoscopic assistance was required in 6 (38 %) patients. Mean operative time was 265 min (range 155-440 min). The morbidity rate was 18.8 % (two small bowel obstructions and one pelvic abscess), requiring re-operation in each case. No leaks occurred, and the mortality rate at 30 and 90 days was 0 %. Resection margins were negative in all patients. A median of 17 nodes (range 12-81) was retrieved per specimen. Mean length of hospital stay was 10 days (range 4-29 days). Patients were followed for an average of 7 months (range 3-23 months).

CONCLUSION

NOTESTME was feasible and safe in this series of patients with mid- or low rectal tumors. The short-term mortality and morbidity rates are acceptable, with no apparent compromise in the oncological quality of the resection. Larger, randomized controlled trials with long-term follow-up are warranted.

Severe novel influenza A (H1N1) infection in cancer patients

Background: The natural history and consequences of severe H1N1 influenza infection among cancer patients are not yet fully characterized. We describe eight cases of H1N1 infection in cancer patients admitted to the intensive care unit of a referral cancer center.

Patients and methods: Clinical data from all patients admitted with acute respiratory failure due to novel viral H1N1 infection were reviewed. Lung tissue was submitted for viral and bacteriological analyses by real-time RT-PCR, and autopsy was conducted on all patients who died.

Results: Eight patients were admitted, with ages ranging from 55 to 65 years old. There were five patients with solid organ tumors (62.5%) and three with hematological malignancies (37.5%). Five patients required mechanical ventilation and all died. Four patients had bacterial bronchopneumonia. All deaths occurred due to multiple organ failure. A milder form of lung disease was present in the three cases who survived. Lung tissue analysis was performed in all patients and showed diffuse alveolar damage in most patients. Other lung findings were necrotizing bronchiolitis or extensive hemorrhage.

Conclusions: H1N1 viral infection in patients with cancer can cause severe illness, resulting in acute respiratory distress syndrome and death. More data are needed to identify predictors of unfavorable evolution in these patients.

The need for a comprehensive response to HIV/ AIDS in north-western Somalia: evidence from a seroprevalence survey

The prolonged civil strife in the North-West Zone of Somalia (Somaliland) has hampered the development of social infrastructure and public health services. There are limited data on HIV/AIDS. In 2004, a sentinel HIV seroprevalence survey was conducted. Blood samples were collected from 1561 women attending antenatal care clinics, 249 tuberculosis (TB) patients and 243 people attending sexually transmitted disease (STD) clinics. Samples were tested for syphilis and HIV. Overall HIV prevalence was 1.4%, significantly higher than that observed in many other countries in the Region. Prevalence was 1.2% among pregnant women 15-24 years, 12.3% among patients with STD and 5.6% among TB patients. The prevalence of syphilis was 1.3% in the pregnant women.

Association of VEGF expression with poor prognosis among patients with low-grade neuroendocrine carcinoma

4091

Background: Low-grade neuroendocrine carcinomas (LGNET) can arise from neuroendocrine cells throughout the body and have a wide range of aggressiveness. Reliable predictive and prognostic markers of outcome are lacking. Angiogenesis is critical for metastasis and tumor growth beyond a small tumor size and VEGF is a powerful mediator of tumor angiogenesis. Methods: LGNET tissue from 50 patients (24 with local-regional disease, 26 with metastasis) who underwent tumor resection at the University of Texas M.D. Anderson Cancer Center was evaluated for expression VEGF by immunohistochemistry. Chi-square and Fisher’s exact test were used to test the association between study parameters. Kaplan-Meier analysis was used to assess the affect of study parameters on progression free survival (PFS). Results: Strong, weak, and negative VEGF expression was observed in 32%, 54%, and 14% of cases respectively. Larger tumor size was observed among patients with strong VEGF expression. Mean tumor sizes in patients with strong, weak and negative VEGF were 4.8, 2.8, and 2.9 cm. Compared to the group with negative VEGF expression, VEGF (weak/strong) expression was associated with metastasis (14% v 58%; P = .045). The median PFS durations of patients with strong and weak VEGF expression were 29 months and 81 months respectively. With a median follow-up duration of 50 months, the median PFS duration for the group with negative VEGF expression has not been reached. Compared by log rank test VEGF expression was associated with poor PFS (P = .022). Conclusions: This study suggests that tissue VEGF expression is associated with aggressive tumor growth and metastasis among patients with LGNET. VEGF expression may serve as a useful prognostic marker following tumor resection.

No significant financial relationships to disclose.

Entropy and holography constraints for inhomogeneous universes

We calculated the entropy of a class of inhomogeneous dust universes. Allowing spherical symmetry, we proposed a holographic principle by reflecting all physical freedoms on the surface of the apparent horizon. In contrast to flat homogeneous counterparts, the principle may break down in some models. We refined fractal parabolic solutions to have a reasonable entropy value for the present observable universe and found that the holographic principle always holds in the realistic cases.

Mutagenicity of the mycotoxin diacetoxyscirpenol on somatic and germ cells of mice

Genotoxicity of diacetoxyscirpenol (DAS) was studied on laboratory mice after intraperitoneal injection with single and repeated doses. DAS was administrated at three different dose levels (0.5, 0.75, and 1.0 mg/kg body weight). The study was conducted on both somatic and germ cells additional to the sperm morphology analysis. DAS treatment resulted in a significant reduction (P<0.01) in mitotic activity at all levels of doses tested, confirming that DAS is a potent protein and DNA synthesis inhibitor. At somatic cells (bone marrow) both structural and numerical chromosome abnormalities were observed. Single dose treatment showed significant abnormalities only with high dose treatment. In contrast, at repeated dose similar abnormalities were also observed with some significance but no systematic relation between the administrated dose and abnormalities ratio could be settled. In germ cells (testicles), structural and numerical abnormalities were also observed. In general, the frequencies of scored abnormalities at germ cells were lower than that the somatic cells. Sperm count test revealed a decrease in the number of released sperm after toxin treatment. Abnormalities of sperm shape (head and tail) were observed, confirming the positive correlation between cytogenetic damage and sperm abnormality.The results also proved that DAS is a very toxic mycotoxin, in addition to inducing chromosomal abnormalities, it causes a severe inhibition of DNA synthesis which subsequently affects the cell cycle and cell division. A good system for good harvesting practice and good food technology can lower the risk for the consumers.

HCV-RNA and anti-HCV IgM in Egyptian subjects bearing IgG anti-HCV antibodies

The hepatitis C virus (HCV) infection is associated with a wide spectrum of clinical entities ranging from asymptomatic carriage to severe forms of chronic hepatitis. In Egypt, HCV infection has been shown to be highly prevalent. The aim of this study was to determine the frequency and significance of anti-HCV IgM in the sera of clinically healthy blood donors and chronic HCV patients, whose sera were also positive for anti-HCV IgG. Anti-HCV IgM was detected in the sera of 7 (46%) of the blood donors (n = 15), of whom 5 (71%) had a positive HCV-RNA. The corresponding results in patients with a chronic hepatitis C (CHC) infection (n = 19) were 8 (42%) and 5 (62%) respectively. The detection of anti-HCV IgM did not correlate with a positive test for HCV-RNA (R = 0.2) in the CHC patients. However, the levels of anti-HCV IgM in CHC patients were associated significantly with the level of serum transaminase, a finding that can be used in monitoring disease activity in such a group of patients. On the other hand, a significant association was evident between the detection of anti-HCV IgM and HCV-RNA in the sera of blood donors. Thus among the blood donors, viraemia correlates well with the detection of HCV-IgM Ab, but it cannot be excluded in its absence. The presence of HCV-IgM in some patients with CHC infection indicates that the antibody as a viral marker may not be unique to acute HCV infection.

Biallelic and heterozygous point mutations in the runt domain of the AML1/PEBP2alphaB gene associated with myeloblastic leukemias

The AML1 gene encoding the DNA-binding alpha-subunit in the Runt domain family of heterodimeric transcription factors has been noted for its frequent involvement in chromosomal translocations associated with leukemia. Using reverse transcriptase-polymerase chain reaction (RT-PCR) combined with nonisotopic RNase cleavage assay (NIRCA), we found point mutations of the AML1 gene in 8 of 160 leukemia patients: silent mutations, heterozygous missense mutations, and biallelic nonsense or frameshift mutations in 2, 4, and 2 cases, respectively. The mutations were all clustered within the Runt domain. Missense mutations identified in 3 patients showed neither DNA binding nor transactivation, although being active in heterodimerization. These defective missense mutants may be relevant to the predisposition or progression of leukemia. On the other hand, the biallelic nonsense mutants encoding truncated AML1 proteins lost almost all functions examined and may play a role in leukemogenesis leading to acute myeloblastic leukemia.